Topics Related to Medicaid Managed Care

NC Medicaid is sharing a list of member counts for Advanced Medical Home practices affiliated with Tailored Plans

Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices

Quality metrics that will assess health plans’ performance across their populations

A delay in identifying individuals in NCTracks as dually eligible for Medicare and Medicaid has been discovered.

From Dec. 1, 2022, to June 30, 2023, they will receive an enhanced medical home payment of $20 per member per month.

Key milestones, playbook updates, verifying eligibility, reverification and more

Independent laboratories shall bill services to the hospital for whom they are providing clinical lab services. Hospitals should bill the PHPs.

Guidance published with examples, training and certification opportunities

NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.

New series begins June 16, 2022