Topics Related to Behavioral Health Providers

Panelists will present a structured PowerPoint presentation focused on Appendix K and Retention Payments for the Innovations Waiver on Thursday, June 11, 2020, at 3 p.m.

In December 2019, DHHS released the draft Tailored Care Management Provider Manual and application questions for providers interested in becoming Advanced Medical Home Plus practices or Care Management Agencies. The Department received many thoughtful comments on the draft Provider Manual and has made several updates.
The Department has decided to further extend the initial application deadline for providers from Feb. 21, 2020 to June 2020 (date TBD).

While the implementation of managed care has been suspended as legislative action is needed to move forward, the Department of Health and Human Services continues to work on the design of Standard Plans and Behavioral Health and Intellectual Developmental Disability (I/DD) Tailored Plans. The Department is releasing a Behavioral Health Crisis System Memo for Standard Plans. 

Effective April 30, 2020, NC Medicaid in partnership with the DHHS Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability (I/DD) Clinical Coverage Policies to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic.

Effective April 30, 2020, NC Medicaid in partnership with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability (I/DD) Clinical Coverage Policies to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic. 

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 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). 

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.
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.