SPECIAL BULLETIN COVID-19 #153: Temporary Provider Rate Increases and Clinical Policy Changes Extended

Thursday, January 21, 2021

In response to the Federal Department of Health and Human Services’ extension of the Federal COVID-19 Public Health Emergency, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through March 31, 2021. 

Federal Public Health Emergency Declaration

The current expiration date for the federal Public Health Emergency is April 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 all temporary rate increases related to COVID-19 through March 31, 2021. As we approach that date, NC Medicaid will reassess both needs and available funding for further extension of temporary rate increases. Note that the legislated 5% rate increases authorized under SL 2020-4 cannot be extended beyond March 31, 2021 unless there is additional legislation amending the end date set in SL 2020-4. Please refer to relevant COVID-19 Medicaid Bulletins and Medicaid fee schedules for details and further communication. 

Temporary Clinical Policy Provisions

Consistent with Special Bulletin COVID-19 #139, 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 the end of the Public Health Emergency + 60 days

1135 Waivers

Expires at the end of the Public Health Emergency

Medicaid Disaster SPAs

Expires at the end of the Public Health Emergency

CHIP Disaster SPA

Expires the latter of the end of the Public Health Emergency or the state-declared emergency​

Concurrence Letter

Expires at the end of the Public Health Emergency

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

Expires six months after the Public Health Emergency ends ​

Contact

NCTracks Contact Center: (800) 688-6696