Medicaid Bulletin

NC Medicaid is implementing temporary clinical policy revisions that will allow dentists to provide additional services to Medicaid and NC Health Choice beneficiaries. These temporary policy changes were applied in the NCTracks system with a retroactive effective date of March 10, 2020.

NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to enable eligible providers to deliver family planning services to NC Medicaid Be Smart Family Planning Medicaid program (MAFDN) eligible beneficiaries via telemedicine or virtual patient communication (telephone call, only) in light of social distancing measures that may prevent in-person visits. 

All providers required to connect and submit data by June 1, 2020, according to House Bill 70/Session Law 2019-23 have been granted an extension and shall begin submitting demographic and clinical data by Oct. 1, 2021.

This bulletin temporarily enables eligible local health departments to deliver maternal support services via telemedicine in light of social distancing measures that may prevent in-person visits.    

Federal law requires all Medicaid providers in North Carolina to comply with the Americans with Disabilities Act (ADA) and Rehabilitation Act, which includes providing reasonable accommodations for people living with disabilities.

This bulletin replaces SPECIAL BULLETIN COVID-19 #68 in its entirety. NC Medicaid is directing increased financial assistance to North Carolina Skilled Nursing Facilities (SNF) and Adult Care Homes (ACH) to support addressing the increased costs of caring for COVID positive (COVID+) residents in a congregate care setting. 
 

Program Year 2019 is Closed, NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA).

On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) announced an amendment of 42 CFR 440.70 that included two policy changes that affect hospice services for Medicaid during the COVID-19 pandemic. Effective March 30, 2020, NC Medicaid is adjusting hospice requirements currently in Clinical Coverage Policy 3D, Hospice Services to align with these recent CMS regulatory changes. 

NC Medicaid is temporarily adding Telemedicine and Telepsychiatry clinical coverage codes for specialty providers and increasing reimbursement rates for telephonic visits and primary care medical home per member per month fees to help primary and specialty care providers continue to serve patients during the COVID-19 emergency.

NOTE: SPECIAL BULLETIN COVID-19 #79 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #103. This Bulletin clarifies that skilled nursing facilities (SNF) are eligible originating sites for telemedicine visits and enables such facilities to bill for a facility fee when a beneficiary located in a SNF receives care via telemedicine from an eligible remote provider.