Topics Related to Hospital Providers

In compliance with federal requirements, beneficiary consent is required for all voluntary sterilizations.

Flexibilities ending at or after the end of the Federal Public Health Emergency

This bulletin provides guidance to assist hospital providers’ compliance with federal requirements.

In response to the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective Aug. 1, 2020.

For clarification purposes of information communicated in October 2018 Medicaid Bulletin, please note that effective Oct.

Additional information on prior authorization is available.

Select provider types enrolled in the NC Medicaid Program are required to file annual Medicaid cost reports utilizing cost reporting schedules which are based on approved Medicare cost reporting platforms.

NC Medicaid is implementing time-limited, targeted, enhanced swing bed reimbursement rates to provide additional financial support to hospitals that provide post-acute care services to COVID-19 positive (“COVID+”) Medicaid beneficiaries and non-COVID+ Medicaid beneficiaries transferred from other acute care hospitals as part of a surge response.  

Effective Oct. 1, 2019, two additional ICD-10 codes will be added to the LARC DRG reimbursement retroactive date of Oct. 1, 2018.  

Providers must bill with the following HCPCS code, and the appropriate ICD-10 PCS code on the inpatient hospital claim to receive the LARC DRG reimbursement.

Recommended updates to the NC Medicaid and Health Choice Preferred Drug List (PDL) as approved by the NC Pharmacy and Therapeutics (P&T) Committee and the NC Physician Advisory Group (PAG) were posted for the required 45-day public comment period on Apr. 2, 2019.