SPECIAL BULLETIN COVID-19 #134: Clarification of COVID-19 Temporary Rate Increases and Clinical Policy Changes

Tuesday, September 22, 2020

This bulletin replaces SPECIAL BULLETIN COVID-19 #119 in its entirety.

NC Medicaid is committed to ensuring beneficiaries continue to receive Medicaid and NC Health Choice services with no interruptions or delays due to COVID-19. In August, NC Medicaid released Special Bulletin #119 which provided information on extensions of the COVID-19 rate enhancements and Clinical Coverage Policies in response to the extension of the federal Public Health Emergency declaration. This bulletin clarifies and further updates information provided. 

Federal Public Health Emergency Declaration

Special Bulletin #119 correctly noted that the federal Public Health Emergency was extended on July 25, 2020 for up to 90 days. The current expiration date for the federal Public Health Emergency is Oct. 23, 2020, not Oct. 25, 2020, as previously stated. The federal government may continue to extend the Public Health Emergency at its discretion. Please refer to the federal Public Health Emergency website for more information and updates. 

Extended Temporary Rate Enhancements

Special Bulletin #119 indicated that temporary rate enhancements would continue through Sept. 30, 2020. NC Medicaid has determined that it is both necessary and feasible to continue temporary enhanced rates related to COVID-19 through the expiration of the Public Health Emergency, currently Oct. 23, 2020. If the federal government extends the federal Public Health Emergency or takes other action, NC Medicaid will reassess both needs and available funding. Please refer to relevant COVID-19 Medicaid Bulletins and Medicaid fee schedules for details. 

Temporary Clinical Policy Provisions

Special Bulletin #119 indicated that Temporary Clinical Coverage Policy modifications would be extended through Dec. 31, 2020. Some policy modifications will require an extension of the federal Public Health Emergency declaration to continue beyond Oct. 23, 2020. 

Many of the Clinical Policy Provisions, such as the telehealth provisions, enacted to support COVID-19 response can continue past the Public Health Emergency and are in the process of becoming permanent policy. NC Medicaid is seeking federal authority where appropriate. 

  • For permanent policy changes to the Medicaid program, NC Medicaid will post changes publicly
  • All stakeholders are encouraged to provide feedback. 

The table below clarifies when certain COVID-19 related federal authorities will end relative to the end of the federal Public Health Emergency. NC Medicaid will notify providers through special bulletins of any termination of temporary policies if the Public Health Emergency is not extended. Please use the table below to review which temporary provisions might be affected if the Public Health Emergency is not extended.

Source of Federal Authority

Expirationof Federal Authority

DHB has the authority to end prior to the end of federal expiration date

COVID-19 1115 Waiver

Expires at end of Public Health Emergency + 60 days

1135 Waiver​s

Expires at end of Public Health Emergency

Medicaid Disaster SPAs

Expires at end of Public Health Emergency

CHIP Disaster SPA

Expires at end of Public Health Emergency or state-declared emergency​ whichever is later

Concurrence Letter

Expires at the end of the Public Health Emergency​                       

Appendix Ks​ (applicable to 1915(c) waivers)

Expires on March 12, 2021 ​

 

Contact

NCTracks Contact Center: 800-688-6696