Marvelous Monday! Enjoy your NCMS Morning Rounds.

July 12, 2021

COVID-19 Accelerated and Advance Payments: Updated FAQs

Centers for Medicare and Medicaid Services (CMS) updated FAQs (PDF) about repayment of COVID-19 accelerated and advance payments. If you got these payments, learn more about how recoupment works and how it affects your Medicare claims payment amounts.

More Information:

NCDHHS Opportunities for NCMS Members

The North Carolina Department of Health and Human Services (NCDHHS) has exciting opportunities currently available for the positions of Disability Medical Consultant and Psychological Consultant. These positions are assigned to the NC Disability Determination Services (DSS) and are responsible for making medical determinations on disability claims for the Social Security Administration and State Medicaid Office.

As a Disability Medical Consultant, there is no direct patient care. Instead, Disability Medical Consultants work with a team reviewing cases to decide whether or not the medical evidence is adequate to make a disability determination. After completing an eight-week training session, the medical consultant will work with a team reviewing cases to decide whether or not the medical evidence is adequate to make a disability determination according to the Social Security Act policies. The review is completed in an electronic environment.  Position requires a degree from an accredited school of medicine and a current license to practice medicine in the state of North Carolina or the ability to obtain a license to practice medicine in the state of North Carolina, during probationary period.

Psychological Consultants are needed to review claimant records and use their medical experience, expertise, and judgement to assist in using that evidence to determine the severity of impairments and residual functional capacity according to the Social Security Act policy. As a Psychological Consultant, you work with a team and do not have direct patient care. Reviews are completed in an electronic environment using a computer. Psychological Consultants engage onsite at the DDS in an eight-week training period followed by ongoing support and coaching after the training period is complete. Position requires a doctoral degree in Clinical Psychology from an accredited institution and current license to practice medicine in the state of North Carolina or the ability to obtain a license to practice medicine in the state of North Carolina, during probationary period.

After the training period is complete, consultants may request Flexible Working Schedules or telework arrangements in accordance with DHHS policy.

Access postings here:

Disability Medical Consultant

Psychological Consultant 

Applications are currently being accepted here until 5:00p.m. on 07/16/21.

Should you have any questions, please don’t hesitate to contact Greg Chavez at [email protected] for additional information.

*If you know someone who may be a great fit for the positions of Disability Medical Consultant or Psychological Consultant, please feel free to forward these opportunities along.*

Key Milestone Dates for NC Medicaid Managed Care

Aug. 1, 2021 – Beneficiaries have 30 days from receipt of notification of their Advanced Medical Home (AMH) assignment to change their AMH/PCP without cause (1st instance) and shall be allowed to change their AMH/PCP without cause up to one time per state fiscal year thereafter (2nd instance). In addition, Members shall be allowed to change their AMH/PCP with cause at any time.

Aug. 30, 2021 – Last date by which the health plan will pay claims and authorize services for Medicaid-enrolled out-of-network providers equal to that of in-network providers (or until end of episode of care, whichever is less)

Sept. 29, 2021 – Last date by which the health plan must honor existing and active prior authorizations on file with the North Carolina Medicaid or NC Health Choice program (or until the end of the authorization period, whichever occurs first)  

Sept. 30, 2021 – End of beneficiary choice period.

In the News

Are Sugary Drinks Linked To A Rise In Colon Cancer Among Young People? Here’s What A New Study Suggests, Advisory Board, 7-8-21

Learning Opportunity

National Association of Community Health Centers (NACHC) Finance Office Hours: Provider Relief Fund Reporting Requirements, July 30th at 2:00 PM Eastern Time

In 2020 health centers received federal funds from the CARES Act, which included Provider Relief Funds and placed increased accountability and reporting on health centers. On Friday, June 11, 2021, the Department of Health and Human Services (HHS) released long-awaited updates to its reporting requirements for Provider Relief Fund (PRF) payments recipients.

This webinar will offer health centers tips on how and where to report PRF funds and update any new reporting requirements. Time will be allotted for Q&A. Submit questions to [email protected].

Register here.

 

If you have policies you’d like your NCMS Board of Directors to consider, please complete the Board input form here. Thanks for reading!