The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) to permit the emergency use of the unapproved product sotrovimab monoclonal antibody (MAB) for the treatment of certain patients.
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Effective with date of service June 9, 2021, the Medicaid and NC Health Choice programs cover amivantamab-vmjw injection, for intravenous use (Rybrevant) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 – Not otherwise classified antineoplastic drugs.
CMS has added new HCPCS codes (J Codes), deleted others and changed the description of some existing codes.
Update on coverage of medications used in the Physician Administered Drug Program when billed with HCPCS code 90697.
Effective with date of service May 17, 2021, the Medicaid and NC Health Choice programs cover dostarlimab-gxly injection, for intravenous use (Jemperli) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective with date of service May 11, 2021, the Medicaid and NC Health Choice programs cover loncastuximab tesirine-lpyl for injection, for intravenous use (Zynlonta) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Providers need to submit new prior authorizations (PA) for services subject to 42 Code of Federal Regulations (CFR) Part II
All Carolina Access Providers who received health equity payments are asked to take 5-10 minutes to complete a survey by Friday, July 30, 2021. The survey allows DHHS to monitor and evaluate how these payments were used.
Prepaid Health Plans (PHPs) began providing non-emergency medical transportation (NEMT) and non-emergency ambulance transportation (NEAT) services for PHP members on July 1, 2021.
Health plans have identified a common billing error of providers submitting professional and institutional EDI claims.
Effective July 1, 2021, some Medicaid beneficiaries receiving Personal Care Services (PCS) transitioned from NC Medicaid Direct to receiving services through an NC Medicaid Managed Care health plan.
Effective with date of service May 17, 2021, Medicaid and NC Health Choice cover dostarlimab-gxly injection.
Effective with date of service May 11, 2021, Medicaid and NC Health Choice cover loncastuximab tesirine-lpyl for injection, for intravenous use (Zynlonta).
Effective July 29, 2021, Session Law 2021-62 (NC Senate Bill 594), repeals portions of the 2020 COVID-19 Recovery Act that permitted the temporary lifting of certain enrollment requirements for providers enrolling in NC Medicaid during the global healthcare emergency.