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Division of Medical Assistance |
| Medicaid for North Carolinians |
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Proposed Medicaid Clinical Coverage Policies
NCGS §108A-54.2 requires that the Department of Health and Human Services consult with and seek the advice of the North Carolina Physician Advisory Group and other professional societies and organizations in developing new or amended Medicaid clinical coverage policies. Additionally, the law requires the Department to publish proposed new and amended clinical coverage policies on the Department's Web site and accept oral and written comments. All consultations and comments are considered. The Department has delegated to the DMA Division Director the authority to make the final decisions regarding clinical coverage policies.
The following proposed new or amended Medicaid clinical coverage policies are available for review. Comments on proposed polices may be submitted by clicking the envelope next to each proposed policy. Comments and questions not specificially related to the proposed policy should not be sent to this Web address. The initial comment period for each proposed policy is 45 days. An additional 15-day comment period follows if a proposed policy is substantively revised as a result of the initial comment period.
| Proposed Policy | Date Posted | Have Comments? | Comment Period End Date |
|---|---|---|---|
| General Coverage Policy A5, Administrative Procedures for Mental Health Drug Management Program | 7/28/2008 |
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9/11/2008 |
| Clinical Coverage Policy 1K-2, Bone Mass Measurement | 7/28/2008 |
|
9/11/2008 |
| Clinical Coverage Policy 1-O-1, Reconstructive & Cosmetic Surgery | 7/28/2008 |
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9/11/2008 |
| Clinical Coverage Policy 1-O-5, Rhinoplasty and/or Septoplasty | 7/28/2008 |
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9/11/2008 |
| Clinical Coverage Policy 1S-1, Genotyping and Phenotyping for HIV Drug Resistance Testing | 7/28/2008 |
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9/11/2008 |
| Prior Authorization Criteria for Growth Hormones (amendment to current criteria; comments will be accepted only on highlighted or struck-through text) | 7/28/2008 |
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9/11/2008 |
Botulinum Toxins Types A (Botox) and B (Myobloc) [Amendment to current policy (prior approval criteria were posted previously); comments will be accepted only on the highlighted and/or struck-through sections] |
7/15/2008 |
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8/29/2008 |
Clinical Coverage Policies and Provider Manuals
All documents above are in PDF format. The free Adobe Acrobat Reader (minimum 4.0) is required to view and print PDF files.
Updated August 18, 2008