NEVADA MEDICAID RESPONSE
You can be confident that the
Division of Health Care Financing and Policy (DHCFP) is closely monitoring the
evolving COVID-19 pandemic and working closely with local, state and federal
government agencies and business health care partners to ensure the health and
safety of the Nevadans we serve.
DHCFP has created this webpage to
answer frequently asked questions, and better share information and resources
as it pertains to the current status of COVID-19 and its impact on Nevada
Medicaid recipients and providers.
Updated information will be posted as more details come available. Vaccine availability is extremely limited at this time. For appointments, please check the links on the right-hand-side of this page. For information on transportation to receive the vaccine, click here.
Some of the activities DHCFP
currently is pursuing:
- Policy review: DHCFP is reviewing policy to identify whether changes are needed to State Plan Amendments (SPAs), waivers, state policy manuals, or managed care contracts to maximize additional flexibility to address COVID-19.
- IT and Systems changes: DHCFP is making systems changes and implementing rates to ensure timely reimbursement for HCPCS and ICD-10 codes associated with COVID-19 testing.
The most important thing we can all do right now
is to follow sensible advice about infection control (see Prevention Tips link
on right). Following these guidelines
will help Nevada flatten the pandemic’s curve, and protect the most vulnerable
On December 11, 2020, the U.S. Food and Drug Administration (FDA) approved the Pfizer VOCID-19 vaccine for individuals ages 16 years and older for Emergency Use Authorization (EUA). On December 18, 2020, the FDA also approved the Moderna vaccine for EUA for individuals ages 18 years and older.
The COVID-19 vaccine will be provided at no-cost to providers by the federal government. Providers may not bill Nevada Medicaid for the vaccine itself, but my bill for the vaccine administration fee only. Providers may not charge Nevada Medicaid recipients for the vaccine or the vaccine administration fee as this is a covered service.
For Nevada Medicaid recipients in both Fee-for-Service (FFS) and Managed Care (MCO) the COVID-19 vaccine and administration fee will be covered at no-cost. For more information and resources on the COVID-19 vaccine, visit Immunize Nevada (https://www.immunizenevada.org/covid-19-vaccine-planning). Medical providers, pharmacies, Immunize Nevada, the media are resources to find out when the vaccine will be available to the general public. Links for COVID-19 vaccine information for the general public and providers are on the right-hand side of this page.
Do you feel sick?
If you feel sick, the Centers for Disease Control and Prevention (CDC) has an online COVID-19 “Self-Checker.” This online self-checker can help you make decisions and seek appropriate medical care when necessary. This website can be found at CDC COVID-19 Self-Checker. You can also call the Nevada COVID-19 hotline at 1-800-860-0620 or Nevada 2-1-1 by dialing "211." If you are enrolled in a Nevada Medicaid Managed Care Organization, you can contact these organizations as well for advice. This includes Anthem Blue Cross Blue Shield, Health Plan of Nevada, and SilverSummit Healthplan. Please look on the right-hand side of this page under Recipients to click on links to these Medicaid Managed Care Organizations.
Nevada’s Approved COVID-19 Waiver Requests
The Division of Health Care Financing and Policy applied to the Centers for Medicare and Medicaid Services (CMS) to waive specific Nevada Medicaid state plan requirements to assist the Division’s response to COVID-19. This was done via a 1135 Waiver, Appendix K Waiver for 1915(c) Home and Community Based Services, and a Disaster State Plan Amendment (SPA).
- Disaster State Plan Amendment
CMS has also provided a Blanket Waiver to allow all states the authority to waive specific requirements of the Social Security Act. This Blanket Waiver is effective from 3/1/2020 through the end of the emergency declaration.
Public Health Emergency Extension
U.S. Department of Health and Human Services Secretary Alex
Azar issued a renewal of the COVID-19 public health emergency, October 23,
2020. Assuming a full 90-day extension, this will extend the PHE through January
21, 2021. This extension means that the Disaster SPA, 1135 Waiver,
Appendix K Waiver, blanket waiver, and telehealth guidelines that the Nevada
Division of Health Care Financing and Policy was approved for will be extended
to this date. This extension also allows for the Division to receive an
enhanced FMAP through Quarter 1, 2021. All U.S. HHS public health emergency
declarations can be found at HHS Public Health Emergency Declarations.