Hurricane Dorian: Receiving & Providing Medicaid Services

The Department of Health and Human Services is committed to ensuring beneficiaries and health care professionals can continue receiving and providing Medicaid services as we recover from Hurricane Dorian. On Sept. 4, 2019, the Department received federal authority to make temporary changes to some Medicaid services and processes that will make it easier for beneficiaries to get the services they need. These flexibilities are reviewed at intervals and changes are posted on this webpage and in more detail in a Medicaid Special Bulletin.

Medicaid Temporary Flexibilities as of Sept. 24, 2019

Below are highlights of the temporary flexibilities and other special procedures in place now due to Hurricane Dorian. IMPORTANT: Please read the Sept. 24, 2019, Medicaid Special Bulletin for details about re-evaluation, provisions, processes and revised effective dates.

  • Reimbursement for medically necessary services. NC Medicaid will reimburse providers for medically necessary drugs and services, and equipment and supplies, provided during the Hurricane Dorian emergency without prior approval from Sept. 4-30, 2019. This includes high-tech imaging prior approval through eviCore. (Extended from 9/20 to 9/30/2019.)
  • NC Health Choice flexibilities. NC Health Choice flexibilities are temporarily added to several key policies and procedures through Nov. 3, 2019.
  • Medication prior approval and prescription refills. Pharmacy providers are approved to override prior approval requirements and to early fill medications effective Sept. 3. (Extended from 9/20 to 9/30/2019.)
  • Critical access hospital bed limits. The limit of 25 beds is lifted Sept. 4-30, 2019. (Extended from 9/20 to 9/30/2019.)
  • Personal care services. Assessments scheduled Sept. 4-6 in certain counties have been cancelled. A list of counties is available in the Medicaid Special Bulletin. An expedited assessment process may be available for evacuees placed in an Adult Care Home by DSS due to shelter needs.
  • Innovations waiver flexibilities. Approved Innovations waiver flexibilities includes temporarily exceeding certain time and benefit limits; postponement or relaxation of timing for annual reassessments, service plan approvals and face-to-face meetings; and no prior approval for services provided out-of-state. Please note: Innovations waiver flexibilities have specific uses and circumstances, and are time limited. Please refer to the Medicaid Special Bulletin for details.  
  • Nursing home admissions. Temporary PASSR procedures are not required for new admissions for 30 days, and transfers between nursing facilities due to Hurricane Dorian will not require a PASSR from Sept. 4 through Oct. 15, 2019. Also, through the 3-day qualifying hospital stay requirement is waived from Sept. 4 through Oct. 15, 2019, for beneficiaries how requires a short-term stay in a nursing facility due to Hurricane Dorian. 
  • Durable medical equipment replacement. Documentation that will be accepted for equipment loss or damage due to Hurricane Dorian. 
  • CAP/C and CAP/DA emergency and disaster plan activation. Preparation steps, coordination and reporting for case management entities to serve CAP/C and CAP/DA beneficiaries. 

Rescinded Flexibilities

Executive Order 107, Sept. 9, 2019: Providers not enrolled in NC Medicaid may no longer apply to temporarily provide service to Medicaid beneficiaries through an expedited process.

Updates will be posted as they become available. Information also will be delivered through future Medicaid Special Bulletins, posted to the NCTracks Provider Portal and emailed as an NCTracks Alert. 

Additional Resources

DHHS Hurricane Dorian web page
NC Governor Roy Cooper's Executive Order 101
NC Governor Roy Cooper's Executive Order 107
Centers for Medicare & Medicaid Services letter of authorization under Section 1135