Medicaid - Special Bulletin COVID-19 #215

February 18, 2022

Waiver of Concurrent and Level of Care Reviews for Inpatient Admissions

Effective Jan. 19, 2022, the prepaid health plans (PHPs) have agreed to temporarily waive initial concurrent and level-of-care reviews for non-elective, medically necessary inpatient admissions. This is an effort to allow hospitals to optimize capacity and avoid the need to shut down beds due to inadequate clinical staffing, and to redeploy resources within their institutions during the most recent COVID-19 surge. This limited waiver will initially be allowed through Jan. 28, 2022 and will be reconsidered weekly by NC Medicaid. The PHPs will continue to require the hospitals to notify them of any admitted patients within five calendar days of the admission, so they can assist in discharge planning and care management.