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The Pulse

The Pulse
  • Medicaid Managed Care Tools and Resources

    The Department of Health and Human Services has created some tools and resources to transition Medicaid providers, and to help patients who are moving to Medicaid Managed Care: New Provider Playbook. DHHS has launched an online “Provider Playbook” to ensure you have at your fingertips the latest information on managed care, including communications and materials […]

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  • Medicaid Reimbursement Increase

    On January 1, the NC Department of Health and Human Services announced that the state plans to amend Medicaid to raise the rates for Evaluation and Management procedure codes for ACA defined primary care practitioners including PAs. The public notice can be found here.

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  • NC Department of Health and Human Services | Hurricane Florence Resources

    Elizabeth Cuervo Tilson, MD, MPH, State Health Director, Chief Medical Officer, Office of the Secretary, from the NC Dept. of Health and Human Services has reached out to many organizations with valuable information regarding Hurricane Florence that may be helpful to individuals throughout the state:   Food and Nutrition Program – We have been granted […]

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  • Medicaid Transformation Update

    On August 9, as directed by legislation in 2015 to convert the state’s Medicaid program from fee-for-service to managed care, NC DHHS released the request for proposal for organizations wishing to participate in the state’s Medicaid program as “Prepaid Health Plans (PHPs).” The PHPs chosen through the RFP process will be responsible for delivering services […]

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  • Bill Modifying the Medicaid Transformation Legislation Passes NCGA

    On Friday, the House and Senate voted on the compromise version of HB 156: Medicaid PHP Licensure & Transformation Modifications, which had been in a conference committee since the end of the 2017 session. The bill is now on the Governor’s desk for final approval.   The changes included in this legislation build off of the […]

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  • NCAPA Responds to the DMA’s Request for Input

    by Sarah Wolfe, Assistant Vice-President, McGuire Woods Consulting  Last month, the North Carolina Department of Health and Human Services’ Division of Medical Assistance (DMA) reached out to stakeholder groups, requesting input on various clinical coverage policies. State law requires that the Department consult with and seek advice from the NC Physician Advisory Group and other […]

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  • Prior Approval Required for Some Outpatient Opioid Prescriptions

    Important Information for Medicaid and Health Choice Providers: Medicaid announced it will require prior approval for outpatient opioid prescriptions in certain situations. Please click here for details: https://files.nc.gov/ncdhhs/PA_Criteria-Opioid-Analgesics.pdf

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  • DHHS Seeking Public Input on Medicaid Reform

    The North Carolina Department of Health and Human Services is seeking public input from April 25 to May 25, 2017, at 11:59 p.m. on the Medicaid and NC Health Choice programs transformation (also known as “Medicaid reform”). While all comments are welcome, the Department is specifically looking for input on the following topics: Integrating Primary […]

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