Featured image for article

CMS approves North Carolina Medicaid Waiver

Last week, North Carolina asked the federal government to waive some Medicaid regulations. On Monday, The Centers for Medicare and Medicaid Services (CMS) approved North Carolina’s Medicaid Section 1135 Waiver:

Your communication to CMS on March 17, 2020, detai1ed a number of federal Medicaid, the Children’s Health Insurance Program (CHIP), and Medicare requirements that pose issues or challenges for the health care delivery system in all counties in North Carolina and requested a waiver or modification of those requirements. Attached, please find a response to your requests for waivers or modifications, pursuant to section 1135 of the Act, to address the challenges posed by COVID-19. This approval addresses those requests related to Medicaid and CHIP.

During times of emergency, states are allowed to waive certain Medicaid regulations. Among other things, this waiver allows North Carolina’s Medicaid program to:

  • Pay doctors who aren’t currently licensed in the state for providing care
  • Temporarily enroll providers who are licensed for Medicare or Medicaid in another state
  • Waive screening requirements upon enrollment of providers
  • Provide care at facilities which currently do not have a Medicaid license
  • Suspend patient pre-admission screening
  • Suspend other prior-authorization requirements

The waiver approved by CMS will grant North Carolina’s Medicaid program and the providers who are currently licensed or not currently licensed in the state with much more flexibility to treat patients and get paid for it. Similarly, Medicaid beneficiaries will have fewer requirements to meet to receive care.

Requesting a Medicaid Section 1135 waiver was one of the recommendations I offered for the state while dealing with the coronavirus pandemic. In our response, we should prioritize the removal of down barriers that stand in between providers treating patients and patients seeking medical care. This waiver will help in that goal by freeing the Medicaid program from restrictive regulations.

 

 

Jordan Roberts / Health Policy Analyst

Jordan joined the Locke Foundation in the summer of 2018 as Health Care Policy Analyst. He analyzes state and national health policy issues with an eye toward removing governm...

Reader Comments