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2006 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.johnson@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:
22-Dec-06Testing Electronic Transactions for the National Provider Identifier (NPI)All Providers that Submit/Receive Electronic Transactions
22-Dec-06Rate Increase for Procedure Code S5102 (Adult Day Health Care) - Effective January 1, 2007Adult Day Health Care Providers in the Elderly or Disabled with Consumer Direction Waiver
22-Dec-06False Claims Act Educational Requirements Mandated by DRAAll Providers / Contractors and Managed Care Organizations (MCOS )
14-Dec-06Updates and Clarification of the Prior Authorization Process for Outpatient Services -December 14, 2006All Outpatient Psychiatric, Outpatient Rehabilitation [including Comprehensive Outpatient Rehabilitation (CORF)], Durable Medical Equipment (DME), Orthotic, Home Health, Physicians, and Non-Emergency MRI, PET, and CAT Scan, Service Providers, and MCO's Participating in the Virginia Medical Assistance Programs
14-Dec-06Updates and Clarification of the Inpatient Prior Authorization Process for Inpatient Acute Care Services -December 14, 2006All Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
14-Dec-06Updates and Clarification of the Prior Authorization Process for Community Based Care Services - December 14, 2006All Home and Community Based Care Waiver Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
14-Dec-06Updates and Clarification of the Prior Authorization Process for Treatment Foster Care Case Management, Residential Treatment Services, and Intensive In-Home Services -December 14, 2006All Treatment Foster Care Case Management, Residential Treatment Service Providers, Intensive In-Home Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
11-Dec-06Family Planning Services Program: Clarification of Eligibility, Covered Services and Billing RequirementsAll Medical Doctors, Nurse Practitioners, Nurse Midwives, Hospitals, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, Laboratories, Pharmacies, and Outpatient Clinics, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
7-Dec-06Modifications to Virginia Medicaid Preferred Drug List (PDL)All Providers Participating in the Virginia Medical Assistance Programs
23-Oct-06Updates and Clarification of the Prior Authorization Process for Treatment Foster Care Case Management, Residential Treatment Services, and Intensive In-Home Services -October 23, 2006All Treatment Foster Care Case Management, Residential Treatment Service Providers, Intensive In-Home Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
23-Oct-06Updates and Clarification of the Prior Authorization Process for Community Based Care Services -October 23, 2006All Home and Community Based Care Waiver Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
23-Oct-06Updates and Clarification of the Inpatient Prior Authorization Process for Inpatient Acute Care Services - October 23, 2006All Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
23-Oct-06Updates and Clarification of the Prior Authorization Process for Outpatient Services -October 23, 2006All Outpatient Psychiatric, Outpatient Rehabilitation [including Comprehensive Outpatient Rehabilitation (CORF)], Durable Medical Equipment (DME), Orthotic, Home Health, Physicians, and Non-Emergency MRI, PET, and CAT Scan, Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
17-Oct-06General Billing Instructions for the New CMS-1500 (08-05) Form - Effective October 1, 2006All Providers Billing on the CMS-1500 (08-05) Form
12-Oct-06Clarification of School ServicesAll School Divisions and Managed Care Organizations Participating in the Virginia Medicaid Program
12-Oct-06Clarification of Review of Psychiatric RecordsAll Psychiatric Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
4-Oct-06National Provider Identifier (NPI) UpdateVirginia Medicaid Participating Health Care Providers and Managed Care Organizations (MCOs)
4-Oct-06National Provider Identifier (NPI) Implementation Plans For the Virginia Medicaid Program: Atypical ProvidersVirginia Medicaid Participating Atypical Providers and Managed Care Organizations (MCOs)
20-Sep-06Updates and Clarification of the Prior Authorization Process for Outpatient Services - September 20, 2006All Outpatient Psychiatric, Outpatient Rehabilitation [including Comprehensive Outpatient Rehabilitation (CORF)], Durable Medical Equipment (DME), Orthotic, Home Health, Physicians, and Non-Emergency MRI, PET, and CAT Scan, Service Providers, and Managed Care Organizations (MCOs)
20-Sep-06Updates and Clarification of the Inpatient Prior Authorization Process for Inpatient Acute, Psych, and Rehab Care ServicesAll Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations (MCOs)
20-Sep-06Updates and Clarification of the Prior Authorization Process for Community Based Care Services -September 20, 2006All Home and Community Based Care Waiver Service Providers and Managed Care Organizations(MCOs)
30-Aug-06Revision of the DMAS-30 R 5/06 and DMAS-31 R 5/06 (Title XVIII) Medicare Part B Deductible and Coinsurance Original and Adjustment/Void Invoice FormsAll Providers and Managed Care Organizations (MCOs)
21-Aug-06Updates and Clarification of the Prior Authorization Process for Treatment Foster Care Case Management and Residential Treatment ServicesTreatment Foster Care Case Management, Residential Treatment Service Providers and MCOs
16-Aug-06Coverage of spacers and peak flow meters through the Durable Medical Equipment and Supply (DME) programDurable Medical Equipment and Supply (DME) Providers, Physicians, Pharmacies, FAMIS, and MCOs.
15-Aug-06Intensity of Treatment Criteria for Acute Inpatient Hospital Psychiatric ServicesProviders of Acute Inpatient Hospital Psychiatric Services
4-Aug-06Updates and Clarification of the Inpatient Prior Authorization Process for Inpatient Acute Care Services -August 4, 2006Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Providers, and MCOs
4-Aug-06Updates and Clarification of the Outpatient Prior Authorization Process for Outpatient ServicesOutpatient Psychiatric, Outpatient Rehabilitation [including Comprehensive Outpatient Rehabilitation (CORF)], Durable Medical Equipment (DME), Orthotic, Home Health and Non-Emergency MRI, PET, CAT Scan Providers and MCOs
4-Aug-06Updates and Clarification of the Prior Authorization Process for Community Based Care Services -August 4, 2006Home and Community Based Care Waiver Providers and MCOs
26-Jul-06Request to Calculate and Report the Estimated Glomerular Filtration Rate (eGFR) Value for Medicaid RecipientsIn-State General Hospitals, Independent Laboratories, Out-of-State Hospitals, Out-of-State Laboratories, and MCOs
14-Jul-06BabyCare Covered Service Changes and mileage rate increaseMaternal Infant Care Coordination (MICC) providers and high risk maternity and infant program managers of MCOs.
13-Jul-06Rate Increase for Private Duty Nursing and Services that are Unique to the MR and DD Waivers - July 1st 2006Private Duty Nursing, Mental Retardation Waiver and Individual and Family Developmental Disabilities Support Waiver providers
7-Jul-06Expansion of Medallion II and FAMIS Programs in Danville - September 2006All Providers and MCOs
26-Jun-06Update Regarding Behavioral Therapeutic Consultation Provider QualificationsBehavioral Therapeutic Consultation Services and Mental Retardation Case Managers
16-Jun-06National Provider Identifier (NPI) Implementation Plans For the Virginia Medicaid Program: Health Care ProvidersHealth care providers and MCOs
13-Jun-06Update to the Physician Provider ManualPhysicians
9-Jun-06Expansion of Medallion II and FAMIS Programs in Culpeper - Summer 2006All Providers and MCOs
7-Jun-06Program Updates for Virginia's Medicaid, FAMIS and FAMIS Plus Children Dental Program (Smiles For Children) - Spring 2006Dental Providers
6-Jun-06Update to the Community Mental Health Rehabilitative Services Provider Manual and changes to the Prior authorization process for extensions to Intensive In Home Services (H2012)Community Mental Health Rehabilitative Services
2-Jun-06Update to the EDCD Waiver Services Provider ManualEDCD Waiver service providers and MCOs
2-Jun-06Update to the Elderly Case Management Services Provider ManualElderly Case Management Services providers
2-Jun-06Update to the IFDDS Waiver Services Provider ManualIFDDS Waiver Services providers, Case Managers and MCOs
2-Jun-06Update to the AIDS Waiver Case Management Services Provider ManualHIV/AIDS Waiver Services Organization providers and MCOs
2-Jun-06Changes to the Preauthorization of Inpatient Psychiatric Residential Treatment and changes to the Psychiatric Services ManualInpatient Psychiatric Residential Treatment Providers and MCOs
2-Jun-06Changes to the Preauthorization of Treatment Foster Care Case Management and changes to the Psychiatric Services ManualTreatment Foster Care Case Management Providers MCOs
1-Jun-06Update to the Technology Assisted Waiver Services (TAWS) Provider ManualTechnology Assisted Waiver Services Providers and MCOs
1-Jun-06Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program and PDL Quicklist and Termination of Automatic PDL Prior Authorizations for Long-Acting Narcotics: Effective July 1, 2006All Providers
26-May-06Update to the Hospital Provider Manuals and New Prior Authorization Contractor: Effective June 12, 2006Hospital and Non-emergency, Outpatient MRI/CAT/PET Scan and MCOs
26-May-06Changes to the Preauthorization of Inpatient Psychiatric Services and and changes to the Psychiatric Services Manual: Effective June 12, 2006Inpatient Psychiatric Services Providers and MCO
22-May-06Prior Authorization transition information  change in Hospital Service Transition Date to KePRO - June 12th; one-time change in PA number for certain types of requests; Clarification of Outpatient Psychiatric Service LimitsAll Pharmacies and MCOS
11-May-06Update to the Rehabilitation Provider Manual and New Prior Authorization Contractor Effective June 5, 2006Rehabilitative Services providers
5-May-06Update to the Home Health Provider Manual and New Prior Authorization Contractor Effective June 5, 2006Home Health providers and MCOs
5-May-06Update to the Durable Medical Equipment and Supplies Provider Manual and New Prior Authorization Contractor Effective June 5, 2006DME providers and MCOs
3-May-06Correction to March 31, 2006 Medicaid Memo regarding Rate Increase for Personal Care and Related Services and Adult Day Health Care ? May 1, 2006Mental Health and Mental Retardation Agencies, Providers of Case Management Waiver Services, Enrolled Service Facilitators under Medicaid Waivers, and Medicaid Recipients Receiving Consumer-Directed (CD) Services
26-Apr-06Changes to the Preauthorization of Outpatient Psychiatric Services and changes to the Psychiatric Services ManualOutpatient Psychiatric Services and MCOs
26-Apr-06Changes to the Preauthorization of Outpatient Psychiatric Services and Changes to the Mental Health Clinic Provider ManualMental Health Clinics and MCOs
3-Apr-06Contracting of Services to a Qualified Fiscal Agent for Consumer-Directed Fiscal Agent Services - Summer 2006Mental Health and Mental Retardation Agencies, Providers of Case Management Waiver Services, Enrolled Service Facilitators under Medicaid Waivers, and Medicaid Recipients Receiving Consumer-Directed (CD) Services
1-Apr-06Increased Dispensing Fee for Brand Name Drug Products - May 1, 2006All Providers
31-Mar-06Rate Increase for Personal Care and Related Services and Adult Day Health Care May 1, 2006Personal Care, Mental Health/Mental Retardation, Consumer-Directed, Respite Care, Private Duty Nursing, Adult Day Health, who provide Personal Care and Related Services and Adult Day Health Care Services
24-Mar-06EPSDT Blood Lead Testing Requirements, Lead-Safe Virginia, and the Discontinued Usage of the Division of Consolidated LaboratoriesAll EPSDT Providers and all MCOs
20-Mar-06Notification of Contract Award and New Prior Authorization and Utilization Review Process - Spring 2006All Providers and all MCOs
1-Mar-06Discontinuation of Virginia Medicaid Interim Reimbursement for Medicare Part D Drugs for Dual Eligibles - March 8, 2006All Pharmacies and MCOs
27-Feb-06Implementation of the National Provider Identification Number (NPI): Typical Anticipated Initial Implementation Date: January 1, 2007Health Care Providers and MCOs
27-Feb-06Implementation of the National Provider Identification Number: Atypical Anticipated Initial Implementation Date: January 1, 2007Treatment Foster Care, Case Management, Respite Care, Personal Care, Adult Day Health Care, Family Caregiver Training, Education Services (Schools), Assisted Living, Non-Emergency Transportation, and Mental Retardation Waiver and/or Developmental Disabilities Waiver Service Providers who are not eligible to obtain a National Provider Identifier (NPI)
1-Feb-06Changes to Virginia Medicaid Billing Instructions for HIPAA Compliance Utilization of Interim Bill TypesHospitals, Intermediate Care Facilities, Residential Treatment Facilities, Nursing Facilities, Hospice, and Temporary Detention Order providers
30-Jan-06New Virginia Medicaid Interim Reimbursement for Medicare Part D Drugs for Dual Eligibles - Effective January 31, 2006All Pharmacies and MCOs
12-Jan-06Changes to Processing of Medicare -Crossover Claims-AddendumAll Pharmacies and MCOs