Medicaid Bulletin

For inclusion in open enrollment and auto-enrollment, provider contracts must be signed and mailed to health plan by the following dates.

This Bulletin replaces SPECIAL BULLETIN COVID-19 #22 in its entirety. NC Medicaid has updated its emergency planning document called an Appendix K to expand its flexibilities on how Medicaid providers and beneficiaries may access and receive home- and community-based services (HCBS) through the CAP waivers in the wake of COVID-19, previously referenced in SPECIAL BULLETIN COVID-19 #22. Updates to the previous Bulletin are noted.

Key dates, webinar series, Provider Directory tool, Provider Ombudsman and PHP manuals updated.

This bulletin provides important information regarding changes in the law concerning connection deadlines to NC HealthConnex, the state-designated health information exchange. It also describes a “Hardship Extension Process” coordinated by DHHS.  

A new Medicaid Managed Care webinar series on the Advanced Medical Home (AMH) program will begin Dec. 10, 2020. 

Following the Oct. 30, 2020, announcement that the NCTracks secure portal is live, providers are encouraged to submit qualifying COVID-19 related primary care services claims for reimbursement through the NCTracks secure portal.  

For facilities using a point-of-care antigen test device for detection of SARS-CoV-2, this is a reminder that providers are required by State Health Director Order to report all results, positive and negative, of diagnostic testing for SARS-CoV-2, the virus that causes COVID-19. 

NCDHHS has announced additional enhancements to NC FAST’s ePASS, the online portal that enables individuals to apply for and manage their Medicaid and Food and Nutrition Services. This latest upgrade incorporates the option for a Spanish version of the home screen, navigation tools and all content, as well as the ability to complete the entire application process online in Spanish. 

During a recent medical and pharmacy claims analysis, billing anomalies for Long Acting Reversible Contraceptives (LARCs) and Depo-Provera (medroxyprogesterone) claims were identified.

Consent Form Expiration Date and Clarifications Related to Aug. 15, 2020 Policy Update