On July 15, 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) finalized modifications to the Confidentiality of Substance Use Disorder Patient Records regulations, 42 CFR Part 2 (“Part 2”). Modifications to Part 2 will be effective Aug. 14, 2020.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
NC-MIPS is Open for Program Year 2020, Program Year 2020 Webinar Series and The Security Risk Analysis (SRA)
Effective with the date of service July 1, 2020, the Centers for Medicare and Medicaid Services (CMS) has added new HCPCS codes (J codes), deleted others, and changed the description of some existing codes.
NC Department of Health and Human Services has announced two Requests for Applications (RFAs) to help communities heavily affected by COVID-19.
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website.
Webinar for Medicaid Providers to be held July 27 at 3 p.m and Application Deadline Extended to Aug. 3.
On May 15, 2020, the Centers for Medicare & Medicaid Services (CMS) updated the Minimum Data Set (MDS) 3.0 item sets (version 1.17.2) to support the calculation of Patient-Driven Payment Model (PDPM) case mix groups on all Omnibus Budget Reconciliation Act (OBRA) assessments.
NC Medicaid is implementing time-limited, targeted, enhanced swing bed reimbursement rates to provide additional financial support to hospitals that provide post-acute care services to COVID-19 positive (“COVID+”) Medicaid beneficiaries and non-COVID+ Medicaid beneficiaries transferred from other acute care hospitals as part of a surge response.
Effective with date of service May 6, 2020, the Medicaid and NC Health Choice programs cover daratumumab and hyaluronidase-fihj injection, for subcutaneous use (Darzalex Faspro™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
Effective July 1, 2020, coverage of therapeutic Continuous Glucose Monitoring (CGM) products is transitioning from the Durable Medical Equipment (DME) Program to the Outpatient Pharmacy Point of Sale (POS) Program.