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2004 Memos and Bulletins

Issue Date Title To:
13-Dec-04 Enrollment of Licensed Marriage and Family Therapists Managed Care Organizations (MCOs), Physicians, Professional Counselors, Psychologists, Clinical Psychologists, Mental Health/Mental Retardation Agencies, Substance Abuse Clinics (FAMIS), Clinical Social Workers, Psychiatric Residential Inpatient Facilities, and Psychiatric Clinical Nurse Specialists
3-Dec-04 Long-Acting Narcotics Step Therapy & the Preferred Drug List Skilled Nursing Homes, Physicians, Nurse Practitioners, Podiatrists, Dentists, Hospices, Ambulatory Surgical Centers, Pharmacies and MCOs
1-Dec-04 Medicaid Eligibility for Infants Born to Non-Medicaid-Eligible Alien Women Whose Deliveries Were Covered By Medicaid as an Emergency Medical Service All Providers and MCOs
1-Dec-04 Annual Review of Phase I of the Virginia Medicaid Preferred Drug List Program and PDL Quicklist All Providers and MCOs
5-Nov-04 Clarification of Family Planning Waiver - Covered Services and Billing Procedures Physicians, Nurse Practitioners, Nurse Midwives, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, Laboratories, Pharmacies, and Outpatient Clinics
5-Nov-04 Waiver Billing and Maintenance Issues All Home Health and Home-and-Community-Based Waiver Providers and all MCOs
5-Nov-04 Changes to the Review Process for Treatment Foster Care-Case Management Services - Effective December 15, 2004 All Treatment Foster Care-Case Management Service providers, MCOs and holders of the Psychiatric Services Provider Manual
15-Oct-04 Maximum Allowable Cost (MAC) Program for Virginia Medicaid and Notification of COX-II Drug Class Changes to Preferred Drug List (PDL) All Pharmacy Providers
1-Oct-04 Implementation of the New Provider Remittances for Professionals and Facilities - November 5, 2004 All Providers, FAMIS, SLH, and MCOs
3-Sep-04 Changes to the Review Process for Residential Treatment Services All Residential Treatment, MCOs, providing services to Virginia Medicaid Recipients, and holders of the Psychiatric Services manual
1-Sep-04 Threshold/Polypharmacy Program All Providers, FAMIS, MCOs
31-Aug-04 Clarification of Day Treatment Services for Children and Adolescents All Providers of Day Treatment Services for Children and Adolescents
20-Aug-04 Use of Electronic Signatures All Providers, FAMIS, SLH, and MCOs
20-Aug-04 Notice of Sentara Family Care's Name Change to Optima Family Care All Providers, and FAMIS
16-Aug-04 Rate Increase for Obstetrical and Gynecological Services All Providers, FAMIS, SLH and MCOs
15-Aug-04 Billing Information Update for Submitting Paper UB-92 Medicare, Crossover Part A and B claims Nursing Home Providers
6-Aug-04 Rate Increase for Specific Home and Community-Based Waiver Services Providers providing services under the following waivers: AIDS, Consumer-Directed Personal Attendant Services, Mental Retardation Waiver and Individual & Family Developmental Disabilities Support
1-Aug-04 Mandatory Generic edits, ePocrates, Weight Loss Drugs-New Prior Approval Procedure and Over the Counter Drugs All Providers and MCOs
26-Jul-04 Re-Implementation of the 180-Day Outstanding Check and Claim Void All Providers, FAMIS, SLH and MCOs
19-Jul-04 Sending Attachments Related to 837 Electronic Claims Transactions (form DMAS-3, reformatted) All Providers, FAMIS, SLH and MCOs
25-May-04 Billing Alert - Processing of Certain Community Mental Health Services covered under FAMIS Mental Health Providers and MCOs participating in the FAMIS Program
17-May-04 Prospective Drug Review Program (ProDUR) Changes to Early Refill All Pharmacy Providers
15-Apr-04 Durable Medical Equipment (DME) Appendix B Information DME, Supplies Providers and MCOs
13-Apr-04 Claim Repayments Due To ClaimCheck Hospitals and Physicians
1-Apr-04 Processing and Payment of Emergency Room Claims Hospitals, Physicians and MCOs
22-Mar-04 Update of Medicaid, FAMIS, and FAMIS Plus ID Cards and Eligibility Verification Systems Information All Providers, MCOs and FAMIS,
18-Mar-04 Billing Information Correction for Submitting Paper UB-92 Medicare Part A and B Claims -March 18, 2004 Nursing Home Providers
1-Mar-04 Phase II of the Virginia Medicaid Preferred Drug List (PDL) Program for Pharmacy Services ? April 2004 (Revised) All Providers and MCOs
6-Feb-04 Request Required by Providers Receiving ASC X12 835 Transactions All Providers, FAMIS, SLH and MCOs
23-Jan-04 Prospective Drug Review Program Changes for Pharmacy Claims, and other pharmacy change programs All Pharmacy providers