COVID-19 #35 – Time-Limited Rate Increases | QM Monitoring | DHB/DMH meeting

Time-Limited Rate Increases

As part of the Partners Service Stability Program, and to align with communication from DHHS, Partners will continue time-limited rate increases for the following Medicaid services as outlined below. The temporary increases will be continued through Jan. 21, 2021.

Quality Management Provider Monitoring Update

The Quality Management (QM) Monitoring Unit will resume monitoring activities on November 16, 2020 on a limited basis.

• TCLI Targeted Reviews of providers will continue until completed. The QM Monitoring Unit has completed approximately 50% of these reviews to date.
• Unlicensed Alternative Family Living (UAFL) sites will be conducted virtually. QM Monitoring Specialists will contact providers to schedule virtual reviews. Any reviews that were normally conducted between March 1, 2020 to October 31, 2020 will be moved to their next annual review date in 2021.
• Post payment reviews (regular monitoring reviews, often referred to as routine monitoring) will resume on a limited basis and will be conducted by desk review. Providers will be notified individually at least 21 days prior to a monitoring review start. QM Monitoring Staff will work individually with each provider to ensure an agreed upon process of dropping off records or uploading records electronically is put into place. The time frames for submitting documentation will be worked out on an individual provider basis to ensure a smooth and somewhat seamless review.

To begin the Post Payment Review, process priority will be given to conducting reviews of:

1. Community Support Team providers.
2. New providers that have begun services between July 1, 2019 to March 31, 2020.
3. Any provider that scored less than 85% during the last Post Payment Review cycle.
4. Employer of Record Members.

It is the intention of the QM Monitoring Unit to work collaboratively with all providers during this time to assist in making the monitoring process as smooth and seamless as possible. Each providers’ unique situation will be taken into consideration so that we can foster a team effort and successful review.

Joint NC DMHDDSAS and DHB COVID 19 Update for NC Providers

The Division of Health Benefits and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services will host their monthly Provider Update on Nov. 5 at 3 p.m.

• During this call, panelists will present policy updates from DMHDDSAS and DHB representatives followed by an open Q&A session.
• NC Start will be giving a short presentation on identifying and coping with stress, depression and other issues in individuals with IDD.
• Division of Public Health will provide information of Tobacco Free policies as they relate to Medicaid.

In addition to DMHDDSAS and DHB subject matter experts we will also have a representative from DHSR on the call to answer questions you might have.  In consideration of the limited time we have on the call, we ask that you review the guidance links (below) on the DHHS website and FAQs on the NC Medicaid site to see if an answer to your question has already been provided.

As things continue to change and move quickly during the COVID-19 pandemic, please continue to stay abreast of emerging issues, guidance, and policies by visiting:

• Broad information and updates
• Policy and Guidance updates
• COVID19 Executive Orders

Register here: https://register.gotowebinar.com/register/622431743863482382

Closed Captioning available at https://www.captionedtext.com/client/event.aspx?EventID=4612765&Customer