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Benchmarks' Upcoming Webinars
Benchmarks' Membership Webinar with PHPs: WellCare
Date: Friday, October 7, 2022
Time: 8:30 am thru 9:30 am
Register
Cancelled! Benchmarks' Child Welfare Webinar with Karen McLeod and Lisa Cauley- We will meet with Lisa again in November.
Benchmarks' Members: Medicaid Forum-Legislative Agenda Planning for 2023 Long Session
Date: Tuesday, October 18, 2022
Time: 9:00 am thru 10:30 am
Register
Benchmarks' Members: Foster, Adoption, Residential (FAR) Webinar-Legislative Agenda Planning for 2023 Long Session
Date: Wednesday, October 19, 2022
Time: 9:00 am thru 10:30 am
Register
Benchmarks' Friday Membership Webinar with Dave Richard and Karen McLeod
Date: Friday, October 21, 2022
Time: 8:30 am thru 9:30 am
Register
Benchmarks' Collection of Past Updates
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Press Release: NCDHHS Delays Medicaid Managed Care Tailored Plans
RALEIGH — To ensure beneficiaries can seamlessly receive care on day one, the North Carolina Department of Health and Human Services will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans until April 1, 2023.
Tailored Plans, originally scheduled to launch Dec. 1, 2022, will provide the same services as Standard Plans in Medicaid Managed Care and will also provide additional specialized services for individuals with significant behavioral health conditions, Intellectual/Developmental Disabilities and traumatic brain injury.
The delayed start of Tailored Plans allows Local Management Entity/Managed Care Organizations, which will operate the Tailored Plans, more time to contract with additional providers to support member choice and to validate that data systems are working appropriately. The decision is supported by the leadership of the state’s six LME/MCOs.
While the start of Tailored Plans will be delayed, specific new services will still go live Dec. 1, 2022.
NCDHHS and LME/MCOs will support providers of Tailored Care Management to launch their services on Dec. 1. Through Tailored Care Management, eligible beneficiaries will have a single designated care manager supported by a multidisciplinary team to provide integrated care management that addresses the beneficiary’s whole-person health needs.
In addition, pending approval from the Centers for Medicare and Medicaid Services, NCDHHS will implement the 1915(i) option on Dec. 1. This program provides services to help beneficiaries remain in their homes and community-based settings through services such as Respite, Individual and Transitional Supports, Community Living and Supports, Community Transition and Supported Employment.
Beneficiaries set to receive care through the Tailored Plans will continue to receive behavioral health services and I/DD and TBI supports through their LME/MCO and physical health and pharmacy services through NC Medicaid Direct, just as they do today.
More information regarding the beneficiary choice period and other key dates leading up to the April 1, 2023, launch will be shared by NCDHHS in the coming weeks.
For more information about Tailored Plans please visit NC Medicaid’s Tailored Plan website.
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Joint Communication Bulletins
Joint Communication Bulletin #J433 - State-Funded Assertive Engagement Service Definition
This bulletin provides information about the formal standardization of the State-funded Assertive Engagement service definition. This definition will replace all existing Alternative Service Definitions for State-funded Assertive Engagement, effective Dec. 1, 2022. State-funded Assertive Engagement is a Core State-funded Tailored Plan service.
Assertive Engagement is a short-term outreach service to adults and/or children with Serious Mental Illness (SMI), Serious Emotional Disturbance (SED), and/or Substance Use Disorder (SUD), who have significant functional impairments, and who have not engaged effectively with treatment services when offered.
The State-funded Assertive Engagement service definition is attached.
If you have any questions, please contact Margaret Herring at 984-236-5057 or via e-mail at [email protected].
Read Here
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Community Health Grant SFY2024 RFA Release and Technical Assistance Webinars
The Office of Rural Health will soon release the Community Health Grant Request for Applications. These grant funds, supported through the North Carolina General Assembly, are for assuring access to primary and preventive care to meet the health needs of vulnerable, underserved and medically indigent patients, with emphasis on providing primary and preventative medical services to uninsured or medically indigent patients.
An important component of this work is to strengthen the safety net through increased levels of collaboration and integration of services to sustain and meet the needs of those served more effectively.
When an eligible primary care medical home safety net organization provides integrated care, grant funding may also support dental, pharmacy, and behavioral health services.
Applicants may request up to $150,000 per year of the grant. The full RFA announcement will be posted to the Office of Rural Health website in early October.
Maximum Award Amount: up to $150,000 per year of the grant
Proposed Project Period: July 1, 2023 – June 30, 2024
RFA Open: October-December (see link below for specific dates)
For more information, please visit this link.
Community Health Grants SFY24 RFA
Please join us for Technical Assistance Webinars in October to find out more information on agency eligibility, length of award, how to apply, and other items specific to this upcoming grant cycle. Interested applicants may attend any session at their convenience. Recordings will be made available on the website.
Webinars by Medicaid Regions will be held on the following dates:
Community Health Grants SFY 2024 Medicaid Region Map
October 3, 2022 at 10:00 am – Regions 1 and 2
https://www.zoomgov.com/j/1609944438?pwd=VUEyVEc5YTN6RnhTZS9KVEZ4b2JuQT09
Meeting ID: 160 994 4438
Passcode: 146192
One tap mobile
+16692545252,,1609944438# US (San Jose)
+16468287666,,1609944438# US (New York)
Dial by your location
+1 669 254 5252 US (San Jose)
+1 646 828 7666 US (New York)
+1 551 285 1373 US
+1 669 216 1590 US (San Jose)
Meeting ID: 160 994 4438
Find your local number: https://www.zoomgov.com/u/abNMKsr941
October 6, 2022 at 2:30 pm – Regions 3 and 5
https://www.zoomgov.com/j/1607675142?pwd=TzFwRmNZRzFuZVE5TjJHb0xYZjFxUT09
Meeting ID: 160 767 5142
Passcode: 895471
One tap mobile
+16692545252,,1607675142# US (San Jose)
+16468287666,,1607675142# US (New York)
Dial by your location
+1 669 254 5252 US (San Jose)
+1 646 828 7666 US (New York)
+1 551 285 1373 US
+1 669 216 1590 US (San Jose)
Meeting ID: 160 767 5142
Find your local number: https://www.zoomgov.com/u/ac4iR46fFB
October 13, 2022 at 1:00 pm – Regions 4 and 6
https://www.zoomgov.com/j/1606486910?pwd=MGZFWVFuNW1GQUFpMkFlZE9sR1M5dz09
Meeting ID: 160 648 6910
Passcode: 000902
One tap mobile
+16692545252,,1606486910# US (San Jose)
+16468287666,,1606486910# US (New York)
Dial by your location
+1 669 254 5252 US (San Jose)
+1 646 828 7666 US (New York)
+1 551 285 1373 US
+1 669 216 1590 US (San Jose)
Meeting ID: 160 648 6910
Find your local number: https://www.zoomgov.com/u/aerYoJimP2
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NCTracks to Receive ACA Site Visit Information Automatically
The NC Medicaid vendor for conducting provider site visits, Public Consulting Group (PCG), currently performs periodic checks to identify any enrolled providers which have not received the required Affordable Care Act (ACA) site visit on file. Once identified, a post-enrollment site visit is initiated. To date, post -enrollment site visit results have not been transferred and captured on the NCTracks provider record.
Effective Oct. 23, 2022, post-enrollment ACA site visit data from Public Consulting Group (PCG) will be transferred directly to NCTracks. Records will be updated accordingly based on pass/fail results.
In addition, NCTracks will now automatically terminate a service location if the provider fails the post-enrollment ACA site visit conducted by PCG. If the terminated service location is the only service location, the provider record will be terminated. If terminated, the provider will receive notice of termination in their Message Center Inbox of the secured provider portal and via certified mail.
DHB to Assess Out-of-State Enrollment Applications for Certain DME Taxonomies
Effective Oct. 23, 2022, NCTracks will send all out-of-state (OOS) Durable Medical Equipment (DME) provider enrollment requests for taxonomy codes 332BC3200X, 332BD1200X, 332BP3500X and 332BX2000X to Division of Health Benefits (DHB) for review.
Provider OOS enrollment requests for these taxonomies will be reviewed by DHB to screen for the applicable criteria. Per Durable Medical Equipment, Prosthetics/Orthotics and Supply (DMEPOS) policies 5A-1, 5A-2, 5A-3, and 5B, subsection 6.0 (Provider(s) Eligible to Bill for the Procedure, Product, or Service), DMEPOS providers/suppliers without a physical presence within the boundaries of North Carolina or the 40-mile border area of a contiguous state may be enrolled only when one of the following three circumstances applies:
1. Access: The medically necessary product the provider supplies or manufactures is not reasonably available through an enrolled provider located within the boundaries of North Carolina or the 40-mile border area of a contiguous state.
2. Medicare Crossovers: The provider is enrolled with Medicare and seeks to serve beneficiaries dually eligible for Medicare and North Carolina Medicaid. In this case, the provider shall be enrolled only for secondary crossover claims payments.
3. Medicare Competitive Bid-winner: The provider is a Medicare competitive bid-winner in at least one of four competitive bidding areas of North Carolina, and then only for the items included in their winning bid.
In addition to meeting clinical coverage policy criteria, providers must upload a completed Out-of-State Durable Medical Equipment (DME) Provider Form with their application. This form will be available on the Provider Policies, Manuals, Guidelines and Forms page of NCTracks under Provider Forms. The NCTracks Provider Enrollment staff will ensure the provider has uploaded the form, which is required for application approval. If the form is not uploaded, the application will be returned to the provider.
A member from the North Carolina Medicaid DME team will review the request and decide if the provider meets the North Carolina Medicaid clinical coverage criteria for OOS providers. The DME reviewer will then recommend to NCTracks whether to approve or deny the provider’s participation as an OOS DME provider. Providers will still receive an approval or denial letter from NCTracks.
If applicable the following denial reason will be included in the denial letter: YOUR REQUEST TO ENROLL AS A NC MEDICAID DURABLE MEDICAL EQUIPMENT (DME) PROVIDER HAS BEEN DENIED, AS YOUR ENROLLMENT REQUEST DOES NOT MEET THE NC MEDICAID OUT-OF-STATE DME PROVIDER REQUIREMENTS.
OOS providers seeking to apply with one of these taxonomy codes are encouraged to review the applicable clinical coverage criteria for enrollment when submitting their application.
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The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:
SPECIAL BULLETIN COVID-19 #264: Pfizer & Moderna Bivalent COVID-19 Booster Vaccines
Effective with date of service Aug. 31, 2022, the NC Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5) - 12 years of age and older (N/A) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code 91312 - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use.
Effective with date of service Aug. 31, 2022, the NC Medicaid and NC Health Choice programs cover Moderna COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5) - Booster Dose (N/A) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code 91313 - Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use. More information.
Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.
Special Edition Pharmacy Newsletter Available
A Special Edition Pharmacy Newsletter, dated September 23, 2022, is now available on the N.C. Medicaid website. This edition of the newsletter includes the article:
- Revised Procedures for Prior Authorization of palivizumab (Synagis®) for Respiratory Syncytial Virus Season 2022/2023 – Coverage starts Oct. 1, 2022
Providers are encouraged to review this important information. The 2022 Medicaid Pharmacy Newsletters can be viewed here.
Columbus Day/Indigenous Peoples' Day Holiday and Checkwrite Schedule
Monday, Oct. 10, 2022, is Columbus Day/Indigenous Peoples’ Day, which is a federal holiday, although not observed by the N.C. Department of Health and Human Services (DHHS) or GDIT.
However, in keeping with the published 2022 checkwrite schedules, because of the federal holiday, the checkwrite date that week will be on Wednesday, Oct. 12. 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 (10/13/22). 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 (10/14/22) afternoon. (Some may post sooner.)
The 2022 checkwrite schedules can be found under Quick Links on the provider portal home page.
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INVITATION-NC Healthcare Broadband Coalition
Benchmarks is honored to be a member of the NC Healthcare Broadband Coalition. The Coalition is working on behalf of North Carolinians to make sure the unprecedented broadband funding from the Infrastructure and Jobs Investment Act, with bipartisan support by the NC legislature, is made available to unserved and underserved healthcare providers and their patients throughout the state.
This is a once-in-a-generation opportunity.
On Monday, October 10, 2022 at 1:00 pm to 2:00 pm, the NC Division of Broadband and Digital Equity will be making a presentation and providing an opportunity for Q&A with the Coalition’s Steering Committee members.
We would LOVE for you to join us.
The Division is the lead organization in NC, drafting the state’s broadband plan, soliciting broadband funding from the Federal government, and allocating those funds throughout the state.
If you have colleagues you think should know about this or would be interested, please forward this invitation to them.
Thanks very much for your interest, and we look forward to your joining us for this important discussion.
Click here to join the meeting on Monday, October 10, 2022 at 1:00 pm.
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Rapid Resource for Families- Great News | |
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Important Survey: School Performance Grades
NC DPI is engaged in creating new School Performance Grades (SPG) for North Carolina schools. Stakeholder meetings have provided feedback around new indicators/measures for SPGs and a survey has been developed for additional stakeholder feedback across the state.
The survey can be found here. Additionally, to support the communication of this work, a new webpage with additional information has been created on the DPI website which can be found here.
* Please consider completing the survey and feel free to share it with your various communities. This survey will close at 5:00 pm on Monday, October 10. All results will be used anonymously in aggregate.
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Risk and Safety Assessment 101 | |
Telehealth improves treatment for opioid use disorder
At a Glance:
- People with opioid use disorder who received telehealth services during the COVID-19 pandemic were more likely to stay on their medications and less likely to overdose.
- The findings support continuing the expanded telehealth access that began during the pandemic.
Read Here
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HHS Withdraws Harmful Guidance Rule
On July 25, 2022 Biden-Harris Administration announced the repeal of the so-called “Good Guidance” Rule a regulation that placed significant restrictions on HHS’s ability to issue and utilize sub-regulatory guidance documents. Finalized in the waning days, of the Trump Administration, the rule was part of the former Administration’s deregulatory agenda that set the foundation for many harmful and restrictive health policies. NHeLP supports the repeal of the Guidance Rule. Repeal of the rule gives HHS the flexibility necessary to improve access to health care for low-income and underserved populations.
Read Here
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Recent Developments and Key Issues to Watch with Medicaid Section 1115 Waivers
This policy watch describes the current landscape of Section 1115 waivers and highlights key issues to watch, including the outcome of litigation related to Georgia’s waiver and the Biden Administration’s decisions on pending requests from Tennessee and other states.
Read Here
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NC DHHS to revamp regional support model (Includes video)
While the current state of Bertie County Department of Social Services (DSS) is not the catalyst for the move, the North Carolina Department of Health and Human Service (NCDHHS) is creating a new Regional Support Model for monitoring county services.
This new model calls for the creation of 14 new positions appropriated in the 2022-2023 state budget. The Regional Support Model will have three child welfare specialists assigned to each region with one for Safety, which includes Intake, CPS Assessments, and CPS In Home, one designated for Permanency Planning services and another for CQI-Continuous Quality Improvement, focusing on case review, data review and the development of CQI plans.
Read Here
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NC child welfare leader says system is ‘in crisis’ and state could be sued ‘at any point’
North Carolina faces problems with finding treatment for children with emotional and behavioral health needs. Some are left waiting for help in emergency rooms and DSS offices, official says.
The state’s child welfare system “is in crisis,” and “at any point there could be a massive class-action lawsuit,” the N.C. Department of Health and Human Services told county directors of social services departments during a presentation earlier this month.
The speaker, Susan Osborne, said she was referring to local DSS offices boarding children in their offices or leaving children with emotional and behavioral health needs in emergency rooms after hospitals have released them because there was nowhere else to place them. Osborne is the assistant secretary for county operations at NCDHHS.
“We average about 50 children in emergency rooms on any given day, who have been discharged, but their appropriate level of placement has not been located,” Osborne said in an interview with Carolina Public Press.
However, Corye Dunn, director of public policy for Disability Rights North Carolina, said the state cannot “foster its way out of this crisis.”
“Children don’t need to be put somewhere, they need to be parented and cared for and in many cases, to receive clinical treatment,” Dunn said. “The very least we can do is give kids better outcomes if we are going to disrupt their families and their lives.”
In an interview with CPP, Osborne said the state is concerned about the lack of qualified beds for children in psychiatric residential treatment facilities and reiterated North Carolina’s last-place rank among seven states in the Southeast in per-child investment in child welfare.
“At this point, every year since I’ve been here, which is four years, we’ve asked for additional funding to support more child welfare workers in counties,” Osborne said. “We haven’t been successful.”
Osborne gave the presentation to DSS directors around the state at the behest of county DSS directors who asked about the state’s takeover of Bertie County’s child welfare office.
Read Here
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Grant to develop housing, opportunities for youth transitioning from foster care (Includes video)
Greenville's housing authority has received more than $2 million in grant funds to build an affordable housing development for youth exiting the foster care system, the agency announced this week. The Housing Authority of the City of Greenville (HACG) said it will use funds totaling $2,085,540 for the construction of "ARISE," which will consist of 20 apartments for youth and young adults between the ages of 18-24 who are transitioning out of foster care and have no place to go.
This first-of-its-kind initiative also will provide life skills training, counseling, educational opportunities, and case management, all at one location.
Read Here
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TODAY!!! Friday, September 30, 2022
NC Medicaid: Delay of Tailored Plans
Time: 1:00 pm thru 2:00 pm
Join Here
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TODAY!!! Friday, September 30, 2022
NC Medicaid Substance Abuse Comprehensive Outpatient Clinical Coverage Policy: Download Draft Policy
Time: 2:00 pm thru 3:00 pm
Join Here
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Rescheduled: Monday, October 3, 2022
Joint DMH/DD/SAS and DHB Monthly Consumer Webinar
Time: 2:00 pm thru 3:00 pm
Register
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New: Tuesday, October 4, 2022
Virtual Training: Crisis Assessment and Intervention When Trauma Strikes: A Five-Step Approach to Foster Hope, Collaboration, and Change
(This is a 4-part Training Series Scheduled for October 4, 11, 18, and 25)
Time: 1:00 pm thru 3:00 pm
Register
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New: Wednesday, October 5, 2022
Improving Access to and Enrollment in PACE
Time: 2:00 pm thru 3:00 pm
Register
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New: Thursday & Friday, October 6 & 7, 2022
2022 State-of-the-Science Conference
Time: 11:00 am thru 4:00 pm
Register
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Friday, October 7, 2022
Benchmarks' Membership Webinar with PHPs: WellCare
Time: 8:30 am thru 9:30 am
Register
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New: Monday, October 10, 2022
NC Division of Broadband and Digital Equity Joins NC Healthcare Broadband Coalition
Time: 1:00 pm thru 2:00 pm
Register
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New: Tuesday, October 11, 2022
Involving Community Partners in Data and Policy Initiatives to Advance Health Equity
Time: 12:00 pm thru 1:30 pm
Register
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Tuesday, October 11, 2022
Leveraging Your EHR to Accommodate the “No Surprises Act”
Time: 1:00 pm thru 2:00 pm
Register
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Cancelled!!! Thursday, October 13, 2022
Benchmarks' Child Welfare Webinar with Lisa Cauley & Karen McLeod
Time: 8:30 am thru 9:30 am
We will meet with Lisa again in November
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Tuesday, October 18, 2022
Benchmarks' Members: Medicaid Forum-Legislative Agenda Planning for 2023 Long Session
Time: 9:00 am thru 10:30 am
Register
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New: Tuesday, October 18, 2022
CMS-North Carolina: Monthly Stakeholder Call (Region IV)
Time: 10:00 am thru 11:00 am
Register
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New: Tuesday, October 18, 2022
Federal Resources for Rural Communities: Tips for Writing a Successful Grant Application
Time: 1:00 pm thru 2:00 pm
Register
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Wednesday, October 19, 2022
Benchmarks' Members: Foster, Adoption, Residential (FAR) Webinar-Legislative Agenda Planning for 2023 Long Session
Time: 9:00 am thru 10:30 am
Register
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Thursday, October 20, 2022
Tailored Plan 101: Ready, Set, Launch Series
Time: 5:30 pm thru 6:45 pm
Register
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Friday, October 21, 2022
Benchmarks' Friday Membership Webinar with Karen McLeod & Dave Richard
Time: 9:00 am thru 10:30 am
Register
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Monday, October 24, 2022
North Carolina Medicare-Medicaid Integration: Advancing Whole-Person Care
Time: 12:00 pm thru 1:00 pm
Register
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Tuesday, October 25, 2022
Virtual PCS Stakeholder meeting
Time: 10:00 am thru 11:00 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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