Medicaid Bulletin

Due to confusion with the language in Clinical Coverage Policy 1A-22, Medically Necessary Circumcision, the policy has been revised with grammar and punctuation updates.

NCDHHS is releasing data on the number of beneficiaries, as of April 2021, who currently meet the eligibility criteria to enroll in Tailored Plans and receive Tailored Care Management scheduled to launch in July 2022.

An amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies with an effective date of April 1, 2021, was posted to the NC Medicaid Clinical Coverage Policy web page.

An amended version of Clinical Coverage Policy 5A-2, Respiratory Equipment and Supplies with an effective date of April 1, 2021, was posted to the NC Medicaid Clinical Coverage Policy web page. 

NC Medicaid implemented system changes on May 9, 2021, requiring providers to keep credentials current on their NCTracks provider enrollment record. 

Affected providers should resubmit claims that were denied for procedure code 58661 at this time.  

NC Medicaid has published updated guidance on Tailored Care Management, including updates on Advanced Medical Home + (AMH+)/Care Management Agency (CMA) Certification, capacity building and rates.

NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021. A stakeholder meeting will be held on Friday, May 21, 2021, at 10 a.m. to share EVV implementation updates and provide training to support provider readiness for June 1, 2021.

June 30, 2021, is the implementation date of Electronic Visit Verification (EVV) for the Innovations waiver, Traumatic Brain Injury (TBI) waiver and (b)(3) services administered by the LME/MCOs.

NCDHHS is in its final week of open enrollment for NC Medicaid Managed Care. Through Friday, May 14, beneficiaries can choose a primary care provider (PCP) and a health plan for their families’ care in preparation for the launch of NC Medicaid Managed Care on July 1.