SPECIAL BULLETIN COVID-19 #139: COVID-19 Temporary Provider Rate Increases and Clinical Policy Changes Extended

Wednesday, October 21, 2020

Consistent with the federal Department of Health and Human Services’ extension of the federal COVID-19 Public Health Emergency to January 21, 2021, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies to that same date. 

In September, NC Medicaid released Special Bulletin #134 which provided information on extensions of the COVID-19 temporary rate increases and clinical coverage policies in response to a previous extension of the federal Public Health Emergency declaration. This action will extend all COVID-19 rate increases currently in place.

Federal Public Health Emergency Declaration

The current expiration date for the federal Public Health Emergency is January 21, 2021. 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 Increases

NC Medicaid has determined that it is both necessary and feasible to continue temporary rate increases related to COVID-19 through the expiration of the Public Health Emergency, currently January 21, 2021. If the federal government extends the federal Public Health Emergency or takes other action, NC Medicaid will reassess both needs and available funding for further extension of temporary rate increases. Note that NC Medicaid will conduct standard annual rate updates on January 1, 2021, and any deviation from the annual process will be communicated through provider bulletins. Please refer to relevant COVID-19 Medicaid Bulletins and Medicaid fee schedules for details. 

Temporary Clinical Policy Provisions

Many of the Clinical Policy Provisions, such as the telehealth provisions, enacted to support COVID-19 response which do not require new federal authorities are in the process of becoming permanent policy and DHB is seeking federal authority where appropriate. For permanent policy changes to the Medicaid program, DHB 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. DHB 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 expiration of temporary provisions.

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