UPDATE: To avoid a disruption in care and support consumers and their families, NC Medicaid is extending Appendix K temporary flexibilities until Feb. 29, 2024, while the Centers for Medicare & Medicaid Services (CMS) reviews the Innovations and Traumatic Brain Injury Waiver amendments.
Appendix K flexibilities were implemented during the Public Health Emergency and were scheduled to end effective Nov. 11, 2023. The Centers for Medicare and Medicaid Services (CMS) is allowing states to continue Appendix K flexibilities beyond Nov. 11, 2023, if the state submits a 1915(c) waiver amendment making some or all the Appendix K flexibilities permanent.
To avoid a disruption in care and support consumers and their families, NC Medicaid is extending Appendix K temporary flexibilities until Feb. 29, 2024, while the Centers for Medicare & Medicaid Services (CMS) reviews the Innovations and Traumatic Brain Injury Waiver amendments.
Once the amended 1915(c) Innovations Waiver becomes effective, only the flexibilities which are permanently added to the 1915(c) Innovations Waiver will continue. NC Medicaid recognizes the need for time to transition from the various flexibilities ending and is requesting CMS to make North Carolina’s 1915(c) Innovations Waiver amendment effective March 1, 2024. NC Medicaid will communicate formal approval of this extension request as soon as it is available from CMS.
NC Medicaid submitted a 1915(c) Innovations Waiver amendment to (CMS) to make the following Appendix K flexibilities permanent:
- Allow home delivered meals (up to seven meals per week/one per day).
- Allow real time, two-way interactive audio and video telehealth for Community Living Support; Day Support, Supported Employment; Supported Living and Community Networking to be delivered via telehealth.
- Allow waiver individuals to receive services in alternative locations: hotel, shelter, church or alternative facility-based settings.
- Remove the requirement for the beneficiary to attend the day supports provider once per week.
- Allow the Community Navigator to note individuals may not receive this support unless they are self-directing one or more of their services through the agency with choice or employer of record model.
- Increase the Innovations waiver cap from $135,000 to $157,000 per waiver year.
- Allow parents of minor children receiving Community Living and Support to provide this service to their child who has been indicated as having extraordinary support needs up to 40 hours/week.
- Allow Supported Living to be provided by relatives.
- Allow relatives as providers for adult waiver individuals to provide above 56 hours/week, not exceeding 84 hours/week of Community Living and Supports.
Medicaid Contact Center, 888-245-0179