Benchmarks will be closed in honor of Memorial Day, May 25, 2020.


Benchmarks Update
May 22, 2020

NC Cases: 21,122
NC Cases Hospitalized:  578
NC Deaths:  726
Counties: COVID-19 cases reported in all 100 counties 
 
Recognizing YOU as Faces of the Frontline!!!
On Wednesday, May 27th, Benchmarks is taking out a full-page ad in the Raleigh News and Observer to recognize and thank all of you for being heroic frontline workers! We are requesting that all of you post on your social media sites the ad we have placed in the paper. We are trying to create a broad social media blitz across NC that recognizes all your amazing work. We have requested that the LME/MCOs share it along with the #CareForNC platform. Don't forget to share it with your staff and board members and encourage them to share it on their social media site as well.
 
This social media work is so important as legislators are planning out the budget for NC. We need legislative leaders to recognize you as frontline healthcare workers and realize critical need for your services to keep communities healthy and prosperous.
 
Don't forget that CareForNC is launching a COVID-19 #FacesOfTheFrontline campaign during May and June . We work amongst healthcare warriors every day in our field and we're asking you to send in photos and short videos we can share to help our state and communities see the many faces of frontline workers!
 
These images will be used in our CareForNC campaign #FacesOfTheFrontline. Make sure you sign up to receive our #CareForNC posts and on our Facebook page so your agencies can repost the CareForNC posts! Be sure to use one or all the hashtags listed below on your agency posts.
  • #FacesoftheFrontlines
  • #NCHeroes
  • #CareforNC
  • #TogetherOnTheFrontLine
To make it easier for you, we have created a Google Drive site with guidance and a submission form for uploading your photos and videos:   https://forms.gle/7ZFx1DCnsqKs7vvq8 
 
If you do not have a google account to use the Google drive, you can email your pictures and videos to carefornc@gmail.com . Many video attachments may be too large to send via email. In that case, please upload your videos to YouTube privately, Dropbox, or use WeTransfer and send a link to the CareForNC email so we can download the file. Be sure to include:
  • Your Name   
  • Organization name 
  • County or counties you serve             
  • Email
  • Description of Content                        
  • Any additional information
Below are some links to provide you additional information to help you create your own #FacesOfTheFronline posts and for video and picture submissions to CareForNC.
 
 
Phase Two
On Wednesday, Gov. Roy Cooper signed an executive order moving the state into a "modest" approach to Phase Two that goes into effect Friday at 5 p.m.
 
Phase two allows restaurants to open at 50% capacity for dine-in customers. Personal care services, like hair salons, can also open at 50% capacity. Workers at personal care businesses, must wear face coverings when they are within six feet of someone. Equipment and furniture that touch a customer must be cleaned and disinfected between customers. Swimming pools can also open at 50% capacity, with additional restrictions. Summer camps, including overnight camps, may also reopen with restrictions. Childcare centers may reopen to all families.
 
Bars, nightclubs, indoor fitness facilities, public playgrounds and indoor entertainment facilities like movie theaters and bowling alleys will remain closed. Mass gathering restrictions are no more than 10 people indoors and no more than 25 outdoors. Religious services are exempt from the order. Phase two is scheduled to run through June 26.
 
Cooper decided to make the move since the state is meeting three of its four benchmarks related to how the coronavirus is spreading throughout the state. North Carolina has leveled the number of people hospitalized by the virus, leveled the number of people presenting with COVID-like symptoms at hospital emergency departments and leveled the state's percentage of positive tests among overall test around 7%. The number of lab-confirmed cases is increasing but state leadership believes that is the result of the significant increase in the amount of statewide increased testing. Early on the state was averaging about 3,000 tests per day while now they average around 9,000 tests but some days have exceeded 12,000 tests.
 
NC DHHS also unveiled an  updated COVID-19 Dashboard . The interactive dashboard provides an overview on the metrics and capacities that the state is following to inform decisions to responsibly ease measures that slow the spread of the virus.
 
Phase 2 Resources
  Interim Guidance for:
NCDHHS Updates Guidance on Who Should be Tested for COVID-19
There is updated guidance on who should be tested for COVID-19. The new guidance recommends that clinicians test any patient in whom COVID-19 is suspected and ensure the following populations have access to testing, regardless of symptoms:
  • Anyone with symptoms suggestive of COVID-19
  • Close contacts of known positive cases, regardless of symptoms 
  • Persons who live in or have regular contact with high-risk settings (e.g., long-term care facility, homeless shelter, correctional facility, migrant farmworker camp)
  • Persons who are at high risk of severe illness (e.g., people over 65 years of age, people of any age with underlying health conditions)
  • Persons who come from historically marginalized populations
  • Health care workers or first responders (e.g. EMS, law enforcement, fire department, military)
  • Front-line and essential workers (grocery store clerks, gas station attendants, etc.) in settings where social distancing is difficult to maintain
 
COVID Tests
NC Department of Public Safety announced Saturday that all juveniles held at the Stonewall Jackson Youth Development Center will be tested for COVID-19 after a staff member reported testing positive for the coronavirus a day earlier. The employee of the juvenile correctional facility in Concord hasn't been onsite since May 10 after exhibiting symptoms and getting tested that same day. Currently no juveniles at the facility have shown COVID-19 symptoms.

The children in those units are being monitored twice a day for fever and other symptoms. All staff members believed to have had close contact with the sick employee will be tested and quarantined.
 
Budget Shortfall
The primary focus at the general assembly is the looming shortfall in the state budget that could be as high as $4 billion or around 16% of North Carolina's $25 billion budget. This shortfall could potentially require large cuts across state government.

More details on the deficit are expected later this week when legislative staff and the state budget office release a consensus revenue forecast. One bright note in this fiscal challenge is that NC has amassed a $1.2 billion-dollar rainy day fund to help offset the deficit. The state also has $1.7 billion in unappropriated funds from the current fiscal year due to a lack of budget being finalized last year. The final picture of the shortfall will not become completely clear until July when tax revenues are in.

Legislators are holding off on spending the remaining $1.97 out of the $3.5 billion Cares Act funds that came to NC until they receive guidance from the federal government about allowances to utilize the money to shore up the state budget.

Until the legislature received additional guidance around the CARES Act money, neither Cooper nor Berger have offered a timeline for a budget rollout. Both the House and the Senate are aiming to complete short session within four to six weeks (sometime in July), but if the guidance is slow to come from the federal government on utilizing the Cares money to fill in budget gaps, that could extend that time period out.
 
Budget Bills
Senate Republicans filed 18 budget-related bills Tuesday that they say are "must-do" priority appropriations for the legislative short session. The bills lay out priorities but do not contain fiscal allocations because the state doesn't know how much money it will have to spend until the budget deficit picture is clear.
The bills include:
  • a salary reserve fund for teacher, law enforcement and state employee pay
  • funding for enrollment growth in K-12 schools, UNC, and community colleges
  • retirement contributions and debt service
  • Medicaid transformation
  • a $623 million allocation to the savings reserve
  • Raise the Age funding for juvenile justice facilities
  • Department of Health and Human Services relocation
  • repairs and renovation money for UNC and state agencies
DHHS Move
The Senate budget proposal , Senate Bill 804, outlines the priorities to move the DHHS headquarters from the Dorothea Dix campus, which will eventually become a Raleigh park. The bill does not include a move to Granville County. Last session, Senate leaders added the requirement to move DHHS headquarters to Granville County as leverage to battle Gov Cooper over the Medicaid expansion he was seeking.

Medicaid Transformation
Senate Bill 808 , Medicaid Transformation Necessities, was introduced this week that would try to resurrect Medicaid Transformation. The bill, sponsored by Senator Brown, Harrington and Jackson, would start the Medicaid Transformation process no later than January 1, 2021. It would roll out the transformation process on a regional basis over five months. It does not contain the controversial components of the bill last session to move forward Medicaid Transformation such as the significant cuts to DHHS and transferring DHHS to Granville County.
 
House members we spoke with are supportive of the bill if it doesn't raise the controversial items again, but are doubtful that Governor Cooper would sign the bill without Medicaid Expansion that Senate leadership's position remains staunchly opposed to.
 
LME/MCO COVID-19 Request and Legislative Agenda
All seven LME/MCOs have worked together to develop a COVID-19 CARES Act fund request and a shared legislative agenda for short session.
 
The CARES Act request is for $81.4 million to cover COVID-19 related cares costs for this fiscal year. Some of the major items this funding would cover include provider reimbursement rates, the costs for moving to telehealth, housing and food for clients and financial stability payments to providers to keep them viable during the crisis. To see their  overview sheet click here.
 
Their legislative agenda requests:
  1. no new single-stream funding cuts
  2. Increase the innovation waiver slots
  • use the additional alcohol sales during the pandemic toward SUD treatment
  • support new funding to add emergency capacity Innovation Waiver slots for COVID-19 related situations
  • Support sufficient allocation of PPE to behavioral Health providers 
Benchmarks Legislative Agenda Short Session
Benchmarks will be supporting the CARES ACT request of the LME/MCOs as well as their legislative agenda items. In addition to those, Benchmarks is supporting the foster care rate reimbursement increase that was included in the last budget in Long Session that was vetoed by the governor and will be pressing to keep the telehealth services that increased quality and access that was implemented during the COVID-19 emergency orders.

We will be reaching out to specific members over the next week to help us with key legislators in their districts to move these agenda items. It will be a slow process until the guidance is received from the federal government as to whether the CARES Act funding can be used to plug the budget holes and the final numbers around the state budget shortfall. However, we need to have these items teed up and supported by legislators if they find funding is available.
 
Cherokee Indictments
A Cherokee County grand jury indicted Cindy Palmer, the former director for Cherokee County's Department of Social Services; former Child Protective Unit supervisor David Hughes; and former DSS attorney Scott Lindsay on three dozen felony and misdemeanor charges among them, related to a Cherokee County DSS practice of separating children from their parents without judicial oversight. They were booked into the Cherokee County Detention Center on Monday and Tuesday and are now free on an unsecured bond.

DSS employees often coerced families to sign custody and visitation agreements, or their children would be placed in a foster home, according to a federal lawsuit the parents have filed.

The documents were an illegal violation of parents' constitutional rights and "the product of both actual and constructive fraud on behalf of the Cherokee County Department of Social Services, its agents and employees, and attorney Scott Lindsay and Director Cindy Palmer," District Court Judge Tessa Sellers ruled in 2018.
 
VAYA Retainer Payments
Vaya Health previously provided retainer payment reimbursement at 60% of the service rate. They have amended this rate and will now provide this reimbursement at 100% of the service rate, retroactive to the start date of the Appendix K retainer payment program. They will not issue new approval letters to network providers.
 
NC CARES 360
Originally, NC CARES 360 planned to have referral sources in all 100 counties by December 2020. As a result of COVID-19 and the increased need for social service resources as unemployment exploded, NC Cares began expediting the onboarding process of referral agencies. By the end of May 2020, all 100 counties will have resources listed in the database system. Some counties may only have a few resources listed but they are working hard to increase those numbers as quickly as possible. You can learn more about the NC CARES 360 response to COVID-19 here.
 
NC DSS
The $100 dollar reimbursement rate increase for children in foster care will not be distributed to providers before June. State DSS just received the funds and are working on guidance to send out to the County DSS agencies.
 
The legislation that passed waiving fingerprinting requirements for foster families, and replacing it with name-based background checks, is still not allowable at this time. The FBI is not allowing the SBI to move forward with the name-based checks as they do not believe the legislation clearly waives all the existing requirements. State DSS is still working on a solution around the issue to move forward name-based background checks.
 
Residential COVID-19 Restrictions
Gov Roy Cooper and Secretary Cohen have remained clear, in their press releases and even the most recent executive order, that residential facilities should not have visitors on campus. However, webinars hosted by DHHS for families, there has been mixed messaging around I/DD facilities where families were told they could visit if they were outside and maintained social distancing. 

They also said that individuals in their homes could resume work in grocery stores but could not have visitors in the home. This has created a lot of confusion and we have reached out to DHHS through multiple channels asking that they clarify the directives for agencies with I/DD homes who are caught in the middle between the state orders for no visitors and the parents pressure to see their loved ones that has escalated due to the mixed messaging on the webinar calls.
 
We have also being hearing from our Children's Homes that there has been increasing pressure, especially after moving into phase one, from county DSS agencies to resume home and site visits. We reached out to NC DSS last week to request that they provide guidance to the counties on protocol on how to slowly resume visits with safety precautions in place. State DSS is currently working with DPH on that protocol that will hopefully be released next week.

Your Update from NCTracks
 
Four New Medicaid Bulletin Articles Available as of May 19, 2020
The NC Division of Health Benefits (DHB) has recently published two new Medicaid Bulletin articles dated May 19, 2020. All articles may be found on the DHB website.
  • Eptinezumab-jjmr Injection, for Intravenous Use (Vyepti™) HCPCS Code J3590: Billing Guidelines
  • Isatuximab-irfc Injection, for Intravenous Use (Sarclisa®) HCPCS Code J9999: Billing Guidelines
  • Peanut (Arachis hypogaea) Allergen Powder-dnfp Powder for Oral Administration (Palforzia™) HCPCS Code J3590: Billing Guidelines
  • Trastuzumab-pkrb for Injection, for Intravenous Use (Herzuma®) HCPCS Code Q5113: Billing Guidelines
 
Reminder - Memorial Day Holiday Monday, Call Center and Checkwrite Schedule
As a reminder, the NCTracks Call Center will be closed this coming Monday, May 25, in observance of the Memorial Day holiday. (The Pharmacy Prior Approval Unit will be open holiday hours from 7:00 a.m. to 6:00 p.m.)
 
In keeping with the published approved 2020 checkwrite schedule, because of the federal holiday, the checkwrite date will be on Wednesday, May 27. The posting and availability of funds to provider bank accounts will depend on the provider's financial institution. Bank of America customers should see their payments in their accounts on the day that the EFT is processed, which will be Thursday (5/28/2020). Providers who bank at other financial institutions should see payments the business day following the date that the EFT is processed, which will be Friday (5/30/2020) afternoon. (Some may post sooner.)
 
The 2020 checkwrite schedules can be found under Quick Links on the NCTracks Provider Portal home page.
 
New COVID-19 Special Medicaid Bulletin Available
In response to CDC recommendation regarding non-aerosolizing dental treatment during COVID-19, NC Medicaid is reminding dentists of the prescription fluoride products for patients at high-risk for caries. SPECIAL BULLETIN COVID-19 #89: Prescription Fluoride Available to Beneficiaries details what prescription fluoride products are included on the Medicaid Preferred Drug List. See the details here.
 
All bulletins, including COVID-19-related special bulletins, are available on the  DHB website.

Edit 01931 Disposition for All Outpatient (Claim Type O) Media Types Set to Pay and Report
As of May 15, 2020, the disposition for edit 01931 (PROCEDURE/NDC XWALK DOES NOT EXIST) has been changed to pay and report for all outpatient (claim type O) media types with a retroactive effective date of Nov. 1, 2019.
 
The posting of this edit is based on processing date rather than service date, so the disposition update is now applicable for any service date submitted after the change. Providers are encouraged to resubmit any denied claims. 

CANCELLED - DHHS COVID19 Update Call for BH/IDD Consumers, Family Members and Community Stakeholders May 25, 2020    
We will not have a DHHS COVID19 Update Call for BH/IDD Consumers, Family Members and Community Stakeholders on May 25, 2020 due to the Memorial Day Holiday.  We will resume our weekly calls on June 1, 2020.
 
Community Engagement & Empowerment
On behalf of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, we hope that you are faring well during this challenging COVID19 pandemic.  Even in the face of the COVID19 pandemic, we remain committed to our mission to provide essential services to improve the health, safety, and well-being of all North Carolinians. 

In order to assist us in accomplishing our mission and to better support North Carolinians across the state, we invite you to complete a brief survey.  Thank you in advance for sharing your feedback.

Welcome to the Harvard Law School Project on Disability (HPOD). 

Our website contains information about upcoming events, news, publications, affiliates, and how you can get involved. Since 2004 HPOD has worked to advance the understanding of disability law, policy, and education around the world. Our academic work in international and comparative law informs our pro bono activities and, in turn, our pro bono work informs our academic initiatives.


Wellness Self-Management for the COVID-19 Crisis
In response to the COVID-19 crisis, the Center for Practice Innovations has developed six new Wellness Self-Management (WSM) lessons, which can be used remotely (or face-to-face) in individual and group meetings.
 
Many practitioners and recipients are familiar with WSM, a curriculum-based clinical practice designed to assist adults to effectively manage serious mental health problems. WSM lessons focus on recovery, mental health wellness, relapse prevention and more.
 
The topics covered include:
  • Understanding the Coronavirus and COVID-19
  • Why Is It Important to Understand Our Stress During the COVID-19 Crisis?
  • Identifying Your Personal Signs of Stress During the COVID-19 Crisis
  • Coping with COVID-19: What works?  What doesn't?
  • Being Connected with Other People is More Important Now than Ever
  • Staying Physically Healthy During the COVID-19 Crisis
OMH is sharing these new WSM-COVID lessons as a valuable tool to support essential services delivery through the disaster emergency.


New Website Highlights COVID-19 Resources    
The ICI has released a series of publications on providing day and employment services during the COVID-19 pandemic. Topics include offering services remotely, effective use of technology, dealing with the economic impact of COVID-19, and much more. Additional publications will be added in the next few weeks.  
 
These resources have been developed to guide professionals, individuals, and families through this challenging time. This public health crisis has created emotional turmoil and economic damage. However, it is also a chance to develop new approaches to providing day and employment services and supporting community life engagement.  
 
ICI's  Think College initiative also has up-to-date resources to support students with intellectual disabilities as they learn, work, and live in the time of COVID-19.    

Working Across Systems to Invest in Family Strengths   
Collaboration between child welfare agencies, community organizations, and court systems can pave the way for timely, safe, and stable reunification. While children and youth are in temporary care, the legal community can be pivotal in supporting the preservation of family connections and maintaining youths' ties to their community.

Use National Foster Care Month as an opportunity to consider how to improve your partnerships-including the courts-and work across systems to invest in the capacity of parents to care for their children.

Explore these new resources  and share them with your staff and community:
Did you know competent legal representation for parents is associated with the achievement of timely reunification? View the new video series  for real-life examples of how collaboration between the courts and the child welfare community can impact permanency.  

Get more tools and resources to support family well-being and increase the likelihood of successful reunification on the National Foster Care Month website.

Help raise awareness for the children and youth in foster care, their families, and the caregivers who support them.  Use the outreach tools like graphics and social media, real-life stories, and more!

Follow us on  Facebook and Twitter for ongoing support and updates, and remember to tag your social media posts with #FosterCareMonth to stay connected to the conversation.

Adopting Children with Disabilities
Of the 125,000 children waiting to be adopted, many of them are considered to have "special needs." Special needs is a term that encompasses several definitions, such as being an older youth or part of a sibling group. It also means a child who has a developmental or physical disability or behavioral issue. Every adoption has its own set of unique challenges and sources of incredible joy. When a family chooses to adopt a child with a disability, there can be additional challenges that require preparation. These vulnerable youth and their families often need additional support.

While there are many things to consider when choosing to adopt a child, families who are considering adopting of a child with a disability have additional things to consider. Prospective parents should ask:
  • What challenges and/or disabilities are we prepared to handle?
  • Do we have the financial resources to care for a child with special needs?
  • s our school district able to support the child's educational needs?
  • Have we identified sources of support for ourselves (training, other families, etc.)?
The Center for Parent Information & Resources is an organization dedicated to supporting families of children with disabilities. The Center offers resources especially for foster and adoptive families with links to factsheets about specific disabilities, including rare disorders. It also directs parents and caregivers to informational hubs for developmental concerns, evaluations, and special education information and where they can find their local Parent Center, which specializes in helping families of children who have disabilities.

There are also Federal and State programs that offer financial assistance to adoptive parents to cover some of the special care and services a child needs. Visit the   Internal Revenue Service Adoption Credit and Adoption Assistance Programs page to learn about Federal adoption tax benefits. Other assistance may be available through your State. The North American Council on Adoptable Children website provides   State-specific adoption assistance and subsidy information.

Prospective and current adoptive families of children with special needs can also use the following resources:

3 Resources to Recruit Adoptive Families for Older Youth

Resources
Information and recommendations are provided to help ABA practitioners make decisions in four key areas: determining if ABA services are deemed "essential" under emergency governmental orders; complying with behavior analyst licensure laws and rules, especially as they pertain to telepractice; using professional standards to guide decision-making about service delivery; and working with third-party payers on the delivery of services via telehealth.

Cancelled:  Monday:  May 25, 2020 (Each Monday until May 26, 2020)
Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call For BH/IDD Consumers, Family Members and Community Stakeholders
Tuesday:  May 26, 2020 
Focus Webinars: Children with Complex Behavioral Health & IDD Needs

Time:  11:30 am to 12:30 pm
Tuesday:  May 26, 2020 
Trauma and Mental Health Peer Support 

Time:  2:00 pm
Wednesday:  May 27, 2020 (Each Friday)
QUESTION, PERSUADE, REFER (QPR) - SUICIDE PREVENTION WEB-BASED TRAINING

Time:  2:00 to 4:00 pm (7 Slots Available)

Thursday:  May 28, 2020
Let's Talk w Dave Hingsburger; Human Trafficking and People with an Intellectual Disability-Staying 'As Safe As Possible'

Time:  2:00 pm

New:  Thursday:  May 28, 2020
Navigating Provider Transformation 'As Safe As Possible'

Time:  3:00 pm to 4:30 pm

Thursday:  May 28, 2020  (Repeats Each Thursday)
NC DHHS COVID-19 Healthcare Professional Webinar Series, in partnership with CCNC and AHEC

Time: 5:30 pm
Thursday:  May 28, 2020
Focus Webinars: Children with Complex Behavioral Health & IDD Needs 

Time:  7:00 pm to 8:00 pm

New:  Friday:  May 29, 2020 
Trillium Call with Day Treatment and Psychosocial Rehabilitation Providers: Reopening Requirements

Time:   10:00 am to 11:30 am

Friday:  May 29, 2020 
COVID-19 Q&A Webinar for Behavioral Health Care

Time:   1:30 pm to 2:30 pm 

Monday:  June 1, 2020 
Statewide Developmental Disabilities Council Launches Virtual Road Tour to "Meet" Communities

Times:  
  • 12:30 pm to 2:00 pm 
  • 6:30 pm to 8:00 pm 
Monday:  June 15, 2020 
Connecting Expertise to Communities to Support Comprehensive Care for People with I/DD: Building on North Carolina's Assets 

Time:  11:00 am to 12:00 pm

Monday:  July 20, 2020 
PCIT Information Calls

Time:  10:00 am
 
Meeting number: 730 385 489
You can also dial 173.243.2.68 and enter your meeting number. Or, join by phone: 1-650-479-3207 Access code: 730 385 489 
Thursday:  July 23, 2020 
PCIT Information Calls

Time:  10:00 am
 
Meeting number: 730 385 489
You can also dial 173.243.2.68 and enter your meeting number. Or, join by phone: 1-650-479-3207 Access code: 730 385 489 
LME/MCO Updates Below Include Only
New Information Posted Since May 20, 2020

Communication Bulletins and Announcements

Case Support Service Established to Help Providers with COVID-19 Pandemic
The state has established a Case Support Service to help providers work with members through the pandemic. Effective June 1, Cardinal Innovations will change the Case Support billing code to YA402 to assist the state in tracking all COVID-19 related services. The current code YP215 will not be used after May 31.  Read more.
 
Peer Support Service Flexibility and COVID-19
To assist providers during the pandemic, the N.C. Department of Health and Human Services is allowing flexibilities in staffing requirements, supervision, and training in the provision of Adult Mental Health Services as outlined in   NC Medicaid Special Bulletin #46. Cardinal Innovations offers guidance related to the authorization and billing of Peer Support Services (PSS). Read more.
 
Updated Checkwrite Schedule - May 2020
UPDATE: The 2020 Checkwrite Schedule has changed due to modifications to Cardinal Innovations Healthcare's internal processes. Read more. 
 
Specialty Services Flexibility and COVID-19
The N.C. Department of Health and Human Services (NC DHHS) has provided guidance on (b)(3) services flexibility as outlined in NC Medicaid Special Bulletin #76 to assist providers during the pandemic. Cardinal Innovations offers additional guidance on authorization and billing of the these services. Read more.
 
Innovations Service Flexibility and COVID-19
To help guide providers offering services via telehealth to members with intellectual and developmental disabilities (IDD) during the COVID-19 pandemic, Cardinal Innovations has created a temporary Clinical Coverage Policy that allows for provision of services via telehealth.  Read more.
 
Additional Telehealth Service Flexibility and COVID-19
Cardinal Innovations is committed to ensuring that members are served as safely and effectively as possible during the new coronavirus (COVID-19) pandemic, and has created a temporary Clinical Coverage Policy that allows for the provision of services via telehealth. Read more.
 
Changes to Claim Form CMS 1500
To ensure providers are paid appropriately for coordination of benefits (COB) when members have primary insurance, Cardinal Innovations has updated the Centers for Medicare and Medicaid Services (CMS) health claim form, CMS 1500. Changes will be effective June 15.  Read more.
 
State Funded IDD Service Flexibility and COVID-19
To assist providers during the pandemic, the state is allowing individuals with intellectual and developmental disabilities to receive services state-funded services via telehealth (two-way, real-time audio and visual communication) as outlined in   NC Medicaid Special Bulletin #75. Cardinal Innovations is adding all codes to each provider contract. This change is retroactive to March 10, 2020. Read more.
 
State Reviews of TCLI Program Member's Person-Centered Plans
In preparation for the LME-MCO Transitions to Community Living Initiative spring reviews, the Division of Mental Health, Developmental Disabilities and Substance Abuse Services will conduct random reviews of members' Person-Centered Plans. Cardinal Innovations has identified opportunities for improvement on these plans to help providers prepare. Read more.
 
System Error with Provider Payments
We are aware of a system error causing duplicate payments, overpayments and/or misalignments with the RAs/835s. We are looking into the cause and we will be in communication as we determine the next steps. If you have questions, reach out to your Network Specialist or call our provider line at 1-855-270-3327.
 
Updated: Provider Monitoring Notice
Cardinal Innovations will continue to suspend provider monitoring during the new coronavirus (COVID-19) pandemic. Read more.

PROVIDER COMMUNICATIONS BULLETIN #105
 
PROVIDER COMMUNICATIONS BULLETIN #105
 

COVID-19 Bulletin 05-21-20