Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices
Topics Related to Medicaid Managed Care
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.
Key milestones, playbook updates, verifying beneficiary eligibility, provider reverification, review provider record in NCTracks and more.