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Benchmarks' Upcoming Webinars
New: Benchmarks' Child Welfare Webinar with Karen McLeod and Lisa Cauley
Date: Thursday, December 8, 2022
Time: 8:00 am thru 9:00 am
Register
New: Benchmarks' Friday Membership Webinar with Dave Richard and Karen McLeod
Date: Friday, December 16, 2022
Time: 8:30 am thru 10:30 am
Register
This meeting will be followed by Benchmarks' Annual Business Meeting
The business meeting is open ONLY to Benchmarks' Member provider agencies. Each provider is allowed one vote during this time, please know we will be carefully monitoring our attendees over this portion of the meeting. We will use this time to give highlights of our successes in 2022 and vote on two nominees to join our Board:
- Valerie Kopetzky-CEO, Anuvia Prevention & Recovery Center
- Natasha Holley-CEO, Integrated Family Services, Inc.
We hope our provider members will join us!
Benchmarks' Collection of Past Updates
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Benchmarks' Child Welfare Webinar
with Karen McLeod & Lisa Cauley
Thursday, November 10, 2022
Associated Links:
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Benchmarks' Friday Membership Webinar
with Dave Richard and Karen McLeod
Friday, November 18, 2022
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Tailored Care Management Updates
Beneficiary Assignment Update
LME/MCOs will begin mailing Tailored Care Management assignment letters to eligible beneficiaries beginning the week of Nov. 14, 2022. A sample letter for NC Medicaid Direct beneficiaries who qualify for Tailored Care Management is available on the NC Medicaid website under Other Beneficiary Notices.
Beneficiaries are free to change their assigned Tailored Care Management provider at any time, with no limit on the number of changes, prior to April 1, 2023.
- If a beneficiary/family/legal guardian wants to change the Tailored Care Management provider for any reason, they should contact their LME/MCO, whose contact number is included in the letter.
- When beneficiaries call, LME/MCOs will share all Tailored Care Management providers certified in their region they can choose from.
Temporary Flexibilities and Program Changes
Recognizing this is a time of substantial change for NC Medicaid enrollees, providers and health plans, NCDHHS will implement temporary flexibilities and program changes for the four-month period between the Dec. 1, 2022, Tailored Care Management launch and March 31, 2023, the day before the start of Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans.
These flexibilities and program changes give organizations providing Tailored Care Management (e.g., Advanced Medical Home + (AMH+s), Care Management Agencies (CMAs) and LME/MCOs) adequate time to gain experience with the model, engage as many eligible beneficiaries as possible and identify and address unexpected challenges.
Beneficiaries will continue to receive Behavioral Health Services, I/DD and traumatic brain injury (TBI) supports through their LME/MCO and physical health and pharmacy services through NC Medicaid Direct, just as they do today. Nothing changes for beneficiaries on Dec. 1, 2022—except they will have access to Tailored Care Management through AMH+s, CMAs and LME/MCOs.
For more information, please see Medicaid provider bulletin article Tailored Care Management Implements Temporary Flexibilities and Program Changes.
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Enhanced Medical Home Payments for Advanced Medical Homes Serving Members Eligible for Tailored Care Management
On Dec. 1, 2022, the $20 per member per month (PMPM) Medical Home Payments for Advanced Medical Homes (AMHs) serving members eligible for Tailored Care Management (TCM) referenced in the Aug. 5, 2022 Medicaid bulletin article Enhanced Medical Home Payments for Advanced Medical Homes Serving Members Eligible for Tailored Care Management will begin.
Effective Dec. 1, 2022, through June 30, 2023, AMHs 1, 2 and 3 that are serving as the assigned primary care provider for NC Medicaid beneficiaries eligible for TCM will receive a medical home payment of $20 PMPM. Continuation of the payment after June 30, 2023, is anticipated, but is dependent on available funding. In the future the $20 PMPM fee may be tied to additional performance expectations for primary care engagement.
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Between Dec. 1, 2022, and March 31, 2023, NC Medicaid will pay this $20 PMPM to AMHs 1, 2 and 3 for all TCM members assigned to the practice. These payments will be made in the same way that the current $5.00 ABD and $2.50 Non-ABD Medical Home payments are administered to Carolina Access (CCNCCA) providers today.
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Between April 1, 2023, and June 30, 2023, this payment will be included in capitation for Tailored Plans. Tailored Plans will pay the $20 PMPM directly to AMHs 1, 2 and 3 for all Tailored Plan members assigned to the practice who are eligible for TCM. NC Medicaid will continue to make these payments for TCM eligible beneficiaries remaining in NC Medicaid Direct. Payments from NC Medicaid will be made in the same way that the current $5.00 ABD and $2.50 Non-ABD Medical Home payments are administered to CCNCCAs providers today.
For information on medical home payments and management fees, please visit the common questions webpage on NCTracks.
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Feedback Requested: NC Medicaid Care Delivery and Value-Based Payment Design
NC Medicaid continues to reform Medicaid delivery and payment with the goal of improving the health of North Carolinians through an innovative, whole-person centered and well-coordinated system of care, which addresses both medical and non-medical drivers of health. As NC Medicaid builds on recent Medicaid transformation efforts, it is focused on how delivery reform and value-based payments for primary care and maternal and infant health can achieve this goal and improve health equity.
NC Medicaid has published a Medicaid Delivery Reform and Value-Based Payment Update to seek stakeholder feedback on how to further evolve this vision. NC Medicaid welcomes feedback and input on all aspects of this update, especially on the specific questions asked within the document related to key strategies and reforms to advance strong, coordinated, and whole-person centered primary care and maternal and infant health.
NC Medicaid remains committed to engaging stakeholders as reforms are developed, and before any significant programmatic or payment changes are implemented. We encourage stakeholders to provide feedback by emailing [email protected] (subject line “VBP Feedback”) by Dec. 19, 2022.
For more information about value-based payments, please visit the NC Medicaid Value-Based Purchasing webpage.
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DCDL: NCDSS NC Kids Adoption & Foster Care Network Exchanged & Permanency Innovation & Initiative
November is National Adoption Month, and our national theme is “Small Steps Open Doors.” The National Adoption Month campaign seeks to increase national awareness of adoption issues, bring attention to the need for adoptive families for teens in the foster care system and emphasize the value of youth engagement. North Carolina Division of Social Services (NCDSS) is committed to the safety, permanency and well-being for children and continues to aim to achieve permanence for children in a timely manner. NCDSS is excited to announce an upcoming webinar to NC Kids Adoption and Foster Care Network and our partnership with Children’s Home Society (CHS) of North Carolina.
NC Kids is the official Adoption Exchange program for the State of North Carolina and is housed at NCDSS. NC Kids Adoption and Foster Care Network Exchange program assists local agencies with finding permanent families for children in foster care who are legally free for adoption and assist approved adoptive applicants in their search for waiting children. All waiting children who do not have an identified adoptive family must be registered with NC Kids within 30 days of becoming legally free for adoption.
The NCDSS Permanency Innovation Initiative (PII) is designed to improve permanency outcomes for children living in foster care via engagement with biological and fictive relatives. Children’s Home Society of North Carolina (CHS), a private child-placing agency, implements an evidence-based Child Focus Recruitment program to discover and engage relatives and network members of children in public foster care. Children’s Home Society has achieved positive outcomes for children and families through focused adoption recruitment and permanency related training.
As part of our ongoing work to enhance our efforts towards permanence for children in a timely manner, NCDSS is excited to announce an upcoming webinar to discuss NC Kids Adoption and Foster Care Network and North Carolina’s Permanency Innovation Initiative (PII) through our partnership with CHS on November 29, 2022, from 10:00 a.m.—11:30 a.m. Please register by clicking the following link: https://attendee.gotowebinar.com/register/7897514272754182671.
During this session, we will provide an overview of NC Kids Adoption and Foster Care Network Exchange, Permanency Innovation Initiative (PII), NCDSS Rapid Response and guest speakers who will share their experience utilizing services from these programs.
If you have any questions, please contact your NC Kids Consultant Jessica Farmer at 919-527-7269 or [email protected] or ShaNia Leach at 919-527-6355 or [email protected].
Read Here
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Proposed Medicaid and NC Health Choice Policies
The following proposed new or amended Medicaid and NC Health Choice clinical coverage policies are available for review. Comments on proposed polices may be submitted by clicking the email link next to each proposed policy. Comments and questions not specifically related to the proposed policy should not be sent to this Web address. The initial comment period for each proposed policy is 45 days. An additional 15-day comment period follows if a proposed policy is modified as a result of the initial comment period. If the adoption of a new or amended medical coverage policy is necessitated by an act of the General Assembly or a change in federal law, then the 45- and 15-day time periods shall instead be 30- and 10-day time periods.
Submit comments for policies listed below open for public comment by emailing: [email protected].
Read More
Please copy Tara & Karen at Benchmarks when submitting public comment so that we can work to support your feedback & suggestions!
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Joint Communication Bulletins
JCB #437: Clarification on the use of 1915 (b)(3) Respite
Read Here
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Office Administrator (OA) Change Tips: How to Answer the Continued Access Question in an OA Change Request
When completing an OA change request, users will see the question “Do you want the existing user to continue to have access to this NPI?” with answer choices of yes or no. This answer determines future access for NPIs previously associated with the OA.
Selecting yes means all other users (previously associated with the NPI) will remain associated with the NPI. Selecting no means most other users will NOT remain associated with the NPI. Regardless of answering yes or no, all existing owners and managing relationship (MR) users will remain associated with the NPI.
What Happens to Users When Yes is Selected?
When yes is selected, the user administrators, general users, MR users and/or enrollment specialists of the previous OA will be transferred to the new OA.
The previous OA and MR users will still have access to the NPI on the Status and Management page because they are still an owner/MR user. The previous OA is still able to submit manage change requests (MCRs), re-verification and re-enrollment applications on behalf of the provider. The new OA must complete an MCR to end-date all owner/MR user relationships that are no longer associated with the NPI. If the new OA wishes to terminate a user’s access to the NPI, they can update the user’s access via the User Maintenance function.
What Happens to Users When No is Selected?
When no is selected, only the previous OA and any MR users for that NPI will be transferred to the new OA. No other previous users will be transferred to the new OA.
The previous OA and MR users will still have access to the NPI on the Status and Management page because they are still an owner/MR user. The previous OA is still able to submit MCRs, re-verification and re-enrollment applications on behalf of the provider. The new OA must complete an MCR to end-date all owner/MR user relationships that are no longer associated with the NPI. If the new OA wishes to terminate a user’s access to the NPI, they can update the user’s access via the User Maintenance function.
When Should I Select Yes or No?
The answer you select may also depend on whether you are an individual or part of an organization. Below are examples for individual providers and organizations.
Scenarios for When to Select Yes or No for Organization NPIs
Select yes if the OA transfer is within the same organization.
Examples – the previous OA is John Doe at ABC Practice:
1. John Doe leaves (retires, resigns, is fired, etc.) and Jane Smith is taking over.
2. XYZ acquired ABC Practice and is keeping the same employees from ABC Practice, and Jane smith will be the OA for ABC Practice.
3. OA John Doe lost access to his NCID and had to get a new NCID.
Select no if the OA transfer is not from within the same organization.
· Example: XYZ acquired ABC Practice and is not keeping the same users from ABC Practice and Jane Smith will be the OA for ABC Practice.
Scenarios for When to Select Yes or No for Individual NPIs
Select yes if the OA transfer is within the same organization.
Examples – the previous OA is John Doe at ABC Practice:
1. John Doe leaves (retires, resigns, is fired, etc.) and Jane Smith is taking over.
2. The practitioner is taking over ownership of their own individual provider record but wants the existing users to still have access to the NPI.
3. OA John Doe lost access to his NCID and had to get a new NCID.
Select no if the OA transfer is not from within the same organization.
Example – the previous OA is John Doe at ABC Practice:
· The practitioner no longer works at ABC Practice and is exclusively at XYZ; ABC Practice no longer needs access to the practitioner’s record.
More information on the OA change process and common questions can be found on the updated FAQ page.
Inclusion of Veterans in NC Minority Provider Criteria
Effective Nov. 20, 2022, veterans will be included in the NC Minority Provider criteria and will be added as a group under the NC Minority Provider (NCMP) designation. The previously announced NC Minority Provider Information Page will be updated to include veterans in the NC Minority Provider criteria.
*The NCMP Information Page is not applicable to Lite application types or Disaster Relief applications.
For more information on the NC Minority Provider Information Page, please see the announcement.
The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:
Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.
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Seeking Healthcare Providers in Halifax County!!!
Benchmarks' is working with the Broadband Coalition to identify healthcare providers in Halifax County to participate in a broadband/survey pilot. We are in the process of recruiting and would LOVE to include your company, if applicable!
Please shoot Tara Fields a quick email if you are doing business in Halifax County and are interested! Thanks so much!
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Help us respond to your health workforce needs! Deadline EXTENDED to November 30, 2022.
The NC Center for Health Workforce is working to take action to address North Carolina’s health workforce needs. An important step in this process is to gather your concerns about recruitment, retention and skill needs of your workforce. The NC Center for Health Workforce will use this information to work with policymakers and educators to develop responses and solutions.
Click here (or paste this URL into your browser) to provide the information we can use to help! https://nc.sentinelnetwork.org/join
About the Sentinel Network:
The Sentinel Network is a tool to understand health employers’ real-time workforce needs – such as challenges related to recruitment, retention, and needed skills – and make that information available to educators and policymakers so they can take action right away. We gather this information twice a year so it will be timely and actionable. For information from previous questionnaires please go to https://nc.sentinelnetwork.org
Your participation is important, and your feedback is confidential.
The information you provide to the Sentinel Network will be kept confidential. Your organization’s data will be reported in aggregate form with data from similar organizations. Care will be taken to ensure that no individual organization’s responses can be identified in reports.
Help us address your – and the North Carolina healthcare industry’s – health workforce needs. Please participate today!
Questions: [email protected]
See summary briefs of prior NC Sentinel results: https://nc.sentinelnetwork.org/findings/overview/
The Sentinel Network is an initiative conducted collaboratively by North Carolina Area Health Education Centers (NC AHEC) and the University of North Carolina’s Program for Health Workforce Research and Policy within the Cecil G. Sheps Center for Health Services Research. Funding to initiate the North Carolina Sentinel Network came from NC AHEC.
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North Carolina distributes last of $3.6B in federal COVID-19 relief funds
The North Carolina Pandemic Recovery Office finished disbursing $3.6 billion in federal Coronavirus Relief Funds this week. North Carolina received $3.6 billion of $150 billion in coronavirus relief funds distributed to states, local governments and U.S. territories as part of the 2020 CARES Act. The funding included $1.35 billion for state and local governments, $826 million for health, $664 million for public services, $478 million for education, $208 million for business relief, $36 million for individual relief and $21 million for infrastructure. State government was by far the biggest beneficiary of the funding, accounting for more than $1 billion. Public services for "families, child welfare, & foster care programing" received the second largest share at nearly $396 million.
Read Here
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New: Tuesday, November 29, 2022
NC Kids Adoption and Foster Care Network and North Carolina’s Permanency Innovation Initiative (PII)
Time: 10:00 am thru 11:30 am
Register
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New: Tuesday, November 29, 2022
Tailored Care Management for children and Youth Served by the Child Welfare System
Time: 12:00 pm thru 1:00 pm
Join Here
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New: Thursday, December 1, 2022
Virtual Office Hours for Medicaid Providers
Time: 5:30 pm thru 6:30 pm
Register
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New: Monday, December 5, 2022
The 2023 Health Care Revolution: Will you be part of the solution or a cog in the wheel?
Time: 1:00 pm thru 2:15 pm
Register
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Tuesday, December 6, 2022
Using new definitions and tools to support alcohol recovery
Time: 12:00 pm thru 1:15 pm
Watch Here
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New: Tuesday, December 6, 2022
Population-Based Payments in Medicaid: Strengthening Provider Incentives to Transform Care
Time: 2:00 pm thru 3:00 pm
Register
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New: Thursday, December 8, 2022
Benchmarks' Child Welfare Webinar with Karen McLeod and Lisa Cauley
Time: 8:00 am thru 9:00 am
Register
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New: Friday, December 9, 2022
DHHS: Medical Care Advisory Committee (MCAC)
Time: 10:30 am thru 12:-30 pm
Join Here
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Tuesday, December 13, 2022
Population Health & Care Management: The Key to Whole-Person Care & Value-Based Care Delivery Models
Time: 1:00 pm thru 2:00 pm
Register
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New: Friday, December 16, 2022
Benchmarks' Friday Membership Webinar with Dave Richard and Karen McLeod
Time: 8:30 am thru 9:30 am
Register
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Tailored Care Management Educational Offerings
Ongoing Webinar Sessions and Trainings: Some are free, some require a fee, and some are for CMA organizations that have passed the desk review only.
NC AHEC has partnered with the NC Department of Health and Human Services and Division of Health Benefits to equip Tailored Care Management (TCM) candidates with the tools and knowledge to effectively provide care management services to North Carolina’s Tailored Plan beneficiaries through Continuing Professional Development (CPD) opportunities. Find a list of monthly offerings below and join us for one or for all!
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