Topics Related to Medicaid Managed Care
This bulletin applies to NC Medicaid Managed Care Standard Plans.The North Carolina Department of Health and Human Services (NCDHHS) is releasing updated information about the care management component of capitation payments to NC Medicaid Managed Care Standard Plans effective July 1, 2024.
Provider Data Management / Credentialing Verification Organization (PDM/CVO) Solution New Launch Date of 2026.
Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.
Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation
Usage of the Nicotine Replacement Therapy Protocol is Eligible for Clinical Services Reimbursement to Pharmacies.
Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.
Feedback Requested on Proposed Approach
The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Recent State Plan Amendment outlines duties of a responsible third party
Providers should work with their Medicaid beneficiary’s health plan and Tailored Care Manager to transition the members to 1915(i) services.