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:

• Initial enrollment;
• Re-enrollment;
• Adding a new owner or a new site location; and
• Re-verification.

In accordance with the North Carolina Identity Management (NCID) Citizen Identity Project, NCTracks is changing the User Login process and implementing Multi-Factor Authentication (MFA) updates. Please complete the following steps to update your NCID profile by Sept. 6, 2024, in advance of the MFA updates:

The federal COVID-19 Public Health Emergency (PHE) ended on May 11, 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.

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.

• From the NC Medicaid 2021 Provider Playbook, you will find Updated FAQs on Medicaid Managed Care Claims and Prior Authorizations. Some examples of FAQ topics include: how to file a claim with each of the PHPs, what information is needed from the provider to file the claim,  portal messaging and how to submit prior authorizations to a health plan and many other topics.  There are helpful links and the PHP Claims Schedule through October 2021.
  

Prepaid Health Plan Information Added to NCTracks Automated Voice Response System 

As part of recent NC Medicaid Managed Care updates, NCTracks accepts beneficiary enrollment and eligibility inquiries through the Automated Voice Response System (AVRS) which can be reached at 800-723-4330. The AVRS response includes the Prepaid Health Plan (PHP) name, contact information and the PHP assigned Primary Care Provider (PCP)/Advanced Medical Home (AMH). The response also includes a reminder that all care must be coordinated through the PHP. 

NCDHHS recently released a fact sheet on Panel Management.  We pulled some highlights from the fact sheet for you on the blog today. 

As a reminder, once an AMH Tier 3 practice has attested to meeting Glidepath payment eligibility in NCTracks, DHHS will validate that the practice is enrolled with NC Medicaid and attested as an AMH Tier 3 practice. DHHS then confirms the attestation with the respective pre-paid health plans in order to validate that each Tier 3 practice has met contracting and testing criteria.   

Providers with Denials for Healthy Opportunities Screening, Assessment and Referrals Claims due to Edit 02088 May Now Resubmit Claims