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Consolidated Appropriations Act of 2021

The Consolidated Appropriations Act of 2021 included a provision that Medicare beneficiaries must have an in-person visit with their behavioral health provider no more than six months before their initial telehealth appointment and annually thereafter, this was delayed until December 31, 2024. Congress has passed an extension to delay the 6-month in-person requirement until March 31. We will call on members in the coming months to advocate for a continued extension. 

1115 Waiver

 DHHS has announced that CMS has renewed North Carolina's 1115 Medicaid Waiver renewing flexibilities and expanding more opportunities to impact health. The original waiver from 2018 allowed the state to invest in housing, food, transportation and more for high-needs Medicaid recipients. Under the original waiver, participants had fewer emergency department visits, less inpatient hospitalizations, and the state spent ~$85 less in medical costs per participant per month. In recognition of these strong results, CMS approved a new waiver.

Key Components of the New 1115 Waiver:

• Healthy Opportunities pilot can be taken statewide
• Provides access for people who are incarcerated to get NC Medicaid health coverage up to 90 days prior to their release, helping to break the expensive cycle of incarceration
• Enables more behavioral health resources and boosts the behavioral health workforce
• Extends federal authority for North Carolina's Medicaid Managed Care program
• Allows for continuous NC Medicaid coverage for children for longer periods of time
• Continues availability of evidence-based SUD treatment for Medicaid beneficiaries while in a qualifying facility

DHHS will meet with stakeholders, including legislators, to discuss what opportunities are now available and how to implement them.