Medicaid Bulletin

Effective Jan. 1, 2021, NC Medicaid and NC Health Choice are temporarily covering Healthy Opportunities screening to encourage providers to gain capacity for screening Medicaid beneficiaries for unmet health-related resource needs and referring them to appropriate community-based resources prior to the launch of Medicaid managed care.  

Effective April 1, 2021, as part of the transition to Medicaid Managed Care, NC Medicaid will offer time-limited payment  to practices that have attested into Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.  

NCDHHS was allocated administrative funds to launch a pilot program targeted to improve equal communication access for Medicaid and NC Health Choice Deaf, Deaf-Blind and Hard of Hearing beneficiaries in health care settings with NC Medicaid providers.  

Undocumented aliens and certain legal aliens who have not resided in the U.S. for more than five years do not qualify for full Medicaid assistance, but do qualify for medical emergency services. 

The public version of the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool is now available. Providers are encouraged to use this tool to confirm the availability and accuracy of information contained in their NCTracks provider enrollment record.

The information in this bulletin is only for pharmacies administering vaccines outside of the CVS/Walgreens Long-Term Care program who have the means to handle the specific storage recommendations required of the COVID-19 vaccine and will be administering it. 

In response to the Federal Department of Health and Human Services’ extension of the Federal COVID-19 Public Health Emergency, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through March 31, 2021. 

After Jan. 31, 2021, providers are required to capture EVV visits for all beneficiaries subject to EVV. Claims paid for services that are not captured through EVV may be subject to recoupment. 

NC Medicaid has approved codes for COVID-19-related medically necessary laboratory testing and has completed adding these services in NCTracks. Please note there are other codes currently under review that will be posted at a later date.

NC Medicaid Clinical Coverage Policy 3L, State Plan Personal Care Services, is being amended to reflect the 21st Century Cures Act federal requirement of implementing Electronic Visit Verification for Personal Care Services.