To ensure nearly 150,000 people seamlessly receive care on day one, the North Carolina Department of Health and Human Services will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans. The launch was scheduled for April 1 and is now targeted for Oct. 1, 2023.

The Centers for Medicare and Medicaid Services (CMS) requires that all Medicaid providers are recredentialed, a process also referred to as reverification. Since March 2020, CMS has allowed for the suspension of reverification due to the Public Health Emergency (PHE) brought on by COVID-19.

This webinar series is designed to support all Medicaid providers, practice managers, quality improvement professionals, care coordinators and other leaders within your practice to help with the preparation for the launch of Tailored Plan in April of 2023. 

From NCTracks: The federal fee for Medicaid enrollment has increased from $630 to $688 for 2023.

From NCTracks News and Updates: In accordance with the Pharmacy Clinical Policy, Physician Administered Drug Program (PADP), NC Medicaid will implement changes to the reimbursement methodology for 340B Long-Acting Reversible Contraception (LARC) on March 12, 2023.

Currently, NCTracks compares the managing employees (ME) listed on an organization's initial enrollment application against the managing employees listed in the Medicare Provider Enrollment, Chain and Ownership System (PECOS). If managing employees listed on the application does not match those listed in PECOS, the application is denied.

On April 1, 2023, beneficiaries currently receiving NC Health Choice coverage will move to NC Medicaid.

Your patients who are eligible for Tailored Care Management will receive a letter between now and November 17th.

Effective Nov. 3, 2022, all fee schedules currently listed on the NC Medicaid website will be moved to a new fee schedule and covered code website available to the public. The new website offers enhanced search options for fee schedules, covered procedure codes and covered revenue code data.

To ensure beneficiaries can seamlessly receive care on day one, the North Carolina Department of Health and Human Services (NCDHHS) will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/ Developmental Disabilities Tailored Plans (Tailored Plans) until April 1, 2023.