Short-Term Goals and Progress Update Requirements for 1915(i)

Under the North Carolina Medicaid 1915(i) Home and Community-Based Services (HCBS) option, short-term goals and progress updates must be carefully documented to maintain compliance, demonstrate clinical necessity, and support authorization renewals.

For Prior Approval Requests (PARs) and annual reauthorizations, providers are required to submit short-term goals and clear and timely progress updates.
Share short-term goals and related updates with the Care Manager once developed. For all authorized services, including Individual and
Transitional Supports (ITS), progress updates must be submitted 21 days before the authorization end date. Please note that ITS authorizations are issued
every 90 days, and updates are required on a quarterly basis.

PARs submitted without short-term goals or progress updates may be at risk of denial of gap in services. Additionally, Care Managers may need to reschedule annual ISP meetings if required documentation is not provided in a timely manner. Please ensure that all required short-term goals and progress updates are completed and submitted within the appropriate timeframes. Please contact your Provider Network Specialist if you have questions. Thank you for your attention to this important requirement.