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Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Bulletins published prior to January 2019

Articles since January 2018 are available in the blog format below.

Antihemophilic Factor (recombinant) PEGylated-aucl, for Intravenous use (Jivi®) HCPCS Code J7199: Billing Guidelines

Friday, October 5, 2018

Effective with date of service Sept. 5, 2018, the Medicaid and NC Health Choice programs cover antihemophilic factor (recombinant) PEGylated-aucl, for intravenous use (Jivi) for use in the Physician's Drug Program (PDP) when billed with HCPCS code J7199-Hemophilia clotting factor, not otherwise classified.

Reminder: Changes to the Recredentialing Process

Friday, October 5, 2018

In April 2018, the recredentialing notification and suspension process was modified. The previous rule to extend the recredentialing due date if a Manage Change Request Application is "In Review" has been removed.

Proposed Clinical Coverage Policies for Public Comment

Friday, October 5, 2018

Proposed new or amended Medicaid and NC Health Choice clinical coverage policies are posted for comment throughout the month. Visit the Proposed Medicaid and NC Health Choice Policies for current posted policies and instructions to submit a comment.

Updates to Clinical Coverage Policy 10A: Outpatient Specialized Therapies

Friday, October 5, 2018

Effective Sept. 15, 2018, Clinical Coverage Policy 10A, Outpatient Specialized Therapies, was updated to increase therapy visit limits for recipients 21 years of age and older.

Patisiran Lipid Complex Injection, for Intravenous Use (Onpattro™) HCPCS Code J3490: Billing Guidelines

Friday, October 5, 2018

Effective with date of service Sept. 5, 2018, the Medicaid and NC Health Choice programs cover patisiran lipid complex injection, for intravenous use (Onpattro) for use in the Physicians Drug Program (PDP) when billed with HCPCS code J3490 - Unclassified drugs.

Update Provider Enrollment Information

Friday, October 5, 2018

Pursuant to Section 6.a. of the NCDHHS Provider Administrative Participation Agreement, providers are required to update their enrollment records in NCTracks within 30 days of a change.

SPECIAL BULLETIN: NC Medicaid Flexibilities due to Hurricane Florence Extended through Oct. 5, 2018

Thursday, September 27, 2018

NC Medicaid and Health Choice will reimburse providers for medically necessary drugs and services and equipment and supplies provided during the Hurricane Florence emergency without prior approval from Sept. 14 through Oct. 5, 2018.

SPECIAL BULLETIN: Many Residents of 27 NC Counties Can Soon Apply for Help Buying Food After Hurricane Florence

Wednesday, September 26, 2018

Residents in 27 counties impacted by Hurricane Florence can apply for help buying food through the Disaster Supplemental Nutrition Assistance Program, or "D-SNAP."

SPECIAL BULLETIN: NC Medicaid Flexibilities due to Hurricane Florence Extended through Sept. 28, 2018

Friday, September 21, 2018

NC Medicaid Flexibilities due to Hurricane Florence Extended through Sept. 28, 2018

SPECIAL BULLETIN: Medicaid Enrollment Requirements for Providers Rendering Services in NC to SC Medicaid Beneficiaries

Monday, September 17, 2018

Per the Sept. 12, 2018, South Carolina Department of Health and Human Services (SCDHHS) Medicaid Bulletin, SCDHHS will, in good faith, reimburse North Carolina qualified providers not currently enrolled with or otherwise pre-approved by the South Carolina Medicaid program for medically necessary and time-sensitive services rendered to South Carolina Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries.

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