The American Rescue Plan Act that was recently enacted includes several changes to COVID-19 Medicaid policy. As of March 11, 2021, North Carolina will be covering all approved COVID-19 vaccines for limited benefit eligibility groups.
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The Health Management System Provider Relations team is excited to announce the launch of the new Provider Portal.
The 2021 ICD-10 update is effective Oct. 1, 2020, through Sept. 30, 2021, for provider use for dates of service within this period.
New Long-Term Services and Supports Care Management web page, Advanced Medical Home Provider Manual 2.1 released and Program Guide added.
Program Year 2021 Announcements and the Security Risk Analysis.
Effective with date of service Feb. 11, 2021 the North Carolina Medicaid and NC Health Choice programs cover naxitamab-gqgk injection.
Effective with date of service Feb. 19, 2021, the North Carolina Medicaid and NC Health Choice programs cover evinacumab-dgnb injection.
Effective with date of service March 11, 2021, the North Carolina Medicaid and NC Health Choice programs cover margetuximab-cmkb injection.
Effective with date of service March 9, 2021, the North Carolina Medicaid and NC Health Choice programs cover trilaciclib for injection.
On May 9, 2021, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment. NCTracks will generate a notification to providers at 60, 30 and 14 calendar days prior to the expiration date of the credential; and will begin a process of suspension if a provider fails to update their credential.
NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021.
As a reminder, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment effective May 9, 2021. NCTracks will generate a notification to providers at 60, 30 and 14 calendar days prior to the expiration date of the credential; and will begin a process of suspension if a provider fails to update their credential.
To assist with identifying North Carolina Medicaid and NC Health Choice beneficiaries currently assigned under the Community Care of North Carolina/Carolina ACCESS (CCNC/CA) program, NCDHHS generated a new Advanced Medical Home (AMH) NC Medicaid Direct/NC Medicaid Managed Care Primary Care Provider (PCP) Enrollee Report for distribution to CCNC/CA participating providers.
Key dates for transitioning to NC Medicaid Managed Care, Provider contracting reminders, Provider Playbook updates, Provider outreach to patient panels, webinars, Provider and health plan look-up tool, PHP quick reference guides, help center, Provider Ombudsman and Tailored Care Management certification.
Providers with Denials for Healthy Opportunities Screening, Assessment and Referrals Claims due to edit 02088 may now resubmit claims; Place of Service Indicator codes updated.