Important EVV Provider Guidance

Attention EVV providers: DHB recently released important EVV provider guidance.

Providers must continue to collaborate, test and operationalize the EVV process with the applicable LME/MCOs and their EVV vendor, HHAeXchange, to meet the June 30, 2021, EVV implementation date.

Read the NC Medicaid May 2021 EVV memo here.

DHHS EVV Joint Communication Bulletin Release

This Joint Communication Bulletin #J395 is to provide the Electronic Visit Verification (EVV) Guidance Document that includes updated code information and assumptions around EVV. The EVV Guidance Document can also be found at NC Medicaid’s EVV Webpage. 

Alliance Brand A

Temporary Medicaid COVID Rates Extended

This notice is an update to the February 25, 2021, Alliance Provider News posting.

To ensure our members continue to receive quality services during the Coronavirus pandemic and to support our providers in their efforts, Alliance has extended the current temporary Medicaid COVID rates indicated below through October 31, 2021.

Rates are currently adjusted within our Alliance Claims System (ACS). Providers should continue to submit claims as usual. Should you have any questions regarding these rates, please feel free to contact or your Provider Network Specialist.

Thank you to all of our providers who continue to work so diligently throughout this pandemic to deliver the best possible care for our members. We appreciate your hard work.

The following Medicaid services are included in the COVID enhanced rates (Click here for a downloadable file):

B3DI Residential
T2033 U4 Supported Living Level I
T2033 HI U4 Supported Living Level II
T2033 TF U4 Supported Living Level III
H2016 U4 Residential Supports Level 1
H2016 U2 U4 Residential Supports Level 1 – AFL
H2016 HI U4 Residential Supports Level 4
H2016 HI U2 U4 Residential Supports Level 4 – AFL
T2014 U4 Residential Supports Level 2
T2014 U2 U4 Residential Supports Level 2 – AFL
T2020 U4 Residential Supports Level 3
T2020 U2 U4 Residential Supports Level 3 – AFL
Innovations Residential
H2016 Residential Supports Level 1
H2016 U2 Residential Supports Level 1 – AFL
H2016 HI Residential Supports Level 4
H2016 HI U2 Residential Supports Level 4 – AFL
T2014 Residential Supports Level 2
T2014 U2 Residential Supports Level 2 – AFL
T2020 Residential Supports Level 3
T2020 U2 Residential Supports Level 3 – AFL
T2033 Supported Living Level 1
T2033 HI Supported Living Level 2
T2033 TF Supported Living Level 3
TBI Residential
H2016 22 Residential Supports 1
H2016 U2 22 Residential Supports Level 1 – AFL
T2014 22 Residential Supports 2
T2014 U2 22 Residential Supports Level 2 – AFL
T2020 22 Residential Supports 3
T2020 U2 22 Residential Supports Level 3 – AFL
PSR
H2017 U5 Psychosocial Rehabilitation During Disaster
CST
H2015 HT Community Support Team
H2015 HTHO CST Team Lead
H2015 HTHF CST LCAS, other SA
H2015 HTHN CST QP/AP
H2015 HTU1 CST NC Peer Support Specialist
H2015 HTHM CST Paraprofessional
H2015 HTHFCR CST LCAS, other SA
H2015 HTU1CR CST NC Peer Support Specialist
H2015 HTHMCR CST Paraprofessional
H2015 HTHNCR CST QP/AP
H2015 HTHOCR CST Team Lead
H2015 HTHFGTCR CST LCAS, other SA
H2015 HTU1GTCR CST NC Peer Support Specialist
H2015 HTHMGTCR CST Paraprofessional
H2015 HTHNGTCR CST QP/AP
H2015 HTHOGTCR CST Team Lead
ACTT
H0040 Assertive Community Treatment Team/IDDT
H0040 CR Assertive Community Treatment Team/IDDT
H0040 GTCR Assertive Community Treatment Team/IDDT
Innovations
T2013 TF Community Living and Supports – Individual
T2021 22 Day Supports – Individual
S5150 Respite Care – Community Individual
TBI
S5150 Respite Care – Community Individual
T2013 TF U5 Life Skills Training – Individual
T2021 22 Day Supports – Individual

 

B3DI
H0045 U4 Respite B3 Individual Child
H0045 HB U4 Respite B3 Individual Adult
T2013 TF U4 Community Living and Supports – Individual
S5150 U4 Respite Care – Individual
T2021 22 U4 Day Supports Individual – Hourly
Outpatient
90837 Psychotherapy – 53+ Minutes
90837 CR Psychotherapy – 53+ Minutes
90837 GT Psychotherapy – 53+ Minutes
90837 GTCR Psychotherapy – 53+ Minutes
99213 E & M Detailed, Estab Patient approx. 15 minutes
99213 GT E & M Detailed, Estab Patient approx. 15 minutes
99213 GTCR E & M Detailed, Estab Patient approx. 15 minutes
99214 E & M Moderate, Estab Patient approx. 25 minutes
99214 GT E & M Moderate, Estab Patient approx. 25 minutes
99214 GTCR E & M Moderate, Estab Patient approx. 25 minutes
PRTF
RC911 PRTF
ICF
RC100 ICF
CHILD RESIDENTIAL
H0036 U3 Z4
S5145  22 HA IAFT
S5145 22 Z3 Rapid Response
S5145
S5145 22 Z2 IDD/MH TFC
H0046
H2020
H2020 CR
H0019 HK
H0019 HK CR
H0019 HQ
H0019 HQ CR
H0019 TJ
H0019 TJ CR
ABA
97153
97153 CR CR
97153 GT CR GT CR
IIH
H2022
MST
H2033 U3 HE

Durham Homelessness Prioritization for Housing Survey

Does your agency provide services to people experiencing homelessness in Durham? If so, your feedback is needed!

Durham’s homeless system, the Continuum of Care (CoC), is required to use a standardized process to prioritize clients for housing. Currently the Durham Continuum of Care uses an assessment called the VI-SPDAT. The CoC is looking at developing a new methodology for prioritizing its limited housing resources. The new process will consider both vulnerability and housing barriers. In order to help us with this new methodology, we’d like to collect information from the Durham community on priorities and relevant barriers. Please complete the survey to share your thoughts.

National Core Indicators Staff Stability Survey

Alliance needs your help!  We are seeking as close to 100% participation from our IDD service providers (Medicaid, Innovations, and state funded) in completing the National Core Indicators Staff Stability Survey.  It is extremely important to gather this data, as it provides information for future policy and system changes related to IDD services.  Can we count on you?

All Provider Meeting June 16

Reminder: Alliance’s All Provider Meeting is scheduled Wednesday, June 16 from 1-3 pm.   This meeting will be conducted via Zoom.

Please register for the meeting using this link. 

Thank you and look forward to “seeing” you on Wednesday.

NCDHHS Update on Tailored Plan Beneficiaries

From NCDHHS:

During the Open Enrollment period, the Department closely monitored data indicating the active selections of Tailored Plan-eligible beneficiaries into Standard Plans. None of these beneficiaries were auto-enrolled in a Standard Plan. Toward the end of Open Enrollment, there was an increased uptick in the number of Tailored Plan-eligible beneficiaries who enrolled in a Standard Plan.

  • Through June 1, approximately 7,000 Tailored Plan-eligible beneficiaries made an active selection to enroll in Standard Plans, which may make them ineligible for services they are currently receiving, have recently received, or may benefit from receiving.

Based on the number and profile of Tailored Plan-eligible beneficiaries who enrolled in a Standard Plan, the Department determined that these beneficiaries would benefit from receiving additional information to ensure they are fully aware of the impact of the decision to leave NC Medicaid Direct and their LME-MCO and enroll in a Standard Plan — including the potential loss of services.

Therefore, the Department will stop Standard Plan enrollments of these beneficiaries and all Tailored Plan-eligible beneficiaries who selected a Standard Plan will remain in NC Medicaid Direct and their LME-MCO through NC Medicaid Managed Care Go-Live on July 1, 2021.

The Department will provide additional information to ensure that these beneficiaries are fully aware of services that may be lost if they move to a Standard Plan. This will include a notice to be sent later this month informing them of the change back to NC Medicaid Direct as well as a detailed list of services that are not available in a Standard Plan.

Beneficiary choice remains paramount and Tailored Plan-eligible beneficiaries will still have the option to enroll in a Standard Plan. The Department plans to implement, by early August, a specific enrollment process for Tailored Plan-eligible individuals that will include enhanced choice counseling to help verify that beneficiaries have all the information they need to understand the impact of their decisions.

We will continue to provide updates on this process and appreciate your ongoing partnership in serving the state’s Medicaid beneficiaries and their families.

Important EVV Provider Guidance

Attention EVV providers: DHB recently released important EVV provider guidance.

Providers must continue to collaborate, test and operationalize the EVV process with the applicable LME/MCOs and their EVV vendor, HHAeXchange, to meet the June 30, 2021, EVV implementation date.

Read the NC Medicaid May 2021 EVV memo here.

DMHDDSAS Needs Assessment Survey

The NC Division of Mental Health Developmental Disabilities and Substance Abuse Services (DMHDDSAS) seeks your assistance in identifying current needs for training across their system servicing children, youth, and young adults dually diagnosed with a mental illness and an intellectual or developmental disability (to include autism spectrum disorder).

DMHDDSAS and Behavioral Health Springboard-UNC Chapel Hill School of Social Work have collaborated to develop a needs assessment to gain more insight on how to best support the workforce.

Currently, they are expanding their training and workforce development efforts and would like your feedback on the subject areas needed for targeted training. They are requesting information from mental health and intellectual and developmental disability provider agencies, LME-MCO staff, consumers, families, and DHHS staff to accomplish this task.

The assessment will take approximately five minutes to complete and is completely voluntary. All responses will be recorded anonymously. They would like as many responses as possible and encourage multiple individuals within organizations and families to complete the needs assessment. If you are a provider agency with multiple sites; they encourage multiple staff from each local site to complete.

Responses will help craft the training and workforce development efforts to strengthen a highly qualified child serving behavioral health system.

The needs assessment will close to participation on Monday, June 14, 2021 at 5 pm.

Click here to complete the assessment.

 

DHHS EVV Joint Communication Bulletin Release

This Joint Communication Bulletin #J395 is to provide the Electronic Visit Verification (EVV) Guidance Document that includes updated code information and assumptions around EVV. The EVV Guidance Document can also be found at NC Medicaid’s EVV Webpage.