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Benchmarks' Upcoming Webinar
Benchmarks' Thursday Child Welfare Webinar w/Lisa Cauley
Date: December 10, 2020
Time: 8:00 am
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LME-MCO Joint Communication Bulletin # 380
Permanent Supportive Housing Training Requirements and the Transitions to Community Living Initiative (Revised)
North Carolina, entering the sixth year of the Transitions to Community Living Initiative (TCLI), coordinates with the Technical Assistance Collaborative (TAC) on the development of comprehensive Permanent Supportive Housing (PSH) training. The PSH training is based on the Substance Abuse Mental Health Services Administration (SAMHSA) Evidence-Based Practices Toolkit and supports the use of best practices in supporting individuals with mental illness in independent, community housing. Effective July 1, 2020, the DHHS Approved Tenancy Supports Training is the PSH training.
The PSH training is required for Community Support Team (CST) staff. Both Assertive Community Treatment (ACT) teams and Transition Management Services (TMS) teams also provide critical housing support to individuals participating in TCLI.
- Per the current ACT policy and the attached TMS service definition, staff must complete the DHHS Approved Tenancy Supports training.
- To support North Carolina in successfully placing and supporting individuals in independent, community housing, DHHS is requiring the primary ACT team member responsible for delivering tenancy support services and TMS Team Leads to complete the PSH training. All ACT teams and TMS teams must meet this requirement no later than April 1, 2021. 2
The training must be facilitated by approved trainers to meet the requirements. Qualified trainers include...
LME-MCO Joint Communication Bulletin # 381
NC Innovations Waiver and NC TBI Waiver - Retainer Payments
On January 31, 2020, the U.S Department of Health and Human Services declared a public health emergency (PHE) in the entire United States due to a global pandemic, novel coronavirus (COVID-19). To assist in meeting the needs of North Carolina Medicaid beneficiaries participating in a home and community-based services (HCBS) waiver such as the Innovations Waiver or the TBI Waiver, an emergency planning document, known as Appendix K, was created to offer flexibilities in how HCBS are rendered during the public health emergency. That document became effective on March 13, 2020, and will expire on March 12, 2021, or the expiration of the public health emergency, whichever comes first.
Retainer payments are time-limited payments made to an essential worker who was approved to provide the below NC Innovations and TBI Waiver Services:
- Innovations Waiver:
- Community Living and Supports,
- Community Networking,
- Day Supports,
- Residential Supports,
- Supported Living and
- Supported Employment.
- NC TBI Waiver:
- Personal Care,
- Community Networking,
- Day Supports,
- Residential Supports,
- Supported Living and
- Supported Employment.
NC Medicaid Transformation, Transition of Care at Crossover NC DHHS Re-Evaluation of Consent Securing Process under 42 CFR Part 2 V3 Draft for Circulation 11/23/2020
Background on Transition of Care:
As part of the State's implementation of the Standard Plan Managed Care Option ("Medicaid Transformation"), the NC DHHS has established various safeguards to ensure member continuity of care and alleviate provider burden during a member's transition to the Standard Plan option. In November, 2019 Medicaid Transformation activity was suspended. In summer, 2020, the NCGA reactivated Medicaid Transformation, setting a revised managed care launch date of July 1, 2021. As part of this reactivation, and in light of COVID-19, NC DHHS is evaluating requirements established prior to Suspension to ensure they continue to meet the goals of transition of care in the most effective and efficient manner. The Issue: Under current 42 CFR Part 2, Medicaid beneficiaries transitioning from the LME-MCO to the PHP at Managed Care Launch (July 1 ,2021) utilizing services covered under 42 CFR Part 2 must provide PHP-specific consent in order for the beneficiary's LME-MCO to be authorized to transfer the member's Prior Authorization (PA) prior to Managed Care Launch. In 2019 (prior to Medicaid Transformation activity being suspended), the NC DHHS developed a process that would require intaking providers to secure a PHP-specific consent from the applicable beneficiary prior to the LME-MCO transferring relevant prior authorizations.
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SPECIAL BULLETIN COVID-19 #143: CAP/C and CAP/DA Home- and Community-Based Services Flexibilities Update for Beneficiaries Enrolled in 1915(c) Waivers
Guidance on Entering Residency Information on Provider Applications
As previously announced, individual providers are required to enter their residency information (if applicable) when completing an Initial, Re-Verification or Re-Enrollment Application. However, NCTracks has received some questions about where to enter this information on the application.
If you are currently completing your residency, the residency information should be entered in the work history section. You should apply for the taxonomy designating you are a student (390200000X - Student Health Care) with a resident training license and enter "RTL" in the license number field.
If you have completed your residency, this information should be entered in the education section. You should select the taxonomy in your area of specialization and enter your full license information in the license number field.
Provider Data Collection FAQs Residency Verification Update
NCTracks' Provider Data Collection FAQs have been updated to reflect the new information on residency verification. Providers are encouraged to review these updates and check back often as more FAQs are added frequently.
Updated Issues List Available
The NCTracks Issues List, which logs known problems affecting providers and their statuses, has been updated. The most current issues list may be found on the provider portal home page under Quick Links. Providers are encouraged to check this list to see if an issue they are experiencing is already known before calling in about an issue.
Details on Common Error Message on Accreditation Page
It has come to the attention of NCTracks that some providers are receiving the following error message on the Accreditation Page during their Enrollment, Re-enrollment or Manage Change Request (MCR) applications:
Please add/edit taxonomy required [accreditation, certification or license] with current/future expiration date.
The accreditation, certification and license sections display exactly which agency/type is required for each taxonomy code. If the incorrect agency or type is selected, the error message displays. To avoid the error message, providers should ensure the appropriate agency and type is selected.
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ICD-10 MS-DRGs Version 38.1 Effective January 1, 2021
In response to the national emergency that was declared concerning the COVID-19 outbreak, the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) is implementing new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), effective January 1, 2021. In addition, the Centers for Medicare & Medicaid Services (CMS) is implementing 21 new procedure codes to describe the introduction or infusion of therapeutics, including monoclonal antibodies and vaccines for COVID-19 treatment, into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), also effective January 01, 2021.
CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge
Agency outlines flexibilities to maximize Acute Hospital Care at Home, Ambulatory Surgical Centers to decompress hospitals treating COVID-19 patients
Today, the Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country. These flexibilities include allowances for safe hospital care for eligible patients in their homes and updated staffing flexibility designed to allow ambulatory surgical centers (ASCs) to provide greater inpatient care when needed. Building on CMS's previous actions to expand the availability of telehealth across the nation, these actions are aimed at allowing health care services to be provided outside a hospital setting while maintaining capacity to continue critical non-COVID-19 care, allowing hospitals to focus on the increased need for care stemming from public health emergency (PHE).
"We're at a new level of crisis response with COVID-19 and CMS is leveraging the latest innovations and technology to help health care systems that are facing significant challenges to increase their capacity to make sure patients get the care they need," said CMS Administrator Seema Verma. "With new areas across the country experiencing significant challenges to the capacity of their health care systems, our job is to make sure that CMS regulations are not standing in the way of patient care for COVID-19 and beyond."
Acute Hospital Care at Home
In March 2020, CMS announced the Hospitals Without Walls program, which provides broad regulatory flexibility that allowed hospitals to provide services in locations beyond their existing walls. Today, CMS is expanding on this effort by executing an innovative Acute Hospital Care At Home program, providing eligible hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes. This program was developed to support models of at-home hospital care throughout the country that have seen prior success in several leading hospital institutions and networks, and reported in academic journals, including a major study funded by a Healthcare Innovation Award from the Center for Medicare and Medicaid Innovation (CMMI).
The program clearly differentiates the delivery of acute hospital care at home from more traditional home health services. While home health care provides important skilled nursing and other skilled care services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.
to streamline the waiver request process and allow hospitals and healthcare systems to submit the necessary information to ensure they meet the program's criteria to participate. CMS will also closely monitor the program to safeguard beneficiaries by requiring hospitals to report quality and safety data to CMS on a frequency that is based on their prior experience with the Hospital At Home model.
Ambulatory Surgical Center Flexibility
As part of Hospital Without Walls, CMS also previously announced regulatory flexibility that allowed ASCs - facilities that normally provide same-day surgical care - the ability to be temporarily certified as hospitals and provide inpatient care for longer periods than normally allowed, with the appropriate staffing in place. ASCs are normally subject to a requirement that patients only remain in their care for less than 24 hours or require admission to a regular hospital.
Today, CMS is announcing an update to that regulatory flexibility, clarifying that participating ASCs need only provide 24-hour nursing services when there is actually one or more patient receiving care onsite. The program change provides ASCs enrolled as hospitals the ability to flex up their staffing when needed and provide an important relief valve in communities experiencing hospital capacity constraints, while not mandating nurses be present when no patients are in the ASC. The flexibility is available to any of the 5732 ASCs throughout the country seeking to participate and will be immediately effective for the 85 ASCs currently participating in the Hospital Without Walls initiative. CMS expects this flexibility will allow these and additional ASCs enrolled as hospitals to serve as an added access point that will allow communities to maintain surgical capacity and other life-saving non-COVID-19, like cancer surgeries. Allowing these types of treatments to occur in designated ASCs enrolled as hospitals while hospitals are managing any surges of COVID-19 would allow vulnerable patients to receive this needed care in settings without known COVID-19 cases.
Today's announcement builds upon the critical work by CMS to expand telehealth coverage to keep beneficiaries safe and prevent the spread of COVID-19. CMS has expanded the scope of Medicare telehealth to allow Medicare beneficiaries across the country to receive telehealth services from any location, including their homes. CMS also added over 135 services such as emergency department visits, initial inpatient and nursing facility visits, and discharge day management services, that could be paid when delivered by telehealth. The flexibilities announced today, and the aggressive action taken by CMS to remove barriers to telehealth, ensure patients and providers have options when receiving and providing care given the challenges and additional stress placed on hospitals and the health care system during the COVID-19 PHE.
https://www.cms.gov/files/document/covid-acute-hospital-care-home-faqs.pdf
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In a new video, Child Trends mental health expert Jessica Dym Bartlett discusses 10 ways for parents and caregivers to support children's emotional well-being during the ongoing COVID-19 pandemic.
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| | 10 Ways to Support Children's Emotional Well-Being During COVID-19 |
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I'm a former foster child and Florida's system needs to be overhauled
The USA TODAY Network's recent landmark investigation into Florida's child welfare system reflects both my personal experience in foster care and the ways in which well-meaning state policies often inflict unintentional harm on a community's most vulnerable population. Other states and our federal government should take note if they're truly committed to doing what's best for children.
In 2014, then-Gov. Rick Scott, Florida lawmakers and child welfare advocates decided to pivot Florida's child welfare strategy away from keeping families unified toward protecting the child at all costs - at least that was their intention. The state allocated millions of dollars to hire new child abuse investigators, which resulted in a spike in the number of children removed from their homes.
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It's natural and highly appropriate for women to be concerned about their health and the wellbeing of their unborn babies during pregnancy. With the outbreak of the pandemic, those concerns have only increased, especially after a study found last spring that about 30 percent of pregnant women who become infected with SARS-CoV-2, the coronavirus that causes COVID-19, needed to be hospitalized.
But that early study didn't clearly divide out hospitalizations that were due to pregnancy from those owing to complications of COVID-19. Now, a large, observational study has taken a more comprehensive look at the issue and published some reassuring news for parents-to-be: the vast majority of women who test positive for COVID-19 during their pregnancies won't develop serious health complications. What's more, it's also unlikely that their newborns will become infected with SARS-CoV-2.
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Does Your Critical Shortage Facility Qualify for Nurse Corps?
The next Nurse Corps Loan Repayment Program (Nurse Corps LRP) application cycle is expected to open in January 2021. Eligible Critical Shortage Facilities (CSFs) must be located in, designated as, or serving a mental health or primary medical care Health Professional Shortage Area (HPSA).
To determine the eligibility of your CSFs, all potential applicants and administrators are encouraged to check and verify sites by using the Health Workforce Connector and the HPSA Find databases.
- The Health Workforce Connector is a searchable database for all Nurse Corps LRP approved service sites, including those with current job openings.
- The HPSA Find allows participants to find shortage areas by address. Include the street address, city, state, and zip code. P.O. Box addresses cannot be used.
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Nov 25, 2020 -- Notice of final rule from the Federal Communications Commission (FCC) establishing the 5G Fund for Rural America as a replacement for the Mobility Fund Phase II and adopting the basic framework for implementing the 5G Fund. The 5G Fund for Rural America will retarget universal service funding for mobile broadband and voice in the high-cost program to support the deployment of 5G services. This rule is effective December 28, 2020.
Nov 24, 2020 -- The Federal Communications Commission is extending the comment period for an information collection regarding the actual speeds and performance of fixed and mobile broadband connections as part of the Measuring Broadband America Program. Comments on the information collection are due by December 24, 2020.
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Nov 25, 2020 -- The U.S. Department of Health and Human Services (HHS) is seeking comments on an information collection regarding regulatory actions that it is considering making permanent or keeping as temporary made in response to the COVID-19 crisis to improve access to care and reduce costs. The information gathered will be used to better inform HHS' decisions regarding which regulatory flexibilities used in the COVID-19 response should be kept temporary or made permanent. Comments are due by December 28, 2020.
Read More Here
Nov 24, 2020 -- The Department of Health and Human Services (HHS) is seeking input regarding effective innovative approaches and best practices in healthcare in response to the COVID-19 pandemic by non-HHS healthcare systems and providers. HHS is specifically interested in novel approaches and best practices that are associated with data confirming efficacy and/or effectiveness with demonstrated improvements in one or more of the following measures: patient outcomes, access to healthcare, safety, quality, and/or value. Comments are due by December 24, 2020.
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Coronavirus Food Assistance Program 2 for Specialty Crop Producers
Don't miss a "beet" and apply for USDA's Coronavirus Food Assistance Program 2 (CFAP 2) by December 11, 2020, through your local USDA Farm Service Agency.
More than 230 fruit, vegetable, horticulture, and tree nut commodities are eligible for CFAP 2, along with honey, maple sap, floriculture and nursery crops. Check to see if the crops you grow are eligible through our Eligible Commodities Finder tool.
Learn more at farmers.gov/cfap or call 877-508-8364 to speak directly with a USDA employee ready to offer assistance.
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AHRQ Views Blog Post: Re-imagining AHRQ's Insight Platform
Ongoing efforts to create an "AHRQ Insight Platform" that provides essential healthcare data to policymakers, healthcare systems and analysts, researchers, payers and clinicians is the subject of a new blog post by agency Director Gopal Khanna, M.B.A., and Joel Cohen, Ph.D., director of the agency's Center for Financing, Access and Cost Trends. Significant gaps in our knowledge about the healthcare system have been revealed by the COVID-19 crisis. AHRQ is building upon its data assets, including the Medical Expenditure Panel Survey (MEPS) and the Healthcare Costs and Utilization Project (HCUP), to deliver information and evidence-based answers to pressing questions about the healthcare system. Efforts have focused on enhancing data in three critical areas: detailed medical claims, physician supply and social determinants of health. A deep understanding of data in these and other areas is essential to a true 21st-century healthcare system. Access the blog post. To receive all blog posts, submit your email address and select "AHRQ Views Blog."
Self-Reliant Patients Less Likely To Use Opioids
Adults with self-reliant attitudes about their health are less likely to start and more likely to discontinue opioid use, according to a study by AHRQ researchers published in Research in Social and Administrative Pharmacy. Researchers' findings were based on 2014 to 2017 responses to AHRQ Medical Expenditure Panel Survey (MEPS) questions that asked patients if they agreed with the statements: "I do not need health insurance," and "I can overcome illness without help from a medically trained person." In addition to finding that self-reliant patients, both with and without chronic pain, were less likely to use opioids, researchers also found that patients who exercised were less likely to choose analgesic treatment for their pain. Furthermore, among opioid users with no chronic pain, those with poor self-reported mental health were less likely to discontinue opioids than those with good self-reported mental health. Researchers concluded that these findings on patients' choices on whether to use opioids can help clinicians guide patients toward nonopioid treatment. Access the abstract.
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Common errors to avoid when claiming employer tax credits
Employers who are filing Form 941, Employer's Quarterly Federal Tax Return and claiming an employer tax credit should read the instructions carefully and take their time when completing the form to avoid mistakes.
- Using a reputable tax preparer including certified public accountants, enrolled agents or other knowledgeable tax professionals
- Mistakes can result in a processing delay or a balance due notice, which could mean a delay or require filing an amended return
- Common mistakes to avoid when completing Form 941
- Reporting advances requested instead of the advance payments of credits received
- Incorrectly reconciling the advance payment of the credit requested and received
- Requirements when using third-party payers or reporting agents
- What third-party payers and reporting agents should also ask employers
Reminder: Work Opportunity Tax Credit extended
The Work Opportunity Tax Credit is a valuable tax credit available to employers who hire long-term unemployment recipients and others certified by their state workforce agency if the individual began or begins work for the employer after December 31, 2014, and before January 1, 2021.
Delivering the CARES Act and Filing Season 2020; IRS offers electronic signature options
The CARES Act and Filing Season 2020
Deputy Commissioner for Operations Support Jeff Tribiano gives a behind-the-scenes look into how the IRS was able to deliver Economic Impact Payments and other tax relief to help Americans during the COVID-19 outbreak while simultaneously executing a highly successful filing season.
Electronic signature options will simplify third-party authorizations
Submitting Form 2848, Power of Attorney and Form 8821, Tax Information Authorization, are currently done on paper. By moving to a new online submission process, it gives tax professionals and taxpayers a safe option to electronically sign and upload these critical documents without an in-person meeting, explains Sharyn Fisk, Director, Office of Professional Responsibility.
"A Closer Look"
These are part of the IRS "A Closer Look" feature. It will be updated frequently and will include articles from a variety of IRS leaders. The online publication will cover a variety of timely issues of interest to taxpayers and the tax community. It will also provide a detailed look at key issues affecting everything from IRS operations and employees to issues involving taxpayers and tax professionals.
IRS to mask key business transcript details; protect taxpayers from identity theft
Moving to protect business taxpayers from identity theft, the IRS announced that starting December 13, 2020, it will begin masking sensitive data on business tax transcripts.
The announcement provides 30 days for stakeholders to make any adjustments and additional information about:
- What a tax transcript is
- What they are used for
- What's visible on the new transcript
- How it would work for a taxpayer seeking to verify income for a lender
Here's who qualifies for the employee business expense deduction
People can no longer claim unreimbursed employee expenses as miscellaneous itemized deductions, unless they're a qualified employee or an eligible educator. See who qualifies in this IRS Tax Tip.
IRS resources to help small business owners
During National Veterans Small Business Week, the IRS shared a variety of resources to help small business owners, including veterans, understand their tax responsibilities. Best of all, most of these resources are available online at IRS.gov.
- Small Business and Self-Employed Tax Center
- Self-Employed Individuals Tax Center
- Sharing Economy Tax Center
New COVID-related text scam; National Tax Security Awareness Week announced
Security Summit partners warn taxpayers of new COVID-related text scam
The IRS, state tax agencies and the tax industry warned of a new text scam created by thieves that trick people into disclosing bank account information under the guise of receiving the $1,200 Economic Impact Payment.
This year, there's a heightened need for security as fraudsters seek to use COVID-19 to scam taxpayers and tax preparers. New protections being offered by Security Summit partners in January can help protect people against tax-related identity theft.
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Upcoming Events
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Wednesday, December 2, 2020
A Multigenerational Approach to Prevention & Treatment of SUDs
Through both environmental and genetic factors, substance use disorders frequently perpetuate from one generation to another within families. Treating individuals struggling with a substance use disorder in isolation often represents a missed opportunity to provide both treatment and preventive measures for others in their family who have been directly impacted by, are at risk for or also struggle with a substance use disorder.
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Wednesday, December 2, 2020
The Collaborative Care Model: A Proven Approach for Integrating Physical and Behavioral Health Care
Collaborative care programs are a proven approach to integration in which primary care providers, care managers, and psychiatric/behavioral health consultants work together to provide team-based care and monitor patients' progress. The model provides the platform for a range of targeted behavioral health services such as brief psychosocial treatments; pharmacotherapies for substance use (medication-assisted treatment) and mental disorders; Screening, Brief Intervention, and Referral to Treatment (SBIRT); and patient education.
Time: 3:00 pm thu 4:00 pm
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Thursday, December 3, 2020
Strategies to Support Clients with Increased Stress and Substance Use during the COVID-19 Pandemic
Time: 1:00 pm
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New: Thursday, December 3, 2020
Ethical Storytelling for Nonprofits and Philanthropy
Time: 2:00 pm thru 3:00 pm
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Thursday, December 3, 2020
Black Foster Youth Handbook
Time: 7:00 pm
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Wednesday, December 9, 2020
Virtual Lecture "All Health Is Not Created Equal"
Time: 12:00 pm
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Thursday, December 10, 2020
Benchmarks' Child Welfare Webinar with Lisa Cauley, NC-DSS
Time: 8:00 am thru 9:00 am
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Friday, December 11, 2020
Medical Care Advisory Committee (MCAC) Quarterly Meeting
Time: 10:30 am thru 12:30 pm
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New: Friday, December 11, 2020
Using Medicaid to Support Parents with Disabilities
Time: 12:30 pm thru 2:00 pm
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Friday, December 11, 2020
NCDHHS Supported Living Level 2 & 3 STAKEHOLDERS MEETING
Time: 1:00 pm thru 3:00 pm
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Friday, December 11, 2020
Ethics, COVID-19 & Telehealth: Part 1
Time: 2:00 pm thru 3:30 pm
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Thursday, December 13, 2020
Medicaid Managed Care Fireside Chat Webinar Series-Beneficiary Attribution
Time: 5:30 pm thru 6:30 pm
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New: Thursday, December 17, 2020
Social Connections Using Technology for People with IDD & Autism
Times Available:
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Thursday, December 17, 2020
Clinical Quality Webinar Series-Behavioral Health
Time: 5:30 pm thru 6:30 pm
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Thursday, January 7, 2021
Medicaid Managed Care Fireside Chat Webinar Series-Policy Approvals, Process Changes & Appeals
Time: 5:30 pm thru 6:30 pm
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Friday: January 8, 2021
Dave Richard Joins Benchmarks' Friday Membership Webinar
Time: 8:30 am thru 9:30 am
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Thursday, January 21, 2021
Clinical Quality Webinar Series-TBD
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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