Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Tailored Plan 101: Ready, Set, Launch Series
New series begins June 16, 2022
SPECIAL BULLETIN COVID-19 #250: Planning for the Transition out of the Appendix K Public Health Emergency for CAP/C and CAP/DA Waivers
Stakeholder dialogs on ending CAP flexibilities coming soon
Prior Approval Requirements Resume for Children’s Developmental Services Agency Providers
PA Resumes for Behavioral Health Services Effective July 15, 2022
Updates to Requirements for the Consent for Sterilization Form
The estimated effective date for this policy update is Aug. 1, 2022.
NC Medicaid Managed Care Provider Update - June 7, 2022
Key milestones, playbook updates, verifying beneficiary eligibility, provider reverification, review provider record in NCTracks and more.
Electronic Visit Verification Personal Care Services Upcoming Claims Reprocessing
Rate increase for EVV PCS claims
Provider and Tailored Plan Contract Deadlines for Inclusion in Beneficiary Choice Period and Auto-Assignment
Providers who do not contract with Tailored Plans by the deadlines risk losing patients
SPECIAL BULLETIN COVID-19 #249: Pfizer-BioNTech Vaccine Booster Dose for Children Age 5 through 11
Coverage for single booster dose
Reminder: Orthotics and Prosthetics Providers Must Include Modifier for Appropriate HCPCS Codes
Effective Sept. 1, 2022, codes submitted without modifier LT (left), or RT (right) will be denied
Prior Authorizations End-dated When a Beneficiary Transitions to Managed Care
NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.