Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NC Managed Care Capitation Rates – Updated Care Management Assumptions for Expansion Population
Includes rate considerations for Medicaid Expansion members effective Dec. 1, 2023.
Over-the-Counter COVID-19 Test for Home Use Pharmacy POS Coverage
CorDx, GoToKnow, FaStep COVID-19 AG Home Tests added to coverage.
Electronic Visit Verification for NC Medicaid-Funded Personal Care Services and Home Health Services
Manual entries and Sandata Mobile Connect 2.0.
Quality of Care Fact Sheets Available
Fact sheets provide key findings, trends, improvements and new programs
Reminder for Home Health Providers: Associations in the Sandata System
How to create an association in Sandata allowing providers to work with their clients
New Exclusion Sanction Questions to be added to Applications for Provider Enrollment
Beginning Jan. 28, 2024, five new additional exclusion sanction questions will be added.
NC Medicaid to Revise the Physician Administered Drug Program (PADP) Fee Schedule
NC Medicaid will update the PADP fee schedule effective Feb. 1, 2024.
Guidance for Private Duty Nursing Providers
How to best serve beneficiaries who have not received nursing services for 30 consecutive days.
Additional NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024
This bulletin replaces the NC Medicaid Respiratory Syncytial Virus (RSV) Guidelines for 2023-2024 - Revised published Nov. 3, 2023.
CPT Code Update Effective Jan. 1, 2024
The American Medical Association has added new CPT codes, deleted others and changed the descriptions of some existing codes.