SPECIAL BULLETIN COVID-19 #220: Temporary Rate Increases Extended or Replaced Update on temporary rates that are extending or being replaced with permanent, legislated increases
This bulletin is an update to COVID-19 #203: NC Medicaid Revising and/or End-Dating All Temporary COVID-19 Rate Increases
NC Medicaid is extending a number of the temporary COVID-19 rate increases in place in January 2022 (as noted in Special Bulletin COVID-19 #203) through February 2022 and ending others that are being replaced with permanent, legislated increases. The specific details of each of these COVID-19 rate actions are listed below.
Temporary COVID-19 Rate Increases that are Continuing
NC Medicaid will continue temporary COVID-19 rate increases for the month of February 2022 for certain Home and Community Based Service (HCBS) provider categories in accordance with CMS guidance related to Section 9817 of the American Rescue Plan and other long-term services and supports. In February 2022, NC Medicaid will review the need and available funding for these continuing rate increases, which are described below.
All HCBS programs receiving temporary COVID-19 rates in January 2022 will receive one of the following in February 2022:
- Continuation of the temporary COVID-19 rate add-on in effect in January 2022.
- A permanent, legislated increase that is higher than the COVID-19 add-on in effect in January 2022.
NC Medicaid is working to finalize the amount of the permanent increase and will follow up with another bulletin with further details before Feb. 1, 2022.
NOTE: HCBS providers with direct care workers (DCWs) eligible for wage increases per the Current Operations Appropriations Act of 2021 (S.L. 2021-180) will be subject to new requirements for passing part of their rate increase to DCWs per Special Bulletin COVID-19 #214. NC Medicaid will provide further details before Feb. 1, 2022.
- Skilled Nursing Facilities (SNF)
The 5%,10% and uniform add-on rate of $47.50 will remain in place for SNFs for the month of February 2022. NC Medicaid will review the need and available funding for continuing these rate increases prior to the end of February 2022.
- Program of All-inclusive Care for the Elderly (PACE)
The 5% temporary COVID-19 rate increase in effect January 2022 for the PACE program will remain in place for the month of February 2022. NC Medicaid will review the need and available funding for continuing these rate increases prior to the end of February.
- Private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs-IID)
The temporary COVID-19 rate increases in effect for ICFs-IID in January 2022 will end-date January 31, 2022 and be replaced with a permanent legislated increase supported by funding provided in the Current Operations Appropriations Act of 2021 (S.L. 2021-180; see Special Bulletin COVID-19 #214). The ICF-IID per diem on the NC Medicaid Direct fee schedule will be increased by a flat amount that is still being finalized. NC Medicaid will provide further detail on the amount before February 1.
Effects on NC Medicaid Managed Care Plans and Contracted Providers
The LME/MCOs are required by contract to adjust provider reimbursement rates by an amount no less than the associated percentage change in the fee schedule made by NC Medicaid in the NC Medicaid Direct program in response to COVID-19. LME/MCOs will be required to continue the temporary COVID-19 payment increases for HCBS services and some residential care and crisis services covered in the LME/MCO program or incorporate the permanent, legislated increases for applicable HCBS programs and ICF-IID.
Standard Plan Prepaid Health Plans (PHP) Rates:
The Standard Plan PHPs are required by contract to adjust provider reimbursement rates by an amount no less than the associated dollar amount change in the fee schedule made by NC Medicaid in the NC Medicaid Direct program in response to COVID-19. PHPs will be required to either continue the public health emergency payment increases or incorporate the permanent, legislated increases for Skilled Nursing Facilities, PCS, PDN and HCBS services, as applicable.