Medicaid Bulletin

NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries may access and receive Medicaid services in the wake of COVID-19. Retainer payments may be made for direct care providers of services that include habilitation or personal care that are currently authorized in the Individual Support Plan (ISP). 

NCDHHS is directing providers to stop collecting copayments from Medicaid and NC Health Choice beneficiaries on all COVID-19 related testing, services and treatments. This change is effective retroactive to Jan.

Considering the challenges providers are facing with COVID-19 pandemic, Medicaid is extending the due date for March 31, 2020, credit balance reports by 90 days. The extension will allow providers to submit their March 31 and June 30, 2020, credit balance reports. All credit balance reports for March 31 and June 30, 2020, quarter ends will be due July 30, 2020.

During the period of the State of Emergency, supervisory visits must be conducted, but may be conducted utilizing eligible technologies that allow the supervising registered nurse to remotely communicate and evaluate services rendered. Supervisory visits can be delivered via any HIPAA-compliant, secure technology with audio and video capabilities including (but not limited to) smart phones, tablets and computers.

To avoid delays in beneficiaries receiving needed private duty nursing services, NC Medicaid is temporarily approving prior authorizations that are in pending status for documentation of validation of primary insurance for 60 calendar days. This will allow for the delayed verification responses from individual third-party insurance providers to be uploaded to the prior authorizations in NCTracks. Details regarding documentation, supervisory visits and eligible remote technologies are included in this bulletin.

Congress has enacted three significant stimulus packages to help the country weather the COVID-19 pandemic, which establish a variety of funding sources to support providers, each with distinct features including which provider types are eligible, if providers must apply to be considered and if the financial benefit is a grant or a loan that must be repaid. NC Medicaid has created a summary of financial relief available by provider type.

NC Medicaid has received federal approval of flexibilities during the COVID-19 crisis for the NC Innovations Waiver for individuals with intellectual and developmental disabilities (IDD); NC Traumatic Brain Injury (TBI) Waiver for individuals who have a TBI diagnosis after age of 21; Community Alternatives Program for Disabled Adults (CAP/DA) for disabled adults and the Community Alternatives Program for Children (CAP/C) for medically fragile children.

Note: Additional Family Planning guidance may be released in the future, which would replace this bulletin.