Effective July 1, 2021, this amendment revises inpatient payment methodology for Medical and Remedial Care and Services. Specifically, this revision to methodology includes incorporating enhanced Base Rates for inpatient claims reimbursement, Graduate Medical Education (GME) payment methodology, and Disproportionate Share Hospital (DSH) payments.

Effective October 1, 2020 until September 30, 2025, pursuant to 1905(a)(29) of the Social Security Act and Section 1006(b) of the SUPPORT Act, this amendment adds medication-assisted treatment (MAT) as a mandatory benefit in the Medicaid state plan. 

CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment seeks to modify certain requirements of Title XIX of the Social Security Act to address the COVID-19 public health emergency, in order to increase the reimbursement for COVID-19 vaccine administration per dose.

CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to temporarily modify the provider recertification process for providers of 1915(i) state plan HCBS. This amendment allows the state to align the state's processes with the state's 1915(c) HCBS and Appendix K submissions.

Effective July 1, 2021, this amendment revises the methodology for calculating hospital specific Medicaid ratio of costs to charges (RCCs) in preparation for the North Carolina Medicaid Transformation to Managed Care. The amendment will also discontinue hospital outpatient supplemental payments, increase hospital RCCs, and define how to establish hospital RCC’s for new hospitals and changes of ownership.

Effective July 1, 2021, this amendment updates the effective date on the introduction page regarding payment rates for certain services. 

Effective July 1, 2021, this amendment redefines the payment limit to eligible medical professionals of UNC Health Care and ECU Physicians from a unique count of eligible medical professional providers to an aggregate dollar cap in preparation for the North Carolina Medicaid Transformation to Managed Care.

Effective January 1, 2021, this amendment allows for a 3.1 percent increase to Hospice and freestanding birth center services.

Effective March 23, 2021, this amendment adds language to the Inpatient Hospital Reimbursement Methodology for Indirect Graduate Medical Education (IME) Payments for services outlined within the State Plan. This amendment has a fiscal impact with an expected increase of $168,393,723 in federal funds for federal fiscal year (FFY) 2020-2021 and an increase of $207,324,368 in federal funds for FFY 2021-2022.