Issued: January 2, 2024
The NC General Assembly appropriated $176 million in state and federal recurring funding in the Current Operations Appropriations Act of 2023 (SL 2023-134, Section 9E.15) to raise NC Medicaid Innovations waiver services rates so that Innovations services providers can in turn raise the hourly wages of their Direct Care Workers (DCW). While the increases vary by service type/payment methodology, they share a uniform unit increase of $1.13 per 15-minute increment of service.
How does this impact providers?
Innovations DCW rate increases will be applied retroactively to July 1, 2023. Partners will reprocess claims for dates of service on or after July 1, 2023, to ensure that providers receive the increased rates beginning on July 1, 2023.
Providers can begin using the updated rates on January 16, 2024.
Importantly, providers must sign and return an Attestation form that is required by legislation. The Attestation form will document each provider’s commitment to using increased rates to benefit its Innovations Direct Care Workers in the form of an increase in hourly wage, benefits, or associated payroll costs. Partners will send the Attestation form to providers through DocuSign. Providers may not submit claims with the new rates before returning the required Attestation form.
Partners updated fee schedule can be found here https://providers.partnersbhm.org/claims-information/, and it contains the Innovations DCW increases that are retroactive to July 1, 2023.
Partners has posted information regarding expectations for the rate increases and information that may be requested regarding documentation on the rate increases to our Provider Knowledge Base. Please note that member and provider-specific rates that are above the new rates will retain the higher rate and no action is required by the provider.
What if providers have questions?
Additional details regarding the services impacted and the base rate assumptions can be found on the NCDHHS website: NC Medicaid Innovations Waiver Provider Rate Increase.
If you have questions regarding these rate increases, please contact your assigned Provider Account Specialist at PAS@PartnersBHM.org.
INNOVATIONS DCW RATE INCREASE REPROCESSING
Impacted Innovations claims submitted before January 16, 2024, will be reprocessed by Partners retroactive to July 1, 2023. For those claims, there is no action needed by providers at this time. Once processed, the updated claims will be included in the provider’s Remittance Advice. If you have questions concerning the reprocessing of claims once the attestation is signed, please email ClaimsDepartment@PartnersBHM.org.