Medicaid Bulletin

Implementation of Rate Floors for Facility-Based Crisis and Mobile Crisis Services

Monday, April 12, 2021

Effective July 1, 2021, NC Medicaid will increase fee-for-service rates and establish rate floors for facility-based crisis and mobile crisis management services that will mandate minimum reimbursement rates.

New and Amended Clinical Coverage Policies – March 2021

Tuesday, April 6, 2021

The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website. 

Last Month to Submit Program Year 2020 Attestations

Tuesday, April 6, 2021

Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.

Quality Strategy Update Draft Posted for Public Comment

Monday, April 5, 2021

An updated draft of NC Medicaid’s Managed Care Quality Strategy is posted for public comments until May 6, 2021. 

Quality Report and Quality Measurement Technical Specifications Manual Posted

Thursday, April 1, 2021

The NC Medicaid Annual Quality report and an updated NC Medicaid Managed Care Quality Measurement Technical Specifications Manual are available.

Primary Care Provider Practice Reassignment for Some Beneficiaries

Thursday, April 1, 2021

NCDHHS has implemented a PCP practice reassignment process to better match beneficiaries to the PCP with whom they already have an active relationship with to help ensure the best health plan is selected during auto-enrollment.

Community Alternatives Program for Children Waiver Renewal Stakeholder Engagement

Wednesday, March 31, 2021

Upcoming stakeholder sessions are announced for the Community Alternatives Program for Children (CAP/C) waiver, which will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.  

Remimazolam for Injection, for Intravenous Use (Byfavo™) HCPCS Code J3490: Billing Guidelines

Tuesday, March 30, 2021

Effective with date of service Jan. 28, 2021, the Medicaid and NC Health Choice programs cover remimazolam for injection, for intravenous use (Byfavo™).

Clinical Policy 1E-7, Family Planning Services Revised Effective May 1, 2021

Tuesday, March 30, 2021

An amended version of Clinical Coverage Policy 1E-7, Family Planning Services, with an effective date of May 1, 2021, will post to the NC Medicaid Clinical Coverage Policy webpage.

Clinical Policy 1A-41: Office-Based Opioid Treatment

Tuesday, March 30, 2021

Clinical Coverage Policy 1A-41, Office-Based Opioid Treatment is being updated to add buprenorphine for the treatment of patients aged 16 years and older.

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