Topics Related to All Providers
To comply with a final rule issued by the Centers for Medicare and Medicaid Services (CMS), which requires additional disclosures by enrolling providers, revisions to the NC Medicaid Provider Enrollment Application are underway. This final rule, effective Nov. 4, 2019, implements statutory provisions that require providers and suppliers to disclose certain current and previous affiliations with other providers and suppliers.
In preparation for the upcoming holidays, please be aware of the change to the schedule for posting of Medicaid Bulletin articles.
New or amended clinical coverage policies are available on NC Medicaid’s website.
The NC Medicaid Electronic Health Record Incentive Payment System is only accepting Program Year 2019 Stage 3 Meaningful Use attestations.
NC Medicaid reimburses qualified providers for child medical evaluation and medical team conference services according to guidelines set forth in NC Medicaid policy 1A-5 Child Medical Evaluation and Medical Team Conference for Child Maltreatment.
NC Medicaid has updated its ICD-10 diagnosis code list. Diagnosis code K35.891 (other acute appendicitis without perforation, with gangrene) has been added as an acceptable ICD-10 diagnosis code effective Oct. 1, 2018.
A new or amended clinical coverage policy regarding facility-based crisis management for children and adolescents is available on NC Medicaid’s website.
As NC Medicaid's managed care launch date approaches, Advanced Medical Home (AMH) providers who believe they are not ready to meet program requirements to perform at the tier level to which they attested may now submit a request to change their AMH Tier status from Tier 3 to Tier 2. The AMH Tier 3 providers may not downgrade lower than AMH Tier 2.
The North Carolina Department of Health and Human Services (DHHS) has expanded the regions awarded to Carolina Complete Health, Inc. (CCH) to serve as a health plan under the state’s transition to Medicaid Managed Care. In addition to serving regions 3 and 5 in the state, the provider-led health plan will also serve region 4.