COVID-19 Medicaid Bulletin Article Summary (#47-62)

The NC Division of Health Benefits (DHB) has recently published Medicaid Bulletin articles related to COVID-19. Below are exerts or summaries of some of the most recent articles and links for more details. All articles may be found on the DHB website.

 

SPECIAL BULLETIN COVID-19 #62: Clinical Policy Modifications - Suspending Copays on COVID-19-related Services

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. 1, 2020 through the end of the calendar quarter of the federally declared public health emergency period. Affected billing codes and more

 

SPECIAL BULLETIN COVID-19 #61: Credit Balance Quarterly Reports Extension

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. More details

 

SPECIAL BULLETIN COVID-19 #60: Fidelity Reviews Delayed for Current Individual Placement and Support (IPS) and Assertive Community Treatment (ACT) Teams

Effective April 16, 2020, any Assertive Community Treatment (ACT) team or Individual Placement and Support (IPS) team that met fidelity prior to the State of Emergency related to COVID-19 will continue to meet Medicaid and State-funded services policy requirements through the end of the declared State of Emergency. These temporary changes are retroactive to March 10, 2020. Read more

 

SPECIAL BULLETIN COVID-19 #59: Telehealth Clinical Policy Modifications - Outpatient Behavioral Health Services

Effective April 20, 2020, NC Medicaid in partnership with the DHHS Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSAS), is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability Clinical Coverage Policy 8C: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers to better enable the delivery of care to NC Medicaid, NC Health Choice and State-funded individuals in response to the COVID-19 Pandemic. More info

 

SPECIAL BULLETIN COVID-19 #58: Personal Care Services Additional Policy Allowances

This bulletin provides guidance on supervisory visits in beneficiary private residences, the requirement for physician referral, PCS conducted outside of beneficiaries’ primary private residence, the documentation request to determine PCS authorization and the service plan requirement. Details

 

SPECIAL BULLETIN COVID-19 #57: Private Duty Nursing Flexibility Updates

NC Medicaid is temporarily approving prior authorizations (PAs) that are in pending status for documentation of validation of primary insurance (PI) for 60 calendar days to allow for the delayed verification responses from individual third party insurance providers to be uploaded to the PA in NCTracks. Also during the period of the State of Emergency, Supervisory visits must be conducted, but may be conducted utilizing eligible technologies that allow the supervising RN to remotely communicate and evaluate services rendered. Read more

 

SPECIAL BULLETIN COVID-19 #56: Key Federal Funding Available for Health Care Providers and Hospitals

The “Key Federal Funding Available for Health Care Providers and Hospitals to Address COVID-19” document compiles information on the new federal funding available, organized by funding opportunity and eligible provider types. For each source of federal funding, the chart indicates whether providers must take some action to benefit, what action (if any) they must take, and where to find more information. Details

 

SPECIAL BULLETIN COVID-19 #55: NC Medicaid Receives Approval for Expanded Flexibilities for Home and Community-Based Services

During federally declared emergencies, states can submit requests to ease certain waiver requirements through an Appendix K. NC Medicaid received approval of Appendix Ks for all four of its waivers from the Centers for Medicare & Medicaid Services (CMS), effective March 13 to March 12, 2021. LME/MCOs and CAP agencies will evaluate the needs of their waiver participants and use the right flexibilities to meet beneficiary’s needs during this pandemic. Details of flexibilities

 

SPECIAL BULLETIN COVID-19 #54: Clinical Policy Modifications - Family Planning Services Annual Exam Requirement Waived

NC Medicaid has temporarily modified its Family Planning Clinical Coverage Policy, 1E-7 to better enable the delivery of remote care to Medicaid beneficiaries. An Annual Exam visit is not required prior to billing for Family Planning services. Claim editing to ensure that annual exams are completed prior to Family Planning visits, as well as HIV Screening and STI Screening and Treatment, have temporarily been suspended. More information

 

SPECIAL BULLETIN COVID-19 #53: Coronavirus Code Added as Billable Diagnosis and Annual Office Visit Limit Exemption

In response to the anticipated spread of coronavirus (COVID-19) in North Carolina, NC Medicaid is adding the following code as a billable diagnosis effective April 1, 2020:

     U07.1 - 2019-nCoV Acute Respiratory Disease

Read more

 

SPECIAL BULLETIN COVID-19 #52: Coverage for Weight Scales and Portable Pulse Oximeters - Temporary Flexibilities

Effective retroactive to March 10, 2020, Medicaid and NC Health Choice plans are temporarily covering weight scales and adding a purchase option for portable pulse oximeters. Details

 

SPECIAL BULLETIN COVID-19 #51: NCDHHS COVID-19 Guidance for NC Clinicians and Laboratories

An update to COVID-19 guidance for North Carolina clinicians and laboratories is now available. This update includes: 

• Updated laboratory testing guidance, 
• Updated criteria for submission of specimens to the North Carolina State Laboratory of Public Health (NCSLPH), and 
• Replacement of information that is not North Carolina-specific with links to relevant CDC guidance.

More information

 

SPECIAL BULLETIN COVID-19 #50: Provider Webinar Added for COVID-19 Appendix K Flexibilities for the NC Innovations and TBI Waivers

NC Medicaid has implemented flexibilities on how Medicaid providers deliver and beneficiaries 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. Note: This Webinar has already occurred, but check back for future updates on upcoming Webinars. More

 

SPECIAL BULLETIN COVID-19 #49: Telehealth Clinical Policy Modifications - Interim Perinatal Care Guidance

NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid beneficiaries. This article is an update to previous bulletin article #42, replacing previous guidance. Details

 

SPECIAL BULLETIN COVID-19 #48: Telehealth Clinical Policy Modifications - Remote Physiologic Monitoring Services

NC Medicaid has temporarily modified its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care to Medicaid beneficiaries. This bulletin article temporarily adds coverage for providers to help their patients engage in Remote Physiologic Monitoring (RPM), providing the opportunity to improve management of diseases and engage patients in their own care. Specific guidance and more

 

SPECIAL BULLETIN COVID-19 #47: Updates for PACE Organizations

This guidance supplements the Special Bulletin COVID-19 #27 released on March 30, 2020 and provides details of PACE Program Flexibilities. Learn more