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Provider Alert

Provider Alert: Innovations Direct Care Workers Rate Increase Communication

Issued: January 2, 2024 The NC General Assembly appropriated $176 million in state and federal recurring funding in the Current Operations Appropriations Act of 2023 (SL 2023-134, Section 9E.15) to raise NC Medicaid Innovations waiver services rates so that Innovations services providers can in turn raise the hourly wages of their Direct Care Workers (DCW).

Provider Alert: Medicaid Expansion is Live

Issued: December 8, 2023 What is happening? NC Medicaid expanded December 1, 2023. This will help many North Carolinians to receive services they were not eligible to receive prior to the expansion. Medicaid pays for doctor visits, yearly check-ups, emergency care, dental care, mental health and more – at little or no cost to the

Provider Alert: Update to ProAuth

Issued: October 9, 2023 Partners Health Management has updated ProAuth to remove some features and has added a new dropdown to reflect pending residential placements. These changes are effective immediately. What is happening? Partners has removed the LOCUS and CALOCUS features from ProAuth. These are no longer required by the Department as communicated in Joint

Provider Alert: Authorizations for Research-Based Behavioral Health Treatment Transition to ALL Codes

Issued: October 2, 2023 Effective Oct. 1, 2023, Partners Health Management began moving all new authorizations for Research-Based Behavioral Health Treatment (RB-BHT) to ALL codes. This applies to each RB-BHT service in order to condense the number of modifier codes needed for authorization. Authorizations with the new codes will be in ProAuth and Alpha by Oct. 14.

Provider Alert: New Authorizations for Medicaid Direct Starting April 1 now in ProAuth

Issued: September 25, 2023 As of September 21, 2023, Partners has transferred Medicaid B and Medicaid C authorizations from Alpha+ to ProAuth. New authorizations were created with NC Medicaid Direct B or NC Medicaid Direct C eligibility starting April 1, 2023, through the original approved end date. What is happening? Partners has transferred Medicaid B and

Provider Alert: IPRS / (b)(3) Funding

Issued: September 21, 2023 Until a state budget is in place, Partners Health Management will not know what funding will be available for IPRS/(b)(3) services. What is happening? Requests for IPRS/(b)(3) funding will be reviewed and tentatively approved based upon need and current utilization of provider contracted funding. Partners cannot guarantee funding or add to

Provider Alert: Partners Utilization Management Update: Prior Authorization Process

Issued: September 7, 2023 On March 30, 2023, Utilization Management (UM) notified providers that Partners would authorize service dates only through the end of the NC Medicaid Direct eligibility period, September 30, 2023. In a Provider Alert (https://legacy.providers.partnersbhm.org/updates-to-partners-prior-authorization-process/), Partners stated that authorizations for the remainder of the request period and units starting October 1, 2023,