Medicaid Rate Update From NCHCFA President & CEO Adam Sholar

For your planning purposes, we’re sharing information about Medicaid rates over the near and medium term based on the latest information we have following a flurry of activity recently, including legislative passage of an updated state budget.

• Without question, members will see current COVID add-ons (5% + 10% + $47.50 PPD) in place through July 15, 2022.

• We have a very, very high level of confidence that our current COVID add-ons will continue at least through July 31, 2022; and rates being loaded in NCTracks to pay initial claims for dates of service starting July 1, 2022 and after are being updated to reflect CMS approval of our Fair Rental Value (FRV) modernization, which should result in at least a modest rate increase for all members.  (Retroactive reprocessing to reflect FRV modernization for dates of service going back to 10/1/21 will also occur, but later.)

• The state budget bill passed by the NC General Assembly yesterday (if it becomes law) will provide $363M in non-recurring funds (of which $95M are state funds) to pay for our current COVID add-on rates (5%, 10%, and $47.50 PPD add-ons) for as long as possible, which works out to be roughly through the end of 2022.  The budget also grants legislative authority for NC DHHS to provide enhanced rates after the $363M in funding is exhausted as it can within available funding sources.  It is too early to predict with certainty what this could look like.

The Governor has not indicated whether he will sign the budget bill into law, and he has 30 days to make this decision.  As soon as the Governor announces any decision on the bill, NCHCFA will let members know.  Please contact the Association with any questions, and thank you for your support.