EDS loses bid to continue servicing NC Medicaid

Computer Sciences Corp has outbid Electronic Data Systems (EDS) to become North Carolina’s new Medicaid processor. CSC has only one other Medicaid customer, the state of New York. See the rest of the article here.

Additional Check Write Added

The Division of Medical Assistance will provide an additional check write in December to assist providers with cash flow. This will result in changes in our published check write dates.
The new cut off and check write dates are as follows:

Electronic Cut-Off Date: 12/18/08 (Thur.) Check write: 12/23/08 (Tues.)
Electronic Cut-Off Date: 12/23/08 (Tues.) Check write: 12/30/08 (Tues.)

Reminder: Checkwrite cutoff on Wednesday not Thursday

Due to Thanksgiving falling on Thursday, cutoff will be on a Wednesday (11/26/2008) so please be prepared and adjust your schedules accordingly.

A Quick Thank you

A quick thank you to all of those that we met and talked to at AHHC's Wilmington show. It was a pleasure to talk to all and hope to see you again in Durham.

New 2009 NC Medicaid Check Write Schedule

2009 Checkwrite Schedule

Please refer to the following table for the 2009 Checkwrite Schedule.

Month	Electronic Cut-Off Date	Checkwrite Date
January	1/8/09	1/13/09
	1/15/09	1/21/09
	1/22/09	1/29/09
	1/29/09	2/3/09
February	2/5/09	2/10/09
	2/12/09	2/18/09
	2/19/09	2/26/09
	2/26/09	3/3/09
March	3/5/09	3/10/09
	3/12/09	3/17/09
	3/19/09	3/26/09
April	4/2/09	4/7/09
	4/9/09	4/14/09
	4/16/09	4/23/09
	4/30/09	5/5/09
May	5/7/09	5/12/09
	5/14/09	5/19/09
	5/21/09	5/28/09
June	6/4/09	6/9/09
	6/11/09	6/16/09
	6/18/09	6/25/09
July	7/2/09	7/7/09
	7/9/09	7/14/09
	7/16/09	7/23/09
	7/30/09	8/4/09
August	8/6/09	8/11/09
	8/13/09	8/18/09
	8/20/09	8/27/09
September	9/3/09	9/9/09
	9/10/09	9/15/09
	9/17/09	9/24/09
October	10/1/09	10/6/09
	10/8/09	10/14/09
	10/15/09	10/20/09
	10/22/09	10/29/09
	10/29/09	11/3/09
November	11/5/09	11/10/09
	11/12/09	11/19/09
	11/25/09	12/1/09
December	12/3/09	12/8/09
	12/10/09	12/15/09
	12/17/09	12/23/09

Rate Freeze for reimbursed rates

As many of you may now know, DMA has a rate freeze on through June 1 2009. This will impact personal care - community and adult care home and all CAP programs.

New Personal Care Services/PCS-Plus Orientation for Registered Nurses

In October 2008, DMA began holding combined Personal Care Services (PCS)/PCS-Plus training sessions in their office in Raleigh. The purpose of the sessions is to provide a policy orientation for registered nurses (RNs) who are new to the PCS program and who conduct PCS and/or PCS-Plus assessments of Medicaid recipients. The training for novice PCS nurses includes a review of the policy guidelines for both the PCS and PCS-Plus programs. Attendees learn the proper way to conduct and document a PCS assessment and re-assessment and the Activities of Daily Living scoring process as well as how to develop a PCS plan of care based on needs using the time and task guidance. Quality assurance/utilization review (QA/UR) issues in PCS and how to develop a corrective action plan before and after a state QA/UR review are also addressed.

Continued...

Contractors versus Employees

Quick Tip:

Employers who classify workers as independent contractors must file Form 1099 reporting compensation paid to those individuals. If a worker is found to be an employee rather than a contractor, the fact that the employer filed a 1099 would reduce the damages to one year of taxes, instead of three.

If the employer has a "colorable argument" that the person was a contractor and filed a 1099, the penalty would be 25 percent of one year's taxes. Otherwise, the penalty is three years' taxes, an amount that can destroy a small business, Tuzynski said.

For more info.

SembraCare and Background Checks

This is a reminder to our customers that use SembraCare for their background checks that we can only process the background checks for those prospective employees who have been in the state longer than 5 years. If your prospective employee has been in the state less than 5 years, a national background check has to be done. Currently, only the SBI can process this background check. To recap see here.

AHHC and Membership

SembraCare encourages all it's clients and other agencies to join AHHC. For more info and the benefits of membership please see this.

MUST Cancelled

The 14 regional training sessions scheduled for May 26, 2008 through July 11, 2008, on the new N.C. Medicaid Uniform Screening Tool (MUST) have been cancelled. DMA has delayed implementation and rollout of the MUST.

Requirements for MPN and NPI

Effective August 1, 2008, all individual providers will be required to maintain only one service-specific MPN to ensure that claims process correctly when billing with National Provider Identifiers. North Carolina DMA will end-date all but one of the provider’s MPNs. Providers who have multiple MPNs will be notified by mail 30 days prior to this action.

Medicaid Billing

All providers are encourage to submit their NPI, Medicaid Provider Number (MPN), and taxonomy on all claims until they receive an NPI Provider Ready letter confirming that their claims are being received correctly.

NPI Questions?

Questions or concerns about NPI? EDS Provider Services has added staff to handle NPI phone calls and research NPI issues. Callers will hear an option for the NPI Help Desk when contacting EDS Provider Services (1-800-688-6696 or 919-851-8888).

NPI Effective Today!

Effective TODAY, all claims must contain a National Provider Identifier (NPI). N.C. Medicaid will no longer accept claims submitted without an NPI on or after May 23, 2008. Unless the provider is atypical, failure to use the NPI by this date will result in a claim denial.

Medicaid Training for PCS providers

The Carolinas Center for Medical Excellence announces continuing provider training for Personal Care Services. The sessions are scheduled for June 2008. Training is recommended for registered nurses, agency administrators, and agency owners who have knowledge of the PCS program and DMA policies. Preregistration is required.

NC Medicaid PCS Cost Reports

Personal Care Services Cost Report training for the 2007 cost reports are scheduled for June 2008. Cost reports are due July 25, 2008. The sessions are intended to provide instructions on the completion of the cost report. Due to the small size of the training site, preregistration is required. The registration form, the 2007 PCS Cost Report schedule, an instruction manual, and other related materials for the training will be available at the DMA’s website (http://www.ncdhhs.gov/dma/costreport.htm) by May 14, 2008.

Professional Claims Billing for Medicaid

Effective July 1, 2008, NC Medicaid will require providers to list the 11-digit National Drug Codes as well as HCPCS codes and units on professional claims. Claims will be reimbursed in the same manner.

Training Sessions

Regional training sessions for the new Uniform Screening Program (USP) and the NC Medicaid Uniform Screening Tool (MUST) application have been scheduled. These sessions will help educate providers on changes to procedures and processes due to the implementation of this new web-based tool. All MUST screeners and users of the USP will be considered qualified after completing MUST regional training and passing an online exam. For more information, see the March 2008 Medicaid Bulletin at http://www.ncdhhs.gov/dma/bulletin.htm.

New Medicaid Refund Process

Providers: there is a new process for submitting refunds to NC Medicaid. The new Provider Refund Request form is available at the DMA website, under the heading “Claim and Claim Adjustments.”

Provider Training

The Carolinas Center for Medical Excellence will offer provider training for Personal Care Services in March 2008. Training is recommended for registered nurses, agency administrators and agency owners who have a working knowledge of the PCS program and DMA policies. Dates and locations will be posted on CCME’s Web site under “Upcoming Events.”

Basic Medicaid Seminars

Basic Medicaid seminars will be held in April 2008. Seminars are intended to educate providers on the basics of Medicaid billing. See the North Carolina Medicaid February bulletin for more information.

NPI Number and North Carolina Medicaid

In the January 2008 provider bulletin, DMA announced that claims would deny effective March 1, 2008, if the NPI, Medicaid provider number and/or taxonomy was missing.

DMA has decided not to implement this policy effective March 1. DMA still requires that all submitted claims contain the Medicaid Provider Number, NPI, and Taxonomy. This data is needed to ensure that providers’ claims are paying to the correct Medicaid Provider Number

Medicaid Prescription Rules

In May 2007, Congress passed legislation requiring that prescriptions for all Medicaid outpatient drugs be written on tamper-resistant prescription pads, to be implemented April 1, 2008. The NC Division of Medical Assistance has published guidance regarding this law, available at the DMA’s website.

Full Zip Code for Billing Required

Providers are now required to include the last four digits of their ZIP codes in the billing address and service facility location address fields on all claims. Once NPI is implemented, the ZIP+4 will be necessary for claims processing.

Medicaid Seminars on NPI

In February 2008, NC Medicaid will sponsor seminars discussing the implementation of National Provider Identifier (NPI). Providers who would like more information on NPI are encouraged to attend. For more details see the NC Medicaid January bulletin.