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Emergency Response: Provider Reimbursement for North Carolina Medicaid Beneficiaries

The purpose of this bulletin is to describe additional state efforts to ensure continued access to care during the emergency response to Hurricane Florence and the impact of these efforts on North Carolina Medicaid beneficiaries and South Carolina Healthy Connections Medicaid providers.

Some North Carolina residents affected by Hurricane Florence have evacuated to South Carolina. During North Carolina's declared emergency response period, Sept. 14-Sept. 21, 2018, and to increase beneficiary access to services, the North Carolina Department of Health and Human Services (NCDHHS) will reimburse out-of-state providers who deliver care to North Carolina Medicaid and North Carolina Health Choice beneficiaries.

To receive reimbursement, the out-of-state provider must enroll as a North Carolina Medicaid provider in an abbreviated, expedited process called Out-of-State (OSS) Lite. 

Providers are encouraged to obtain a prior approval if it is possible to do so and normally required for the service; however, it is not mandatory during this emergency response period. 

The South Carolina Department of Health and Human Services (SCDHHS) encourages Healthy Connections Medicaid providers to enroll as North Carolina Medicaid providers to serve North Carolina residents during this emergency response period. Unless otherwise noted, these exceptions are in effect for dates of service from Sept. 14 through Sept. 21, 2018. North Carolina will evaluate the need to extend the exceptions and will publish any changes.

If you have any questions, please contact the NCTracks Call Center at (800) 688-6696.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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