Medicaid Bulletin

Registration is open for the August 2018 instructor-led provider training courses listed below. Slots are limited.

The following new or amended combined North Carolina Medicaid and NC Health Choice clinical coverage policies are available on Medicaid’s website:

If a provider’s enrollment application or Manage Change Request (MCR) does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.

Note: This article was originally published as a Special Bulletin in January 2018, with updates regarding clinical pharmacist practitioners.

If a provider’s enrollment application or Manage Change Request does not contain errors, it will process more quickly. The NCTracks Enrollment Team identified commons errors that cause delays in processing applications and MCRs.

North Carolina Medicaid will reprocess Medicare Part B Crossover Professional and Outpatient claims submitted to Medicare from Jan. 2, 2017, to Jan. 5, 2017.

As a reminder, providers are to request and obtain proper PA before services are scheduled or rendered. Contractually, CSRA (Medicaid’s fiscal vendor) has five business days (excluding holidays and weekends) to process a PA request once all required information is obtained.

Effective July 1, 2018, the North Carolina Medicaid and N.C. Health Choice programs will cover nusinersen injection, for intrathecal use (Spinraza) for use only in the Physician's Drug Program.

Effective Aug. 1, 2018, North Carolina Medicaid will make a change to the N.C. Medicaid and N.C. Health Choice Preferred Drug List in the Antihyperkinesis/Attention Deficit Hyperactivity Disorder (ADHD) class.

Effective with date of service March 8, 2018, the North Carolina Medicaid and N.C. Health Choice (NCHC) programs cover mometasone furoate sinus implant (Sinuva) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.