Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

NC Medicaid is making system modifications that will start the process of 45 and 60 day notifications of suspension if a provider fails to update their credential prior to the expiration date. 

Effective with the date of service April 1, 2021, the Centers for Medicare & Medicaid Services added new HCPCS codes (J codes), deleted others and changed the description of some existing codes. 

Effective July 1, 2021, NC Medicaid will increase fee-for-service rates and establish rate floors for facility-based crisis and mobile crisis management services that will mandate minimum reimbursement rates.

The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website. 

Program Year 2020 Webinar Series, The Security Risk Analysis (SRA) and Program Year 2021 Announcements.

An updated draft of NC Medicaid’s Managed Care Quality Strategy is posted for public comments until May 6, 2021. 

The NC Medicaid Annual Quality report and an updated NC Medicaid Managed Care Quality Measurement Technical Specifications Manual are available.

NCDHHS has implemented a PCP practice reassignment process to better match beneficiaries to the PCP with whom they already have an active relationship with to help ensure the best health plan is selected during auto-enrollment.

Upcoming stakeholder sessions are announced for the Community Alternatives Program for Children (CAP/C) waiver, which will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.  

Effective with date of service Jan. 28, 2021, the Medicaid and NC Health Choice programs cover remimazolam for injection, for intravenous use (Byfavo™).