Topics Related to Medicaid Managed Care

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
Key milestones, playbook updates, verifying beneficiary eligibility, provider reverification, review provider record in NCTracks and more.
Providers who do not contract with Tailored Plans by the deadlines risk losing patients
NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.
A new PA is required for beneficiaries returning to NC Medicaid Direct.