Medicaid Bulletin

This article is a reminder to providers of the process for submitting requests for Disproportionate Share Hospital data. Medicaid and NC Health Choice Providers must request and obtain batch Medicare DSH Recipient Eligibility Verifications and Provider Statistical and Reimbursement reports through NCTracks.

We know these are challenging times and are grateful for the continued support of our partners across the state. There is a wealth of information on the DHHS website and our team is working around the clock to make it as user-friendly as possible.

NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak.

Effective March 1, 2020, Medicaid will begin issuing letters to PDN agencies addressing non-compliance with the timely submission of required documentation as indicated in the Request for Additional Information notice. 

NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak. A webcast has been scheduled to discuss temporary modifications to certain policies and provide related billing codes. 

Effective with date of service Jan. 6, 2020, Medicaid and NC Health Choice programs cover fam-trastuzumab deruxtecan-nxki for injection, for intravenous use (Enhertu) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service Dec. 31, 2019, the Medicaid and NC Health Choice programs cover enfortumab vedotin-ejfv for injection, for intravenous use (Padcev) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

The department is releasing a Behavioral Health Crisis System Memo for Standard Plans

While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department of Health and Human Services continues to work on the design of Standard Plans and Behavioral Health and Intellectual Developmental Disability (I/DD) Tailored Plans. The Department is releasing a Behavioral Health Crisis System Memo for Standard Plans. 

NC-MIPS is Open for Program Year 2019; The Security Risk Analysis (SRA); Reminder from CMS Regarding Objective 6 and Objective 7; Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and General Reminders.