Public Notice ND Medicaid Program Effective for dates of service on or after January 1, 2021, North Dakota Medicaid will be providing a 2.

Public Notice
ND Medicaid Program
Effective for dates of service on or after January 1, 2021, North Dakota Medicaid will be providing a 2.5% inflationary increase for all Nursing Facility services. In addition to the 2.5% inflationary increase and consistent with Medicaid State Plan Authority, rates for Medicaid-eligible individuals residing in nursing facilities will be adjusted, based on cost reports submitted by the facilities within the current rate methodology. Medicaid expenditures for these services are expected to increase $10.7 million for a 12-month period.
Effective for date of service on or after January 1, 2021, North Dakota Medicaid will be providing a 2.5% inflationary increase for all Psychiatric Residential Treatment Facility services. In addition to the 2.5% inflationary increase and consistent with Medicaid State Plan Authority, rates for Medicaid-eligible individuals residing in instate psychiatric residential treatment facilities will be adjusted, based on cost reports submitted by the facilities within the current rate methodology. Medicaid expenditures for these services are expected to increase $525,000 for a 12-month period.
Effective for dates of service on or after January 1, 2021, and consistent with approved state plan language, ND Medicaid will update the payment rate for lodging to the amount established for the month of January 2021 by the General Services Administration. Medicaid expenditures for these services are expected to increase $1,000 for a 12-month period.
A decrease in the capitated monthly rates paid for the Program for All Inclusive Care of the Elderly (PACE) is estimated to save $700,000 for the 12-month period.
The capitated monthly rate for Medicaid Expansion, effective January 1, 2021, is estimated to increase, based on actuarial certification of the rates and Sanford Health Plan acceptance of those rates, and is expected to have a minimal fiscal impact.
ND Medicaid follows the National Correct Coding Initiative (NCCI) Edits. These edits were developed by the Centers for Medicare and Medicaid Services (CMS) based on coding conventions defined in the American Medical Association's Correct Procedure Terminology Manual, national and local polices and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practices, and a review of current coding practices. CMS annually updates the National Correct Coding Initiative Coding Policy Manual.
Comments can be sent to and viewed at: Medical Services Division Room 309, ND Department of 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.
(Dec. 30, 2020) 2870317