Medicaid Bulletin

Effective with date of service Oct. 4, 2019, the Medicaid and NC Health Choice programs cover immune globulin subcutaneous, human – klhw 20% solution (Xembify®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3590 - Unclassified biologics.
 

The Community Alternatives Program for Children (CAP) §1915( c) Home and Community-Based Services (HCBS) waiver application has been amended and approved by the Centers for Medicare and Medicaid Service (CMS), effective May 1, 2020. 

NC Medicaid continues provide support to Skilled Nursing Facilities (SNF) and Personal Care Services (PCS) and Home Health (HH) providers to strengthen their infection prevention and management activities as they serve beneficiaries at high risk of contracting COVID-19. 

NC Medicaid is implementing temporary clinical policy revisions that will allow dentists to provide additional services to Medicaid and NC Health Choice beneficiaries. These temporary policy changes were applied in the NCTracks system with a retroactive effective date of March 10, 2020.

NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to enable eligible providers to deliver family planning services to NC Medicaid Be Smart Family Planning Medicaid program (MAFDN) eligible beneficiaries via telemedicine or virtual patient communication (telephone call, only) in light of social distancing measures that may prevent in-person visits. 

All providers required to connect and submit data by June 1, 2020, according to House Bill 70/Session Law 2019-23 have been granted an extension and shall begin submitting demographic and clinical data by Oct. 1, 2021.

This bulletin temporarily enables eligible local health departments to deliver maternal support services via telemedicine in light of social distancing measures that may prevent in-person visits.    

Federal law requires all Medicaid providers in North Carolina to comply with the Americans with Disabilities Act (ADA) and Rehabilitation Act, which includes providing reasonable accommodations for people living with disabilities.

This bulletin replaces SPECIAL BULLETIN COVID-19 #68 in its entirety. NC Medicaid is directing increased financial assistance to North Carolina Skilled Nursing Facilities (SNF) and Adult Care Homes (ACH) to support addressing the increased costs of caring for COVID positive (COVID+) residents in a congregate care setting. 
 

Program Year 2019 is Closed, NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA).