Medicaid Bulletin

Beginning April 1, 2021, NC Medicaid will begin strictly applying its timeline business rules for the receiving, processing and closing out referral requests.

The five-year cost of dispensing (COD) survey has been completed for NC pharmacies.

The U.S. Food and Drug Administration has issued an Emergency Use Authorization for the unapproved products, bamlanivimab and etesevimab to be administered together for qualifying patients. 

Janssen COVID-19 vaccine is authorized for use under an Emergency Use Authorization (EUA) for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 18 years of age and older.

NCDHHS announced today the launch of statewide open enrollment for NC Medicaid Managed Care. Beneficiaries can enroll through May 14, 2021 in preparation for NC Medicaid Managed Care launch on July 1, 2021. 

The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website. 

The Advanced Medical Home Glidepath Attestation functionality is now live in NCTracks. 

NC Medicaid has updated its Appendix K to extend flexibilities on how Medicaid providers and beneficiaries access and receive home- and community-based services through CAP/C, CAP/DA, NC Innovations waiver and Traumatic Brain Injury waiver. 

To ensure that NC Medicaid meets implementation timelines and can fully integrate EVV through claims adjudication for all providers, alternate EVV Solutions must pass testing validation by March 10, 2021. If the solution has not passed testing by March 10, 2021, provider agencies currently enrolled with their solution may be required to enroll with the State’s EVV solution, Sandata, to ensure they are compliant with EVV requirements.

Providers have until April 30, 2021, to submit a complete and accurate attestation for Program Year 2020. After that no changes can be made.