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To Adult Care Home and Family Care Home Providers,
On October 11, 2024, NC Medicaid issued a number of Hurricane Helene Policy Flexibilities to Support Providers and Members. These Policy Flexibilities have implications for Medicaid Personal Care Services (PCS) and are pasted below.
This applies to NC Medicaid Direct and NC Medicaid Managed Care
Conditions from the impact of Hurricane Helene may present situations where NC Medicaid Direct and NC Medicaid Managed Care beneficiaries in impacted areas cannot receive their scheduled in-person personal care new or annual assessment. In those situations, a telephonic assessment, if attainable, may be conducted from Sept. 26, 2024, through Dec. 31, 2024, (unless otherwise communicated by DHHS).
To ensure the health and well-being of impacted individuals who meet medical necessity for PCS and expedited or abbreviated initial assessment may be conducted from Sept. 26, 2024, through Dec. 31, 2024.
From Sept. 26, 2024, all existing PAs will be continued through the duration of the PHE (Public Health Emergency). During the hurricane recovery period, providers and beneficiaries are asked to call NCLIFTSS at 833-522-5429 to provide new contact information, if applicable to maintaining consistent communication.
NC Medicaid Direct and NC Medicaid Care beneficiaries who are displaced from their homes or facilities may continue to receive their PCS in their relocated settings. The flexibilities below are specific to beneficiaries impacted by Hurricane Helene.
NC Medicaid will allow the following flexibilities:
- Use of telephonic assessments in place of in-person assessments for initial PCS requests
- Use of virtual real-time supervisory visits for In-Home PCS in place of in-person
- Use of telephonic mediation and appeal resolution (when resumed)
- Extension from 90 days to 120 days for the requirement to meet with practitioner in the preceding period for new referrals.
- Authorization for In-Home PCS delivered in a temporary alternate primary non-institutional location
- In situations where beneficiary or legally responsible person’s written consent cannot be attained, acceptance of a “verbal signature” or “verbal concurrence”.
For NC Medicaid Direct, NCLIFTSS will work with individuals in impacted areas to reschedule in-person assessments as telephonic assessments.
For NC Medicaid Managed Care, providers can contact the provider service line (numbers are listed in the Contact Information under the Health Plan Provider Service Lines section at the bottom of this bulletin) to confirm if additional steps need to be completed for individuals impacted and are scheduled for in-person assessments.
(The below is from a reprint from a communication sent by NCSLA on 10/10/2024)
NCSLA received the below information today from the NC Department of Health and Human Services (NCDHHS) regarding Hurricane Helene. The information addresses Hardship Advances, Stabilization Payments and Retainer Payments for Home and Community-Based Services (HCBS) providers, which includes adult and family care home Medicaid Personal Care Services (PCS), to assist providers in maintaining staff and capacity.
(From NCDHHC)
"Dear Community Partners,
NC Medicaid and the health plans are committed to supporting providers impacted by the devastating effects of Hurricane Helene. The following financial supports may be available to providers, even if they are unable to submit claims or perform services.
- Hardship Advances: All health plans and NC Medicaid Direct have processes to make hardship advances for providers unable to meet financial obligations.
- Stabilization Payments: The health plans have the flexibility to make stabilization payments to support provider sustainability and beneficiary access.
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Retainer Payments for Home and Community-Based Services (HCBS): NC Medicaid is seeking authority to make retainer payments for 1915(c) waiver services to support certain HCBS providers with maintaining staff and capacity, even if service delivery is temporarily interrupted.
Providers in need of financial supports should work directly with the health plans to learn what supports each plan is offering and their associated process(es).
Contact Information
Provider support: 855-759-9700
Provider support: 888-738-0004
Provider support: 833-552-3876
Provider support: 844-594-5072
Provider support: 877-398-4145
Provider support: 855-250-1539
Provider support 800-638-3302
Provider Support Line: 866-990-9712
Provider support 866-799-5318
Information on the flexibilities in place for Hurricane Helene can be found on the NC Medicaid Bulletins webpage.
Visit the NC Medicaid Hurricane Helene Virtual Bulletin Board for information and resources for NC Medicaid beneficiaries and families impacted by Hurricane Helene. Updates are added as the recovery continues."
We hope the above information is helpful. If there are questions regarding Licensure, Medicaid, regulatory or other issues, please do not hesitate to contact me.
Jeff Horton, NCSLA Executive Director
Email: jeff@ncseniorliving.org
Phone: 919-787-2526
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