NCTracks Changes to Provider Verification Process

Currently, NCTracks sends notifications for expiring credentials (licenses, certifications and accreditations) to all enrolled providers required to be licensed, certified and/or accredited. These notices are sent to the Provider Message Center Inbox beginning 60 days in advance of the expiration date of the credential.

Effective May 9, 2021, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation and responsibility to keep credentials current on their NCTracks enrollment record by making system modifications to begin a process of 45 and 60 day notifications of suspension if a provider fails to update their credential prior to the expiration date on file with NCTracks. Providers were first informed of this forthcoming system modification in March 2018.

Choosing from providers with complete and up-to-date licensure, certification and accreditation information allows NC Medicaid beneficiaries to make informed choices to achieve the best health outcomes. System modifications alerting providers to update expiring credentials will assist providers in meeting federal and State enrollment and credentialing requirements and will assist NC Medicaid in removing unlicensed providers and expired credentials from provider records. With updated provider information, NC Medicaid will be able to transmit accurate provider data to health plans and other departmental partners who serve Medicaid beneficiaries.

Please see NCTracks Changes to Provider Verification Process for additional information on the timeline for notifications, suspension and termination as well as what happens when credentials expire.

Provider Data Updates

Providing the most accurate and complete provider information is a top priority so Medicaid and NC Health Choice beneficiaries can make the most informed choice for their health plan and primary care provider. NCTracks is the “system of record” for provider enrollment data, which is then shared with health plans to inform contracting and provider directories.

In our review, the primary challenge with accurate data has been encouraging providers to keep their information accurate and current on all applicable enrollment records. If provider information is not current, then the data that flows forward to the health plans and the enrollment broker will not be accurate.

It is critical that all providers take the time now to review their provider records in NCTracks and submit changes as needed using the Manage Change Request (MCR) process.
Please see Provider Data Updates for additional information and resources.

Community Mental Health Centers (CMHC) Grant Program

SAMHSA is accepting applications for the fiscal year (FY) 2021 Community Mental Health Centers (Short Title: CMHC) grant program. The purpose of this program is to enable community mental health centers to support and restore the delivery of clinical services that were impacted by the COVID-19 pandemic and effectively address the needs of individuals with serious emotional disturbance (SED), serious mental illness (SMI), and individuals with SMI or SED and substance use disorders, referred to as co-occurring disorder (COD). SAMHSA recognizes the needs of individuals with behavioral health conditions, including minority populations and economically disadvantaged communities, have not been met during the pandemic and that CMHC staff and other caregivers have been impacted.

SAMHSA plans to issue approximately 165–825 awards of up to $500,000–$2,500,000 per year for up to 2 years. Application due date is Friday, May 21, 2021.

Credentialing Process Update

Alliance’s Credentialing Department will be implementing a new process of sending and receiving Re-Credentialing applications. Providers identified for Re-Credentialing will receive the applications and attachments from [email protected].

Providers will submit all documents requested by the deadline identified to [email protected].

If you would like technical assistance or would like to schedule a meeting, please email
[email protected] so that a date and time can be arranged to assist you.

Please note: Failure to submit the Re-Credentialing documents by the deadline identified may result in Credentialing and Claims Denial and/or Disruption of Reimbursement for services. ​

Training: Integrating HIV/Sexual Health into Behavioral Health

This workshop on April 28 from 10am-11am will provide an update on HIV and other sexually transmitted infections (STIs) including incidence, treatment, and prevention. A model for integrating conversations about sexual health will be presented.

  • Participants will be able to list at least four barriers to sexual health integration;
  • Participants will be able to review at least three communication skills to use when conducting risk assessment;
  • Participants will be able to identify at least four common STIs and prevention approaches; and
  • Participants will be able to discuss at least three biomedical approaches to prevention of communicable diseases.

This training is restricted to Alliance staff and providers.

Training: Transition to Tobacco Free Campuses, Expansion of Tobacco Use Treatment Supports

As part of Medicaid Transformation, contracted providers will be required to implement a tobacco free policy, with the exception of services subject to HCBS final rule.  The NC Tobacco Prevention and Control Branch is offering a training on April 14 through MAHEC to help providers prepare for these changes.

Information below on the required changes:

Tobacco – Free Campus Requirements from the BH I/DD Tailored Plan RFA

Require as part of objectivity quality standards that contracted facilities, with the exception of the residential provider facilities noted below, implement a tobacco-free policy covering any portion of the property on which the participating provider operates that is under its control as owner or lessee, to include buildings, grounds, and vehicles. A tobacco-free policy includes a prohibition on smoking combustible tobacco products and the use of non-combustible tobacco products, including electronic cigarettes, as well as prohibiting participating providers from purchasing, accepting as donations, and/or distributing tobacco products (combustible and non-combustible products including electronic cigarettes) to the clients they serve. However, contracted facilities that are owned or controlled by the provider and which provide ICF-ID services or residential services that are subject to the HCBS final rule are exempt from this requirement. In these settings:

(1) Indoor use of tobacco products shall be prohibited in all provider owned/operated contracted settings.

(2) For outdoor areas of campus, providers shall:

i. Ensure access to common outdoor space(s) that are free from exposure to tobacco products/use; and

ii. Prohibit staff/employees from using tobacco products anywhere on campus.

Training: Protocol-Driven System to Manage Efficacy and Side Effects of Clozapine

This 12-week virtual learning collaborative ( April 12 to July 4, 2021) will aid participants in gaining knowledge of evidence-based monitoring parameters for efficacy and side effects for patients with serious mental illness (SMI) prescribed clozapine.

Learning objectives include:

  • Identify scales relevant to implementing measurement-based care to patients who are prescribed clozapine.
  • Evaluate the balance between clozapine and efficacy for control of psychiatric symptoms with that of common side effects.
  • Review major organ systems for how to assess and mitigate clozapine side effects using a systematic approach.
  • Develop and implement a protocol to manage efficacy and side effects for your clozapine system.

*Earn up to 12.0 AMA PRA Category 1 Credits™.

Training: Mastering the Safe and Effective Use of Long-Acting Injectable Antipsychotics

To increase appropriate use of long-acting injectables (LAI), this free  12-week virtual learning collaborative (April 12 to July 4) will focus on increasing use of LAIs to serve the needs of patients with serious mental illness. LAIs are associated with decreased risks of relapse, improvements in symptoms, functioning, and patient satisfaction.

This collaborative is intended for clinicians who want to optimize LAI use for their patients. Through the 12-week activity, participants will increase access to LAIs using the following steps: improving knowledge about the various formulations of LAIs, their pharmacokinetics and pharmacodynamics, considering patient eligibility for LAIs, developing an effective strategy for having a conversation about LAIs, monitoring for side effects of LAIs and manage them if they occur, and successfully treating breakthrough symptoms for people taking LAIs.

By the end of the learning collaborative, participants will increase their knowledge about LAIs, and may more effectively discuss with their patients the risks and benefits of these medications.

*Earn up to 12.0 AMA PRA Category 1 Credits™.

Training: Getting Started Building Your Clozapine Practice

This 12-week virtual learning collaborative (April 12 to July 4) is intended for clinicians who want to prescribe more clozapine or build a clozapine program that they will direct. Through the 12-week activity, participants will increase access to clozapine using the following steps: involve and gain support from members of a clozapine team, assess patient eligibility for clozapine, lead the care team for tracking of side effects and response and delivery of clozapine, ensure provision of education for patients or families, and routinely track panels of clozapine patients. There is no cost for this learning collaborative.

*Earn up to 12.0 AMA PRA Category 1 Credits™.

Reminder: Medicaid Transformation Community Forums

Alliance will be hosting a series of virtual forums for members of the community to learn more about Medicaid Transformation and Alliance’s transition to becoming a Tailored Plan. Sara Wilson, Senior Director of Government Relations, will be sharing information and resources to help navigate through this transition. There will be a question and answer session after each presentation.

Thank you to the Cumberland, Durham, Johnston, and Wake CFAC’s and Community Collaboratives for coordinating these forums and to the NC Collaborative for Children, Youth, and Families for holding one session during one of their regularly scheduled meetings.

Below are links to join:

April 12, 2021 5:30pm – 6:30pm

April 13, 2021 5:30pm – 6:30pm

April 23, 2021 10:00am – 11:00am

April 27, 2021 9:00am – 10:00am

If you have any questions you would like to submit ahead of the presentation, please send them to Starlett Davis, Member Engagement Specialist, [email protected].