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Upcoming Benchmarks' Webinars
Benchmarks' Friday Membership Webinar
Dave Richard Joins Karen McLeod
Date: Friday, February 5, 2021
Time: 8:30 am thru 9:30 am
Benchmarks' Membership Child Welfare Webinar Lisa Cauley Joins Karen McLeod Date: Thursday, February 11, 2021 Time: 8:00 am thru 9:00 am Benchmarks' Friday Membership Webinar Date: Friday, February 19, 2021 Time: 8:30 am thru 9:00 am Note: There are no Benchmarks' webinars scheduled for the rest of this week.
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SPECIAL BULLETIN COVID-19 #153: Temporary Provider Rate Increases and Clinical Policy Changes Extended
In response to the Federal Department of Health and Human Services' extension of the Federal COVID-19 Public Health Emergency, NC Medicaid is extending COVID-19 temporary provider rate increases and clinical coverage policies through March 31, 2021.
Federal Public Health Emergency Declaration The current expiration date for the federal Public Health Emergency is April 21, 2021. The federal government may continue to extend the Public Health Emergency at its discretion. Please refer to the federal Public Health Emergency website for more information and updates. Extended Temporary Rate Increases NC Medicaid has determined that it is both necessary and feasible to continue all temporary rate increases related to COVID-19 through March 31, 2021. As we approach that date, NC Medicaid will reassess both needs and available funding for further extension of temporary rate increases. Note that the legislated 5% rate increases authorized under SL 2020-4 cannot be extended beyond March 31, 2021 unless there is additional legislation amending the end date set in SL 2020-4. Please refer to relevant COVID-19 Medicaid Bulletins and Medicaid fee schedules for details and further communication. Temporary Clinical Policy Provisions Consistent with Special Bulletin COVID-19 #139, many of the Clinical Policy Provisions, such as the telehealth provisions enacted to support COVID-19 response which do not require new federal authorities, are in the process of becoming permanent policy and DHB is seeking federal authority where appropriate. For permanent policy changes to the Medicaid program, DHB will post changes publicly. All stakeholders are encouraged to provide feedback.
The table below clarifies when certain COVID-19-related federal authorities will end relative to the end of the Federal Public Health Emergency. DHB will notify providers through special bulletins of any termination of temporary policies if the Public Health Emergency is not extended. Please use the table below to review expiration of temporary provisions.
DHSR Update on the Automated Background Check Management System (ABCMS)
Earlier this month, you received a notification regarding NC DHHS transitioning from Scantron sheets to the automated background check management system (ABCMS) beginning March 1, 2021. Many of you have reached out with questions regarding how this change impacts your existing processes today. Attached is a revised document that we hope answers your questions. If you have additional questions that are not answered in the attached document, then please contact the appropriate entity below.
Who Do I Contact for Questions?
NC DHHS - Criminal Background Check Unit
Telephone: 919-814-6420
ABCMS - Help Desk
Hours of Operation: Monday-Friday 8am-6pm
NC SBI - Access Agreement
Telephone: 919-582-8639
Medicaid Managed Care Provider Directory and Health Plan Look Up Tool
Providers are encouraged to use this tool to confirm the availability and accuracy of information contained in their NCTracks provider enrollment record. The provider directory contains all active Medicaid and NC Health Choice providers, including primary care providers, specialists, hospitals and organizations. The authenticated portal will be available to beneficiaries beginning March 1, 2021.
COVID-19 Stakeholder Updates
PRESS RELEASES since the last update include:
NEW resources since the last update include:
UPDATED guidance since the last update include:
UPDATED reports since the last update include:
Upcoming Olmstead Meetings
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Update to NCTracks Automated Voice Response System to Include Prepaid Health Plans
Effective Saturday evening, Jan. 23, 2021, the NCTracks Automated Voice Response System (AVRS) which providers reach when calling the NCTracks Call Center will be updated to include options to be transferred directly to Prepaid Health Plans (PHPs). Providers are encouraged to listen carefully for the new options when calling.
Update to January Provider Training Meeting Information
Due to technical difficulties, all January provider training classes now have updated meeting information. Please see the updated details for each class below.
Please note that the two classes scheduled for today have been moved to this Friday to account for the change in meeting information. For more information, please see the announcement.
Prior Approval Medical (Zoom)
Thursday, Jan. 28, 9:30 a.m. - noon
This course shows authorized users how to electronically submit, inquire about and void prior approvals for different kinds of medical services. At the end of this training, authorized users will be able to:
- Submit medical prior approval requests
- Inquire about prior approvals
- Void a prior approval
Meeting Information
Meeting ID: 160 792 7065
Password: 6^WuzPjpEc
Submitting a Professional Claim (Zoom)
Thursday, Jan. 28, 1:00 p.m. - 4:00 p.m.
This course will show authorized users how to submit professional (CMS-1500/837P) claims using the NCTracks web portal. Authorized users will learn what they need to know to file a claim and how to easily navigate claims entry screens. At the end of this training, authorized users will be able to:
- Create a professional claim
- Save a draft
- Use the Claims Draft Search tool
- Submit a claim
- View results of a claim submission
- View claim status and create a claim copy
- Resubmit a claim
- Void a prior claim or create a replacement for a prior claim
Meeting Information
Meeting ID: 161 777 6934
Password: 8@YpxHWu7K
Prior Approval Institutional (Zoom)
Friday, Jan. 29, 9:30 a.m. - noon
The purpose of this training is to show authorized users how to submit prior approvals (PAs) electronically via NCTracks. The prior approval functional area accepts PA data from provider-initiated information entry through the NCTracks web portal. This course will cover:
- Submitting PA requests to help ensure compliance with Medicaid clinical coverage policy and medical necessity
- Inquiring about PA requests to determine their status
Meeting Information
Meeting ID: 160 357 9628
Password: 1+AuHzY*7$
Submitting an Institutional Claim (Zoom)
Friday, Jan. 29, 1:00 p.m. - 4:00 p.m.
This course will provide instructions for authorized users to submit institutional claims electronically in NCTracks. At the end of this training, authorized users will be able to:
- Create an institutional claim via the NCTracks web portal
- Save a claim draft
- Submit a claim
- Search claim status
- Review claim status
- Copy a claim
- Void or replace a previous claim
Meeting Information
Meeting ID: 161 832 1934
Password: 2.JzPXu.UR
Training Enrollment Instructions
Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Log onto the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor-Led Training (ILT). The courses can be found in the sub-folder labeled ILTs: Remote via WebEx (although this is the sub-folder name, please note that, as previously mentioned, courses will now be conducted via Zoom and not WebEx).
Refer to the Provider User Guides & Training page of the public provider portal for specific instructions on how to use SkillPort. The Provider Training Tool Kits page also includes a quick reference regarding Java, which is required for the use of SkillPort.
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Updated Federal Poverty Guidelines for 2021:
U.S. FEDERAL POVERTY GUIDELINES USED TO DETERMINE FINANCIAL ELIGIBILITY FOR CERTAIN FEDERAL PROGRAMS
Administration Letter to Governors Indicates PHE to Extend Through 2021
Recently, the Biden Administration sent a letter to the nation's Governors signaling its intent to renew the COVID-19 Public Health Emergency (PHE) throughout 2021. Further, the letter indicates that the U.S. Department of Health and Human Services will provide states with 60 days' notice prior to terminating the PHE or allowing it to expire. Statute requires the PHE to be renewed every 90 days.
CMS Updates SUD Data Book
Notable findings include:
- Of the 55.9 million Medicaid beneficiaries with full or comprehensive benefits ages 12 and older, 4.6 million (8 percent) were treated for a SUD in 2018.
- 57 percent of beneficiaries treated for a SUD were diagnosed with tobacco use disorder and 30 percent had an opioid use disorder.
- Nearly half of beneficiaries (46 percent) treated for a SUD received emergency services (the most common SUD treatment service).
- 26 percent received at least one service in an outpatient or home- or community-based setting within 30 days of discharge.
Read Here
CMS Publishes LTSS and HCBS Waiver Expenditure Reports
Earlier this month, the Centers for Medicare and Medicaid Services published two reports on Medicaid long-term services and supports (LTSS) expenditures.
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Physician-pharmacist collaboration may improve care for opioid addiction
Each day, more than 130 people die from opioid overdoses. Opioids are a class of drugs that include prescription pain relievers like oxycodone. They also include illegal drugs like heroin. In 2019, 1.6 million Americans had an opioid addiction. This is also known as opioid use disorder. Yet effective medications-like buprenorphine, methadone, and naltrexone-are prescribed to only a fraction of people with opioid use disorder.
Patients often receive such medications in an opioid treatment program. Methadone, for example, can only be given in a certified treatment program. Primary care physicians can apply for a waiver to prescribe buprenorphine. However, less than 10% of U.S. primary care providers have a buprenorphine waiver. Given the limited number of patients that each physician can treat, involving pharmacists in opioid treatment may improve access.
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Bringing a Child Home From Psychiatric Hospitalization
An open letter on what to expect and how to manage it
Dear Parent,
Congratulations! If your child has been hospitalized, and you have finally made it to discharge, the inpatient saga is in the rearview mirror. Now all you have to do is figure out what happens next. That may suddenly feel like a daunting task. By now your child has probably idealized what being home is like and you have forgotten how hard it was to have her in the house. By now your other kids have started to like getting some attention again, too. Expect bumps. Re-entry is hard.
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DRUG OVERDOSE MYTHS
Many of these tragedies could have been prevented. But when it comes to overdoses a lot of people just don't have the right information.
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Upcoming Events
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Wednesday, January 27, 2021
Session 2
Post-Acute Care and Long Term Care Facility Pandemic Response Best Practices and Lessons Learned
Time: 2:00 pm thru 3:00 pm
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Wednesday, January 27, 2021
NC Medicaid Transition to Managed Care
Time: 3:00 pm
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Thursday, January 28, 2021
Tips for Keeping Kids Safe Online
Time: 10:00 am thru 11:30 am
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Thursday, January 28, 2021
Time: 1:00 pm thru 2:00 pm
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Friday, January 29, 2021
SESSION 3: Patient Engagement and Education
Time: 2:00 pm thru 3:30 pm
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New: Tuesday, February 2, 2021
Learn about loan repayment assistance for nurses specializing in women's health.
Time: 2:00 pm thru 3:00 pm
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Tuesday, February 2, 2021
Medicaid Managed Care Organization (MCO) Learning Hub - Webinar on MCO Investments in Affordable Housing
Time: 2:00 pm thru 3:00 pm
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New: Wednesday, February 3, 2021
Addressing COVID-19 Vaccine Hesitancy
Time: 1:00 pm thru 2:15 pm
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New: Wednesday, February 3, 2021
COVID-19 and the Legacy of Racism: Vaccine Hesitancy and Treatment Bias
Time: 3:00 pm thru 4:00 pm
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Thursday, February 4, 2021
Medicaid Managed Care Fireside Chat Series: Value-Based Payment/Advanced Payment Models & Quality
Time: 5:30 pm thru 6:30 pm
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Friday, February 5, 2021
Benchmarks' Friday Membership Webinar
Dave Richard Joins Karen McLeod
Time: 8:30 am thru 9:30 am
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Friday, February 5, 2021
SESSION 4: What's Next? A Roadmap for Telehealth Policy Beyond the Pandemic
Time: 2:00 pm thru 3:30 pm
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Thursday, February 11, 2021
Benchmarks' Membership Child Welfare Webinar
Lisa Cauley Joins Karen McLeod
Time: 8:00 am thru 9:00 am
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New: Thursday, February 11, 2021
IER Webinar for Refugee and Asylee Service Providers Refugees' and Asylees' Right to Work
Time: 12:00 pm thru 1:00 pm
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Thursday, February 11, 2020
Save The Date: A State-Wide Convening on the Direct Care Workforce
Time: 9:00 am thru 12:00 pm
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Thursday, February 11, 2021
Time: 10:00 am thru 12:00 pm
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New: Thursday, February 11, 2021
What Does a Person-Centered System Look Like?
Time: 2:30 pm thru 4:00 pm
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Friday, February 12, 2020
Save The Date: A State-Wide Convening on the Direct Care Workforce
Time: 9:00 am thru 12:00 pm
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New: Wednesday, February 17, 2021
IER Webinar for Refugee and Asylee Service Providers Refugees' and Asylees' Right to Work (Identical to the webinar on 2/11/21)
Time: 2:00 pm thru 3:00 pm
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Thursday, February 18, 2021
Clinical Quality Webinar Series-TBD
Time: 5:30 pm thru 6:30 pm
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Friday, February 19, 2021
Benchmarks' Friday Membership Webinar
Time: 8:30 am thru 9:30 am
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Tuesday and Wednesday, March 2 & 3, 2020
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Thursday, March 4, 2021
Medicaid Managed Care Fireside Chat Series: Policy Approvals, Process Changes and Appeals
Time: 5:30 pm thru 6:30 pm
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Please click on each of the following links to view details sent out from each LME/MCO.
Benchmarks' wants to be sure to make the following list handy for our members to visit and suggests a peek at least once per week to find information that may be pertinent to your agency and contracts.
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