SPECIAL BULLETIN COVID-19 #242: Continued Reimbursement for COVID-19-Related Services for the Uninsured. Effective April 4, 2022
NC Medicaid continues to reimburse providers for COVID-19 related services for the NC Medicaid Optional Eligibility Group (which includes the uninsured (MCV) and MAFDN Family Planning Group). This program was initiated in 2020 for COVID-19 and expanded by the America Rescue Plan Act to include COVID-19 treatment and vaccination. NC Medicaid will continue to operate this program through the federal public health emergency.
It was recently announced that the Health Resources and Services Administration (HRSA) -led initiative to reimburse for COVID-19 testing and treatment will end. This program also reimbursed health care providers for delivering COVID-19 testing, treatment and vaccines to those without health insurance. As of March 22, 2022, the program stopped accepting claims for testing and treatment services. On April 5, 2022, the program will stop accepting claims for vaccine administration.
This bulletin services as a reminder that the two programs are separate entities, and that NC Medicaid will continue to reimburse providers who deliver COVID-19 treatment, testing, and vaccine administration for the uninsured in the state. To be eligible for the program, individuals must:
- Enroll in Medicaid for the uninsured (MCV) group or MAFDN Family Planning.
- Be uninsured.
- Be a resident of North Carolina.
- Meet the citizenship and legal immigration status requirements of the Medicaid program.
Detailed eligibility requirements may be found in SPECIAL BULLETIN COVID-19 #206.
Also in North Carolina, The Board of Pharmacy has completed a rulemaking to amend Rule .1816, now titled “Centralized Pharmacy Services.” The amended rule broadens the availability of remote medication order processing (“RMOP”) arrangements among pharmacies to all pharmacy practice types. The full rule is found here: 21 NCAC 46.1816
The new RMOP provisions became effective March 1, 2022. However, the Board’s Expanded Emergency Services Waiver, issued on March 17, 2020, because of the COVID-19 public health emergency, authorized expanded RMOP arrangements: Expanded Emergency Services Waiver
Pharmacies may continue to operate RMOP arrangements pursuant to the waiver until June 1, 2022. Beginning June 1, 2022, the Board will enforce the Rule .1816-based RMOP requirements. To assist pharmacies transitioning to the rule based RMOP requirements, Board staff have prepared two guidance documents.
The first, http://www.ncbop.org/PDF/GuideToInterPharmacyRMOP.pdf – provides a detailed overview of the revised rule governing inter-pharmacy RMOP arrangements. Please note, this guidance document only concerns RMOP services arranged between two pharmacies. The Board has proposed a new rule (Proposed New Rule 21 NCAC 46.2515) authorizing intra-pharmacy remote services (i.e., a pharmacy uses its own personnel to provide off-site services). Once that rulemaking is complete, the Board staff will provide a separate guidance document on that topic. In the meantime, intra-pharmacy remote services are allowed under the Expanded Emergency Services Waiver linked above.
The second, http://www.ncbop.org/PDF/HowToRegisterAsNABPVerifyHolder.pdf – provides detailed instructions on how out-of-state pharmacists who are performing RMOP services and who are not individually licensed to practice pharmacy in North Carolina may obtain an NABP Verify credential and register with the Board of Pharmacy, as required by revised Rule .1816.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
