Effective May 1, 2017, new pharmacy point of sale clinical edits for behavioral health medications were applied for pediatric and adult beneficiaries. Note: This article was originally published in February 2017 Medicaid Bulletin.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
In response to provider comments and questions regarding the December 2017 Special Bulletin, Billing Guidance:340B Modifiers, North Carolina Medicaid is publishing updated information regarding the use of the JG, TB and UD modifiers which are required to identify 340B drug claims.
Effective May 1, 2018, Clinical Coverage Policy 1C-1, Podiatry Services, is revised to include annual updates to International Classification of Diseases (ICD-10-CM) codes.
42 CFR 455.450 requires a state Medicaid agency to screen all initial provider applications based on a categorical risk level of “limited,” “moderate,” or “high.”
Registration is open for several instructor-led training courses for providers that will be held in May 2018. Slots are limited.
The NC Medicaid Electronic Health Record (EHR) Incentive Program is no longer accepting Program Year 2017 attestations.
Per Session Law (S.L.) 2015-241, as of June 1, 2018, hospitals, mid-level physicians and nurse practitioners who currently have an electronic health record system must be connected to NC HealthConnex to continue to receive payments for Medicaid and NCHC services.
The Department of Health and Human Services, Division of Medical Assistance, provides notice of its intent to amend the Medicaid State Plan to increase the rates for metabolic formula – Durable Medical Equipment.
By July 1, 2018, Medicaid behavioral health providers added to NCTracks by their current Local Management Entity/Managed Care Organization Provider Upload Process must complete re-verification.
Effective May 1, 2018, North Carolina Medicaid will cover digital breast tomosynthesis (3D tomosynthesis) for both screening and diagnostic mammography.