Blog Entry List

Effective Sept. 1, 2020, NC Medicaid will begin reimbursing COVID-19 testing costs for uninsured individuals enrolled in the NC Medicaid Optional COVID-19 Testing (MCV) program. This option was made available to all states through Section 6004(a)(3) of the Families First Coronavirus Response Act (FFCRA). Testing providers are encouraged to download paper applications to be completed, collected and mailed to NC Medicaid at the address on the form.

Executive Order 156 and a State Health Director Memo have extended, but not waived, North Carolina proof-of-immunization documentation deadlines for school and child-care facilities. Additionally, the Executive Order also extends the deadline to submit a school health assessment for children entering North Carolina public school for the first time.

To help increase well-child visits and immunization rates for Medicaid beneficiaries younger than 19 years old, NC DHHS and NC Medicaid is partnering with Community Care of North Carolina (CCNC), NC AHEC, the Division of Public Health (DPH) and Local Health Departments (LHDs) on the new Keeping Kids Well program.

On July 15, 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) finalized modifications to the Confidentiality of Substance Use Disorder Patient Records regulations, 42 CFR Part 2 (“Part 2”). Modifications to Part 2 will be effective Aug. 14, 2020.

CMS announced changes to the Provider Relief Fund opportunities for Medicaid providers which include the application deadline being extended to Aug. 28, 2020, certain providers who previously received Medicare funds can apply for Provider Relief Funds and payments for providers who have changed ownership.
 

Recently, the federal Declaration of Emergency scheduled to end July 25, 2020, was extended through Oct. 25, 2020. In response to this new date, NC Medicaid has extended its COVID-19 related temporary Clinical Coverage Policy provisions to Dec. 31, 2020. COVID-19 related rate enhancements are extended through Sept. 30, 2020.

NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA)
 

Effective with the date of service July 1, 2020, the Centers for Medicare and Medicaid Services (CMS) has added new HCPCS codes (J codes), deleted others, and changed the description of some existing codes.

NC Department of Health and Human Services has announced two Requests for Applications (RFAs) to help communities heavily affected by COVID-19.

The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website. 

Webinar for Medicaid Providers to be held July 27 at 3 p.m and Application Deadline Extended to Aug. 3.

Effective with date of service May 6, 2020, the Medicaid and NC Health Choice programs cover daratumumab and hyaluronidase-fihj injection, for subcutaneous use (Darzalex Faspro™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective July 1, 2020, coverage of therapeutic Continuous Glucose Monitoring (CGM) products is transitioning from the Durable Medical Equipment (DME) Program to the Outpatient Pharmacy Point of Sale (POS) Program. 

On May 15, 2020, the Centers for Medicare & Medicaid Services (CMS) updated the Minimum Data Set (MDS) 3.0 item sets (version 1.17.2) to support the calculation of Patient-Driven Payment Model (PDPM) case mix groups on all Omnibus Budget Reconciliation Act (OBRA) assessments.

NC Medicaid is implementing time-limited, targeted, enhanced swing bed reimbursement rates to provide additional financial support to hospitals that provide post-acute care services to COVID-19 positive (“COVID+”) Medicaid beneficiaries and non-COVID+ Medicaid beneficiaries transferred from other acute care hospitals as part of a surge response.