Deb Goda from the NC Medicaid program presented on ambulance transport to crisis facilities on January 14, 2019. NC Medicaid met with stakeholders to draft a legislative report on establishing Medicaid reimbursement for ambulance transport of patients in behavioral health crisis to alternative locations like clinics by July 1, 2019 per a state law. Next steps include engaging more stakeholders and updating policies to include reimbursing ambulance transport to appropriate alternative locations, while developing outcome measures and rules for providers to report on patient experiences.

1. NCDHHS, Division | Presentation Title | Presentation Date 1
NC Department of Health and Human Services
Ambulance Transport to
Crisis Facilities
Deb Goda
Behavioral Health Manager,
NC Medicaid
January 14, 2019

2. NCDHHS, Division | Presentation Title | Presentation Date 2
Background
Session Law 2018-5, Sec. 11H.4 instructed the NC
Department of Health and Human Services (DHHS) to
submit to the Centers for Medicare and Medicaid
Services (CMS) for the necessary authority to
establish Medicaid reimbursement for ambulance
transports of Medicaid beneficiaries in behavioral
health crisis to behavioral health clinics or other
alternative appropriate locations effective July 1,
2019.

3. NCDHHS, Division | Presentation Title | Presentation Date 3
What has been done?
NC Medicaid met with State Stakeholders to draft legislative
report on necessary authority and proposed reimbursement
methodology; expected costs; expected outcomes and savings
and coverage plans.

4. NCDHHS, Division | Presentation Title | Presentation Date 4
What comes next?
The Division of Health Benefits (DHB) will engage stakeholders as
required by Policy Promulgation.
• Behavioral Health Providers; Facility- Based Crisis Centers,
Behavioral Health Urgent Cares (BHUCs);
• LME-MCOs;
• Ambulance transport providers (county and private);
• North Carolina Office of Emergency Management Services
(NCOEMS);
• Division of Mental Health/Developmental Disabilities/Substance
Abuse Services (DMH/DD/SAS);
• Division of Health Service Regulation (DHSR);
• Other interested parties

5. NCDHHS, Division | Presentation Title | Presentation Date 5
What comes next?
• DHB will update Clinical Coverage Policy 15, Ambulance Services, to
include reimbursement ambulance transport to appropriate
alternative locations.
• DHB will work with DHHS and stakeholders to develop measures on
patient experiences and outcomes on which EMS providers will
report, as well as any necessary rules.

6. NCDHHS, Division | Presentation Title | Presentation Date 6
QUESTIONS?