Archive | NC Medicaid

NC DHHS announced earlier this week that the first round of updates to Medicaid’s Enrollment Broker Provider Directory are now in place. The directory’s search function now returns only primary care providers and helps searchers more easily locate primary care physicians by their location, business, or organization name as listed in NCTracks. Additional improvements are […]

Primary care physicians serving Medicaid with E&M codes ranging from 99201 to 99499 as defined by the Affordable Care Act (ACA) are now being paid at an increased rate. CMS approved the rate increase effective Jan. 1st, 2019, thanks to the advocacy efforts of the NCAFP and the NC Pediatric Society. NC DHHS is re-processing […]

DHHS announced earlier this week that it will delay the go-live date of Medicaid managed care to February 1st, 2020, due to the state budget situation which is preventing the Department from completing critical startup functions. The newly adjusted timeline only affects counties in Phase 1 that were previously scheduled to begin November 1st. Medicaid […]

Academy Past President Shannon Dowler, MD (’13) has been named the new incoming Chief Medical Officer for the North Carolina Division of Health Benefits/North Carolina Medicaid. Dr. Dowler has a long history of service in leadership roles in North Carolina. Professionally, she most recently served as the Chief of Community Medicine and Ambulatory Population Health […]

North Carolina Medicaid has issued a series of questions and answers regarding concerns about the provider directory being used by the enrollment broker for Medicaid Managed Care. The Department has developed a document to answer several of these concerns that can be downloaded here.

It’s full steam ahead with Medicaid Managed Care! NC DHHS has announced that its Medicaid Managed Care call center (833-870-5500) and its official enrollment website both went live on June 28th. Medicaid beneficiaries are already using both to learn more about managed care and enroll in a health plan. The program is currently on track […]

A new policy paper released by NC DHHS describes how clinically-integrated networks (CINs) can help Advanced Medical Homes (AMHs) meet the care coordination and management requirements as listed in the Preferred Health Plans RFP and the AMH Provider Manual. The paper describes methods for increasing administrative efficiencies in these activities, while elaborating on the roles […]

NC Medicaid will launch a webinar series to support providers and practices during their transition to NC Medicaid Managed Care. “General” webinars are overviews of significant changes and features of the managed care program. “Topical” webinars are in-depth reviews of specific managed care topics. The first webinar in this series, Provider Transition to NC Medicaid […]

NC DHHS is moving forward with paying primary care at 2018 Medicare rates for Medicaid. As soon as the official State Plan Amendment is approved by CMS (expected to be later this spring or early summer), all payments will be retroactive to January 1st. For over a year, the NCAFP advocacy team, along with its […]