{"data":{"id":"us-nc/n.c.-gen.-stat.-108c-9","jurisdiction":"us-nc","citation":"N.C. Gen. Stat. § 108C-9","heading":"Provider enrollment criteria.","body":"(a)\tApplicants who submit an initial application for enrollment in North Carolina Medicaid shall be required to submit an attestation and complete trainings prior to being enrolled.\n(b)\tThe applicant's attestation shall contain a statement that the applicant's organization has met the minimum business requirements necessary to comply with all federal and State requirements governing the Medicaid and Children's Health Insurance programs, does not owe any outstanding taxes or fines to the U.S. or North Carolina Departments of Revenue or Labor or the Division of Employment Security (DES) of the Department of Commerce, does not owe any final overpayment, assessment, or fine to the North Carolina Medicaid program, the former NC Health Choice program, or any other State Medicaid or Children's Health Insurance program, and has implemented a corporate compliance program as required under federal law. The Department shall set forth by rule the minimum business requirements necessary to comply with all federal and State requirements governing the Medicaid or Children's Health Insurance programs.\n(c)\tPrior to being initially enrolled in the North Carolina Medicaid program, an applicant's representative shall attend trainings as designated by the Department in rules, including, but not limited to, the following:\n(1)\tThe Basic Medicaid Billing Guide, common billing errors, and how to avoid them.\n(2)\tAudit procedures, including explanation of the process by which the Department extrapolates audit results.\n(3)\tHow to identify Medicaid recipient fraud.\n(4)\tHow to report suspected fraud or abuse.\n(5)\tMedicaid recipient due process and appeal rights.\nOnline training shall be available for completion through the Department's website. The Department may charge a fee to recover costs of such trainings.\n(d)\tMaking any materially false or misleading statement in an attestation or enrollment application shall be grounds for denial, termination of, or permanent exclusion from enrollment in the North Carolina Medicaid program.\n(e)\tBoard Certified Behavior Analysts and Qualified Autism Services Practitioner Supervisors shall not be permitted to enroll in the North Carolina Medicaid program as out-of-state providers. (2011-399, s. 1; 2011-401, s. 5.1; 2022-74, s. 9D.15(n); 2025-25, s. 29(5); 2026-1, s. 3C.18(c).)","path":["Chapter 108C. Medicaid Provider Requirements."],"source_url":"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_108C/GS_108C-9.html","current_through":"S.L. 2026-30","vintage":"","retrieved_at":"2026-08-27T18:16:32Z","sha256":"370193d26dca74cc77004d7f1eb4f140025d66eb196cae486d2db615c8a76dc8","source_id":"us-nc","stale":false,"prev":"us-nc/n.c.-gen.-stat.-108c-8","next":"us-nc/n.c.-gen.-stat.-108c-10"},"notice":"GroundRules: Original legal text. Not legal advice."}