It’s hard to believe the Medicaid Managed Care launch is upon us.  The past year and a half we have experienced many challenges to be sure. You can rest assured your Northwest AHEC Practice Support team is here to help you navigate these changes.  Below are some new resources NCDHHS has provided to help you and your practice as they launch Medicaid Managed Care. 

With Medicaid Transformation comes the introduction of new points of contact for beneficiaries, such as the Enrollment Broker and health plans. A long-term goal of NC Medicaid is to provide a single point of contact – one number – for beneficiaries to call for assistance. For now, please try to direct beneficiaries to the appropriate contact using the information provided in this guide. The attached tables provide the various points of contact, key responsibilities, and phone numbers and/or websites beneficiaries can use.  

All Carolina Access Providers who received health equity payments are asked to take 5-10 minutes to complete this survey by July 16, 2021. The survey allows DHHS to monitor and evaluate how these payments were used. 

Welcome to the Best Practices in Opioids Prescribing and Management Webinars

We invite you to learn more about the lectures available for viewing and select what interests you, choose any or all 10. These pre-recorded lectures are all online via your computer or mobile device at your own pace.

The “mandatory use” provision of the NC STOP Act becomes effective July 7, 2021. Under this provision, prescribers and dispensers of a controlled substance MUST perform a search of a patient's prescription history in PMP AWARE (North Carolina’s Controlled Substances Reporting System) before a controlled substance can be prescribed or dispensed. This system is intended to be used as a clinical tool to improve patient care and safety while avoiding potential drug interactions and identifying individuals that may be in need of referral to substance use disorder services. In addition, prescribers can audit their personal controlled substances prescribing history.

In the April 2021 Medicare Secondary Payer MLN Booklet, CMS clarified the policy on accepting payments for services when another insurance is primary to Medicare. 

To learn more about Medicare Secondary Payer(MSP) billing and claims review the Medicare Secondary Payer MLN Booklet.  Common MSP coverage situations are listed in Table 1 (pp 5-8).

In 2019, The Northwest AHEC re-prioritized our health education objectives to include non-medical drivers of health. These non-medical key drivers of an individual’s health (e.g. employment status, where we live, the air we breathe, our access to food and safe places nearby to exercise) have gained an elevated status in improving public health. This is noted in the Office of Disease Prevention and Health Promotion’s seminal work on preventing premature injury, the Healthy People 2030 Framework. Healthy People 2030 in its foundational principles includes: healthy physical, social, and economic environments to strengthen the potential to achieve health and well-being.

NC-PAL is a free telephone consultation program to help health care providers address the behavioral health needs of their patients.

The Medicaid Managed Care webinars on the 1st and 3rd Thursday of the month are dedicated to bringing you late breaking information and guidance on NC Medicaid’s transition to Managed Care. Topics will vary, but each session will include an open question and answer period.  

On May 27, 2021, Governor Roy Cooper signed into law House Bill 395 (now NCSL 2021-26) allowing additional time for providers to connect to the state-designated health information exchange NC HealthConnex.  The bill extends the deadline for connecting from October 1, 2021 to January 1, 2023.