As previously communicated in the Medicaid Bulletin released on Dec. 14, 2022, Skilled Nursing Facilities Provider Assessment Modifications and Update on Temporary COVID-19 add on Rates, NC Medicaid revised the skilled nursing facility (SNF) provider assessment program structure to allow NC Medicaid to reinvest additional provider tax collections and associated federal matching dollars into an increase in Medicaid SNF-specific per diem rates.
The change and resulting new per diem rates also incorporated the temporarily enhanced federal match in place at the time as part of the federal COVID-19 response. Since that temporarily enhanced federal match rate will adjust on April 1, 2023, consistent with federal law, NC Medicaid must now adjust the SNF provider assessment amount accordingly.
Provisions of the Families First Coronavirus Response Act (FFCRA) signed into law on March 18, 2020, allowed states meeting certain requirements to be eligible for enhanced federal match of Medicaid payments during the COVID-19 Public Health Emergency (PHE). The SNF provider assessment, which is authorized to fund part of the non-federal share of SNF per diem rates, was temporarily reduced by the presence of the temporarily enhanced federal match. Had this enhanced match not been in place on Nov. 1, 2022, the provider assessment rate increase put into effect on that date would have been higher.
Provisions of the federal Consolidated Appropriations Act of 2022 signed into law on Dec. 29, 2022, severed the linkage between the enhanced federal match and the end of the COVID-19 PHE. Instead, the Act identified a phased reduction of the enhanced federal match beginning April 1, 2023.
Consequently, effective April 1, 2023, and quarterly thereafter, NC Medicaid will adjust the quarterly SNF provider assessment rate as identified below to continue supporting the same level of per diem rates as outlined in Medicaid Bulletin released on Dec. 14, 2022:
For Dates of Service Beginning |
Continuing Care Retirement Communities and Tribal Facilities |
Nursing Facility Total Annual Census |
Nursing Facility Total Annual Census |
Greater than 42,000 Patient Days |
0 - 42,000 Patient Days |
||
Jan. 1, 2023 |
$0.00 |
$8.64 |
$26.74 |
April 1, 2023 |
$0.00 |
$7.88 |
$24.38 |
July 1, 2023 |
$0.00 |
$9.45 |
$29.25 |
Oct. 1, 2023 |
$0.00 |
$9.45 |
$29.25 |
Jan. 1, 2024 |
$0.00 |
$9.45 |
$29.25 |
April 1, 2024 |
$0.00 |
$9.45 |
$29.25 |
Pursuant to Section .0109 in Chapter 22, Subchapter G of the North Carolina Administrative Code, SNF per diem assessments are imposed on occupied non-Medicare patient days and are due within 15 days of the last day of the reporting month. For example, payment at the new rate for the reporting month of April 2023 is due by May 15, 2023.
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NCTracks Call Center: 800-688-6696