The Contract for Prepaid Health Plan Services (the State Contract) between the Department of Health and Human Services (the Department) and the selected Medicaid Managed Care plans (i.e., Prepaid Health Plans or PHPs) indicates that contracts between PHPs and providers shall comply with the terms of the State Contract and must be approved by the Department.
Topics Related to All Providers
The Contract for Prepaid Health Plan Services (the State Contract) between the Department of Health and Human Services (the Department) and the selected Medicaid Managed Care plans (i.e., Prepaid Health Plans or PHPs) indicates that contracts between PHPs and providers shall comply with the terms of the State Contract and must be approved by the Department.
In the May 2019 Special Bulletin, Procedures Billable by Independent Diagnostic Testing Facilities (IDTF), NC Medicaid stated that coverage for 825 additional procedure codes for IDTFs would take effect June 1, 2019.
Please post an English and Spanish version of the “Notice Of Your Rights Under Hawkins v. Cohen” in a prominent location for at least 180 calendar days. This notice contains important information regarding beneficiary rights as they pertain to improper termination of Medicaid benefits, resulting from a federal lawsuit filed in 2017 on behalf of Medicaid beneficiaries in North Carolina.
In response to provider requests and to align more closely with Medicare coverage for Independent Diagnostic Testing Facilities (IDTF), effective June 1, 2019, NC Medicaid will add coverage for additional procedure codes outlined in the attached document.
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.
This email is an update to yesterday’s email and previous North Carolina Medicaid Bulletins. In response to provider feedback, the use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will be extended from January 31, 2018 to April 30, 2018.
The Special Medicaid Bulletin, Generic Dispensing Rate Adjustments and Flovent HFA Inhaler Moved to Preferred Status on the Preferred Drug List, had an incorrect date in the first sentence. Here is the article with the correct information.
Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018. For additional information, please refer to the Sept. 27, 2018 Special Medicaid Bulletin.
NCTracks Call Center, 1-800-688-6696
Pharmacy providers: NCTracks Pharmacy Call Center, 1-866-246-8505
NC Medicaid Hurricane Florence Response & Recovery website
You are receiving this notice in regard to Hospice claims that were adjudicated in NCTracks beginning Jan. 1, 2016.