53 Out of Every 100 NC Medicaid HCBS Providers Failed Their Last PCG Audit.
New rules. Clear steps.
NC HB 696 / SL 2026-1 rewrote the compliance requirements for CCP 3L and 3L-1 providers. PCG (Public Consulting Group) is already auditing under the new rules. The NC State Auditor referred over $27 million in improper Medicaid payments to the NC Attorney General last year alone. Your free checklist is one download away.
Free Compliance Audit Checklist for NC HB 696 / SL 2026-1
Built specifically for NC Medicaid HCBS Clinical Coverage Policy 3L and 3L-1 providers. Know your gaps before PCG does.
Free download. Gumroad account required for access.
The Audit Risk Is Not Theoretical. The Numbers Prove It.
PCG — Public Consulting Group — is the contracted post-payment review auditor for NC DHHS Division of Medical Assistance. Their job is singular: find improper Medicaid payments and recover them. The NC State Auditor's mandate is to ensure every Medicaid dollar is spent according to policy — and to refer providers with significant findings to the NC Attorney General for collection.
This is not a future threat. It is happening now, in your provider type, in your county.
What the 95% appeal rate means for your agency: Fighting a PCG finding after the fact is not a realistic strategy. Of every 100 providers who received an adverse audit finding and appealed, 95 still had to repay. Prevention — before the auditor arrives — is the only strategy with a real success rate.
What NC HB 696 / SL 2026-1 Changed
- New documentation requirements for CCP 3L and 3L-1 service notes
- Tighter service authorization and prior approval alignment
- H.R. 1 monthly eligibility verification creates new timely filing reset triggers starting October 1, 2026
- PHP-specific timely filing windows vary — and one PHP ties its deadline to the NCTracks eligibility modification date
- Supervisory and service personnel documentation requirements updated
What the Free Checklist Addresses
- Every HB 696 / SL 2026-1 documentation requirement for CCP 3L and 3L-1
- PCG's most common audit triggers — mapped, flagged, and explained in plain language
- Service note standards that survive post-payment review
- Timely filing deadline reference by PHP
- Billing code verification with high-risk flags identified
Supervised Living I/DD providers under CCP 3L: the correct billing code is CPT 99209 HI — not 99509 HI. This distinction is one of the most frequently cited findings in PCG's post-payment reviews of CCP 3L providers. The free checklist flags this and every other known high-risk billing pattern for your policy type.
How It Works
AdaptBridge delivers compliance knowledge as downloadable documents — built from deep NC Medicaid regulatory research and real PCG audit data. No scheduling. No waiting. Download, open, and start auditing your agency today.
Download
Get the free checklist instantly from Square.
Self-Audit
Work through every item in the checklist against your current documentation practices. Score your CCP 3L / 3L-1 compliance gaps against every HB 696 / SL 2026-1 requirement — before PCG does it for you.
Close Your Gaps
When the checklist surfaces gaps — and for most providers, it will — the complete CCP 3L / 3L-1 Compliance Kit is available for instant download. SOPs, service note templates, billing verification guides, and more.
Free Compliance Audit Checklist for NC HB 696 / SL 2026-1
Free Download- Complete documentation requirements checklist for CCP 3L and CCP 3L-1
- PCG audit trigger reference — mapped to the most common post-payment findings
- Service note compliance standards with pass/fail criteria
- Billing code verification section with high-risk flags (including CPT 99209 HI vs. 99509 HI)
- Timely filing deadline quick-reference by PHP (AmeriHealth Caritas, Carolina Complete Health, Partners Tailored Plan, Healthy Blue)
- H.R. 1 monthly eligibility verification impact on timely filing windows
- Prior authorization and service authorization alignment checklist
- Personnel and supervisory documentation requirements under SL 2026-1
Our Core Values: ADAPT
Every document we publish is built on these five principles. They are why AdaptBridge products deliver results that generic compliance content cannot.
Built Exclusively for NC Medicaid HCBS Providers
This is not a general compliance guide. Generic compliance content is written to be broadly applicable — which means it is precisely applicable to no one. Every AdaptBridge document is built from the ground up for a specific NC Medicaid Clinical Coverage Policy and provider type.
The free checklist was developed specifically for providers operating under Clinical Coverage Policy 3L (Personal Care Services) and CCP 3L-1 (Enhanced Personal Care) who bill NC Medicaid through a PHP — AmeriHealth Caritas NC, Carolina Complete Health, Partners Health Management Tailored Plan, or Healthy Blue — or through NC Medicaid Direct.
CCP 3L — Personal Care Services
Documentation, billing, supervisory, and service note requirements under HB 696 / SL 2026-1. Includes high-risk CPT code verification.
CCP 3L-1 — Enhanced Personal Care
All 3L requirements plus the additional enhanced service documentation standards and prior authorization alignment checks specific to 3L-1.
Why NC Medicaid Providers Download This Checklist
There is no shortage of compliance content online. Here is what makes this different.
Built from 1,400+ Real PCG Audit Records
Every item on this checklist maps to a documented PCG post-payment review finding pattern. Nothing was invented. Nothing is speculative. If it is on this checklist, PCG has cited it as a basis for a repayment demand.
95% of Findings Are Upheld on Appeal
The providers who wait until after a PCG finding to get serious about compliance almost never win on appeal. The checklist exists to prevent the finding — not fight it. Prevention is the only strategy with a reliable success rate.
Specific. Immediate. No Wait.
Download now. Open it. Start your self-audit today. AdaptBridge products are built for providers who need to act, not schedule. No appointment. No waiting room. Just the information you need, ready when you are.
October 1, 2026 Is Closer Than You Think.
H.R. 1 monthly eligibility verification begins in weeks. New timely filing reset triggers are already live under SL 2026-1. The providers who run their compliance audit today will be the ones still billing in 2027. The ones who wait will be in the 53%.
Download Free Compliance Audit ChecklistFree download · CCP 3L / 3L-1 · NC HB 696 / SL 2026-1