Waiver extension has been approved by CMS
Topics Related to Community Alternatives Program (CAP/C & CAP/DA) Providers
NC Medicaid has extended its deadline to February 2022 to send the renewed waiver application to the Centers for Medicare and Medicaid Services to request approval of the CAP/C waiver for another five years.
This Bulletin contains updates on the implementation of electronic visit verification (EVV) claims adjudication, entering manual visits, alternate EVV solutions, EVV system updates, EVV implementation for Innovations and TBI Waivers administered by LME-MCOs, EVV implementation for managed care health plans, and quick help tips and resources.
UPDATE Oct. 28, 2021: Procedure code T1004 has been removed from this list, as it is excluded, and was originally listed in error. EVV visits for respite services must follow EVV capture requirements.
NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021. A stakeholder meeting will be held on Friday, May 21, 2021, at 10 a.m. to share EVV implementation updates and provide training to support provider readiness for June 1, 2021.
NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021.
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.