Medicaid Bulletin

SPECIAL BULLETIN COVID-19 #30: Personal Care Services Assessments

Tuesday, March 31, 2020

On March 10, 2020, Governor Roy Cooper issued an executive order declaring a State of Emergency for North Carolina to respond to COVID-19. In addition, the Department of Health and Human Services made several recommendations to slow the spread of COVID-19 and reduce the number of people infected.

SPECIAL BULLETIN COVID-19 #29: Coverage for Automatic Blood Pressure Monitors: Temporary Flexibilities Effective March 30, 2020

Tuesday, March 31, 2020

Effective March 30, 2020 NC Medicaid and NC HealthChoice coverage was added for HCPCS code A4670 – automatic blood pressure monitor.

SPECIAL BULLETIN COVID-19 #28 [ADDENDUM to Bulletin #9 Effective March 30, 2020]: Telehealth Provisions - Clinical Policy Modification

Monday, March 30, 2020

This is an update to SPECIAL BULLETIN COVID-19 #9: Telehealth Provisions – Clinical Policy Modification, originally issued on March 20, 2020.

This revised Special Medicaid Bulletin #28, issued March 30, 2020, supersedes Special Bulletin COVID-19 #9.

SPECIAL BULLETIN COVID-19 #27: Update for PACE Organizations

Monday, March 30, 2020

PACE organizations are responsible for providing all required Medicare and Medicaid covered services to its PACE participants. This responsibility also extends to the participants’ home setting. Due to the COVID-19 pandemic, NC Medicaid recognizes that PACE organizations will need to adjust business operations and the methods utilized to address the needs of PACE participants.

SPECIAL BULLETIN COVID-19 #26: Expansion of Home Infusion Therapy Drug Categories; Clinical Policy Modification 3H-1

Monday, March 30, 2020

Effective March 30, 2020 NC Medicaid is temporarily modifying the Home Infusion Therapy Clinical Coverage Policy No.: 3H-1 to better enable the delivery of remote care to Medicaid members. These temporary changes will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded. This expansion of home infusion therapy serves to allow beneficiaries to receive services in the home rather than in a dedication infusion center to reduce potential exposure to COVID-19.

SPECIAL BULLETIN COVID-19 #25: Emergency Update to NC Medicaid and NC Health Choice Preferred Drug List (PDL) and REMS Program Flexibilities

Friday, March 27, 2020

Effective March 25, 2020, due to drug shortages in the marketplace, the NC Medicaid and NC Health Choice PDL Category of “Respiratory: Beta-Adrenergic Handheld, Short Acting” has changed.

SPECIAL BULLETIN COVID-19 #24: NC Medicaid Cost Report Filing Extensions Due to COVID-19

Friday, March 27, 2020

Select provider types enrolled in the North Carolina Medicaid Program are required to file annual Medicaid cost reports utilizing cost reporting schedules which are based on approved Medicare cost reporting platforms.

SPECIAL BULLETIN COVID-19 #23: Home and Community-Based Services (HCBS) Flexibilities for Waiver Beneficiaries Enrolled in NC Innovations Waiver and NC TBI Waiver

Friday, March 27, 2020

NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries may access and receive Medicaid services in the wake of COVID-19. Utilization and prior approval limits for specific State Plan Medicaid services will be relaxed for all Medicaid beneficiaries impacted by COVID-19 including individuals participating in the NC Innovations Waiver and the NC TBI Waiver. NC Medicaid has created an emergency planning document called Appendix K to seek approval to modify the scope, frequency, amount and setting of how waiver services are used and approved.

SPECIAL BULLETIN COVID-19 #22: CAP/C and CAP/DA Home and Community-Based Services (HCBS) Flexibilities for Waiver Beneficiaries Enrolled in 1915(c) HCBS Waivers

Friday, March 27, 2020

NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries may access and receive Medicaid services in the wake of COVID-19. Prior approval and service utilization limits for specific State Plan Medicaid services will be relaxed for all Medicaid beneficiaries impacted by COVID-19, including individuals participating in the Community Alternatives Program (CAP) waivers.

SPECIAL BULLETIN COVID-19 #21: Telehealth Provisions - Outpatient Specialized Therapies and Dental Services

Friday, March 27, 2020

Effective March 30, 2020, NC Medicaid is temporarily modifying its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid and NC Health Choice beneficiaries. These temporary changes will be retroactive to March 10, 2020, and will end the earlier of the cancellation of the North Carolina state of emergency declaration or when this policy is rescinded.

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