Starting October 1, 2024, the Centers for Medicare and Medicaid Services incorrectly returned certain Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) claims with reason code W7072:
RHCs and FQHCs should resubmit these claims that were returned in error.
Your patients might be eligible! Two NCDHHS options to help them keep warm this winter!
NCDHHS' Low Income Energy Assistance Program (LIEAP) is a federally-funded program that provides for a one-time vendor payment to help eligible households pay their heating bills.
While households including a person aged 60 or older, or disabled persons receiving services through the NC Division of Aging and Adult Services were eligible to sign up in the month of December, all other households may apply now through March 31, 2025 or until funds are exhausted.
Households that meet the following criteria may be eligible:
More details about eligibility criteria
Southern Regional AHEC hosts the NC AHEC Practice Management Academy.
There are courses available to you on a variety of topics!
Topics for 2025 include:
Leadership, Operations Management and Quality Improvement.
Learn more and register:
The Rural Communities Opioid Response Program (RCORP)---Overdose Response is a one-year program supporting improved health care in rural areas by addressing their immediate and short-term needs related to the provision of substance use disorder services. RCORP--Overdose Response aims to reduce and prevent the risk of overdoses in rural areas. HRSA (Health Resources and Services Administration) will make approximately 20 rewards of up to $300,000 each.
The RCORP--Overdose Response Program will support specific, short-term substance use disorder prevention, treatment, and recovery activities, as well as work related to capacity building, supportive services, and special populations. Allowable activities are defined in the notice of funding opportunity.
Eligible organizations include all domestic public or private, non-profit, or for-profit entities.
Source: HRSA.gov Federal Office of Rural Health Policy
Photo generated using AI
Everyone deserves a path to recovery from substance use disorders, and treatment can be the first step. You can make a difference in the lives of your patients.
This could be the year you make a new difference in the lives of your patients! Whether your patient is taking a Dry January break from alcohol or working through recovery from substance use disorder long-term, every step forward counts!
Find resources to help better treat and support them: samhsa.gov/medications-substance-use-disorders/provider-support
The NC Office of Rural Health has released Wave 2 of the Telehealth Infrastructure Grants funding opportunity! Applicants have until January 31, 2025 to apply.
Grants resulting from this Request for Applications (RFA) will enhance the accessibility and effectiveness of telehealth services throughout the state. This RFA aims to support the development and improvement of the technological infrastructure required for delivering remote healthcare services, such as broadband connectivity, video conferencing systems, electronic medical records, and secure communication tools with a priority on independent primary care practices and Ob-GYN practices.
If your organization participates in the Aetna State Plan, we advise you to confirm your participation ahead of the January 1, 2025 launch date!
Effective January 1, 2025, Aetna will replace Blue Cross Blue Shield NC for the NC State Health Plan coverage.
Which plans are included?
This change does NOT impact members enrolled in the Humana Medicare Advantage plans.
The current pharmacy benefit manager (CVS Caremark®) will not change.
Humana Military's claim processor will switch from Wisconsin Physicians Service (WPS) to PGBA LLC, effective January 1, 2025.
Key Changes:
EDI Claims:
Claims and Document Submissions:
Clearinghouse Requirements:
Claims with 2024 Dates of Service (DOS)
ERA/EFT Enrollment:
Source: Tricare EFT Changes Coming in 2025
A Year of Innovation and Progress
As 2024 comes to a close, we at Northwest Area Health Education Center (AHEC) reflect on an extraordinary year of adaptation and advancement. From addressing workforce challenges to promoting value-based care, the contributions from our partners in the Practice Support Community have driven remarkable progress. Together, we’ve expanded telehealth capabilities, targeted health disparities, integrated mental health services in primary care, and explored the potential of artificial intelligence in patient care. The commitment from the Health Care Professionals in the Practices we Support has been pivotal in improving healthcare delivery across our community.
Key Achievements
This year, our Practice Support team engaged with healthcare practices in 29 counties, completing 2,481 coaching encounters across 27 topics. From guiding Medicaid Expansion to addressing disaster recovery and optimizing electronic health records (EHR), our coaches worked tirelessly to meet your diverse needs. Highlights include support for advanced medical home (AMH) tiers, billing and coding assistance, and quality improvement projects for diabetes management and pediatric immunizations. The team assisted on key behavioral health initiatives including 99 Tailored Care Management coaching encounters and 115 encounters regarding Collaborative Care Model implementation which integrates behavioral health into primary care.
Figure 1: Encounter Topics 2024
Figure 2 Encounters Per County 2024
Expanding Resources and Outreach
Northwest AHEC has broadened its reach through various digital initiatives. Our Practice Support Blog featured 95 posts with over 5,500 views, while our online courses—covering topics such as diabetes care and behavioral health integration—garnered strong participation. Additionally, our 13 curated Library Resource Guides offered accessible, actionable knowledge for healthcare professionals across disciplines.
Looking Ahead to 2025
In 2025, Northwest AHEC will continue focusing on innovative strategies such as leveraging AI for improved clinical decisions, enhancing cybersecurity to protect patient data, and prioritizing sustainable healthcare practices. Our vision remains rooted in equipping practices to navigate the evolving healthcare landscape while maintaining a steadfast commitment to quality and equity in care.
Partnering for a Healthier Future
Your dedication and collaboration fuel our shared success. Our quality improvement services remain available at no cost to eligible practices, ensuring access to tailored support for clinical and operational advancements. Together, let’s continue to enhance healthcare delivery and improve the health of our communities. To connect with a practice support coach, submit an application here or email practicesupport@ncahec.net for more information.
Thank you for being an essential part of the Northwest AHEC community. Let’s make 2025 another year of impactful progress!
Today we bring you News and Updates from NCTracks:
Federal Provider Enrollment Application Fee Increase for Year 2025
A Message from NCTracks on Behalf of NC Medicaid
The federal fee for Medicaid enrollment has increased to $730 for calendar year 2025.
The Centers for Medicare & Medicaid Services (CMS) Federal Register 89 FR 95215 (see Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2025) finalized provisions related to the imposition of application fees as part of the Medicaid provider enrollment process for institutional providers and suppliers. The fee will vary from year to year pursuant to the consumer price index for all urban consumers (CPI-U).
The federal fee for Medicaid enrollment will increase from $709 to $730 for calendar year 2025, and effective Jan 1, 2025, will be required as noted on the Provider Permission Matrix for:
