PUBLISHING OF COVID-19 RESPONSE AND OUTBREAK FACILITY MEDICAID RATES

Changes are being implemented to the rate letter notification process being utilized to advise providers of traditional Medicaid base rates, and the status of facility-specific COVID-19 Outbreak and Response Facility rates. These changes are being made to alleviate the multiple rate letter notifications providers may be receiving and to assist in correctly interpreting the timeliness and effective dates associated with all Skilled Nursing Facility rates.

Effective immediately, providers will no longer receive rate letters. All facility-specific rates and their corresponding rate letter components will be posted on the Division of Health Benefits (Medicaid) website at https://medicaid.ncdhhs.gov/providers/fee-schedules/nursing-facility-fee-schedules. The posted expanded fee schedule will serve as official publication of rates in lieu of individual facility rate letters.

Outbreak/Response Facility rates are calculated for all SNFs in the event an outbreak occurs during the posted timeframe of the expanded fee schedule. These rates will only be activated in NCTracks for approved response facilities and facilities with outbreaks after outbreaks have been confirmed by the Department of Public Health (DPH).

In order to provide guidance as to when the increased rates should be billed, a listing of all outbreaks, along with the effective dates, will be delivered to each facility’s NCTracks Message Center inbox and updated bi-weekly (every other week, beginning 9/14/2020). Please allow at least one week from the DPH notification date for outbreak rates to be finalized in NCTracks.

Should you have any questions, please contact katrina.t.brown@dhhs.nc.gov.