Medicaid Bulletin

Effective with date of service March 1, 2018, North Carolina Medicaid and NC Health Choice (NCHC) programs cover buprenorphine extended-release injection (Sublocade), for subcutaneous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Effective Jan. 4, 2018, the North Carolina Medicaid and NC Health Choice (NCHC) programs will cover aprepitant injectable emulsion (Cinvanti), for intravenous use in the Physician’s Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Medicaid provided instructions to NCTracks to update the claims processing system to address claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).

Providers have until April 30, 2018, to submit a complete and accurate attestation for Program Year 2017 of the NC Electronic Health Record Incentive Program.

Following a 45-day public comment period, Clinical Coverage Policy 3B, Program of All-Inclusive Care for the Elderly (PACE), was amended and posted on North Carolina Medicaid Community-Based Services Clinical Coverage Policy web page.

Effective March 1, 2018, North Carolina Medicaid has revised Clinical Policy 11C, Ventricular Assist Devices

This article assists providers to identify and report potential report fraud, waste, or abuse.

This article was updated on May 10, 2018. Topics include: list of providers due for re-credentialing, changes to re-credentialing process, and changes to ongoing verification process.

In response to provider feedback, the use of the NPI Exemption List for residents and interns enrolled in graduate dental and medical programs, and area health education centers will be extended from Jan. 31, 2018 to April 30, 2018. Note: This article was originally published as a Special Bulletin in January 2018.

Effective April 1, 2018, North Carolina Medicaid will make several changes to the Medicaid and NC Health Choice Preferred Drug List (PDL):