Blog Entry List
When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.
Three Months Left to Submit Program Year 2021 Attestations and the Security Risk Analysis.
Actions providers should take to reduce claim denials and payment delays.
DHHS announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).
This bulletin provides important information regarding changes in the law concerning NC HealthConnex, the state-designated health information exchange.
While NC Medicaid works to resolve issues impeding the billing process for CDSA-Contracted Providers to NCTracks, providers who are at risk of not meeting financial obligations this month as a result of this delay may request a hardship advance to offset the business cost due to pended or denied claims.
The updated Quality Strategy now incorporates the quality activities of all managed care plans, including the Behavioral Health I/DD Tailored Plans, the Eastern Band of Cherokee Indians (EBCI) Tribal Option and Community Care of North Carolina.
Durable Medical Equipment (DME) is covered under NC Medicaid Managed Care for beneficiaries enrolled in a managed care plan and under NC Medicaid Direct for those beneficiaries who remain in NC Medicaid Direct.
Effective June 1, 2021, all personal care services (PCS) claims that were subject to the electronic visit verification (EVV) mandate must include visit data information before the claim can process to adjudication in NCTracks.
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.
NC Medicaid is extending COVID-19 temporary provider rate increases for all providers except hospitals through Sept. 30, 2021.
Update on coverage of medications used in the Physician Administered Drug Program when billed with HCPCS code 90697.
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.
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.
CMS has added new HCPCS codes (J Codes), deleted others and changed the description of some existing codes.