Medicaid Bulletin

SPECIAL BULLETIN COVID-19 #20: Telehealth Provisions for Enhanced Behavioral Health Services

Friday, March 27, 2020

Effective March 30, 2020 through the conclusion of the declared North Carolina State of Emergency related to COVID-19, the Division of Health Benefits and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services is temporarily modifying the following Enhanced Behavioral Health policies to better enable the delivery of remote care to Medicaid and State funded beneficiaries.

SPECIAL BULLETIN COVID-19 #19: Update to Telehealth Provisions: Clinical Policy Modifications

Friday, March 27, 2020

Effective March 30, 2020 through the conclusion of the declared North Carolina State of Emergency related to COVID-19, the Division of Health Benefits and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services is temporarily modifying the Telemedicine and Telepsychiatry Clinical Coverage Policies to better enable the delivery of remote care to Medicaid and State funded beneficiaries.

SPECIAL BULLETIN COVID-19 #18: Guidelines for Non-Emergency Medical Transportation

Thursday, March 26, 2020

This Bulletin provides information to local Departments of Social Services (DSS) and NEMT providers on NC Medicaid’s requirements for NEMT services, the recommended safety procedures and protocols to help reduce the spread of COVID-19 and guidance. 

SPECIAL BULLETIN COVID-19 #17: Prior Approval for Hydroxychloroquine and Chloroquine Products

Thursday, March 26, 2020

Effective March 27, 2020, North Carolina Medicaid is requiring prior approval for hydroxychloroquine and chloroquine containing products. Prior approval is required to ensure beneficiaries continue to have access to these medications for maintenance of their autoimmune conditions, for treatment of malaria, and for treatment of extraintestinal amebiasis.  

SPECIAL BULLETIN COVID-19 #16: Re-verification Due Dates Extended for NC Medicaid Providers

Thursday, March 26, 2020

To offset potential hardships due to COVID-19, for NC Medicaid and Health Choice providers who were due to re-verify their enrollment between the dates of March 1, 2020 and June 30, 2020, NCTracks has reset your re-verification due date to Sept. 13, 2020. 

SPECIAL BULLETIN COVID-19 #15: Medicaid and NC Health Choice Temporary Flexibilities - 1135 Waiver Provisions

Tuesday, March 24, 2020

The Centers for Medicare & Medicaid Services (CMS) has granted NC Medicaid the authority to temporarily modify several Medicaid and NC Health Choice policies retroactive to March 1, 2020, and through the end of federal emergency declaration or when the flexibility is ended by the State or CMS

SPECIAL BULLETIN COVID-19 #14: Diagnosis Code Being Added to Exemption List for the Annual Office Visit Limit

Tuesday, March 24, 2020

In response to the anticipated spread of the novel coronavirus (COVID-19) in North Carolina, NC Medicaid is adding the following diagnosis code to the list of diagnoses exempt from the annual visit limit:

SPECIAL BULLETIN COVID-19 #13: EviCore Chest Computed Tomography (CT) Auto-Approval

Tuesday, March 24, 2020

In response to the anticipated spread of the novel coronavirus (COVID-19) in North Carolina, EviCore, NC Medicaid’s contracted vendor for imaging services, will auto-approve the following chest CT codes effective immediately:

SPECIAL BULLETIN COVID-19 #12: Suspension of Pharmacy POS Adult and Pediatric Behavioral Health Clinical Edits

Tuesday, March 24, 2020

The Outpatient Pharmacy point of sale (POS) adult and pediatric clinical edits for behavioral health medications will temporarily suspend effective March 23, 2020. These point of sale edits target dosages exceeding the FDA approved maximum limit and in class therapeutic duplication.  

SPECIAL BULLETIN COVID-19 #11: Outpatient Specialized Therapies Temporary Flexibilities

Tuesday, March 24, 2020

Effective March 23, 2020, if medically necessary, outpatient Respiratory Therapy (RT) services provided through the Independent Practitioner Provider (IPP) program that typically require prior authorization (PA), may be provided to NC Medicaid and NC Health Choice beneficiaries without PA.

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