Issued: December 3, 2020
NC Innovations Waiver Retainer Payments
On Nov. 24, the North Carolina Department of Health and Human Services (DHHS) issued Joint Communication Bulletin (JCB #381) regarding retainer payments for NC Innovations Waiver Services through Appendix K.
JCB #381 provides specific updates on the billing of retainer payments. For reference, retainer payments are time-limited payments made to an essential worker who was approved to provide the following NC Innovations Waiver Services: Community Living and Supports, Community Networking, Day Supports, Residential Supports, Supporting Living and Supported Employment.
Per JCB #381, and in accordance with the Centers for Medicare and Medicaid Services (CMS), retainer payments may only cover 30 billable days for up to a total of three separate, consecutive approval periods. Utilizing consecutive approval periods allows for payment to an essential worker for up to 90 consecutive billable days of the first retainer payment agreement.
Retainer payments were implemented in April 2020 without clear guidance on the utilization of this Appendix K flexibility, and as such, there are providers who have exceeded the guidelines as provided above for billing. As a result, NCDHHS has indicated that effective Dec. 31, 2020, retainer payment billing will stop for staff that have either utilized or exceeded the maximum number of retainer payments.
It is important to note that any paid claims made past the 90-day limit, prior to Dec. 31, 2020, are not subject to recoupment. Any providers found to be out of compliance with this billing starting Jan. 1, 2021, could be subject to a recoupment.
For those providers who have already exceeded the limit of 90 days of billing for retainer payments for the members that they support (as of Nov. 25, 2020), Partners has sent letters to affected providers, members, and legally responsible persons as notification of the implementation of these rules and the requirement to cease retainer payment billing by Dec. 31, 2020. The letters are also available for viewing in AlphaMCS. In addition, Care Management staff have or will reach out to the members/providers/legally responsible persons impacted.
The tracking of retainer payments is the responsibility of the provider. Please review member records to accurately ensure appropriate compliance with these new rules for the billing of claims for all retainer payments, effective Dec. 31, 2020.
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Registration of Interest Reissued
Partners has reissued the Registration of Interest for NC Medicaid Children and Youth Services for Burke and Rutherford Counties (ROI #1020-001). Information regarding this ROI can be found at https://providers.partnersbhm.org/request-for-services/#ROI-1020-001. Responses to this ROI are due by 5 p.m. on Dec. 31, 2020.
Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call for NC Providers
The next Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call for NC Providers will be held on Dec. 10 at 3 p.m. Please register at https://attendee.gotowebinar.com/register/330355276697976588. After registering, you will receive a confirmation email containing information about joining the webinar.
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NCDHHS Launches New Beneficiary Portal
On Wed., Dec. 2 the North Carolina Department of Health and Human Services announced the launch of a new Beneficiary Portal, on the NC Medicaid website. The portal will serve as a centralized information resource for those receiving or looking to apply for Medicaid benefits. It also offers information about Medicaid Managed Care, set to launch July 1, 2021.
The Beneficiary Portal is available in English and Spanish and retains all the information that was on the previous “Beneficiaries” page but organizes it in a more user-friendly way, adding easy-to-follow graphics and links. The portal adds a knowledge center starting with over 70 common questions and answers and a Help Center Assistant search feature that guides users to their most applicable topics of interest. More questions and answers are being added as they come in from users through the Medicaid Contact Center and other sources. The Portal will also offer new educational materials regarding telehealth services to help beneficiaries feel more confident accessing health care in a virtual format during COVID-19 and beyond.
Information and functionality will continue to be expanded to support greater self-service and more ways for beneficiaries to manage their Medicaid account. These will include personalized account views, a single password to access the portal and integration with NC FAST and other systems. It will also include the ability to get real-time assistance with an agent online through a bilingual chat feature.