New Medicare-only Lite Enrollment Application Coming Soon

In accordance with FY2022 Inpatient Prospective Payment System/Long-Term Care Hospital Prospective Payment System (IPPS/LTCH PPS) Final Rule, Centers for Medicare & Medicaid Services (CMS) 1752-F, State Medicaid agencies must accept enrollment of all Medicare-enrolled providers and suppliers (even if a provider or supplier is of a type not recognized as eligible to enroll in the State Medicaid program) if the provider or supplier otherwise meets all federal Medicaid enrollment requirements.

Effective Jan. 29, 2023, a new Medicare-only Lite enrollment option will be added in NCTracks to align with CMS requirements. 

Currently, if a provider is present on a Medicare crossover claim as a billing provider but is not enrolled in NCTracks, they do not receive a remittance advice (RA). With this update, Medicare providers may complete a simplified enrollment process that will allow them to access an RA for the Medicare crossover claim. Although providers must be actively enrolled with Medicare, no taxonomy, application fee, training, or fingerprinting is required for this application under NC Medicaid.

Medicare-only Lite enrollment lasts one year. At the end of the one year, a termination letter will be sent to the provider with termination reason: ENROLLMENT TERMINATED DUE TO END OF MEDICARE LITE ONE YEAR ENROLLMENT PERIOD. A RE-ENROLLMENT APPLICATION IS REQUIRED IN ORDER TO CONTINUE PARTICIPATION IN MEDICAID.

Providers enrolled with a Medicare-only Lite application are not eligible to receive payment from NC Medicaid but may choose to enroll as a full provider by submitting a manage change request (MCR). All enrollment criteria must be met to become fully enrolled, including selection of a Medicaid accepted taxonomy. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M22341-R-2575