Effective July 1, 2021, some Medicaid beneficiaries receiving Personal Care Services (PCS) transitioned from NC Medicaid Direct to receiving services through an NC Medicaid Managed Care health plan.
Topics Related to Personal Care Services Providers
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.
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.
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 public comment period has been extended through March 15, 2021, for Personal Care Services Policy 3L, Implementation of Electronic Visit Verification.
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.
After Jan. 31, 2021, providers are required to capture EVV visits for all beneficiaries subject to EVV. Claims paid for services that are not captured through EVV may be subject to recoupment.
NC Medicaid Clinical Coverage Policy 3L, State Plan Personal Care Services, is being amended to reflect the 21st Century Cures Act federal requirement of implementing Electronic Visit Verification for Personal Care Services.