Issued: October 14, 2024
The North Carolina Department of Health and Human Services (NCDHHS) is committed to North Carolina’s response to and recovery from Hurricane Helene. Flexibilities for both Medicaid and State-Funded services have been extended through Dec. 31, 2024. The Division of Mental Health, Developmental Disabilities and Substance Use Services (Division of MH/DD/SUS) is working with county, state and federal partners to (1) support both Medicaid members and uninsured/underinsured individuals to access and receive services and (2) support providers to deliver services.
NCDHHS has posted information on its website about flexibilities for both State-Funded and Medicaid services.
What is happening?
Hurricane Helene Policy Flexibilities are being extended through Dec. 31, 2024 (unless otherwise communicated by DHHS), for both Medicaid members and State-Funded recipients.
The Division of MH/DD/SUS, in partnership with the DHHS Division of Health Benefits (DHB) NC Medicaid and the Division of Health Service Regulation (DHSR), is temporarily modifying some of its mental health, substance use disorder, intellectual and developmental disability and traumatic brain injury clinical policies to better enable the delivery of care to individuals impacted by Hurricane Helene.
What do providers need to do?
Providers should read the bulletins for complete information on the flexibilities:
NCDHHS is recommending that providers only leverage the flexibilities to support impacted individuals or while impacted facilities and staff are recovering from Hurricane Helene. Providers should return to normal business operations as soon as possible to be compliant with the Division of MH/DD/SUS State-Funded service definitions.
This bulletin replaces in full the Update on NC Medicaid Temporary Flexibilities Due to Hurricane Helene – Oct. 1, 2024, bulletin. It contains several new clinical policy flexibilities which have been implemented due to the Hurricane Helene Public Health Emergency (PHE). Providers should return to normal business operations as soon as possible to be compliant with NC Medicaid Clinical Coverage Policies (CCPs).
New sections added from the previous bulletin are:
- Behavioral Health Services
- Dental
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies
- Family Planning
- Long Term Services and Supports
- Home Health
- Additional Nursing Facilities Flexibilities
- Obstetrical Services
- Outpatient Specialized Therapies
- Pharmacy
- Additional Pharmacy Flexibilities
- Key Reminders for Providers
- Information on Checking Beneficiary Eligibility
- Reminder to Provide Services Regardless of Copayment
The flexibilities listed are intended to benefit those members and providers directly impacted by Hurricane Helene and to alleviate burden for providers who are supporting impacted members and/or have additional patients (patient surges). NCDHHS is recommending that providers only leverage the flexibilities to support impacted beneficiaries or while impacted facilities and staff are recovering from Hurricane Helene.
As a reminder, providers should always check NC Medicaid eligibility in NCTracks to confirm beneficiary enrollment in NC Medicaid, especially when the beneficiary presents without a Medicaid ID or their health plan ID card, to determine which health benefit the beneficiary is enrolled in and whether their eligibility remains current. (Please see Key Reminders for Providers>Information on Checking Beneficiary Eligibility section at the bottom of the bulletin.)
Who can providers call if they have questions?
If providers have questions, they can:
- Contact their account specialist or email PAS@PartnersBHM.org(behavioral health) or PHPAS@PartnersBHM.org (physical health)
- Call the Provider Services Line at 1-877-398-4145
- Email UMQuestions@PartnersBHM.org(behavioral health) or PHUMQuestions@PartnersBHM.org (physical health)
- Call Partners Pharmacy line at 1-866-453-7196with pharmacy questions