Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
Per Session Law (S.L.) 2015-241, as of June 1, 2018, hospitals, mid-level physicians and nurse practitioners who currently have an electronic health record system must be connected to NC HealthConnex to continue to receive payments for North Carolina Medicaid and NC Health Choice services.
The following new or amended combined North Carolina Medicaid and NC Health Choice (NCHC) clinical coverage policies are available on Medicaid’s clinical coverage policy web pages.
Beginning April 1, 2018, diabetic testing supplies will be transitioned to the North Carolina Medicaid and NC Health Choice Preferred Drug List (PDL) and Roche diabetic testing supplies will remain preferred.
Beginning April 1, 2018, diabetic testing supplies will be transitioned to the North Carolina Medicaid and NC Health Choice Preferred Drug List and Roche diabetic testing supplies will remain preferred.
Effective April 1, 2018, the following CPT codes for diabetic testing supplies will be removed from the Home Health fee schedule.
Personal Care Services (PCS) regional training sessions will be held April 30 – May 16, 2018. Registration begins at 8 a.m. and training will be held from 9 a.m. to 1 p.m. Training sessions are free, but registration is required.
Effective March 2018, DMA will begin a quarterly review of providers identified as non-compliant with the timely completion of the online Personal Care Services (PCS) service plan as required by Clinical Coverage Policy 3L, State Plan Personal Care Services.
Effective with date of Service Jan. 1, 2018, the North Carolina Medicaid and NC Health Choice programs cover treprostinil injection (Remodulin), for subcutaneous infusion or intravenous infusion in the Physician’s Drug Program when billed with HCPCS code J3285 - Injection, treprostinil, 1 mg.
Effective with date of service Dec. 11, 2107, the North Carolina Medicaid and NC Health Choice (NCHC) programs cover letermovir injection (Prevymis) for intravenous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.
Effective with date of service, June 1, 2016, the North Carolina Medicaid program covers Axumin for use in the Physician’s Drug Program (PDP) when billed with HCPCS code A4641, radiopharmaceutical, diagnostic, not otherwise classified.