Reminder- Upcoming Changes to NCTracks

EVV Process Updates for Vendors Coming Soon

Beginning Jan. 28, 2024 the electronic visit verification (EVV) process will be updated for vendors. Currently, vendors are able to update EVV fields using the same visit record after a claim has been paid. 

Starting Jan. 28 , 2024, vendors will need to use a new visit record each time an EVV is completed. If a visit record has already been used and a claim has been paid, the visit record will be rejected. 

Vendors will receive an error message when their update to an existing EVV record is rejected, but providers will not be notified. It will be the vendor’s responsibility to update their records accordingly.

 

Changes to Pricing Methodology for 340B Pharmacy Claims 

Effective Jan. 28, 2024, the pricing methodology for non-blood clotting factor, 340B pharmacy claims will be updated to the lesser of the 340B acquisition cost or the 340B Ceiling price on file.

If the submitted 340B acquisition cost is higher than the 340B Ceiling price the following message will be displayed on the National Council for Prescription Drug Programs (NCPDP) response transaction: "Submitted 340B acquisition cost was higher than expected. Reimbursement will be calculated based on the 340B Ceiling Rate on file.”

This change will not affect claims with dates of service before Jan. 28, 2024. 

 

New Exclusion Sanction Questions to be added to Applications for Enrollment

Beginning Jan. 28, 2024, five new additional exclusion sanction questions will be added to enrollment, re-enrollment, full MCRs, office administrator (OA) and re-verification applications: 

  • L. Has the enrolling provider had any liability insurance carrier canceled, refused coverage, or rated up because of unusual risk or have any procedures been excluded from coverage?
  • M. Has the enrolling provider ever practiced without liability coverage?
  • N. Does the enrolling provider have any medical, chemical dependency or psychiatric conditions that might adversely affect your ability to practice medicine or surgery or to perform the essential functions of your position?
  • O. Has the enrolling provider's hospital and/or Clinic privileges ever been limited, restricted, reduced, suspended, revoked, denied, not renewed, or have you voluntarily surrendered or limited your privileges during or under the threat of an investigation or are any such actions pending?
  • P. Has the enrolling provider had a professional liability claim assessed against them in the past five years or are there any professional liability cases pending against them?

All five questions are applicable to individual providers. However; only two of the questions will be applicable to organizations:

  • L. Has the enrolling provider had any liability insurance carrier canceled, refused coverage, or rated up because of unusual risk or have any procedures been excluded from coverage?
  • M. Has the enrolling provider ever practiced without liability coverage?

Affirmative answers to exclusion sanction questions on all applications require a written explanation AND supporting documentation.

A thorough written explanation for each question answered affirmatively must be signed and dated by the responsible party within six months of the application date. Failure to disclose documentation related to an affirmative response will result in a denial of the application. A full explanation of the new documentation requirements can be found at: https://www.nctracks.nc.gov/content/public/providers/provider-communications/2023-Announcements/Update-to-Documentation-Requirements-for-Exclusion-Sanction-Questions.html.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24024-R-2715,2719,2708