Medicaid Bulletin

DHHS Awards Contract for Electronic Visit Verification

Friday, October 2, 2020

NC DHHS awarded a contract to Sandata Technologies, LLC on Sept. 24, 2020, and will implement services for Electronic Visit Verification (EVV) statewide on Jan. 1, 2021. EVV is a method used to verify visit activity for services delivered as part of home- and community-based service programs. EVV offers a measure of accountability to help ensure that individuals who are authorized to receive services in fact receive them.

SPECIAL BULLETIN COVID-19 #114: Hospice Room and Board Reimbursement Rate Increase and Clarification of COVID-19 Rate Billing Guidelines for Skilled Nursing Facilities and Hospice Providers

Monday, July 20, 2020

This NC Medicaid Bulletin provides an  overview of COVID-19 rate increases applicable to SNFs and Hospice providers; Hospice provider rate increase from 95% to 100% of Skilled Nursing Facility (SNF) reimbursement rates for room and board services provided in a SNF; and billing guidelines for Hospice services provided in a SNF designated as a “COVID-19 Outbreak” or “COVID-19 Response” site.

SPECIAL BULLETIN COVID-19 #100: Hospice Provider COVID-19 Rate Structure Clarifications

Monday, June 15, 2020

NC Medicaid has implemented COVID-19 rate increase functionality to reimburse hospice care provided in a skilled nursing facility (SNF) designated as a “SNF COVID-Outbreak site” or “SNF COVID-Response site” in a ratio consistent with how hospice care is reimbursed in all other SNFs. 

SPECIAL BULLETIN COVID-19 #81: Hospice Clinical Coverage Policy: Changes due to CMS Amendment and Other Flexibilities

Monday, May 4, 2020

On March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) announced an amendment of 42 CFR 440.70 that included two policy changes that affect hospice services for Medicaid during the COVID-19 pandemic. Effective March 30, 2020, NC Medicaid is adjusting hospice requirements currently in Clinical Coverage Policy 3D, Hospice Services to align with these recent CMS regulatory changes. 

SPECIAL BULLETIN COVID-19 #79: Telehealth and Virtual Patient Communications Clinical Policy Modifications – Skilled Nursing Facilities

Friday, May 1, 2020

NOTE: SPECIAL BULLETIN COVID-19 #79 has been replaced in its entirety by SPECIAL BULLETIN COVID-19 #103. This Bulletin clarifies that skilled nursing facilities (SNF) are eligible originating sites for telemedicine visits and enables such facilities to bill for a facility fee when a beneficiary located in a SNF receives care via telemedicine from an eligible remote provider.  

Clinical Coverage Policy Update

Monday, January 13, 2020

The following new or amended clinical coverage policies are available on the NC Medicaid Clinical Coverage Policies web page.

Reminders on Hospice Policy

Monday, July 1, 2019

Clinical review is not required for North Carolina Medicaid and NC Health Choice hospice services until after the completion of the first and second 90-day benefit period.   

Hospice Payment Reform Update

Monday, July 1, 2019

Due to the implementation of Centers for Medicare and Medicaid Services (CMS) FY 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements Final Rule, NC Medicaid made policy and system changes to allow for the use of two-tier hospice fee schedules effective Jan. 1, 2016.

Clinical Coverage Policies 3D - Hospice Services Policy Update

Thursday, February 8, 2018

Effective Jan. 15, 2018, updates to Clinical Coverage Policy 3D, Hospice Services, are approved. The amended policy is posted to the North Carolina Medicaid website.

Corrections to N.C. Medicaid Bulletin December 2017- Hospice Policy Updates

Tuesday, January 9, 2018

With each prior approval (PA) entry beginning with the third and subsequent benefit periods, providers must fax a copy of the Approval Status Inquiry Form, or the NCTracks Web Submitted Request for Hospice Prior Approval Confirmation Page, to DMA at 919-715-9025. DMA requests that providers include their name and e-mail address on the above forms.

Subscribe to Medicaid Bulletins Updates

Medicaid Bulletin Monthly Digest

Medicaid Bulletin Archive

Articles beginning January 2018 are available in the blog format.

Associated Files