Medicaid Bulletin

Clinical Coverage Policies

Monday, January 13, 2020

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

Federal Enrollment Application Fee Increase for Year 2020

Monday, January 13, 2020

Section 6401(a) of the Affordable Care Act requires the Secretary to impose a fee on each "institutional provider of medical or other items or services and suppliers." Based upon provisions of the ACA, this fee will vary from year to year based on adjustments made pursuant to the Consumer Price Index for Urban Areas.

NC Medicaid Electronic Health Record (EHR) Incentive Program Announcements

Monday, January 13, 2020

NC-MIPS is Open for Program Year 2019, Reminder from CMS Regarding Objective 6 and Objective 7, Clarification from CMS Regarding Objective 5 Measure 1: Patient Electronic Access and general reminders.
 

Clinical Coverage Policies

Tuesday, December 17, 2019

New or amended clinical coverage policies are available on NC Medicaid's website. 

Updated ICD Diagnosis Code List

Tuesday, December 17, 2019

NC Medicaid has updated its ICD-10 diagnosis code list.

CPT Code Update: 2020

Tuesday, December 17, 2019

Effective with date of service Jan. 1, 2020, the American Medical Association (AMA) added new CPT codes, deleted others and changed the descriptions of some existing codes. 

New Coverage, Prior Approval and Billing Requirement for CAR-T Cell Therapy (KYMRIAH & YESCARTA)

Tuesday, December 10, 2019

A Clinical Coverage Policy has been developed to add coverage for Chimeric Antigen Receptor (CAR) T-Cell Therapies KYMRIAH and YESCARTA. This policy will become effective Dec. 1, 2019.

NC Medicaid Electronic Health Record (EHR) Incentive Program Announcements

Tuesday, December 10, 2019

The NC Medicaid EHR Incentive Payment System is only accepting Program Year 2019 Stage 3 Meaningful Use attestations.

Clarification from CMS Regarding Objective 5, Measure 1: Patient Electronic Access

Tuesday, November 26, 2019

The Centers for Medicare and Medicaid Services (CMS) has recently provided clarification outside of the specification sheet for their intent of Stage 3 Meaningful Use’s Objective 5, Measure 1.

SPECIAL BULLETIN: DHHS Suspends Implementation of Managed Care

Wednesday, November 20, 2019

While this year’s legislative session was one of the longest in recent memory, it ended without needed action required for managed care to move forward. The General Assembly adjourned last week without providing required new spending and program authority for the transition to managed care. Therefore, the Department of Health and Human Services will be suspending managed care implementation and open enrollment. Managed care will not go live on February 1, 2020.

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