CMS announced changes to the Provider Relief Fund opportunities for Medicaid providers which include the application deadline being extended to Aug. 28, 2020, certain providers who previously received Medicare funds can apply for Provider Relief Funds and payments for providers who have changed ownership.
Recently, the federal Declaration of Emergency scheduled to end July 25, 2020, was extended through Oct. 25, 2020. In response to this new date, NC Medicaid has extended its COVID-19 related temporary Clinical Coverage Policy provisions to Dec. 31, 2020. COVID-19 related rate enhancements are extended through Sept. 30, 2020.
Effective with the date of service July 1, 2020, the Centers for Medicare and Medicaid Services (CMS) has added new HCPCS codes (J codes), deleted others, and changed the description of some existing codes.
Effective with date of service May 6, 2020, the Medicaid and NC Health Choice programs cover daratumumab and hyaluronidase-fihj injection, for subcutaneous use (Darzalex Faspro™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J9999 - Not otherwise classified, antineoplastic drugs.
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.
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.