Topics Related to All Providers
PACE organizations are responsible for providing all required Medicare and Medicaid covered services to its PACE participants. This responsibility also extends to the participants’ home setting. Due to the COVID-19 pandemic, NC Medicaid recognizes that PACE organizations will need to adjust business operations and the methods utilized to address the needs of PACE participants.
Effective March 30, 2020 NC Medicaid is temporarily modifying the Home Infusion Therapy Clinical Coverage Policy No.: 3H-1 to better enable the delivery of remote care to Medicaid members. These temporary changes will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded. This expansion of home infusion therapy serves to allow beneficiaries to receive services in the home rather than in a dedication infusion center to reduce potential exposure to COVID-19.
Effective March 25, 2020, due to drug shortages in the marketplace, the NC Medicaid and NC Health Choice PDL Category of “Respiratory: Beta-Adrenergic Handheld, Short Acting” has changed.
Select provider types enrolled in the North Carolina Medicaid Program are required to file annual Medicaid cost reports utilizing cost reporting schedules which are based on approved Medicare cost reporting platforms.
NOTE: SPECIAL BULLETIN COVID-19 #21 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #36: Telehealth Clinical Policy Modifications - Outpatient Specialized Therapies and Dental Services
NOTE: SPECIAL BULLETIN COVID-19 #19 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #34: Telehealth Clinical Policy Modifications - Definitions, Eligible Providers, Services and Codes.
Effective March 27, 2020, North Carolina Medicaid is requiring prior approval for hydroxychloroquine and chloroquine containing products. Prior approval is required to ensure beneficiaries continue to have access to these medications for maintenance of their autoimmune conditions, for treatment of malaria, and for treatment of extraintestinal amebiasis.
To offset potential hardships due to COVID-19, for NC Medicaid and Health Choice providers who were due to re-verify their enrollment between the dates of March 1, 2020 and June 30, 2020, NCTracks has reset your re-verification due date to Sept. 13, 2020.
The Centers for Medicare & Medicaid Services (CMS) has granted NC Medicaid the authority to temporarily modify several Medicaid and NC Health Choice policies retroactive to March 1, 2020, and through the end of federal emergency declaration or when the flexibility is ended by the State or CMS, whichever is first.
In this Medicaid Bulletin are descriptions of the 1135 waiver policy flexibilities:
In this Medicaid Bulletin are descriptions of the 1135 waiver policy flexibilities:
In response to the anticipated spread of the novel coronavirus (COVID-19) in North Carolina, NC Medicaid is adding the following diagnosis code to the list of diagnoses exempt from the annual visit limit:
Z20.828 - Contact with and (suspected) exposure to other viral communicable diseases
For additional information regarding NC Medicaid’s annual visit limit, please visit this website.
GDIT 800-688-6696
Z20.828 - Contact with and (suspected) exposure to other viral communicable diseases
For additional information regarding NC Medicaid’s annual visit limit, please visit this website.
GDIT 800-688-6696