Topics Related to Hospice Providers

Rate increases continuing and effects on managed care plans and contracted providers

Flexibilities ending at or after the end of the Federal Public Health Emergency

EVV Home Health Implementation Review and Updates

Providers are required to complete the EVV readiness survey by July 22, 2022

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.

This NC Medicaid Bulletin provides an  overview of COVID-19 rate increases applicable to SNFs and Hospice providers; Hospice provider rate increase from 95% to 100% of Skilled Nursing Facility (SNF) reimbursement rates for room and board services provided in a SNF; and billing guidelines for Hospice services provided in a SNF designated as a “COVID-19 Outbreak” or “COVID-19 Response” site.

NC Medicaid has implemented COVID-19 rate increase functionality to reimburse hospice care provided in a skilled nursing facility (SNF) designated as a “SNF COVID-Outbreak site” or “SNF COVID-Response site” in a ratio consistent with how hospice care is reimbursed in all other SNFs. 

On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) announced an amendment of 42 CFR 440.70 that included two policy changes that affect hospice services for Medicaid during the COVID-19 pandemic. Effective March 30, 2020, NC Medicaid is adjusting hospice requirements currently in Clinical Coverage Policy 3D, Hospice Services to align with these recent CMS regulatory changes. 

NOTE: SPECIAL BULLETIN COVID-19 #79 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #103. This Bulletin clarifies that skilled nursing facilities (SNF) are eligible originating sites for telemedicine visits and enables such facilities to bill for a facility fee when a beneficiary located in a SNF receives care via telemedicine from an eligible remote provider.