Effective April 16, 2020, any Assertive Community Treatment (ACT) team or Individual Placement and Support (IPS) team that met fidelity prior to the State of Emergency related to COVID-19 will continue to meet Medicaid and State-funded services policy requirements through the end of the declared State of Emergency.
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Considering the challenges providers are facing with COVID-19 pandemic, Medicaid is extending the due date for March 31, 2020, credit balance reports by 90 days. The extension will allow providers to submit their March 31 and June 30, 2020, credit balance reports. All credit balance reports for March 31 and June 30, 2020, quarter ends will be due July 30, 2020.
NCDHHS is directing providers to stop collecting copayments from Medicaid and NC Health Choice beneficiaries on all COVID-19 related testing, services and treatments. This change is effective retroactive to Jan.
SPECIAL BULLETIN COVID-19 #56: Key Federal Funding Available for Health Care Providers and Hospitals
Congress has enacted three significant stimulus packages to help the country weather the COVID-19 pandemic, which establish a variety of funding sources to support providers, each with distinct features including which provider types are eligible, if providers must apply to be considered and if the financial benefit is a grant or a loan that must be repaid. NC Medicaid has created a summary of financial relief available by provider type.
NC Medicaid has received federal approval of flexibilities during the COVID-19 crisis for the NC Innovations Waiver for individuals with intellectual and developmental disabilities (IDD); NC Traumatic Brain Injury (TBI) Waiver for individuals who have a TBI diagnosis after age of 21; Community Alternatives Program for Disabled Adults (CAP/DA) for disabled adults and the Community Alternatives Program for Children (CAP/C) for medically fragile children.
Effective retroactive to March 10, 2020, Medicaid and NC Health Choice plans are temporarily covering weight scales and adding a purchase option for portable pulse oximeters.
Effective April 1, 2020, in response to the anticipated spread of coronavirus (COVID-19) in North Carolina, NC Medicaid is adding "U07.1 - 2019-nCoV Acute Respiratory Disease" as a billable diagnosis. Additionally, diagnosis code U07.1 is being added to the list of diagnoses exempt from the annual visit limit also effective April 1.
Note: Additional Family Planning guidance may be released in the future, which would replace this bulletin.
NC Medicaid has implemented flexibilities on how Medicaid providers deliver and beneficiaries receive Medicaid services in the wake of COVID-19. Utilization and prior approval limits for specific State Plan Medicaid services will be relaxed for all Medicaid beneficiaries impacted by COVID-19 including individuals participating in the NC Innovations Waiver and the NC TBI Waiver.
NC Medicaid has added coverage for providers to help their patients engage in Remote Physiologic Monitoring (RPM), providing the opportunity to improve management of diseases and engage patients in their own care.
This SPECIAL BULLETIN COVID-19 #49 replaces SPECIAL BULLETIN #42: Telehealth Clinical Policy Modifications - Postpartum Care. Please note billing guidance change to postpartum care visits, which can be billed separately OR as part of a pregnancy package code.
The following new or amended clinical coverage policies are available on the Clinical Coverage Policies web page on NC Medicaid’s website: 3K-2, Community Alternatives Program for Disabled Adults (CAP/DA) – March 1, 2020
Given the presence of the COVID-19 virus in North Carolina, point of sale pharmacy claims processing flexibility has been instituted to help reduce the administrative burden of providing appropriate medications in a timely fashion to NC Medicaid and NC Health Choice beneficiaries.
SPECIAL BULLETIN COVID-19 #42: Telehealth Clinical Policy Modifications – Postpartum Care.has been replaced by SPECIAL BULLETIN COVID-19 #49: Telehealth Clinical Policy Modifications – Interim Perinatal Care Guidance.
NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid beneficiaries.