NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021.
Topics Related to Community Alternatives Program (CAP/C & CAP/DA) Providers
To ensure NC Medicaid continues to move forward with EVV implementation and can fully integrate EVV through claims adjudication for all providers, alternate EVV solutions must pass testing validation by April 30, 2021.
Upcoming stakeholder sessions are announced for the Community Alternatives Program for Children (CAP/C) waiver, which will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.
NC Medicaid will extend the pay and report period for providers subject to Electronic Visit Verification (EVV) past the original cutoff date of March 31, 2021. Medicaid will provide 30 days’ notice prior to the conclusion of pay and report.
This Bulletin gives guidance on the use of EVV for the Community Alternatives Programs for Children and Disabled Adults (CAP/C and CAP/DA) to ensure compliance with Section 12006 of the 21st Century Cures Act.
Beginning April 1, 2021, NC Medicaid will begin strictly applying its timeline business rules for the receiving, processing and closing out referral requests.
NC Medicaid has updated its Appendix K to extend flexibilities on how Medicaid providers and beneficiaries access and receive home- and community-based services through CAP/C, CAP/DA, NC Innovations waiver and Traumatic Brain Injury waiver.
To ensure that NC Medicaid meets implementation timelines and can fully integrate EVV through claims adjudication for all providers, alternate EVV Solutions must pass testing validation by March 10, 2021. If the solution has not passed testing by March 10, 2021, provider agencies currently enrolled with their solution may be required to enroll with the State’s EVV solution, Sandata, to ensure they are compliant with EVV requirements.
The Community Alternatives Program for Children (CAP) §1915(c) Home- and Community-Based Services (HCBS) waiver will expire on Feb. 28, 2022. By October 2021, NC Medicaid will submit a request to the Centers for Medicare and Medicaid Services (CMS) to renew the CAP/C waiver.
NC Medicaid acknowledges challenges with implementing EVV and is extending flexibilities for EVV dates of service to providers who make a good faith effort to connect with their EVV vendor of choice.