Update to Addiction and Recovery Treatment Services (ARTS) Manual Chapters 2, 4, and 6, and Preferred Office-Based Addiction Treatment and Opioid Treatment Program (OBAT-OTP) Supplement

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Memo

August 2, 2023, 3:51PM

To:

All Providers Participating in the Virginia Medicaid and FAMIS Programs

From:

Cheryl J. Roberts, Director Department of Medical Assistance Services (DMAS)

The purpose of this memorandum is to notify providers that updates have been made to the Addiction and Recovery Treatment (ARTS) Manual. This manual update includes the following changes:

Chapter 2: Text was added to clarify that children can receive 2 hours per day minimum of Intensive Outpatient Services.

Chapter 4: The following text changes were made:

Clarified that children can receive 2 hours per day minimum of Intensive Outpatient Services.
Changed references to the “BHSA” to the “DMAS FFS Contractor.
Revised references to “office-based opioid treatment” to “office-based addiction treatment.”
Removed reference to “Buprenorphine Waivered Practitioners” because in accordance with Section 1262 of the

Consolidated Appropriations Act, 2023, DMAS is required to remove the federal requirement that practitioners obtain a DATA-Waiver or X-Waiver to prescribe medications, like buprenorphine, to treat patients with opioid use disorder. Accordingly, providers who have a current license to practice and a Drug Enforcement Administration (DEA) registration authorizing the prescribing of Schedule III drugs may prescribe buprenorphine for the treatment of opioid use disorder or pain management.

Chapter 6: Duplicated content was removed.

Supplement: Section 1262 of the Consolidated Appropriations Act, 2023 removes the federal requirement for practitioners to have a waiver to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD). All practitioners who have a current DEA registration that includes Schedule III authority, may now prescribe buprenorphine for OUD in their practice if permitted by applicable state law. The changes to this manual reflect the removal of the buprenorphine waiver requirement for prescribers to align with these federal changes.

PROVIDER CONTACT INFORMATION & RESOURCES

Virginia Medicaid Web Portal Automated Response System (ARS)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

https://vamedicaid.dmas.virginia.gov/

Medicall (Audio Response System)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

1-800-884-9730 or 1-800-772-9996

Acentra Health

Service authorization information for fee-for-service members.

https://dmas.kepro.com/

Provider Appeals

DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal.

https://www.dmas.virginia.gov/appeals/

Managed Care Programs

Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE). In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals.

Medallion 4.0

http://www.dmas.virginia.gov/#/med4

CCC Plus

http://www.dmas.virginia.gov/#/cccplus

PACE

http://www.dmas.virginia.gov/#/longtermprograms

Magellan Behavioral Health

Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members.

www.MagellanHealth.com/Provider

www.magellanofvirginia.com, email: VAProviderQuestions@MagellanHealth.com,or

Call: 1-800-424-4046

Provider Enrollment