Topics Related to Community Alternatives Program (CAP/C & CAP/DA) Providers
NC Medicaid State Plan Personal Care Services (PCS) and Community Alternatives Programs (CAP) providers who render personal care-type services, are required to complete a secure survey regarding Electronic Visit Verification (EVV) by Dec. 7, 2020.
Effective Jan. 1, 2021, Personal Care Services and Community Alternatives Programs providers subject to Electronic Visit Verification will no longer be able to submit claims using span dating.
This Bulletin replaces SPECIAL BULLETIN COVID-19 #22 in its entirety. NC Medicaid has updated its emergency planning document called an Appendix K to expand its flexibilities on how Medicaid providers and beneficiaries may access and receive home- and community-based services (HCBS) through the CAP waivers in the wake of COVID-19, previously referenced in SPECIAL BULLETIN COVID-19 #22. Updates to the previous Bulletin are noted.
This Bulletin replaces SPECIAL BULLETIN COVID-19 #22 in its entirety. NC Medicaid has updated its emergency planning document called an Appendix K to expand its flexibilities on how Medicaid providers and beneficiaries may access and receive home- and community-based services (HCBS) through the CAP waivers in the wake of COVID-19, previously referenced in SPECIAL BULLETIN COVID-19 #22.
NC DHHS awarded a contract to Sandata Technologies, LLC on Sept. 24, 2020, and will implement services for Electronic Visit Verification (EVV) statewide on Jan. 1, 2021. EVV is a method used to verify visit activity for services delivered as part of home- and community-based service programs. EVV offers a measure of accountability to help ensure that individuals who are authorized to receive services in fact receive them.
To ensure the waiver enrollment administrative processes are executed as approved in each waiver application, until the award of a contract to an external CIAE vendor, NC Medicaid will implement an internal independent assessment review process. This internal independent assessment process will begin in October 2020 with a go-live date of Oct. 19, 2020.
To begin the preparation for the renewing of the CAP/C waiver, NC Medicaid is soliciting comments, recommendations, and suggestions in the areas of access, flexibilities of home and community-based services, and operational efficiencies. An open public comment period begins Sept. 22, 2020.
NOTE: UPCOMING PROVIDER WEBINAR
NC Medicaid COVID+ Rate Reporting Technical Assistance Session
Wednesday, June 3, 1:00 p.m.
Register
NC Medicaid is implementing a targeted rate increase and additional billable hours for State Plan and CAP/C and CAP/DA In-Home Personal Care Service (PCS) providers for direct service to a COVID-19-positive (COVID+) beneficiary. This bulletin:
NC Medicaid COVID+ Rate Reporting Technical Assistance Session
Wednesday, June 3, 1:00 p.m.
Register
NC Medicaid is implementing a targeted rate increase and additional billable hours for State Plan and CAP/C and CAP/DA In-Home Personal Care Service (PCS) providers for direct service to a COVID-19-positive (COVID+) beneficiary. This bulletin:
The Community Alternatives Program for Children (CAP) §1915( c) Home and Community-Based Services (HCBS) waiver application has been amended and approved by the Centers for Medicare and Medicaid Service (CMS), effective May 1, 2020.
PACE organizations should continue to follow the guidance of the local, state and federal officials regarding COVID-19 and thoroughly document reasoning for making decisions which may fall outside of the PACE program model. This guidance supplements the Special Bulletin COVID-19 #27 released on March 30, 2020. The temporary flexibilities noted in Special Bulletin COVID-19 #27 and this Special Bulletin will end the earlier of the cancellation of the North Carolina state of emergency declaration or December 31, 2020.