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2015 Memos and Bulletins

Important Notice:  Provider Memos and Bulletins issued prior to 2020 will no longer be available for download from this website.  These Memos and Bulletins are still available by request directly from DMAS.  To request a memo or bulletin from 2020 or earlier, please email the MES document team here: dezari.alexander@dmas.virginia.gov

Listings of memos and bulletins for years prior to 2020 are still available.  Please  include the Title and Issue Date when making your email request.

Issue DateTitleTo:
17-Dec-15Medicaid Reimbursement Rate Changes for Hospice Services–Effective January 1, 2016All Providers of Hospice Services Participating in the Virginia Medical Assistance Programs
15-Dec-15Enhanced Ambulatory Patient Group (EAPG) for Ambulatory Surgical Centers; New Weights, Base Rate, and EAPG Grouper Version for Claims Payment Effective January 1, 2016Enhanced Ambulatory Patient Group (EAPG) for Ambulatory Surgical Centers; New Weights, Base Rate, and EAPG Grouper Version for Claims Payment
14-Dec-15Information for Providers on the Proposed Transition from CCC to MLTSSAll Providers Participating in the Virginia Medical Assistance Services Program
11-Dec-15Plan First Gets A New Look - Effective March 1, 2016All Medical Doctors, Nurse Practitioners, Professional Midwives, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, Laboratories, Pharmacies, Outpatient Clinics, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
3-Dec-15Requirement for Valid ICD-10 Diagnosis for All Claims - Effective 10/1/2015All Providers of Long Term Care and Transportation Services
1-Dec-15Fee-For-Service Medicaid/FAMIS/FAMIS MOMS: Coverage of Lactation Services - Effective January 1, 2016All Physicians, Nurse Practitioners, Professional Midwives, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, Durable Medical Equipment (DME) providers (In-state and Out-of-state) and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
30-Nov-15Consumer Directed Waiver Services - Employer of Record Changes - Effective January 1, 2016Services Facilitation Providers for EDCD, DD, ID, and for the EPSDT Program
19-Nov-15Virginia Medicaid Preferred Drug List (PDL) Program Changes Effective January 1, 2016, Drug Utilization Review (DUR) Board Approved Drug Service Authorization (SA) Requirements and Coverage of Over-the-Counter (OTC) drugsAll Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
12-Nov-15Court of Appeals Decision in 1st Stop Health Services v. DMASAll Providers Participating in the Virginia Medical Assistance Program
14-Oct-15Required CCC Merged Member Satisfaction and Quality of Life SurveysAll Providers Participating in the Virginia Medical Assistance Commonwealth Coordinated Care (CCC) Program
13-Oct-15Notification That KEPRO Will Accept Mass Volume Requests to Change Authorizations from Atypical Provider IDs (APIs) to National Provider IDs (NPIs) - Effective ImmediatelyAll Enrolled Providers for Elderly or Disabled with Consumer Direction (EDCD) Waiver Participating with Medicare-Medicaid Plans (MMPs) for Commonwealth Coordinated Care (CCC)
5-Oct-15Medicaid Reimbursement Rate Changes for Hospice Services - Effective October 1, 2015All Providers of Hospice Services Participating in the Virginia Medical Assistance Programs
2-Sep-15Revised Patient Pay Payment Processing for Claims Submitted by Providers of Long-Term Services and Supports Except Those Providing Supports Under the Intellectual Disability (ID), Individual and Family Developmental Disabilities Support (IFDDS) and Day Support (DS) Waivers - Effective October 1, 2015Providers of Long-Term Care Services
31-Aug-15Medicaid Reimbursement Rate Changes for Home Health Services in Culpeper and Rappahannock Counties - Effective July 1, 2015All Providers of Home Health Services Participating in the Virginia Medical Assistance Programs
25-Aug-15Implementation of ICD-10 Diagnosis and Procedure Codes for All DMAS Providers - Effective October 1, 2015All Providers in the Virginia Medical Assistance Program
1-Jul-15Governor's Access Plan for the Seriously Mentally Ill (GAP) Eligibility Changes - Effective May 15, 2015All Providers in the Virginia Medical Assistance Program
15-Jun-15Implementation of Provider Paperless Communications - Effective August 3, 2015All Billing Providers Participating in the Virginia Medical Assistance Programs
15-Jun-15Notification that KEPRO is Converting to Electronic Process for Submitting Service Authorization Requests - Effective September 1, 2015All Providers Enrolled as Hospitals, Elderly or Disabled with Consumer Direction (EDCD) Waiver; Money Follows the Person (MFP), Technology Assisted (Tech) Waiver, Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services (Private Duty Nursing, Personal Care and Attendant Care and MCO Carve Out School Services); Support Coordinators for Individual and Family Developmental Disabilities Support (DD) Waiver; Durable Medical Equipment and Supplies; and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
3-Jun-15Drug Utilization Review (DUR) Board Approved Drug Service Authorization (SA) Requirements and Virginia Medicaid Preferred Drug List (PDL) Program Changes - Effective July 1, 2015; and DMAS’ Policy on Medicaid Coverage of Physician Administered Drugs and DevicesAll Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
3-Jun-15New Requirements for Providers of the Commonwealth Coordinated Care ProgramAll Atypical Providers Enrolled in the Virginia Medical Assistance Program &
Medicare/Medicaid Plans
3-Jun-15Processing of Emergency Room Physician Claims - Effective July 1, 2015Emergency Room Physicians Participating in the Virginia Medical Assistance Program Providing Services to Virginia Medicaid Recipients
3-Jun-15Interim Instructions for Waiver Providers in Use of API (Atypical Provider Identification) vs NPI (National Provider Identification) and Changes to KEPRO’s Service Authorization Process and Impact on Provider Services - Effective July 1, 2015All Medicaid Enrolled Providers of Outpatient Rehabilitation Services, Physicians, Elderly and Disabled with Consumer Direction (EDCD) Waiver, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
18-May-15Implementation of RUG-Adjusted Rates for Hospice Services Furnished to Nursing Facility Residents - Effective July 1, 2015All Providers of Hospice Services and Nursing Facility Services
15-May-15Virginia Governor’s Access Plan for the Seriously Mentally Ill (GAP) - Pharmacy ServicesAll Pharmacy Providers in the Virginia Medical Assistance Program
4-May-15Rate Changes for Home and Community Based Services and EPSDT Nursing and Personal Care/Respite Services - Effective July 1, 2015All Providers of Home and Community-Based Services and Nursing and Personal Care/ Respite Services in the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) Program, and Managed Care Organizations
17-Apr-15Electronic Pre-Admission Screening (ePAS) ProcessProviders of Long-Term Care Services and Acute Care Hospitals
25-Mar-15Delay of New Patient Pay Payment Processing for Claims Submitted by Long-Term Care ProvidersProviders of Long-Term Care Services
9-Mar-15Changes to Community Mental Health Rehabilitative Services - Final Regulations Pertaining to all Community Based Services with the Exception of Mental Health Skill-Building ServicesProviders of Community Mental Health Rehabilitative Services, Magellan Health of Virginia, and Managed Care Organizations
6-Mar-15Clarifications to the EPSDT Behavioral Therapy ManualAll Providers of Behavioral Health Services
27-Jan-15Dental Coverage for Medicaid Enrolled Adult Pregnant Women and FAMIS MOMS - Effective March 1, 2015Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations, Except Dental
9-Jan-15Automation of the Pre-Admission Screening (PAS) ProcessAll Providers of Pre-Admission Screenings Participating in the Virginia Medical Assistance Program and Managed Care Organizations
18-Jan-15Provider Assessment of Settings - To Be Completed By January 31, 2015All Providers of Residential Support, Day Support, Prevocational and Group Supported Employment services through the Intellectual Disability (ID), Day Support (DS) and Individual and Families Developmental Disabilities Support (DD) Waivers
7-Jan-15Commonwealth Coordinated Care (CCC) Waiver Quality Assurances Required for CCC EDCD Enrollees by the Center for Medicare and Medicaid Services - Effective December 1, 2014All Providers of the Elderly or Disabled With Consumer Directed (EDCD) Waiver Participating in Virginia Medical Assistance Program and Managed Care Organizations