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2007 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:
26-Dec-07Plan First-The Medicaid Fee-For-Service Family Planning Waiver Program - Eligible Population, Enrollment, Covered Services, Service Limits and Billing Requirements as well as Upcoming Training Dates - Effective January 1, 2008All 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
20-Dec-07Prior Authorization - Outpatient Substance Abuse Services that will Transition to KePRO for Fee-for-Service Enrollees - Effective January 1, 2008All Managed Care Organizations (MCOs), Physicians, Licensed Professional Counselors, Licensed Clinical Psychologists, Psychiatric Nurse Practitioners, Mental Health/Mental Retardation Agencies, Substance Abuse Clinics (FAMIS), Licensed Clinical Social Workers, Psychiatric Clinical Nurse Specialists, Licensed Marriage and Family Therapists, and Licensed Substance Abuse Treatment Practitioners.
11-Dec-07Children's Mental Health Program - Effective December 1, 2007All Potential Providers of the Children's Mental Health Program, Psychiatric Residential Treatment Facilities, and Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Program
4-Dec-07Changes to Enhanced Prospective Drug Utilization Review Programs and Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program Effective January 1, 2008All Pharmacy and Medical Providers Participating in the Virginia Medical Assistance Programs
19-Oct-07Outpatient Substance Abuse Services that require Prior Authorization for Fee-for-Service EnrolleesAll Managed Care Organizations (MCOs), Physicians, Licensed Professional Counselors, Licensed Psychologists, Clinical Psychologists, Mental Health/Mental Retardation Agencies, Substance Abuse Clinics (FAMIS), Licensed Clinical Social Workers, Psychiatric Residential Inpatient Facilities, Psychiatric Clinical Nurse Specialists, Licensed Marriage and Family Therapists, and Licensed Substance Abuse Treatment Practitioners.
19-Oct-07Updates and Clarification of the Prior Authorization Process for Outpatient ServicesAll 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
11-Oct-07Medicaid Enrollment and Coverage of Certified Professional MidwivesAll Virginia Licensed Certified Professional Midwives, Medical Doctors, Nurse Practitioners, Nurse Midwives, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, Laboratories, Outpatient Clinics, and Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Program
9-Oct-07Changes to the Prior Authorization and Billing Process for Psychiatric Residential Treatment and Treatment Foster Care - Effective October 1, 2007All Psychiatric Residential Treatment Providers, Treatment Foster Care Case Management Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs, and all CPMT Chairpersons
9-Oct-07Prior Authorization Updates - Waivers ? Effective ImmediatelyAll Home and Community Based Care Waiver Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
3-Oct-07Delayed Implementation of Tamper Resistant Prescription Pad Requirements Now Effective April 1, 2008All Pharmacy, Medical Providers, Dental Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
2-Oct-07Discontinuation of Legacy Automated Response System (ARS) AccessAll Providers Participating in the Virginia Medical Assistance Program
12-Sep-07Virginia Medicaid Healthy ReturnsSM Disease Management Program Expanded to Include Chronic Obstructive Pulmonary Disease (COPD) Effective May 1, 2007All Providers (with the exception of Dentists) and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
5-Sep-07Implementation of Tamper-Resistant Prescription Pad Requirements - Effective October 1, 2007All Pharmacy, Medical Providers, Dental Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
30-Aug-07Update to Second Edition of the Durable Medical Equipment and Supplies Provider ManualAll Durable Medical Equipment and Supplies providers participating in the Virginia Medical Assistance Program, Managed Care Organizations, and holders of the Durable Medical Equipment and Supplies Provider Manual.
27-Aug-07Provider Education for the Hospital Utilization Review Audit ProcessAll Inpatient Acute and Inpatient Psychiatric Service Providers.
23-Aug-07Early Periodic Screening Diagnosis and Treatment (EPSDT) Screening and Developmental AssessmentsEarly and Periodic Screening, Diagnosis, and Treatment (EPSDT) Providers and DMAS-Enrolled Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
8-Aug-07Integration of Acute and Long Term Care Services - Phase IAll Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations (Excluding Dental Providers).
1-Aug-07Enrollment of Additional Specialties of Licensed Nurse Practitioners - Effective August 1, 2007Physicians, Nurse Practitioners, Clinical Nurse Specialists, Nurse Midwives, Hospitals, State Mental Hospitals, Private Mental Hospitals, Residential Treatment/Treatment Foster Care Facilities, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, School Health Clinics,Outpatient Clinics, and Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Programs
31-Jul-07Provider Satisfaction Survey for Prior Authorization ServicesAll 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; All Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers; All Treatment Foster Care Case Management, Residential Treatment Service Providers, Intensive In-Home Services; All Home and Community Based Care Waiver Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
13-Jul-07New Rates and Processing of Emergency Room Physician Claims - Effective July 1, 2007Emergency Room Physicians Participating in the Virginia Medical Assistance Program and Managed Care Organizations providing services to Virginia Medicaid Recipients
5-Jul-07Expansion of Managed Care Services in Lynchburg - Effective October 1, 2007All Providers (with the exception of Dentists) and Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Programs
26-Jun-07Increase in the Personal Needs Allowance for Institutionalized Individuals Residing in Nursing Facilities and in Intermediate Care Facilities for the Mentally Retarded (ICF-MR) - Effective July 1, 2007All State Mental Hospitals, Long Stay Hospitals, Skilled Nursing Home Mental Health Facilities, Medical Surgery Facilities serving the Mentally Retarded, Skilled Nursing Homes, Skilled Nursing Facilities, Long Stay Inpatient Hospitals, Mental Health Medical Surgery Facilities, and Intermediate Care Facilities participating in the Virginia Medicaid Program.
12-Jun-07Medicaid Coverage of Substance Abuse Services - Effective July 1, 2007All Managed Care Organizations (MCOs), Physicians, Licensed Professional Counselors, Licensed Psychologists, Clinical Psychologists, Mental Health/Mental Retardation Agencies, Substance Abuse Clinics (FAMIS), Licensed Clinical Social Workers, Psychiatric Residential Inpatient Facilities, Psychiatric Clinical Nurse Specialists, Licensed Marriage and Family Therapists, and Licensed Substance Abuse Treatment Practitioners.
7-Jun-07BabyCare Rate Changes - Effective July 1, 2007All Providers of Maternal Infant Care Coordination (MICC) services participating in the Virginia Medical Assistance Programs, including Physicians, Nurse Practitioners, Nurse Midwives, Health Department Clinics, Federally Qualified Health Centers, Rural Health Clinics, Department of Social Service, Case Management Providers, Prenatal Nutritionists, Private Home Health Agencies and Community Service Boards, and High Risk Maternity and Infant Program Managers of the Medicaid Managed Care Organizations (MCOs).
5-Jun-07Physician Rate Increases - Effective July 1, 2007All Physicians participating in the Virginia Medical Assistance Program, FAMIS, and Managed Care Organizations providing services to Virginia Medicaid and FAMIS recipients.
5-Jun-07Rate Increase for Personal Care and Related Services - Effective July 1, 2007All Personal Care and Related Services Providers.
5-Jun-07Northern Virginia Rate Differential for MR, DD, and Day Support Waiver Services - Effective July 1, 2007Mental Retardation (MR), Individual and Family Developmental Disabilities Support (DD) and Day Support Waiver Providers programs.
31-May-07New National Drug Code (NDC) Billing Requirement for Drug-Related HCPCS J-Codes - Effective July 1, 2007All Prescribing Physician Providers Participating in the Virginia Medical Assistance Programs.
31-May-07Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program, Enhanced Prospective Drug Utilization Review Programs, National Provider Identifier (NPI) Dual Use Extension, and Pharmacy Web-Based Prior Authorization ProcessAll Pharmacy and Prescribing Medical Providers Participating in the Virginia Medical Assistance Programs.
8-May-07National Provider Identifier (NPI) Update: DMAS Dual Use Period Extended Beyond May 23, 2007 and Paper Claim Form Deadline (June 1, 2007)All Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations.
23-Apr-07Changes to the Prior Authorization Request Form for Intensive In-Home ServicesAll Intensive In-Home Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
23-Apr-07Changes to the Prior Authorization Process for Psychiatric Residential TreatmentAll Psychiatric Residential Treatment Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs, and all CPMT Chairpersons.
19-Apr-07New Questionnaires Available to Facilitate Waiver Services Requests for Prior AuthorizationAll Home and Community Based Care Waiver Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
19-Apr-07Northern Virginia Rate Differential for MR, DD, and DS Waivers - Effective July 1, 2007Mental Retardation (MR) Waiver, Individual and Family Developmental Disabilities Support (DD)Waiver, and Day Support (DS) Waiver providers.
19-Mar-07NPI Update: DMAS Requirements for National Taxonomy Codes for Home Health, Private Duty, and Atypical Service ProvidersVirginia Medicaid Participating Home Health, Private Duty Nursing, Personal Care, Respite, Adult Day Health, Assisted Living, MH-MR Services, Case Management Waiver, Family Caregiver Training, and Treatment Foster Care Providers.
12-Mar-07Changes to the Prior Authorization Process for Treatment Foster Care Case Management - Effective March 1, 2007All Treatment Foster Care Case Management Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs, and all CPMT Chairpersons.
21-Feb-07General Billing Instructions for the New CMS-1450 (UB-04) - Effective April 1, 2007All Providers Billing on the CMS-1450 (UB-04) Form.
14-Feb-07Updates and Clarification of the Prior Authorization Process for Inpatient ServicesAll Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs Assistance Programs.
14-Feb-07Updates and Clarification of the Prior Authorization Process for Outpatient Services - February 14, 2007All 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.
9-Feb-07Atypical Provider Identifier (API) Update: DMAS Dual Use Period - March 26 - May 22, 2007 - March 26 - May 22, 2007Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations.
9-Feb-07National Provider Identifier (NPI) Update: DMAS Dual Use Period - March 26 - May 22, 2007Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations.
31-Jan-07Baby Care Mileage Rate Increase - Effective February 1, 2007All Providers of Maternal Infant Care Coordination (MICC) services participating in the Virginia Medical Assistance Programs, including Health Department Clinics, Federally Qualified Health Centers, Rural Health Clinics, Department of Social Service, Case Management Providers, Private Home Health Agencies and Community Service Boards.
31-Jan-07Changes to Treatment Foster Care Case Management Reimbursement - Effective March 1, 2007Providers of Treatment Foster Care Case Management
19-Jan-07New Web Site for the Automated Response System (ARS) and National Provider Identifier (NPI) Compliance for the ARS - Effective February 19, 2007All Providers Participating in the Virginia Medical Assistance Program
10-Jan-07Updates and Clarification of the Prior Authorization Process for Community Based Care ServicesAll Home and Community Based Care Waiver Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
10-Jan-07Updates and Clarification of the Inpatient Prior Authorization Process for Inpatient Acute Care ServicesAll Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
10-Jan-07Updates and Clarification of the Prior Authorization Process for Outpatient Services -January 10, 2007All 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
10-Jan-07Updates and Clarification of the Prior Authorization Process for Treatment Foster Care Case Management, Residential Treatment Services, and Intensive In-Home ServicesAll Treatment Foster Care Case Management, Residential Treatment Service Providers, Intensive In-Home Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs