Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Prior Approval Requirements Resume for Children’s Developmental Services Agency Providers
Effective Oct. 15, 2021, CDSAs and independent practitioners providing individualized family service plan services must resume submitting PA requests.
ICD-10 Annual Update Reminder
The 2022 ICD-10 update is effective Oct. 1, 2021
Anifrolumab-fnia Injection, for Intravenous Use (Saphnelo™) HCPCS Code J3590: Billing Guidelines
Effective Aug. 18, 2021, the Medicaid and NC Health Choice programs cover anifrolumab-fnia injection
North Carolina Standard & Tailored Plan Tobacco-Free Policy Requirement
Tobacco-related policy requirements go into effect on July 1, 2022.
NC Medicaid EHR Incentive Program Announcements - September, 2021
Two Months Left to Submit Program Year 2021 Attestations; Security Risk Analysis
Interim Process for Submitting Prior Authorization Requests for Beneficiaries Disenrolled to NC Medicaid Direct
Providers are encouraged to confirm which PA types are included in this long-term design.
Clinical Coverage Policy 11A-17 CAR T-Cell Therapy Revision Effective Oct. 1, 2021
Will cover all U.S. FDA approved CAR T-Cell Therapies when administered per U.S. FDA approved guidelines
SPECIAL BULLETIN COVID-19 #178: Temporary Provisions for COVID Surge: Post-Acute PA Exceptions and Hospital at Home Program
Temporary Suspension of Prior Authorization for Post-Acute Placements and Temporary Availability of the Hospital at Home Program
SPECIAL BULLETIN COVID-19 #177: Casirivimab and Imdevimab Approved for Emergency Use
Casirivimab and Imdevimab have been given emergency use authorization for treatment of mild to moderate COVID-19 in some patients.
Single State Audit SFY2021
OSA has begun the Single Audit for state fiscal year 2021