The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Topics Related to Medicaid Managed Care
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.
The Centers for Medicare & Medicaid Services has approved State Plan Amendments to revise reimbursement methodology.
Includes information on Provider Fact Sheets, LME/MCO consolidation, Innovations and TBI waivers, federal fee increase, updates to NCTracks and more.
Effective with date of service Jan. 16, 2024, NC Medicaid covers benzathine benzylpenicillin (Extencilline)
This rate increase in the latest Physician Administered Drug Program fee schedule supports treating Medicaid members for Congenital Syphilis.
Policies to promulgate on May 1, 2024.
An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of Dec. 1, 2023, is posted.
Includes information on LME/MCO consolidation, Innovations and TBI waivers, federal fee increase, updates to NCTracks, Medicaid expansion and more.