March 2010

 

DMA established a Preferred Drug List (PDL) on March 15, 2010 to obtian better prices for covered outpatient drugs through supplemental rebates. Initially, there will be NO changes in the drugs that are currently covered.  In the future, selected therapeutic drug classes will be reviewed and specific drugs defined as "preferred." Generally, these drugs will not require Prior Authorization(PA) unless there are other clinical PA requirements such as step therapy or quantity limits.

"Non-preferred" drugs will be available if prior authorization criteria are met.  The PA process will be the same as it is today.  The prescriber will be responsible for initiating a PA request.  For therapeutic drug classes that do not appear on the PDL, nothing has changed.

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ANNOUNCEMENTS

February 2010

The North Carolina legislature authorized the establishment of a North Carolina Medicaid Preferred Drug List (PDL) in an effort to contain costs.  The PDL is a list of drugs that are preferred by Medicaid. The PDL will go into effect on March 15, 2010. This notice is being sent to all Medicaid recipients as that everyone knows about the change.  If you also have Medicare and Medicaid pays for some of your drugs, this will apply to the drugs Medicaid covers.  Regardless of the PDL, children under 21 are entitled to prescription drugs that are not needed to "correct or ameliorate defects and physical and mental illness and contitions" under the Early Periodic Screening, Diagnosis and Treatment (EPSDT) Program.

August 2009

The Stroke/Hypertention Project plans to celebrate the accomplishment of the participants with a Hypertention Forum.  This event will consist of a cooking class, Nutrition Education, Exercise Physiologist, and an award ceremony. This is an collaboration of local agencies, NC Cooperative Extention and  Stretch Break "Fitness for Life". The event will take place at Bethel Adult Day Health Care Center, Thursday, August 20, 2009.

 

July 2009

To help raise pediatric asthma awareness, the Cumberland County Asthma Action Group hosted an Asthma Day Camp for 33 young asthma sufferers on Saturday, July 25, 2009, at the Fayetteville Swamp Dogs' J.P. Riddle Stadium. The event helped mild to severe asthmatic children understand  that even though they have a debilitating disease, they can still participate in outdoor activities.

The campers were pre seleected and divided into four teams, each having its own physicians and medical staff.  Swamp Dogs players volunteered assisting at each activity stations: (1) frisbee golf, (2) pitching machine, (3) trigger bowling, and (4) relay race.  Music and refreshments were available, as well as emergency staff and trauma. The mascot for Kidsville News, Truman the dragon, also made an apperance. The children weren't the only ones to benefit from the event, parents also receied education through the various activities stations.

It was a rewarding and educational day for everyone,and the plans are under way for a 2010 Asthma Day Camp.

June 2009

Effective June 30, 2009, oral nutrition will no longer be available as a waiver service for children under the age of 21.  Medically necessary oral nutrition products for recipients under the age of 21 are now covered as a Medicaid State Plan service.

 

May 2009

Full implementation of National Provider Identifiers (NPIs) will take place in May 2009. Upon full implementation, the Medicaid Provider Number (MPN) will no longer be allowed on paper or electronic claims.  Claims submitted with the MPN will be denied unless the provider is atypical.  In preparation for this transition, N.C. Medicaid encourages providers to begin submitting a small number of claims with the NPI  and taxonomy only, even if you have not received a ready letter.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Carolina Collaborative Community Care (4C)

Phone: (910) 485-1250 Fax: (910) 485-7238