Benchmarks' Friday Membership Webinar
United Healthcare/Optum PHP & Karen McLeod
Benchmarks' Upcoming Webinars

Benchmarks' Child Welfare Webinar
Lisa Cauley Joins Karen McLeod
Date: Thursday, February 10, 2022
Time: 8:00 am thru 9:00 am

Benchmarks' Friday Webinar
Dave Richard Joins Karen McLeod
Date: Friday, February 18, 2021 thru December 16, 2022
Time: 8:30 am thru 9:30 am
(This registration is for a recurring meeting)

Benchmarks' Foster, Adoption, & Residential (FAR) Committee Meeting: Legislative Agenda Development
Date: Tuesday, March 1, 2022
Time: 9:00 am thru 10:30 am

Benchmarks' Medicaid Forum: Legislative Agenda Development
Date: Thursday, March 3, 2022
Time: 9:00 am thru 10:30 am

Benchmarks' Friday Membership Webinar with AmeriHealth Caritas PHP & Karen McLeod
Date: Friday, March 4, 2022
Time: 8:30 am thru 9:30 am
Updates on Provider Flexibilities During the PHE
NC Medicaid has evaluated data from the use of COVID-19 public health emergency (PHE) flexibilities implemented during the state’s pandemic response as well as considered stakeholder feedback over the past two years of these flexibilities. Based on this review, many of the policy flexibilities implemented during the NC State of Emergency and federal PHE have been made into permanent NC Medicaid Clinical Coverage.

NC Medicaid continues to be committed to providing as much advance notice as possible to the provider community as temporary COVID-19 flexibilities end. While the NC State of Emergency has not been rescinded, NC Medicaid has decided to rescind some of the temporary COVID-19 flexibilities, effective April 1, 2022. SPECIAL BULLETIN COVID #226: Permanent Changes Made for PHE Flexibilities & Plan for sunsetting Temporary Policies contains information on:
  • Flexibilities that have been or are being incorporated into permanent policy.
  • Temporary Flexibilities that will end on April 1, 2022 (i.e., sunsetting on March 31, 2022).
  • Temporary Flexibilities that will end at the end of the federal PHE.

There is information on the following services contained within this bulletin:
  • Behavioral health
  • Children’s Development Services Agencies (CDSA)
  • Community Alternatives program for Children and Disabled Adults (CAP/C and CAP/DA)
  • Dental
  • Durable medical equipment
  • End Stage Renal Disease (ESRD)
  • Family planning
  • Home health
  • Home Infusion Therapy (HIT)
  • Hospice
  • NC Medicaid optional eligibility group (includes MAFDN Family Planning Medicaid and uninsured MCV beneficiaries)
  • Nursing facility
  • Obstetrical
  • Optical (eyeglasses) and hearing aid
  • Optometry
  • Outpatient specialized therapies
  • Personal care service
  • Pharmacy
  • Pregnancy Management Program (formerly Pregnancy Medical Home)
  • Private duty nursing
  • Program of All-Inclusive Care for the Elderly (PACE)
  • Remote physiologic monitoring treatment management
  • Smoking and tobacco cessation counseling
  • Well child visits

Please review the information in the bulletin for those details.

1115 Waiver Demonstration - NC Amendment
North Carolina seeks authority to amend its Section 1115(a) demonstration titled, “North Carolina Medicaid Reform Demonstration”. With this amendment request, the state seeks to extend the end date of the demonstration, adjust the coverage approach under the BH I/DD Tailored Plans, modify implementation of the Healthy Opportunity Pilots, and exclude the COVID-19 testing group from mandatory managed care. The federal public comment period will be open from February 2, 2022 through March 4, 2022.



FUNDING ANNOUNCEMENT! Building Capacity for HCBS through Collective Impact
We are pleased to announce that Cares at the UNC-Chapel Hill School of Social Work has been contracted by North Carolina Money Follows the Person (MFP) to oversee an initiative titled, Building Capacity for Home & Community Based Services through Collective Impact.
 
Funding for this project comes from the Centers for Medicare and Medicaid Services (CMS) and is aimed at addressing areas of concern in building communities that are inclusive of people with Intellectual and Developmental Disabilities (I/DD), Traumatic Brain Injury (TBI), physical disabilities, and older adults with support needs.
 
Cares is requesting applications for a four-year project (plus an optional fifth year renewal). Up to four (4) organizations will receive grant funding to develop and implement initiatives using the collective impact framework. Awarded funds will not exceed one hundred and fifty thousand dollars ($150,000) per grantee per contract year.
 
Awards will be given in the following focus areas:
  1. Affordable accessible housing
  2. Transportation
  3. Direct support workers
  4. Natural supports
 
More information and application materials can be found at: https://cares.unc.edu/mfp/rfa2022/
 
Behavioral Health Minority Provider Virtual Summit
The Department of Mental Health, Developmental Disabilities and Substance Use Services is pleased to offer this Virtual Summit on February 15, 2022 designed exclusively for minority providers. Minority providers play an integral role in advancing the behavioral health of North Carolinians and we want to ensure that all providers are well equipped to apply for funds, compete for resources and manage and monitor program goals.

Historically marginalized populations must have equitable access to care and services. This training is being offered at no-cost to minority behavioral health providers in the state. We are pleased to partner with the African American Technology Transfer Center to offer such an opportunity. 

Please use the following link to access information regarding the Behavioral Health Minority Provider Virtual Summit.
 
REVISED AND UPDATED!!!!

Deadline for DCW One-Time Bonus Submissions EXTENDED to Friday, February 11, 2022
Please send related questions to Karen and Tara.

SPECIAL BULLETIN COVID-19 #228: Direct Care Worker One-Time Bonus
This is an update to COVID-19 #212. The Current Operations Appropriations Act of 2021 approved a NC Medicaid budget provision for one-time bonuses up to $2,000 for eligible direct care workers (DCWs) and support staff. More information

Updates to SPECIAL BULLETIN COVID-19 #212, 213 and 214
The NC Division of Health Benefits (DHB) has recently published updates to some Medicaid Bulletin articles pertaining to COVID-19:
 
SPECIAL BULLETIN COVID-19 #212: Direct Care Worker and Support Staff One-Time Bonus See Updates
 
SPECIAL BULLETIN COVID-19 #213: Direct Care Worker ICF-IID Wage Increase See Updates
 
SPECIAL BULLETIN COVID-19 #214: Direct Care Worker HCBS Wage Increase See Updates
 
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 BULLETIN COVID-19 #219: Over-the-Counter Tests for Home Use
Effective Jan. 10, 2022, NC Medicaid-enrolled pharmacy providers may bill point-of-sale (POS) for FDA-approved over-the-counter (OTC) COVID-19 tests dispensed for use by NC Medicaid beneficiaries in a home setting. More information

SPECIAL BULLETIN COVID-19 #220: Temporary Rate Increases Extended or Replaced
Update on temporary rates that are extending or being replaced with permanent, legislated increases. More Information
 
SPECIAL BULLETIN COVID-19 #221: Status of Federal Vaccine Mandates
The Medicare and Medicaid Programs; Omnibus COVID-19 Health Care Staff Vaccination Interim Final Rule (IFC) was published by the Centers for Medicare & Medicaid Service (CMS) on Nov. 5, 2021. The IFC requires Medicare and Medicaid-certified provider and supplier types (collectively, “facilities”) that are regulated under the Medicare health and safety standards known as Conditions of Participation (CoPs), Conditions for Coverage (CfCs), or requirements to have a process or policy in place ensuring that all staff are vaccinated against COVID-19. More Information

SPECIAL BULLETIN COVID-19 #222: FDA Approves Remdesivir (Veklury) for Qualifying Pediatric Patients
On Jan. 21, 2022, the FDA approved authorization of Remdesivir (Veklury) for the treatment of COVID-19 in pediatric patients. More Information

SPECIAL BULLETIN COVID-19 #223: Omicron Surge Flexibilities
Additional flexibilities to support hospitals
 
SPECIAL BULLETIN COVID-19 #224: Update on Direct Care Worker Bonus and Wage Increase Initiative
Changes to details regarding eligibility, timelines and provider requirements
 
SPECIAL BULLETIN COVID-19 #225: Update on Direct Care Worker ICF-IID Wage Increase
Update to Special Bulletin COVID-19 #213: Direct Care Worker ICF-IID Wage Increase. Please review the updated bulletin in its entirety for details. More Information
 
SPECIAL BULLETIN COVID-19 #226: Permanent Changes Made for Public Health Emergency Flexibilities and Plan for Sunsetting of Temporary Policies
Certain COVID-19 Flexibilities implemented by NC Medicaid under State Authority will end as of March 31, 2022 More Information
 
SPECIAL BULLETIN COVID-19 #227: Direct Care Worker Initiative Webpage Now Available
Session Law 2021-180, the recently adopted NC Appropriations Act, includes funds to give a one-time bonus for eligible direct care workers (DCWs) and support staff who provide services to Medicaid and NC Health Choice beneficiaries. The Act also includes a provision to implement a HCBS and ICF-IID DCW wage increase for eligible employees who provide services to Medicaid and NC Health Choice beneficiaries. 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.

New Medicaid Bulletin Available as of Feb. 4, 2022
The NC Division of Health Benefits (DHB) has recently published a new Medicaid Bulletin article:
 
 
New Medicaid Bulletins Available as of Feb. 1, 2022
The NC Division of Health Benefits (DHB) has recently published new Medicaid Bulletin articles:
 
·    NC Medicaid Eyeglasses Dispensing Fee Billing and Payment
·    Billing Information for Continuous Glucose Monitoring for CPPs
·    Tailored Care Management Updates – Jan. 28, 2022
·    Tailored Care Management Update: AMH+/CMA Certification Round Two Desk Reviews Completed
·    NC Medicaid Managed Care Provider Update – Jan. 27, 2022 

Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB's Medicaid Bulletin webpage.
 
Feb. Pharmacy Newsletter Available
The latest Medicaid Pharmacy Newsletter, dated Feb. 2022, is now available on the N.C. Medicaid website. In addition to the March 2022 checkwrite schedule, this edition of the newsletter includes the articles:
 
·    Billing information for Continuous Glucose Monitoring for CPPs
·    SPECIAL BULLETIN COVID-19 #216: Pharmacies Will Cover Oral Tablets (Paxlovid and Molnupiravir)
·    SPECIAL BULLETIN COVID-19 #217: Third Dose of Pfizer-BioN Tech Vaccine for Children Ages 5-11
·    Ozobax and Qdolo Update
·    Over-the-Counter COVID-19 Tests for Home Use
 
Providers are encouraged to review this important information. The 2022 Medicaid Pharmacy Newsletters can be viewed here.
 
Save the Dates – February Webinars for Medicaid Providers
Fireside Chat: Medicaid Managed Care Hot Topics
Thursday, Feb. 17, 2022 | 5:30-6:30 p.m. Register
 
Please join NC Medicaid Chief Medical Officer (CMO) Dr. Shannon Dowler, along with the NC Medicaid Managed Care Plan CMOs, for the February Fireside Chat on Thursday, Feb. 17 from 5:30-6:30 p.m. 
 
This webinar will cover a variety of important NC Medicaid updates including COVID-19 vaccination counseling, vaccination data rates and PHP COVID-19 Member Incentive program impact being offered by the PHPs. We will review the timing of sunsetting temporary COVID-19 flexibilities and discuss those made permanent, including the future of telephonic codes. Other updates will include: Non-Emergency Medical Transportation (NEMT), Collaborative Care Codes, Hospital at Home and other quick updates that arise over the next two weeks!
 
Have a question you would like addressed during the webinar? Please use this link to enter your questions to ensure they are asked and answered the evening of the webinar. The link will become inactive on Tuesday, Feb. 15.
 
Medicaid Managed Care: Quality & Population Health Webinar
Thursday, Feb. 24, 2022 | 5:30-6:30 p.m. Register
 
This series, formerly the Advanced Medical Home (AMH) Webinar Series, is designed to support practice managers, quality improvement professionals, care coordinators and others within your practice who are responsible for meeting the NC Medicaid Managed Care provider requirements. Join us on Thursday, Feb. 24 from 5:30-6:30 p.m. for a discussion on Evaluating Medicaid Transformation.
 
Visit the AHEC Medicaid Managed Care webpage for additional information and registration for upcoming webinars, as well as recordings, slides and transcripts from previous webinars.

February 2022 Provider Training Now Available
Registration is open for the Feb. 2022 instructor-led provider training courses listed below. Slots are limited. NCTracks Zoom courses can be attended remotely from any location with a computer and internet connection. Please note that as of Jan. 1, 2021, training will be conducted through Zoom; individualized meeting information has been created for each course. Please see the Training Enrollment Instructions section below for registration details.

Prior Approval Dental/Ortho (Zoom)
Tuesday, Feb. 22, 2022, 9:30 a.m. – Noon  
This course will cover: how to electronically submit and inquire about prior approval requests for dental and orthodontic procedures. 
Meeting Information
Follow the steps below for audio and visual access to the Zoom online training sessions: 
1. Dial US Toll-Free 833-568-8864
2. Enter meeting ID 161 129 8422#
3. Press the # key 
4. Enter meeting passcode 5924613381#
·    Providers may choose to use the computer audio instead of dialing in.
 
Submitting a Dental/Ortho Claim (Zoom)
Tuesday, Feb. 22, 2022, 1:00 p.m. – 4:00 p.m.  
This course will focus on how to submit a Dental and Orthodontic Claims. At the end of training, the user will be able to:
·    Create a Dental Claim via the NCTracks web portal
·    Submit a Dental Claim 
·    Save a Draft Claim 
·    Use Claims Draft Search 
·    Submit a Claim 
·    View results of a Claim submission
 
Meeting Information
Follow the steps below for audio and visual access to the Zoom online training sessions: 
1. Dial US Toll-Free 833-568-8864
2. Enter meeting ID 160 915 9559#
3. Press the # key 
4. Enter meeting passcode 38446457451#
·    Providers may choose to use the computer audio instead of dialing in.
 
Prior Approval Medical (Zoom)
Wednesday, Feb. 23, 2022, 9:30 a.m. - Noon 
This course will cover: 
·    Submitting Prior Approval requests, to help ensure compliance with Medicaid clinical coverage policy and medical necessity
·    Inquiring about Prior Approval requests to determine their status
·    Voiding a Prior Approval
 
Meeting Information
Follow the steps below for audio and visual access to the Zoom online training sessions: 
1. Dial US Toll Free 833-568-8864
2. Enter meeting ID 160 469 2841#
3. Press the # key 
4. Enter meeting passcode 3122107555#
·    Providers may choose to use the computer audio instead of dialing in.
 
Submitting a Professional Claim (Zoom)
Wednesday, Feb. 23, 2022, 1:00 p.m. – 4:00 p.m.  
This course will show authorized users how to electronically submit a Professional claim. At the end of training, users will be able to:
·    Submit a Professional claim via the NCTracks web portal
·    Create a claim
·    Save a claim draft 
·    Use Claims Draft Search
·    Submit a claim 
·    View results of a claim submission
·    Perform a Claim Status Search
·    Copy the claim
·    Resubmit a claim
·    Void or replace prior claims
 
Meeting Information
Follow the steps below for audio and visual access to the Zoom online training sessions: 
1. Dial US Toll-Free 833-568-8864
2. Enter meeting ID 161 526 3955 #
3. Press the # key 
4. Enter meeting passcode 8405513764 #
·    Providers may choose to use the computer audio instead of dialing in.
 
Prior Approval Institutional (Zoom)
Thursday, Feb. 24, 2022, 9:30 a.m. – Noon
This course will cover:
·    Submitting Prior Approval requests, to help ensure compliance with Medicaid clinical coverage policy and medical necessity.
·    Inquiring about Prior Approval requests to determine their status.
 
Meeting Information
Follow the steps below for audio and visual access to the Zoom online training sessions:
1. Dial US Toll-Free 833-568-8864
2. Enter meeting ID 160 874 3689#
3. Press the # key
4. Enter meeting passcode 1722540938#
·    Providers may choose to use the computer audio instead of dialing in.
 
Submitting an Institutional Claim
Thursday, Feb. 24, 2022, 1:00 p.m. – 4:00 p.m.
At the end of training, the user will be able to submit an institutional claim via the NCTracks web portal:
·    Initial claim
·    Save a claim Draft
·    Use Claims Draft Search
·    Submit a claim
·    View results of a claim submission
·    Perform a Claim Status Search
·    Copy a claim
·    Resubmit a claim
·    Void a prior claim or replace a prior claim
 
Meeting Information
Follow the steps below for audio and visual access to the Zoom online training sessions:
1. Dial US Toll-Free 833-568-8864
2. Enter meeting ID 161 370 7791#
3. Press the # key
4. Enter meeting passcode 5820579677#
·    Providers may choose to use the computer audio instead of dialing in.
 
Training Enrollment Instructions
Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Log onto the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The courses can be found in the sub-folder labeled ILTs: Remote via WebEx (although this is the sub-folder name, please note that, as previously mentioned, courses will now be conducted via Zoom and not WebEx).
 
Refer to the Provider User Guides & Training page of the public provider portal for specific instructions on how to use SkillPort. The Provider Training Tool Kits page also includes a quick reference regarding Java, which is required for the use of SkillPort.
HIEs Overcome Challenges to Value-Based Care
Cary Medical Management shares how NC HealthConnex, the state-designated health information exchange, helps it overcomes the challenges to delivering value-based care.

Although cost immediately comes to mind, one of the primary challenges to delivering value-based care is changing the practices of patients, providers, and healthcare systems. A singular focus on cost dilutes the promise of value-based care and brings risk- and cost-focused regulations that make it just one more thing to do for health providers.

With NC HealthConnex, Cary Medical Management has found a powerful tool to overcome one challenge to value-based care: fragmented health care technology, particularly electronic health records. For example, primary care providers might not be aware when their patients are hospitalized, which can increase readmissions and reduce productivity and community engagement.

NC HealthConnex and NC*Notify, a patient-encounter alert system, eliminate Cary Medical Management's problems with surprise discharges that include poorly reconciled medications and complex discharge instructions. Providers can see their patients and their needs across all health information silos through the NC HealthConnex's Smartlink Health integration in their suite of EHRs.

"We don’t log into dozens of fragmented hospital and practice information silos. We’re able to render high-touch patient engagement and management wherever our patients are during the most vulnerable moments in their lives," said Siu Tong, chief executive officer of Cary Medical Management.
Currently, Cary Medical Management has created a bidirectional connection between NC HealthConnex and a Cary location with 12 providers. The company is working to connect another five locations, with up to 100 providers, by the end of the year.

In one case, a 14-provider clinic operated by Cary Medical Management faced losing timely discharge information from a community hospital because the lack of a direct ADT feed meant that the clinic got hospital discharge notifications for only about half of its patients or even less.

However, a live connection with NC*Notify now gives the clinic discharge information for area hospitals, along with useful data from other specialists. Smartlink SDC also inserts critical information into patient charts for immediate review.

NC HealthConnex has become a critical component of Cary Medical Management's community- and collaboration-focused methodology to deliver value-based care. This framework has improved health outcomes and produced an average of $76,000 in shared savings and incentives per provider per year.
Upcoming Events
Tuesday, February 8, 2022
Psychological Safety for Today’s Workforce

Time: 1:00 pm thru 2:00 pm
  
Thursday, February 10, 2022
Benchmarks' Child Welfare Webinar with Karen McLeod and Lisa Cauley

Time: 8:00 am thru 9:00 am
  
New: Thursday, February 10, 2022
Recruiting, Revitalizing & Diversifying: Examining the Health Care Workforce Shortage

Time: 10:00 am thru .....
  
New: Thursday, February 10, 2022
National Institute on Alcohol Abuse and Alcoholism Virtual Advisory Council Meeting

Time: 12:45 pm thru 5:00 pm
  
Monday February 14, 2022
Promoting Equity for the Direct Care Workforce

Time: 1:00 pm thru 2:00 pm
  
Tuesday, February 15, 2022
Supporting Smiles: Promoting Childhood Dental Benefits Covered Under Medicaid and CHIP

Time: 2:00 pm thru 3:30 pm
  
New: Wednesday, February 16, 2022
ESSENTIAL STEPS TO TELEHEALTH: WORKSHOPS TO HELP IMPROVE OR SUSTAIN YOUR PROGRAM

Please join us virtually for an interactive workshop to learn more about telehealth in North Carolina. In this 90-minute workshop we will answer questions, provide information, and work through some common challenges that health care providers face when working with telehealth. This webinar is offered on multiple dates. This is an interactive session, so bring your questions and ideas!
 
Select one date from the following:
 
Wednesday, February 16th 9:00-10:30 AM
 
Thursday, March 3rd 12:00-1:30 PM
 
Wednesday, March 9th 9:00-10:30 AM
 
Event Password: telehealth
New: Wednesday, February 16, 2022
Interactive Monthly Update

Time: 2:00 pm thru 3:00 pm
  
New: Thursday, February 17, 2022
Kickoff Event: Improving Access to Programs of All-Inclusive Care for the Elderly (PACE)

Time: 11:00 am thru 12:00 pm
  
Thursday, February 17, 2022
DSS 2nd Private Provider Quarterly Meeting

Time: 1:00 pm thru 2:30 pm
  
Friday, February 18, 2022
Benchmarks' Friday Membership Webinar: Dave Richard Joins Karen McLeod

Time: 8:30 am thru 9:30 am
  
Tuesday, March 1, 2022
Benchmarks' Foster, Adoption, Residential (FAR) Meeting: Legislative Agenda Development

Time: 9:00 am thru 10:30 am
  
Thursday, March 3, 2022
Benchmarks' Medicaid Forum: Legislative Agenda Development

Time: 9:00 am thru 10:30 am
  
Friday, March 4, 2022
Benchmarks' Friday Membership Webinar with AmeriHealth Caritas PHP & Karen McLeod

Time: 8:30 am thru 9:30 am