This bulletin is an update to SPECIAL BULLETIN COVID-19 #233.
NC Medicaid appreciates the engagement of all providers who submitted information to participate in the Direct Care Worker One-Time Bonus initiative. NC Medicaid’s initial review of provider submissions identified cases that required further review for eligibility. To allow time for the reviews, NC Medicaid delayed payment for these submissions. NC Medicaid has completed review of these submissions and will be issuing payments to providers with confirmed eligibility determinations during the March 29, 2022, checkwrite. This bulletin provides guidance for affected providers to distribute those one-time bonus payments.
Provider Payment Receipt
Providers with confirmed submissions from the NC Medicaid eligibility review will receive one-time bonus payments combined with regular claims payments in a single EFT transaction. Providers can identify the total amount of bonus funds and the number of eligible DCWs through a remittance message on the FINANCIAL TRANSACTION page of the Remittance Statement. An example of this message is shown below:
Identification of Eligible Direct Care Workers
Providers who did not have submissions under review for “other” position descriptions should use the number of DCWs listed in the remittance message and their submission history within the DCW Bonus Eligibility Portal to identify the DCWs and support staff who were reported. Providers are responsible for identifying the non-licensed DCWs they reported as eligible and paying them the one-time bonus within 45 days of funds receipt.
- NC Medicaid completed review of submissions that included DCWs reported under the “other” positional description. Instructions and next steps are below for providers in this submission category to identify the eligible position descriptions:
- NC Medicaid has deducted any number of workers reported under ineligible position listings from the total number of DCWs the provider submitted. Additionally, any number of workers submitted under the “Licensed Professionals” positional description have been deducted from the total number of DCWs funded. The payment providers receive on March 29, 2022, as well as the remittance message will reflect these changes.
- NC Medicaid will provide email notifications on March 29, 2022, to providers detailing any deductions made to the total number of direct care workers they reported. The email notification will be sent to the provider’s authorized user.
- IMPORTANT: The email notification will include a link to the case submission detail and the list of position descriptions that NC Medicaid identified as ineligible. Providers will use the list of ineligible position descriptions and the case submission detail to identify the position descriptions NC Medicaid determined were eligible for the one-time bonus. For example:
- Provider A submits “other” positional descriptions as “CEO” and “CNA”
- The authorized user of provider A will receive email notification with a link to the case submission detail and a list of ineligible position descriptions containing “CEO”
- The authorized user will access the case submission detail and determine the number of workers submitted under “CNA” and any other eligible positions to pay those workers their one-time bonus
- IMPORTANT: During this review, NC Medicaid identified submissions that need provider cooperation to determine eligibility. NC Medicaid will distribute email notifications to the authorized users of these providers requesting more information. NC Medicaid strongly recommends providers respond within five business days or risk having their submission deemed ineligible.
Provider Payment Distribution
Each provider will receive a total amount of $2,095.24 for each eligible non-licensed DCW and support staff employee. Providers must pay each eligible non-licensed DCW and support staff employee a gross bonus amount of $1,946.34 and may utilize the remaining $148.90 (7.65% of gross bonus) per employee to account for payroll costs.
A breakdown of the uniform bonus amount is below:
- Total amount providers receive per DCW and support staff: $2,095.24
- Amount allotted for provider share of FICA: $148.90
- Gross bonus amount each DCW and support staff employee will receive: $1,946.34
- Note: Gross bonus payment is also subject to state and federal payroll taxes for the employee.
Providers are responsible for identifying the non-licensed DCWs they reported as eligible and paying them the one-time bonus. The DCW Bonus Eligibility Portal remains open for providers to review submission history, which includes the number of DCWs and support staff submitted and their positional descriptions. Providers are required to distribute the one-time bonus within 45 days of funds receipt.
Outstanding One-Time Bonus Submissions
NC Medicaid will distribute requests to certain providers for additional information to support completion of the “other” positional description reviews, and identification of correct NPIs. NC Medicaid strongly recommends that providers respond to any inquiry within five business days or they risk the submission being deemed ineligible. NC Medicaid anticipates finalizing all outstanding one-time bonus submissions for payment during an April 2022 checkwrite.
Resources
- Providers who believe the bonus funds they received are in error should contact the Medicaid.DCW.Bonus.Help.Center@dhhs.nc.gov.
- NC Medicaid will be updating this bulletin with a link to frequently asked questions related to this aspect of the DCW One-Time Bonus. Additional information regarding all DCW initiatives can be found on NC Medicaid’s Direct Care Worker Initiative webpage.
For any remaining questions, providers may contact Medicaid.DCW.Bonus.Help.Center@dhhs.nc.gov.