Medicaid Bulletin

New Information Required in Applications for Individual Providers Enrolling in Medicaid and NC Health Choice

Monday, June 8, 2020

Effective July 26, 2020, changes will be made to initial enrollment, re-enrollment, re-verification applications and manage change requests (MCRs) for individual providers (excluding disaster relief and Out of State Lite providers). The updates include the addition of a new page, as well as additional exclusion sanction questions. 

SPECIAL BULLETIN COVID-19 #95: HIV Case Management Policy Allowances

Friday, June 5, 2020

NC Medicaid will allow temporary changes to Clinical Coverage Policy 12B for Written Physician Orders, Use of Remote Technology and Signature Requirements. 

Understanding New Remittance Advice Refund Message

Wednesday, June 3, 2020

Beginning June 2020, the Remittance Advice will include a detailed explanation of any refund (Lump Sum / Miscellaneous Payment) issued to the provider. This message will be on the Financial Transactions page.

SPECIAL BULLETIN COVID-19 #94: Second Increase in Therapeutic Leave Days for ICF/IDD Facilities Due to COVID-19

Tuesday, June 2, 2020

NC Medicaid is temporarily increasing the number of therapeutic leave days for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IIDs) from 60 days to 120 days. This is a change from the previous increase to 90 days. NC Medicaid continues to waive the requirement of approval needed for more than 15 consecutive days per Clinical Coverage Policy 8E. 

NC Medicaid Electronic Health Record Incentive Program Announcements

Tuesday, June 2, 2020

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

SPECIAL BULLETIN COVID-19 #93: Targeted Rate Increase, Additional Hours and Associated Reporting Requirements for In-Home Personal Care Services (PCS) Providers under State Plan PCS and CAP/C and CAP/DA Programs

Friday, May 29, 2020

NC Medicaid COVID+ Rate Reporting Technical Assistance Session

Wednesday, June 3, 1:00 p.m.


SPECIAL BULLETIN COVID-19 #92: Coronavirus (COVID-19) EviCore Chest Computed Tomography (CT) Auto-Approval Ending May 31, 2020

Friday, May 29, 2020

Effective Sunday, May 31, 2020, NC Medicaid is terminating the auto approval for lung imaging requested through EviCore, NC Medicaid’s contracted vendor for imaging services. 

SPECIAL BULLETIN COVID-19 #91: Federal Provider Relief Fund: Guidance on How to Access "General Distribution" Funds

Friday, May 29, 2020

Congress created a $175 billion Provider Relief Fund to support providers as they deal with COVID-19. Recently, the federal Department of Health and Human Services (HHS) began distribution of the first $50 billion of this fund—through the so-called “General Distribution” mechanism—for providers who billed Medicare in 2019. To help providers understand how to access funding, NC Medicaid has developed the Federal Provider Relief Fund: Guidance on How to Access “General Distribution” Funds.

Continuous Glucose Monitoring Systems Coverage Transition

Friday, May 29, 2020

Effective July 1, 2020, coverage of therapeutic Continuous Glucose Monitoring products will transition from the Durable Medical Equipment Program to the Outpatient Pharmacy Point of Sale Program. 

SPECIAL BULLETIN COVID-19 #90: Telehealth and Virtual Patient Communications Clinical Policy Modifications - Smoking and Tobacco Cessation Counseling

Wednesday, May 20, 2020

NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid and Health Choice beneficiaries. 

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