Issued: June 5, 2018
Reminder: Perception of Care Surveys Due
Please be reminded that today, June 5th, is the last day of the Perception of Care survey process.
All completed surveys should be dropped off as soon as possible to the Partners’ Gastonia office at 901 S. New Hope Road addressed to the attention of April Corder, or you may contact your account specialist and request a pick-up of your completed surveys.
Thank you for your assistance in the Perception of Care Survey process.
June 2018 NC Medicaid Bulletin—Behavioral Health Providers Needing Reverification
The following information is republished from the June 2018 Medicaid Bulletin. To view the bulletin in its entirety, please visit https://dma.ncdhhs.gov/documents/2018-medicaid-bulletin-and-index.
Effective July 1, 2018, North Carolina Medicaid and NC Health Choice (NCHC) behavioral health providers who were added to NCTracks via the Local Management Entity/Managed Care Organization (LME/MCO) Provider Upload process must complete reverification. Medicaid identified 474 behavioral health providers as needing to complete reverification. Providers identified are being notified of their reverification due date via NC Tracks communication to the Office Administrator (OA) on record.
Providers who do not respond by the July 1, 2018 reverification due date will be subject to claims payment suspension. Providers must submit either a reverification application or a full Managed Change Request (MCR) to NCTracks for a claims payment suspension to be removed.
NOTE: A list of providers scheduled for reverification is available on
Medicaid’s provider enrollment web page under the “Re-credentialing” header.
Pursuant to 42 CFR 438.608 (b), Provider screening and enrollment requirements, the state, through its contracts with a Managed Care Organization (MCO), Prepaid Inpatient Health Plan (PIHP), Prepaid Ambulatory Health Plan (PAHP), Primary Care Case Management (PCCM), or PCCM entity must ensure that all network providers are enrolled with the State as Medicaid providers, consistent with the disclosure, screening and enrollment requirements of 42 CFR 455, subparts B and subpart E.
Reverification of Behavioral Health providers in NCTracks will generate the following requirements:
- A state-mandated application fee of $100. Additionally, the Federal Application fee of $569 may be charged to moderate or high-risk provider as defined in N.C. General Statute 108C-3, and the Provider Permission Matrix.
- Medicaid providers in moderate-and high -risk categories as defined by N.C. General Statute 108C-3 are subject to site visits and required by 42 CFR 455 Subpart B. The site visits will be conducted by Public Consulting Group (PCG).
- Fingerprint-based background checks for all high-categorical risk providers and any person with a 5 percent or more direct or indirect ownership interest in the provider as a condition of enrollment in the NC Medicaid Program, Federal Regulation 42 CFR 455.434 and 42 CFR 455.450 (c).
For more information on the Fingerprint process, refer to the articles titled, Fingerprinting Process for Providers or Submit Fingerprinting Criminal Background Check and Related Information by Deadline to Prevent Termination in this Medicaid Bulletin, or the Frequently Asked Questions (FAQs) posted on NCTracks.
DHHS Issues “Supporting Provider Transition to Medicaid Managed Care,” to Host Webcast
The NC Department of Health and Human Services (DHHS) has issued a policy paper, Supporting Provider Transition to Medicaid Managed Care and will host webcasts to discuss the paper and topics related to providers. Comments will be accepted through June 11, 2018 and should be emailed to Medicaid.Transformation@dhhs.nc.gov.
To read the policy paper or to register to attend one of the three webcasts, please visit https://www.ncdhhs.gov/medicaid-transformation.
In addition, NC DHHS is accepting comments on the policy paper, Prepaid Health Plans in NC Medicaid Managed Care through June 11, 2018. Comments should be emailed to Medicaid.Transformation@dhhs.nc.gov.
Reminders
June Provider Webinar: There is still time to register for our June Provider Webinar!
Date and Time: Wednesday, June 13, 2018 at 1 p.m.
Meeting will be held via Webinar. Registration is required
To register, visit https://register.gotowebinar.com/register/3508865250810933761
If you have questions about the Provider Webinar, please contact Roanna Newton at 828-323-8054 or email rnewton@partnersbhm.org.
2018 Community Needs Assessment: Our Community Needs Assessment Survey gives you the opportunity to tell us what services are needed and share where other services might be improved. If you haven’t completed this survey, you have until Friday, June 15 to share your thoughts and observations.
We also ask that you encourage your consumer and family members to participate in the survey as well. You are welcome to email the consumer/family member link to consumers, refer them to www.partnersbhm.org, or print off copies that can be faxed to Roanna Newton at 828-325-8178.
Thank you for helping us improve healthcare services in western North Carolina!