Medicaid Bulletin
Implementation of Rate Floors for Facility-Based Crisis and Mobile Crisis Services
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
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
Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.
Quality Strategy Update Draft Posted for Public Comment
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
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
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
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
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
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
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.
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
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