End: Sunday, December 31, 2023 - 11:59 pm Categories:
The flexibilities that were temporarily implemented due to the COVID-19 Public Health Emergency (PHE) will sunset on May 11, 2023 with the end of the PHE.
Certain flexibilities that were granted through an 1135 waiver that will end on May 11, 2023 are:
- PASRR (Pre-Admission Screening and Resident Review) Level I and Level II assessments were waived for 30 days on admission. These assessments must now be completed as required by 42 CFR 483 Subpart C.
- Temporary suspension of fee-for-service prior authorization requirements
- Extension of pre-existing fee-for-service prior authorizations
- Extension of timelines for service authorization and appeal requirements for Medicaid managed care
- Extension of timelines for state fair hearing requests
- Waiver of certain provider enrollment requirements
- Allowing legally responsible individuals to render personal care services
- Waiver of the requirement to obtain beneficiary and provider written consent of new or amended HCBS person-centered service plans
- Modify the timeframes associated with Tribal Consultation
Certain flexibilities that were granted through a COVID-19 disaster relief SPAs that will end on May 11, 2023 are:
- The number of nursing facility therapeutic leave days will return to 24 days per year.
- The number of intermediate care facility (ICF) therapeutic leave days will return to 30 days per year.
- The 15-day limit for payment for bed hold for an inpatient hospitalization for a resident of a nursing facility or intermediate care facility (ICF) will be reinstated regardless of the diagnosis.
- The flexibilities of adjustments to the day supply or quantity limit for covered outpatient drugs, prior authorization for medications expanded by automatic renewal, exceptions to their published Preferred Drug List if drug shortages occur will expire.
- The option to suspend Qualified Service Provider qualifications regarding competency and state criteria will expire
- The option to waive the timelines for nursing facility rate reconsiderations and appeals will expire.
Comments can be sent to and viewed at: Medical Services Division, Room 309, ND Health and Human Services, 600 E. Boulevard Ave., Dept. 325, Bismarck, ND 58505-0250. Questions may be directed to human service zone offices, or individuals may contact the ND Medicaid Program at 1-800-755-2604.
Date Posted: April 21, 2023