NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries may access and receive Medicaid services in the wake of COVID-19. Retainer payments may be made for direct care providers of services that include habilitation or personal care that are currently authorized in the Individual Support Plan (ISP).
Blog Entry List
NC Medicaid has temporarily enabled licensed clinical social workers at Local Health Departments to conduct Health and Behavior Intervention visits for pregnant and postpartum women who have serious psychosocial needs via telemedicine. Local health departments can bill for a variety of other medical and behavioral services provided by an MD, NP, PA, CNM, or appropriate Behavioral Health personnel when delivered via telehealth or virtual patient communications, as outlined in various NC Medicaid Special Bulletins (#34, 35, 36, 43, 48 and 49) regarding Telehealth Clinical Policy Modifications that have been instituted in light of COVID-19.
NC Medicaid has temporarily enabled providers to conduct postpartum depression screenings of postpartum women via several remote modalities in light of social distancing measures that may prevent in-person visits.
NC Medicaid is temporarily adding telemedicine coverage for providers to conduct Well Child Visits with patients to ensure the provision of comprehensive and preventive health care services for children under age 21. Providers are encouraged to continue providing well child visits, immunizations and or preventive care during the pandemic.
NC Medicaid has eliminated the restriction that teletherapy services cannot be conducted via “video cell phone interactions.” These services can now be delivered via any HIPAA-compliant, secure technology with audio and video capabilities, including (but not limited to) smart phones, tablets and computers.
Effective April 20, 2020, NC Medicaid is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability Clinical Coverage Policy 8C: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic. This guidance on allowing telephonic outpatient psychotherapy is in addition to the telehealth flexibilities previously added.
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.
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.
To avoid delays in beneficiaries receiving needed private duty nursing services, NC Medicaid is temporarily approving prior authorizations that are in pending status for documentation of validation of primary insurance for 60 calendar days. This will allow for the delayed verification responses from individual third-party insurance providers to be uploaded to the prior authorizations in NCTracks. Details regarding documentation, supervisory visits and eligible remote technologies are included in this bulletin.
During the period of the State of Emergency, supervisory visits must be conducted, but may be conducted utilizing eligible technologies that allow the supervising registered nurse to remotely communicate and evaluate services rendered. Supervisory visits can be delivered via any HIPAA-compliant, secure technology with audio and video capabilities including (but not limited to) smart phones, tablets and computers.
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.
An update to COVID-19 guidance for North Carolina clinicians and laboratories includes updated laboratory testing guidance; updated criteria for submission of specimens to the North Carolina State Laboratory of Public Health (NCSLPH); and replacement of information that is not North Carolina-specific with links to relevant CDC guidance.
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.