§ 108A-54.2. Procedures for changing medical policy. - North Carolina Statutes

§ 108A‑54.2.  Proceduresfor changing medical policy.

The Department shall develop,amend, and adopt medical coverage policy in accordance with the following:

(1)        During thedevelopment of new medical coverage policy or amendment to existing medicalcoverage policy, consult with and seek the advice of the Physician AdvisoryGroup and other organizations the Secretary deems appropriate. The Secretaryshall also consult with and seek the advice of officials of the professionalsocieties or associations representing providers who are affected by the newmedical coverage policy or amendments to existing medical coverage policy.

(2)        At least 45 daysprior to the adoption of new or amended medical coverage policy, the Departmentshall:

a.         Publish the proposednew or amended medical coverage policy on the Department's Web site;

b.         Notify all Medicaidproviders of the proposed, new, or amended policy; and

c.         Upon request,provide persons copies of the proposed medical coverage policy.

(3)        During the 45‑dayperiod immediately following publication of the proposed new or amended medicalcoverage policy, accept oral and written comments on the proposed new oramended policy.

(4)        If, following thecomment period, the proposed new or amended medical coverage policy is modified,then the Department shall, at least 15 days prior to its adoption:

a.         Notify all Medicaidproviders of the proposed policy;

b.         Upon request,provide persons notice of amendments to the proposed policy; and

c.         Accept additionaloral or written comments during this 15‑day period.  (2006‑66, s. 10.4;2009‑451, s. 10.68A(b).)