Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Effective with date of service Feb. 19, 2021, the North Carolina Medicaid and NC Health Choice programs cover evinacumab-dgnb injection. 

New Long-Term Services and Supports Care Management web page, Advanced Medical Home Provider Manual 2.1 released and Program Guide added. 

On May 9, 2021, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment. NCTracks will generate a notification to providers at 60, 30 and 14 calendar days prior to the expiration date of the credential; and will begin a process of suspension if a provider fails to update their credential.

NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021.

As a reminder, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment effective May 9, 2021. NCTracks will generate a notification to providers at 60, 30 and 14 calendar days prior to the expiration date of the credential; and will begin a process of suspension if a provider fails to update their credential.

To assist with identifying North Carolina Medicaid and NC Health Choice beneficiaries currently assigned under the Community Care of North Carolina/Carolina ACCESS (CCNC/CA) program, NCDHHS generated a new Advanced Medical Home (AMH) NC Medicaid Direct/NC Medicaid Managed Care Primary Care Provider (PCP) Enrollee Report for distribution to CCNC/CA participating providers.

Effective May 9, 2021, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment.

Key dates for transitioning to NC Medicaid Managed Care, Provider contracting reminders, Provider Playbook updates, Provider outreach to patient panels, webinars, Provider and health plan look-up tool, PHP quick reference guides, help center, Provider Ombudsman and Tailored Care Management certification.

Providers with Denials for Healthy Opportunities Screening, Assessment and Referrals Claims due to edit 02088 may now resubmit claims; Place of Service Indicator codes updated.

NC Medicaid will offer time-limited payments to practices that have attested as an Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.