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North Carolina Department of Health and Human Services Division of Medical Assistance Pat McCrory Governor August 28, 2014 Dear County Department of Social Services Director: Aldona Z. Wos, M.D. Ambassador (Ret.) Secretary DH14S Robin Gary Cummings, M.D. Deputy Secretary for Health Services Director, Division of Medical Assistance Over the past three months County Departments of Social Services have made dramatic progress in reducing the number of untimely Medicaid applications from a high of 104,000 to just over 26,000 and we are well on the way to meet the August time frame we established to complete the ACA back log. DHHS commends each of you and your staff for the hard work and commitment that has been devoted to this important task. As stated previously during conference calls, North Carolina has received approval from the Centers for Medicare and Medicaid Services (CMS) for County Departments of Social Services to receive 75% reimbursement for Medicaid eligibility functions performed in the EIigibility Information System (EIS). This approval is retroactive to June 1, 2014. On August 25, 2014, SIS change notice #04 -14 was sent out providing instructions for coding time in EIS to 75% reimbursement retroactive to the June service month. As we complete hard launch over the next few months, counties can expect to be able to claim 75% reimbursement for Medicaid eligibility functions throughout SFY 2014.2015 and ongoing. In response to the .Tune 13, 2014 Dear County Director Letter, every county has submitted an Accelerated Medicaid Processing Plan (AMPP). While each of these plans remains in force, we do note that almost every county has relied on compensatory time and /or paid overtime to reduce the number of overdue Medicaid applications. We have heard from many of you that the stress on staff has increased over the past few months. Continuing to rely on compensatory or paid overtime alone does not constitutes a sustainable plan for managing the present and future workload. We strongly encourage counties to evaluate your current staffing situation and determine staffing needs going forward. The approvat from CMS for 75% reimbursemat in ISIS is based uporn our cetw ies investing savings in nwded resources to "successfully conquer the challenges of ACA MAGI application backless, .MAGI recertifications and the rollout of NC FAST." Decisions about staffing must take into account the increase in applications expected during each annual ACA open enrollment period. Department staff will be contacting you to discuss your plans reflecting the resources needed to successfully prepare for and meet the challenges that lie ahead. These plans are critical to NC's success and must reflect each county's on -going capacity far: 1. Maintaining the Food and Nutrition Services workload for both applications and recertifications, 2. Eliminating all untimely Medicaid applications; 3. Eliminating all untimely Medicaid recertifications; www.ncdhhs.gov Tel 919- 855 -4100 - Fax 919 - 733 -6608 Location: 1985 Umstead Drive • Kirby Building • Raleigh, NC 27603 Mailing Address: 2501 Mail Service Center • Raleigh, NC 27699 -2501 An Equal Opportunity / Affirmative Action Employer Attachment number 1 G -2 Page 113