Reminder of Changes Coming to NCTracks Next Weekend

A few changes are coming to NCTracks July 28, 2019. Please see the details below.

 

Disaster Relief Enrollment Application Streamlined

Effective July 28, 2019, an expedited Disaster Relief Provider Enrollment Application process will be available during times of disaster such as a State of Emergency. This abbreviated enrollment application will collect limited information to enroll a provider for a limited time (120 days) and will be available to in-state, out-of-state (OOS) and border providers that are not yet enrolled in NC Medicaid, including individual providers and organizations.

For the Disaster Relief Provider Enrollment Application only, federal application requirements may be waived (training, site visit, federal/state fees, background checks, and fingerprinting).

The enrollment application process will be expedited. NCTracks will verify the provider’s enrollment status with Medicare or the provider’s home State Medicaid agency to ensure the provider is in good standing. NCTracks will deny the Disaster Relief Provider Enrollment Application if the provider is not in good standing.

More information will be provided during a disaster which deems the Disaster Relief Provider Enrollment Application necessary for relief efforts. 

 

Modification to Hospice Day Count for Two-Tier Calculation

This notice is in regard to Hospice claims that were adjudicated in NCTracks beginning Jan. 1, 2016.

As per the FY 2016 Hospice Wage Index and Payment Rate Update final rule, the Centers for Medicare & Medicaid Services (CMS) mandated two-tier hospice day count pricing effective January 1, 2016. On Nov. 1, 2017, NCTracks system changes were implemented and all claims for hospice service began to be reimbursed in accordance with the requirements of Hospice Payment Reform.  

It was determined that NCTracks system updates were required to correct the two-tier day count based on the hospice election date. This NCTracks system change will be implemented on July 28, 2019, with a retroactive effective date of January 1, 2016.

For more information on the two-tier hospice day count reimbursement, please see the FY 2016 Hospice Wage Index and Rate Update final rule (80 FR 47172), CMS updates to the final rule, the January 2016 Medicaid Special Bulletin, and the October 2016 Medicaid Bulletin.

*All claims affected by this change will be reprocessed at a later date. Affected providers will be notified through future Medicaid Bulletins and/or NCTracks Provider Communications regarding the claims reprocessing schedule.  

 

Provider Enrollment for Presumptive Eligibility Transitioning to NCTracks

Effective July 28, 2019, the Presumptive Eligibility Provider Enrollment process will be transitioned from NC Medicaid to NCTracks. NCTracks will assume the enrollment process for Providers of Presumptive Eligibility for Pregnant Women and Hospital Providers of Presumptive Eligibility for Medicaid Programs.

The requirements are not changing, however, the processes are slightly different for hospital-only providers and other medical/Medicaid providers. Separate Presumptive Eligibility Provider Agreements will be available on the NCTracks Provider Enrollment page under Quick Links (on the right side of the page) as of Monday, July 29, 2019, following implementation of the transition.