Table of Contents. State Plan Amendment (SPA) #: This file contains the following documents in the order listed:
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1 Table of Contents State/Territory Name: North Carolina State Plan Amendment (SPA) #: This file contains the following documents in the order listed: 1) Approval Letter 2) Summary Form 179 3) Approved SPA Pages
2 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Atlanta Regional Office 61 Forsyth Street, Suite 4T20 Atlanta, Georgia DIVISION OF MEDICAID & CHILDREN S HEALTH OPERATIONS December 12, 2013 Ms. Sandra Terrell, MS, R.N., Acting Director Division of Medical Assistance Department of Health and Human Services 2501 Mail Service Center Raleigh, NC Re: North Carolina Title XIX State Plan Amendment, Transmittal We have reviewed the proposed State Plan Amendment TN , which was submitted on September 24, This amendment implements a rate freeze for Home Health and Private Duty Nursing Services in North Carolina for fiscal years 2014 and Based on the information provided, the Medicaid State Plan Amendment NC was approved on December 12, The effective date of this amendment is August 1, We are enclosing the HCFA Form 179 and the approved plan pages. If you have any additional questions or need further assistance, please contact Clarence Lewis at , or Donald Graves at Sincerely, //s// Jackie Glaze Associate Regional Administrator Division of Medicaid and Children s Health Operations
3 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Atlanta Regional Office 61 Forsyth Street, Suite 4T20 Atlanta, Georgia DIVISION OF MEDICAID & CHILDREN S HEALTH OPERATIONS December 12, 2013 Ms. Sandra Terrell, MS, R.N., Acting Director Division of Medical Assistance Department of Health and Human Services 2501 Mail Service Center Raleigh, NC Re: North Carolina Title XIX State Plan Amendment, Transmittal We have reviewed the proposed State Plan Amendment TN , which was submitted on September 24, This amendment implements a rate freeze for Home Health and Private Duty Nursing Services in North Carolina for fiscal years 2014 and Based on the information provided, the Medicaid State Plan Amendment NC was approved on December 12, The effective date of this amendment is August 1, We are enclosing the HCFA Form 179 and the approved plan pages. If you have any additional questions or need further assistance, please contact Clarence Lewis at , or Donald Graves at Sincerely, //s// Jackie Glaze Associate Regional Administrator Division of Medicaid and Children s Health Operations
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5 State Plan Under Title XIX of the Social Security Act Medical Assistance Program State: North Carolina Attachment 4.19-B Supplement 1, Page 1 Payments for Medical and Remedial Care and Services Payment for Home Health Services: FY 2003 No adjustment for other services. FY 2005 and 2006 No rate increase from the June 30, 2005 rate for all Medicaid private and public providers with the following exceptions: federally qualified health clinics, rural health centers, state institutions, outpatient hospital, pharmacy and the non-inflationary components of the case-mix reimbursement system for nursing facilities NC General Assembly legislation mandates that effective July 1, 2005, reimbursement rates for these programs (Home Health) for the state fiscal years and will remain at the rate in effect as of June 30, FY Effective 1/1/2007 inflationary increases were applied to the following programs: Home Health received an increase of 2.98%. FY No inflationary adjustment and 5.73% rate reduction (annualized over nine months) for Home Health. FY No inflationary or rate adjustments for Home Health. FY 2012 Rates will be frozen at the rate in effect on June 30, Effective November 1, 2011, existing rates are adjusted by a negative 2.67% to yield a twelve (12) month two percent (2%) reduction in the nine (9) remaining months of this State Fiscal Year. FY 2013 Effective July 1, 2012, the rates will be adjusted such that they will equal 98% of the rate in effect July 1, There will be no further annual adjustments this State Fiscal Year. SFY 2014 The rates will be frozen at the rates in effect on June 30, There will be no further annual adjustment. SFY Rates will be frozen at the rate in effect on June 30, There will be no further annual adjustments this state fiscal year. Reference: Attachment 4.19-B, Section 7, Pages 1-4 TN No: Supersedes Approval Date : Eff. Date: 8/1/2013 TN No:
6 State Plan Under Title XIX of the Social Security Act Medical Assistance Program State: North Carolina Attachment 4.19-B Supplement 1, Page 1c Payments for Medical and Remedial Care and Services Payment for Private Duty Nursing Services: FY 2003 A 5% rate reduction is applied to Private Duty Nursing. FY 2005 and 2006 No rate increase from the June 30, 2005 rate for all Medicaid private and public providers with the following exceptions: federally qualified health clinics, rural health centers, state institutions, outpatient hospital, pharmacy and the non-inflationary components of the case-mix reimbursement system for nursing facilities NC General Assembly legislation mandates that effective July 1, 2005, reimbursement rates for Private Duty Nursing for the state fiscal years and will remain at the rate in effect as of June 30, FY Effective 1/1/2007 an inflationary increase of 4.25% is applied to Private Duty Nursing services. FY No inflationary adjustment and 5.73% rate reduction (annualized over nine months) for Private Duty Nursing. FY No inflationary or rate adjustments are made for Private Duty Nursing. FY 2012 Rates will be frozen at the rate in effect on June 30, Effective November 1, 2011, existing rates are adjusted by a negative 2.67% to yield a twelve (12) month two percent (2%) reduction in the nine (9) remaining months of this State Fiscal Year. FY 2013 Effective July 1, 2012, the rates will be adjusted such that they will equal 98% of the rate in effect July 1, There will be no further annual adjustments this State Fiscal Year. SFY 2014 The rates will be frozen at the rates in effect on June 30, There will be no further annual adjustment. SFY Rates will be frozen at the rate in effect on June 30, There will be no further annual adjustments this state fiscal year. Reference: Attachment 4.19-B, Section 8, Page 1 TN No: Supersedes Approval Date: Eff. Date: 8/1/2013 TN No:
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