Effective July 1, 2020, coverage of therapeutic Continuous Glucose Monitoring (CGM) products is transitioning from the Durable Medical Equipment (DME) Program to the Outpatient Pharmacy Point of Sale (POS) Program.
Blog Entry List
On May 15, 2020, the Centers for Medicare & Medicaid Services (CMS) updated the Minimum Data Set (MDS) 3.0 item sets (version 1.17.2) to support the calculation of Patient-Driven Payment Model (PDPM) case mix groups on all Omnibus Budget Reconciliation Act (OBRA) assessments.
NC Medicaid is implementing time-limited, targeted, enhanced swing bed reimbursement rates to provide additional financial support to hospitals that provide post-acute care services to COVID-19 positive (“COVID+”) Medicaid beneficiaries and non-COVID+ Medicaid beneficiaries transferred from other acute care hospitals as part of a surge response.
On July 17, 2020, the Centers for Medicare & Medicaid Services announced that the deadline for Medicaid/CHIP providers to submit their financial data to apply for federal Provider Relief Funds has been extended to Aug. 3, 2020.
This NC Medicaid Bulletin provides an overview of COVID-19 rate increases applicable to SNFs and Hospice providers; Hospice provider rate increase from 95% to 100% of Skilled Nursing Facility (SNF) reimbursement rates for room and board services provided in a SNF; and billing guidelines for Hospice services provided in a SNF designated as a “COVID-19 Outbreak” or “COVID-19 Response” site.
North Carolina providers that participate in Medicaid may be eligible to receive federal relief as a result of lost revenue or new expenses relating to the COVID-19 Public Health Emergency.
The Centers for Medicare & Medicaid Services (CMS) recently approved North Carolina’s Medicaid Disaster 1115 Waiver. The waiver includes several provisions that allow flexibility for long-term services and supports (LTSS) to maintain services for beneficiaries and financial relief for home and community-based service (HCBS) providers.
Registration is open for the August 2020 NCTracks instructor-led provider training courses listed below. Slots are limited. WebEx courses can be attended remotely from any location with a telephone, computer and internet connection.
Clinical Policy 1E-3, Sterilization Procedures, has been revised and will post Aug. 15, 2020 on the NC Medicaid website.
Effective Jan. 1, 2020, the title of Clinical Coverage Policy 1A-34 changed to Dialysis Services. In addition to the title change, the Division of Health Benefits will now cover services for Acute Kidney Injury (AKI).
Effective July 1, 2020, End Stage Renal Disease (ESRD) Treatment providers (261QE0700X) were added to the list of eligible providers for Procedure Code J0887, Mircera, Injection, Epoetin Beta, 1 Microgram, (FOR ESRD ON DIALYSIS).
NCTracks has reset the due date for providers required to re-verify their enrollment between the dates of July 1, 2020, and Aug. 31, 2020.
NC Medicaid has received federal approval of additional flexibilities during the COVID-19 pandemic for the NC Innovations and NC Traumatic Brain Injury waivers.
A webcast for the Provider Relief Fund will be held Wednesday, July 8 from 4-5 p.m. Reminder - the application deadline is July 20, 2020.
NC Medicaid is committed to ensuring beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to the novel coronavirus (COVID-19) outbreak.