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Medicaid waivers approved for Virginia, North Carolina in response to coronavirus

Posted: 9:56 AM, Mar 25, 2020
Updated: 2020-03-25 10:03:11-04
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The Centers for Medicare & Medicaid Services approved an additional 11 state Medicaid waiver requests under Section 1135 of the Social Security Act Tuesday, bringing the total number of approved Section 1135 waivers for states to 13.

According to a release by CMS, the waivers provide relief on a number of fronts, such as prior authorization and provider enrollment requirements, suspending certain nursing home pre-admission reviews, and facilitating reimbursement to providers for care delivered in alternative settings due to facility evacuations.

Virginia and North Carolina are among the 11 states whose waivers were approved.

According to CMS, Virginia requested waivers to temporarily delay scheduling of Medicare fair hearings, allowing enrollees to have more than 90 days and up to an additional 120 days for an eligibility or fee for service appeal to request a fair hearing.

The state also requested a temporary suspension of Medicaid fee-for-service prior authorization requirements, and will now be able to extend pre-existing authorizations for which a beneficiary has previously received prior authorization through the end of the public health emergency.

These section 1135 waivers are effective March 1, 2020 and will end upon termination of the public health emergency, including any extensions. Last week, CMS approved COVID-19 related state Medicaid section 1135 waiver requests for Florida and Washington.

To learn more about CMS' response to the novel coronavirus, click here.

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