Due to confusion with the language in Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, the policy has been revised with grammar and punctuation updates.
Topics Related to All Providers
NCDHHS is releasing data on the number of beneficiaries, as of April 2021, who currently meet the eligibility criteria to enroll in Tailored Plans and receive Tailored Care Management scheduled to launch in July 2022.
NC Medicaid implemented system changes on May 9, 2021, requiring providers to keep credentials current on their NCTracks provider enrollment record.
Affected providers should resubmit claims that were denied for procedure code 58661 at this time.
NC Medicaid has published updated guidance on Tailored Care Management, including updates on Advanced Medical Home + (AMH+)/Care Management Agency (CMA) Certification, capacity building and rates.
NCDHHS is in its final week of open enrollment for NC Medicaid Managed Care. Through Friday, May 14, beneficiaries can choose a primary care provider (PCP) and a health plan for their families’ care in preparation for the launch of NC Medicaid Managed Care on July 1.
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.
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.
Effective with date of service March 9, 2021, the North Carolina Medicaid and NC Health Choice programs cover trilaciclib for injection.
Effective with date of service March 11, 2021, the North Carolina Medicaid and NC Health Choice programs cover margetuximab-cmkb injection.