SPECIAL BULLETIN COVID-19 #7: Public Health Emergency Enrollment Applications for Health Care Professionals Not Currently Enrolled as an NC Medicaid Provider

Friday, March 20, 2020

NC DHHS continues to take action to protect the health and safety of our state’s patients and providers during the novel coronavirus (COVID-19) outbreak. NC DHHS received authority under Section 1135 of the Social Security Act to waive certain federal Medicare, Medicaid, CHIP and HIPAA requirements.
These modifications take effect as of 6 p.m. EST on March 15, 2020, with a retroactive effective date of March 1, 2020, and will ensure that sufficient health care items and services are available to meet the needs of our state residents and providers.

NC DHHS has implemented a temporary, expedited enrollment process to allow non-Medicaid enrolled health care professionals rendering services to Medicaid beneficiaries due to the COVID-19 outbreak to quickly enroll as a NC Medicaid provider.

The screening and enrollment requirements temporarily waived are described below. 

  • Temporarily waiving payment of application fee to temporarily enroll a provider; 
  • Temporarily waiving fingerprinting background checks to temporarily enroll a provider; 
  • Temporarily waiving site visits to temporarily enroll a provider; 
  • Temporarily ceasing revalidation of providers who are enrolled with NC Medicaid or otherwise directly impacted by the emergency; 
  • Temporarily waiving requirement that physicians and other health care professionals be licensed in the state in which they are providing services, so long as they have equivalent licensing in another state or enrolled with Medicare;  
  • Providing payments to facilities for providing services in alternative settings, including an unlicensed or temporary facility, if the provider’s licensed facility has been evacuated, compromised, is inadequate to meet the demand as determined by the state or the facility or is necessary to protect the health and safety of other patients.  

The Disaster Relief Provider Enrollment Application, which will be utilized for the expedited enrollment, is an abbreviated enrollment application that collects limited information to enroll a provider for a limited time (180 days).  The application is available to in-state, out-of-state (OOS) and border providers that are not yet enrolled in NC Medicaid, including individual providers and organizations.  

Providers can complete and submit the application through the NCTracks Provider Portal. Please refer to the Job Aid available here

Providers should review the job aid in advance of working on the application, as several preliminary steps are necessary. For expedited processing, providers must indicate the application is for this public health emergency by answering “Yes” to the Disaster Relief enrollment question on the Basic Information page of the application

Note: This process is not for providers who see NC Medicaid recipients on a regular basis. 

NC Medicaid will continue to evaluate the need to extend the exceptions and will publish any changes. All claims are subject to audit.

Additional information for Medicaid providers is available here.

GDIT, (800) 688-6696