PCS Audit Aware and Audit Prepared

Audit Brochure 2014 page 2 “When we got the recoupment demand, we thought seriously about closing our doors – how could we fight the State? SembraCare got us on the right track in fighting the recoupment and helped save us an enormous amount of money. And we’re still here.” Philip Morris, Home Choice Healthcare

Home Health Care Agency Guide to Getting Paid During Appeals

Your Home Health Care Agency won’t stay in business if you can’t get paid!  DMA’s site has a new “how to get paid” guide, located at http://www.ncdhhs.gov/dma/provider/URVendorInstruct.pdf .  This guide makes a few points that are worth going over: First, it is imperative to get your clients ready for letters from DMA or CCME which […]

DMA Publishes New Clinical Coverage Policies

On October 29, 2010 North Carolina Division of Medical Assistance published two new proposed Clinical Coverage Policies for In Home Care Adults (IHCA) and In Home Care Children (IHCC), which are intended to replace the existing PCS/PCS Plus program. DMA is looking to close down the existing PCS and PCS Plus programs as soon as […]

Important Notice for PCS Providers About CCME Errors and Fixes

DMA confirmed today that, prior to this week,  the “end dates” for Medicaid benefits from PCS recipients were calculated wrong by CCME due to a miss-communication with the programmer about what the effective end dates should be.  This error affected 100% of the 1,089 individuals who were sent cut-off letters, and was brought to DMA’s […]

DMA – The need to remove prohibited task from care plans

DMA is reemphasizing the need to remove prohibited tasks from care plans by April 30, 2010.   We quote: The new PCS and PCS-Plus Clinical Coverage Policy 3C includes changes required by Session Law 2009-451 (Senate Bill 202). Section 10.68A.(a)(3) of Senate Bill 202 mandated the addition of the following items to the list of tasks […]

Medicaid Announces Public Hearing on Bond Rules

The Department of Health and Human Services, Division of Medical Assistance will hold a public hearing for Medical Assistance Eligibility, Provider Enrollment, Provider Performance Bond rules published January 4, 2010 The public hearing will be held 10:00 a.m., Wednesday, February 17, at Dorothea Dix Campus, Kirby Building room 132 (1985 Umstead Drive, Raleigh, NC 27603). […]