SPECIAL BULLETIN COVID-19 #163: Temporary Provider Rate Increases and Clinical Policy Changes Extended
In response to the NC General Assembly's extension of the legislated 5% rate increase authorized under SL 2020-4 and consistent with the federal Department of Health and Human Services stated intent to extend the federal COVID-19 Public Health Emergency (PHE), NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through June 30, 2021.
Federal Public Health Emergency Declaration
Although the current expiration date for the federal PHE is April 21, 2021, the federal government has informed states in writing that it plans to extend the PHE through at least the end of the calendar year. 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, contingent on official extension of the federal PHE, to continue all temporary fee-for-service rate increases related to COVID-19 through June 30, 2021. As we approach that date, NC Medicaid will reassess both needs and available funding for further extension of temporary rate increases. Please refer to relevant COVID-19 Medicaid Bulletins and Medicaid fee schedules for details and further communication.
NC Medicaid will also continue to fund through June 30, 2021, COVID-19 related provider reimbursement increases consistent with those in the fee-for-service system for behavioral health and I/DD services. This extension will be managed through LME/MCO capitation rates.
Temporary Clinical Policy Provisions
Consistent with Special Bulletin COVID-19 #139, many Clinical Policy Provisions, such as the telehealth provisions enacted to support COVID-19 response that do not require new federal authorities, are in the process of becoming permanent policy and 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 outlines when certain COVID-19 related federal authorities will end relative to the end of the federal PHE. NC Medicaid will notify providers through special bulletins of any termination of temporary policies if the PHE is not extended. Please use the table below to review expiration of temporary provisions.
|SOURCE OF FEDERAL AUTHORITY||EXPIRATION OF FEDERAL AUTHORITY*|
|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|
*NC Medicaid has the authority to end prior to the end of the end of the federal expiration date.
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