Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Confirming Medicaid Coverage for Beneficiaries
Providers and pharmacies should always use NCTracks to confirm eligibility.
What Providers Need to Know After the July 1, 2021 Full Launch of Electronic Visit Verification
The State solution for reporting electronic visit verification and aggregation is Sandata.
Prior Authorizations for Medically Necessary Contact Lenses When a Beneficiary Transitions NC Medicaid Direct
Providers must submit a contact lens prior approval request to NCTracks for a beneficiary who has transferred back to NC Medicaid Direct.
Prior Authorizations Covered When a Beneficiary Transitions to NC Medicaid Direct
When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.
NC Medicaid Managed Care Provider Update – Aug. 4, 2021
Key milestones, playbook updates, prior authorizations, FAQs, contracting, ombudsman, webinars and more.
Guidance to Pharmacies Supporting Beneficiaries Transitioning to NC Medicaid Direct
Guidance to pharmacies on prior authorizations that transfer from a health plan to NC Medicaid Direct.
Eyeglasses Prior Approval and Dispensing Fee Claims Submission When a Beneficiary Transitions to NC Medicaid Direct
Providers must submit ALL eyeglasses prior approval requests for NC Medicaid Direct beneficiaries and health plan members to NCTracks.
NC Medicaid EHR Incentive Program Announcements
Three Months Left to Submit Program Year 2021 Attestations and the Security Risk Analysis.
Guidance for Providers Experiencing Payment Issues
Actions providers should take to reduce claim denials and payment delays.
NCDHHS Announces Medicaid Managed Care Regional Behavioral Health I/DD Tailored Plans
DHHS announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).