Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Private Duty Nursing - beneficiaries under 21 years of age, Private Duty Nursing - all beneficiaries and Home Health – All Beneficiaries.

To ensure beneficiaries continue to receive Medicaid and NC Health Choice services with no interruption or delays due to the COVID-19 outbreak, the disposition for three claim processing edits have been temporarily changed.

This article is a reminder to providers of the process for submitting requests for Disproportionate Share Hospital data. Medicaid and NC Health Choice Providers must request and obtain batch Medicare DSH Recipient Eligibility Verifications and Provider Statistical and Reimbursement reports through NCTracks.

We know these are challenging times and are grateful for the continued support of our partners across the state. There is a wealth of information on the DHHS website and our team is working around the clock to make it as user-friendly as possible.

NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak.

Effective March 1, 2020, Medicaid will begin issuing letters to PDN agencies addressing non-compliance with the timely submission of required documentation as indicated in the Request for Additional Information notice. 

NC Medicaid is committed to ensuring our beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak. A webcast has been scheduled to discuss temporary modifications to certain policies and provide related billing codes. 

Effective with date of service Jan. 6, 2020, Medicaid and NC Health Choice programs cover fam-trastuzumab deruxtecan-nxki for injection, for intravenous use (Enhertu) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

Effective with date of service Dec. 31, 2019, the Medicaid and NC Health Choice programs cover enfortumab vedotin-ejfv for injection, for intravenous use (Padcev) for use in the Physician Administered Drug Program when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.

The department is releasing a Behavioral Health Crisis System Memo for Standard Plans