SPECIAL BULLETIN COVID-19 #199: Temporary Provider Rate Increases and Clinical Policy Changes Extended
Rate increases originally extended to November 30 now set to expire Dec. 31, 2021

NC Medicaid is extending all current COVID-19 temporary provider rate increases through Dec. 31, 2021.

THIS BULLETIN IS AN UPDATE TO SPECIAL BULLETIN COVID-19 #193, POSTED ON OCT. 22, 2021. 

NC Medicaid is extending all current COVID-19 temporary provider rate increases through Dec. 31, 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 on the status of all rate increases as more information becomes available,. 

As previously communicated in Medicaid SPECIAL BULLETIN COVID-19 #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 for additional details on how the rate increases apply. 

Federal Public Health Emergency Declaration

The current expiration date for the federal public health emergency (PHE) is Jan. 16, 2022, and DHHS is monitoring the federal changes closely. 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, to continue all current temporary fee-for-service rate increases related to COVID-19 through Dec. 31, 2021. As we approach that date, NC Medicaid will reassess whether both need and available funding support further extension of temporary rate increases. Please refer to relevant COVID-19 Special Medicaid Bulletins and Medicaid fee schedules for details and further communication.

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. Please note, policies not made permanent that were authorized under the NC State of Emergency (SOE) rather than as part of a federal authority could end with the SOE. DHB will provide additional details on the termination timelines for temporary clinical policies as more information on the end of the PHE and SOE is available.
 

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.

Contact

NCTracks Contact Center: 800-688-6696

 

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