Blog Entry List
North Carolina Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
North Carolina Medicaid has provided instructions to NCTracks and the following procedure code list has been updated recently to include additional NP and PA taxonomies.
Effective Dec. 1, 2018, the North Carolina Medicaid Uniform Screening Tool (NCMUST) application and operation of the Level 1 PASRR screen process transitioned from a NC Medicaid vendor to NC DHHS ITD and NC Medicaid. The transition enables NC DHHS to achieve a more efficient screening process for PASRRs and provide NCDHHS with direct knowledge of issues and barriers that may impact the timely processing of PASRR Level 1 screens and Level 2 evaluations.
Personal Care Services (PCS) regional training sessions will be held May 13-22, 2019. Registration begins at 8 a.m. and training will be held from 9 a.m. to 1:30 p.m. Training sessions are free, but registration is required.
Effective Mar. 4, 2019, NC Medicaid implemented functionality in QiRePort allowing providers to submit the Internal Quality Improvement Program Attestation (NC Medicaid-3136) and Session Law 2013-306 PCS Training Attestation (NC Medicaid-3085) Forms via upload.
Effective May 1, 2019, beneficiaries requesting Personal Care Services must use the updated NC Medicaid-3051 Request for Independent Assessment for Personal Care Services Attestation of Medical Need Form. This form is a revision of the currently used NC Medicaid-3051 Form. The current form will be accepted by the Independent Assessment Entity through July 1, 2019.
NC Medicaid has developed a general overview and topic-based webinar series that will educate providers to effectively support their transition to Medicaid Managed Care. General webinars are designed to give providers an overview of major changes and important things to know while the focused, topical webinar series will offer a deeper dive on specific topics.
Session Law 2017-57, Section 11H.13/(a) was amended to appropriate funding to be used to increase the rate for in-home aide services to no more than three dollars and ninety cents ($3.90) paid per 15-minute billing unit provided under the Community Alternatives Program for Disabled Adults (CAP/DA) waiver pursuant to Clinical Coverage Policy 3K-2, effective Jan. 1, 2019.
A renewal application for § 1915 (c) Home and Community-Based Services (HCBS) waiver for the Community Alternatives Program for Disabled Adults (CAP/DA) was submitted to the Centers for Medicare & Medicaid Services (CMS) on Mar. 1, 2019 for review and approval.
On Feb. 4, 2019, the North Carolina Department of Health and Human Services announced the selection of five Prepaid Health Plans that will participate in Medicaid managed care when the program launches in November 2019.
NCTracks receives files from the North Carolina Medical Board the first week of every month. Providers do not need to update their license renewals in NCTracks. The expiration date will be updated by NCTracks automatically as long as the license number on the provider's record is correct and matches the license number issued by the Board.
The following new or amended clinical coverage policies are available on NC Medicaid’s website:
There are only two months left to submit an attestation for Program Year 2018. The NC Medicaid EHR Incentive Payment System (NC-MIPS) will close for Program Year 2018 at midnight on April 30, 2019. After that, no changes can be made.
Registration is open for the March 2019 instructor-led provider training courses listed below. Slots are limited. WebEx courses can be attended remotely from any location with a telephone, computer and internet connection.
Proposed new or amended North Carolina Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month.
This is a reminder that not all drugs administered by injection or infusion are covered in the Physicians Drug Program (PDP) as a part of the medical benefit. Some of these drugs are only covered in the outpatient pharmacy benefit when requested by prior authorization (PA) and dispensed by a retail or specialty pharmacy.