SPECIAL BULLETIN COVID-19 #174: Temporary Provider Rate Increases and Clinical Policy Changes Extended

NC Medicaid is extending COVID-19 temporary provider rate increases for all providers except hospitals through Sept. 30, 2021. While the rate increases for providers authorized under SL 2020-4 were set to expire on June 30, 2021, NC Medicaid has discretion to continue these and other temporary rate increases assuming budget availability. NC Medicaid will continue to provide updates in September on the status of these increases. As previously communicated in Medicaid COVID-19 Special Bulletin #171, COVID-19 temporary provider rate increases applicable in NC Medicaid Direct (formerly known as fee-for-service) will also apply in managed care (Standard Plan PHPs and LME-MCOs). Please see the bulletin above for additional details on how the rate increases apply.

Federal Public Health Emergency Declaration

Although the current expiration date for the federal public health emergency (PHE) is Oct. 17, 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 feasible, contingent on official extension of the federal PHE, to continue temporary NC Medicaid Direct rate increases related to COVID-19 through Sept. 30, 2021, for all providers except hospitals. 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.

Enhanced inpatient and outpatient hospital base rates were effective July 1, 2021. To stay within federal upper payment limitations, the legislated 5% COVID-19 rate increases for hospitals were discontinued effective July 1, 2021.

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. Please use the table below to review expiration of temporary provisions.

* NC Medicaid has the authority to end prior to the expiration of the federal authority.

Contact

NCTracks Call Center: 800-688-6696