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2005 Memos and Bulletins


Issue Date Title To:
30-Dec-05 Proper Procedure for Sending Checks for Claims Processing Errors All Pharmacies and MCOs
30-Dec-05 Discontinuation of Default Medicaid Prescriber ID Numbers - Effective February 1, 2006 All Pharmacies and MCOs
30-Dec-05 Upcoming Changes to the Processing of Medicare Crossover Claims

All Providers and all MCOs

27-Dec-05 New Federal Requirements Regarding the Compliance with Seclusion and Restraint Regulations - Effective Immediately

NO LONGER AVAILABLE

Level C Residential Treatment Providers and MCOs

20-Dec-05 Termination of Erectile Dysfunction Drug Coverage for Medicaid Enrollees - Effective January 1, 2006 All Providers and all MCOs
20-Dec-05 Virginia Medicaid Healthy Returns (SM) Disease Management Program Expands - Effective January 13, 2006 All Providers and all MCOs
20-Dec-05 Monitoring Kidney Functions & the Classification Stages of Chronic Kidney Disease (CKD) See Medicaid Memo
20-Dec-05 Managed Care Organization (MCO) Merger Between Anthem HealthKeepers Plus & UniCare Health Plan of Virginia - Effective January 1, 2006 All Providers (except dentists) in Northern Virginia and the Greater Charlottesville area and the surrounding counties
5-Dec-05 Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program and PDL Quicklist & Medicare Part D Implementation - Effective January 1, 2006 All Providers and all MCOs
5-Dec-05 Pending Cancellation of DMAS Disaster Relief Health Care Coverage for Victims of Hurricane Katrina All Providers and all MCOs
2-Dec-05 Implementation of ClaimCheck for all Physician and Laboratory Services - Effective January 9, 2006 All Providers and all MCOs
29-Nov-05 Managed Care Organization (MCO) Program Expands Into the Winchester Region - Effective December 1, 2005 All providers in Winchester, Virginia and surrounding counties
7-Nov-05 Medicaid Reimbursement Rate Changes for Culpeper and King George Counties - Effective January 1, 2006 Community-Based Care Waiver Service Providers and Community Service Boards (CSBs) in Culpeper and King George Counties
16-Sep-05 Clarification of BabyCare Claims Process & FAMIS MOMS Eligibility for BabyCare Services All BabyCare and MCOs
6-Sep-05 Changes to Orthotic Services Pre-authorization (PA) Process - Effective October 1, 2005 Durable Medical Equipment/Supplies. Prosthetic Services Providers and Orthopedic Surgeons
     
19-Aug-05 FAMIS MOMS Enrollees - How to Apply for Newborn Coverage Hospitals, Pediatricians and MCOs
9-Aug-05 Expansion of Managed Care Organization (MCO) Program in Northern Virginia All Providers and all MCOs
1-Aug-05 Correction to the Billing Instructions for the UB-92 Claim Form Inpatient Private Mental Hospitals, Inpatient Psychiatric Residential Treatment Facilities, State Mental Health Facilities, and (MCOs)
1-Aug-05 Rate Increases & New Patient Pay Payroll Procedure for Consumer-Directed (CD) Services - Effective July 1, 2005

NO LONGER AVAILABLE

Mental Health and Mental Retardation Agencies, Service Facilitators and Providers of Case under Medicaid Waivers, and Medicaid Recipients Receiving Consumer-Directed (CD) Services

14-Jul-05 Reimbursement for Dental Services under Smiles For Children - Effective July 1, 2005 Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), and MCOs
8-Jul-05 Coverage Changes to the FAMIS Program (FAMIS MOMS & FAMIS Select) - Effective August 1, 2005 All Providers and MCOs
28-Jun-05 Billing Changes to Date of Discharge for Hospice Services - Effective July 1, 2005 Hospice and MCOs
28-Jun-05 Preferred Drug List (PDL) Changes Affecting Nursing Home Providers - Effective August 1, 2005 Nursing Homes
14-Jun-05 Coverage of Orthodontics Billing Procedures for Medicaid FAMIS, and FAMIS Plus Children - Effective July 1, 2005 Orthodontists and MCOs
14-Jun-05 Dental Program Coverage of Medical/Surgical Procedures for Medicaid, FAMIS and FAMIS Plus Children - Effective July 1, 2005 Oral Surgeons and MCOs
10-Jun-05 Smiles For Children, Virginia's Dental Program for Medicaid, FAMIS, and FAMIS Plus Children - Effective July 1, 2005 Dental Services and MCOs
10-Jun-05 Annual Review of Phases II and III of the Virginia Medicaid Preferred Drug List (PDL) Program, Review of New Drugs, Dispensing Fee for Generic Drugs, and PDL Quicklist - Effective July 1, 2005 All Providers and all MCOs
3-Jun-05 Termination of Erectile Dysfunction (ED) Drug Coverage for Individuals Convicted of a Sex Offense Pharmacies, Out-of-State Pharmacies, Physicians and (MCOs)
19-May-05 Change in Reimbursement Policy for School-Based Health Screenings of Children Enrolled in Medicaid Managed Care Organizations School Divisions
28-Mar-05 New Billing Requirements for Non-emergency, Outpatient MRI/CAT/PET Scans

NO LONGER AVAILABLE

Providers of Non-emergency, Outpatient MRI/CAT/PET Scans

28-Mar-05 Patient Pay Recorded on Paper Claim Submissions for Waiver Services Long Term Care and Community-Based Care Waiver Service Providers
10-Jan-05 Services Requiring Claims Submission Through the VaMMIS

NO LONGER AVAILABLE

Community Service Boards/Behavioral Health Executive Directors, Consumer-Directed Service Facilitators, MR Waiver Pre-vocational Service Providers and Agency-Directed Companion Services Providers

5-Jan-05 Clarification of Day Treatment Services for Children and Adolescents -January 5, 2005

NO LONGER AVAILABLE

Day Treatment Services for Children and Adolescents