Medicaid Bulletin

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

SPECIAL BULLETIN COVID-19 #177: Casirivimab and Imdevimab Approved for Emergency Use

Casirivimab and Imdevimab have been given emergency use authorization for treatment of mild to moderate COVID-19 in some patients.

Single State Audit SFY2021

OSA has begun the Single Audit for state fiscal year 2021

Medicaid Claims Documentation: 2020 Single State Audit

Tips for providers to reduce the likelihood of future documentation errors

Influenza Vaccine and Reimbursement Guidelines for 2021-2022 for NC Medicaid and NC Health Choice

Billing codes for Medicaid beneficiaries

Eyeglasses Prior Approval and Dispensing Fee Claims Submission When a Beneficiary Transitions to NC Medicaid Direct – Aug. 30, 2021

This replaces the bulletin, published on Aug. 4, 2021

Electronic Visit Verification Soft Launch Update for PHPs and LME/MCOs

Providers rendering personal care services subject to EVV through the prepaid health plan payer type have until Oct. 1, 2021 to complete EVV credentialing and begin processing EVV claims.

Rebate Eligible Prescription Drug Coverage by Prepaid Health Plans

PHPs are required to provide drug coverage to Medicaid beneficiaries consistent with the drug coverage determined by NC Medicaid under fee for service.

In-Network Provisions Extended Through September

To support providers during the recent COVID-19 surge, the policy for in-network provider provisions has been extended

Claims Denied – Taxonomy Codes Missing, Incorrect, or Inactive

Taxonomy codes must be included when submitting claims to prepaid health plans

Tailored Care Management: Conflict-Free Care Management Guidance

Ensure compliance with the HCBS final rule and prepare Tailored Plans and Providers for the launch of Tailored Care Management.