Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Bulletins published prior to January 2019
Articles since January 2018 are available in the blog format below.
Managed Care for Providers: PHP Contracts Awarded
On Feb. 4, 2019, the North Carolina Department of Health and Human Services announced the selection of five Prepaid Health Plans that will participate in Medicaid managed care when the program launches in November 2019.
New American Dental Association Procedure Codes
Effective with date of service Jan. 1, 2019, the following dental procedure codes were added for the NC Medicaid and Health Choice Dental Programs. These additions are a result of the Current Dental Terminology (CDT) 2019 American Dental Association (ADA) code updates. Clinical Coverage Policy 4A, Dental Services will be updated to reflect these changes.
Reminder about Drugs Administered by Injection or Infusion
This is a reminder that not all drugs administered by injection or infusion are covered in the Physicians Drug Program (PDP) as a part of the medical benefit. Some of these drugs are only covered in the outpatient pharmacy benefit when requested by prior authorization (PA) and dispensed by a retail or specialty pharmacy.
Credentialing Updates from the NC Medical Board
NCTracks receives files from the North Carolina Medical Board the first week of every month. Providers do not need to update their license renewals in NCTracks. The expiration date will be updated by NCTracks automatically as long as the license number on the provider's record is correct and matches the license number issued by the Board.
NCTracks Common Questions: Currently Enrolled Provider vs. Office Administrator Change Process
There has been some confusion over the difference between the currently enrolled provider (CEP) registration and the office administrator (OA) change process. To understand which you may need to use, please see the explanations below.
Sterilization Consent Form
The sterilization consent form found on the U.S. Department of Health & Human Services (HHS) website has been updated.
Updates to the NC Medicaid Electronic Health Record (EHR) Incentive Program
There are only three months left to submit an attestation for Program Year 2018. Providers have until Apr. 30, 2019 to submit a complete and accurate attestation for Program Year 2018.
Clinical Coverage Policies
The following new or amended clinical coverage policies are available on NC Medicaid’s website. These policies supersede previously published policies and procedures.
NCTracks Provider Training Available in February 2019
Registration is open for the February 2019 instructor-led provider training courses listed below. Slots are limited. WebEx courses can be attended remotely from any location with a telephone, computer and internet connection. Please note that the WebEx information has changed.
Policy Clarification for Out-of-state Providers
Out-of-state providers, including border-area providers, must be enrolled in Medicare or their home-state Medicaid program to enroll in NC Medicaid and Health Choice programs.
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