NC Medicaid will sunset its CARES Act funded reimbursement of nursing facility staff COVID-19 testing in June 2021. This bulletin provides an update on processing timelines for previously submitted cases and provides additional guidance for final payments under this initiative.
Topics Related to COVID-19
The American Rescue Plan Act that was recently enacted includes several changes to COVID-19 Medicaid policy. As of March 11, 2021, North Carolina will be covering all approved COVID-19 vaccines for limited benefit eligibility groups.
This bulletin provides an update on the final reconciliation activity related to nursing facility staff COVID-19 testing payments authorized under Secretarial Orders No. 2 and No. 4.
The U.S. Food and Drug Administration has issued an Emergency Use Authorization for the unapproved products, bamlanivimab and etesevimab to be administered together for qualifying patients.
Janssen COVID-19 vaccine is authorized for use under an Emergency Use Authorization (EUA) for active immunization to prevent coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in individuals 18 years of age and older.
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.
CPT Code 87428 (related to COVID-19) was improperly defined in a previous Bulletin and is being correctly defined here.
NC Medicaid is initiating its final phase of reconciling projected versus actual testing cost submission activity for nursing home staff testing payments authorized under Secretarial Orders 2 and 4 on March 1, 2021.
Effective June 1, 2020, NC Medicaid began reimbursing COVID-19 testing for “Be Smart” Family Planning (MAFDN) beneficiaries through the NC Medicaid Optional COVID-19 Testing (MCV) Program. NC Medicaid is adding codes into NC Tracks for lab testing coverage for MAFDN beneficiaries with retroactive effective dates.
The Centers for Medicare & Medicaid Services and the American Medical Association have announced the release of several new codes to report testing for COVID-19.