Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018. For additional information, please refer to the Sept. 27, 2018 Special Medicaid Bulletin.

In April 2018, the recredentialing notification and suspension process was modified. The previous rule to extend the recredentialing due date if a Manage Change Request Application is "In Review" has been removed.

Personal Care Services (PCS) regional training sessions will be held Oct. 18-Nov. 1, 2018.

Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit the Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.

The Department of Health and Human Services is implementing the Referral Screening Verification Process for individuals being considered for admission to an Adult Care Home effective Nov. 1, 2018.

Effective with date of service Aug. 17, 2018, the Medicaid and NC Health Choice programs cover plazomicin injection, for intravenous use (Zemdri) for use in the Physician's Drug Program when billed with HCPCS code J3490-Unclassified drugs.

Effective with date of service Sept. 5, 2018, the Medicaid and NC Health Choice programs cover patisiran lipid complex injection, for intravenous use (Onpattro) for use in the Physicians Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Registration is open for several instructor-led training courses for providers that will be held in October 2018.

Providers are reminded that NC Medicaid flexibilities due to Hurricane Florence end on Oct. 5, 2018.

The 2019 ICD-10 update is effective Oct. 1, 2018 through Sept. 30, 2019, for provider use.