North Carolina’s request for additional regulatory flexibility for its Medicaid program was granted Tuesday by the federal Centers for Medicare and Medicaid Services.
North Carolina is one of 11 states approved for a temporary waiver related to Section 1135 of the Social Security Act for its coronavirus prevention and treatment strategies.
CMS said the waiver “offers states new flexibilities to focus their resources on combating the outbreak and providing the best possible care to Medicaid beneficiaries in their states.”
The waivers were made effective retroactively to March 1. The waivers would end upon termination of the public health emergency, including any extensions.
Medicaid now serves 2.22 million North Carolinians. That number is projected by the N.C. Department of Health and Human Services to increase to 2.28 million in by mid-2021 and 2.39 million in mid-2023.
North Carolina made its request March 17 following President Donald Trump’s March 13 declaration of the COVID-19 crisis as a national emergency. The declaration enables CMS to waive certain requirements in Medicare, Medicaid and Children’s Health Insurance Program protocols under emergency authority.
CMS cited examples of waivers available including:
- Temporarily suspending prior authorization requirements.
- Extending existing authorizations for services through the end of the public health emergency.
- Modifying certain timeline requirements for state hearings and appeals.
- Relaxing provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care.
- And altering public notice and submission deadlines for certain COVID-19 focused Medicaid state plan amendments, enabling states to make changes faster and ensure they can be retroactive to the beginning of the emergency.
The other states receiving waiver approvals are Alabama, Arizona, California, Illinois, Louisiana, Mississippi, New Hampshire, New Jersey, New Mexico and Virginia. Florida and Washington state already had been approved for the waivers.
“These waivers give a broad range of states the regulatory relief and support they need to more quickly and effectively care for their most vulnerable citizens,” CMS Administrator Seema Verma said in a statement.
N.C. Department of Health and Human Services has submitted other waiver requests besides those cited Tuesday by CMS.
CMS and N.C. DHHS officials could not be immediately reached for comment on whether these additional steps are included in the CMS waiver approvals.
Those would include:
- Waiving limits on facility access and length of stay, which would allow, for example, critical access hospitals to have more beds and for patients to stay longer.
- Cutting red tape so beneficiaries in jeopardy of losing Medicaid benefits can stay eligible.
- Allowing alternative settings to deliver care, such as providing services in home.
- Temporary modifications to home- and community-based services provided through Medicaid state plan waivers, including the Innovations, Community Alternatives for Disabled Adults, Community Alternatives for Children and Traumatic Brain Injury waivers.
- And temporarily waiving the required annual enrollment fee, co-payments and unpaid enrollment fee balances and waiving the prior authorization requirements for the Children’s Health Insurance Program.
“These requests include removing certain dollar and stay limits, expanding the type of location where services can be delivered and easing requirements for reviews of personalized care plans and in-person meetings,” N.C. DHHS said.
“Temporary modifications to waiver services and requirements will be made on an individual basis.”