Medicaid Bulletin

North Carolina health care providers are required by law to connect with NC HealthConnex, North Carolina’s designated health information exchange.

Effective with date of service Sept. 5, 2018, the Medicaid and NC Health Choice programs cover antihemophilic factor (recombinant) PEGylated-aucl, for intravenous use (Jivi) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J7199-Hemophilia clotting factor, not otherwise classified.

NC Medicaid and Health Choice will reimburse providers for medically necessary drugs and services and equipment and supplies provided during the Hurricane Florence emergency without prior approval from Sept. 14 through Oct. 5, 2018.

Residents in 27 counties impacted by Hurricane Florence can apply for help buying food through the Disaster Supplemental Nutrition Assistance Program, or "D-SNAP."

NC Medicaid Flexibilities due to Hurricane Florence Extended through Sept. 28, 2018

Per the Sept. 12, 2018, South Carolina Department of Health and Human Services (SCDHHS) Medicaid Bulletin, SCDHHS will, in good faith, reimburse North Carolina qualified providers not currently enrolled with or otherwise pre-approved by the South Carolina Medicaid program for medically necessary and time-sensitive services rendered to South Carolina Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.

Facility providers can access Sterilization Consent Form status including denial reasons, on the secure NCTracks Provider Portal, if the sterilization consent form has been properly completed.

Providers may request prior approval for polycarbonate lenses without medical justification or additional documentation when eligible beneficiaries meet at least one of the following criteria.

The clinical criteria used by NC Medicaid for the 2018/2019 Respiratory Syncytial Virus (RSV) season are consistent with guidance published by the American Academy of Pediatrics (AAP): 2018 – 2021 Report of the Committee on Infectious Diseases, 31th Edition.

NC-MIPS is accepting Program Year 2018 Modified Stage 2 and Stage 3 MU attestations.