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2009 Memos and Bulletins


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28-Dec-09 Rate Changes for Intensive In-Home, Community-Based Residential Services (Level A), and Therapeutic Behavioral Services (Level B) for Children and Adolescents - Effective February 1, 2010 All Providers of Intensive In-Home, Community-Based Residential Services (Level A) and Therapeutic Behavioral Services (Level B) for Children and Adolescents Services,and Managed Care Organizations Participating in the Virginia Medical Assistance Programs Assistance Programs
28-Dec-09 Rate Changes for Clinical Laboratory Services All Providers of Clinical Laboratory Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs Assistance Programs
17-Dec-09 Prior Authorization Request Process Through KePRO -- Electronic Submission of PA Requests through iEXCHANGE? All Outpatient Rehabilitation Agencies [including Comprehensive Outpatient Rehabilitation Facilities (CORF)]; Durable Medical Equipment (DME), Orthotic, Home Health, Physicians, and Non-Emergency MRI, PET, and CAT Scan Service Providers, Inpatient Acute, Out-of-State Acute Hospitals, Out-of-State Physicians, Out-of-State Laboratories, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
3-Dec-09 Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program, Addition to the Enhanced Prospective Drug Utilization Review Program (Maximum Quantity limits) - Effective January 1, 2010 All Prescribing Providers and Pharmacists Participating in the Virginia Medical Assistance Programs
2-Dec-09 Implementation of Medicaid Reimbursement Process for Never Events ? Effective January 1, 2010 All Physicians, Nurse Practitioners, Nurse Midwives, Clinical Nurse Specialists, Clinical Psychologists, Clinical Social Workers, Licensed Professional Counselors, Hospitals, Nursing Facilities, Federally Qualified Health Centers, Rural Health Clinics, Certified Outpatient Rehabilitation Facilities, Substance Abuse Practitioners, Marriage and Family Therapists, Health Department Clinics, Renal Units, Community Services Boards, and DMAS Enrolled Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Program
2-Dec-09 Implementation of Medicaid Reimbursement Process for Hospital Acquired Conditions ? Effective January 1, 2010 All Fee-for-Service In-State and Out-of-State Hospitals and Managed Care Organizations Participating in the Virginia Medical Assistance Program
20-Nov-09 AMERIGROUP Community Care?s Expansion into Three Localities (Madison, Orange, and Rappahannock Counties) ? Effective December 1, 2009 All Providers and Managed Care Organizations (MCOs) participating in the impacted localities/surrounding areas in the Virginia Medical Assistance Programs
30-Oct-09 Reimbursement Procedure for Medical Screening and Assessment During Emergency Custody in Absence of Emergency Custody Order (ECO) Licensed Hospitals and Health Care Providers, Community Services Boards, and Hospital Emergency Departments
8-Oct-09 Notice of Changes to the Prior Authorization Process for Intensive In-Home Program  Effective December 1, 2009 All Medicaid Enrolled Intensive In-Home Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
6-Oct-09 Termination of Virginia Medicaid Healthy ReturnsSM Disease Management Program ? Effective October 31, 2009 All Physicians and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
2-Oct-09 Medicaid Transportation Billing: Changing to a 2 Code System ? Effective November 1, 2009 All Fee-For-Service Emergency Ground Ambulance, Emergency Air Ambulance, and Neo-Natal Ambulance Service Providers that participate in the Virginia Medical Assistance Program
30-Sep-09 Expansion of DMAS Telemedicine Coverage ? Effective November 1, 2009 Physicians, Nurse Practitioners, Nurse Midwives, Clinical Nurse Specialists, Clinical Psychologists, Clinical Social Workers, Licensed Professional Counselors, Hospitals, Nursing Facilities, Federally Qualified Health Centers, Rural Health Clinics, Certified Outpatient Rehabilitation Facilities, Substance Abuse Practitioner, Marriage and Family Therapists, Health Department Clinic, Renal Units, Community Services Boards, and DMAS Enrolled Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Program
24-Sep-09 Virginia Premier Health Plan Exits From Six (6) Localities Effective October 1, 2009 All Providers and Managed Care Organizations (MCOs) participating in the impacted localities/surrounding areas in the Virginia Medical Assistance Programs
16-Sep-09 Federal Targeted Case Management Regulations ? Effective May 6, 2009 All Providers of Targeted Case Management Services
10-Sep-09 Early Intervention Services Early and Periodic Screening, Diagnosis, and Treatment Providers, Community Services Boards, Outpatient Rehabilitation Providers, Rehabilitation Hospital Providers, Infant and Toddler Connection Providers and DMAS-Enrolled Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
4-Sep-09 Prior Authorization Request Process Through KePRO--Electronic Submission of PA Requests through iEXCHANGE All Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs Assistance Programs.
4-Sep-09 Specific Guidance for Hospital Outpatient Clinics Billing on UB-04-CMS-1450 Claim Form for the Plan First Family Planning Services Program ? Effective October 1, 2009 All Outpatient Psychiatric, Treatment Foster Care Case Management, Psychiatric Residential Treatment Facility Service Providers, Intensive In-Home Services, Outpatient Substance Abuse Providers, Psychosocial Rehabilitation Providers, Mental Health Case Management Providers, Intensive Community Treatment Providers, Mental Health Support Services Providers, Therapeutic Day Treatment for Adults/Adolescents Providers, Day Treatment/Partial Hospitalization Providers, Community-Based Residential Services for Children and Adolescents Providers (Level A), Therapeutic Behavioral Services Providers (Level B), and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
30-Jun-09 Revision of the Present on Admission Indicator, Implementation of Never Events Policy, and Information on Hospital Acquired Conditions Policy To Inpatient Private Mental Hospitals.
23-Jun-09 Notice of Assessments and Prior Authorization Requirements for Therapeutic Day Treatment for Children and Adolescents, Intensive Community Treatment, Psychosocial Rehabilitation, Mental Health Supports, Mental Health Case Management, Day Treatment/Partial Hospitalization ? Effective August 1, 2009 Notice of Service Limit Edits for Claims Processing ? Effective August 1, 2009 Notice of New Mental Health Auditing Contractor ? Effective July 1, 2009 All Medicaid Enrolled Providers of Mental Health Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
9-Jun-09 Rate Changes for Home Health Providers ? Effective July 1, 2009 All Home Health Providers Participating in the Virginia Medical Assistance Program.
8-Jun-09 Rate Changes for Congregate Residential and Personal Care Services ? Effective July 1, 2009 All Personal Care and Related Services Providers; Intellectual Disabilities (ID) Waiver Providers.
2-Jun-09 Reduction of the Dispensing Fee for Brand and Generic Name Drug Products and Modifications to the Virginia Medicaid PDL Program ? Effective July 1, 2009 All Pharmacists and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
2-Jun-09 Modifications to the Virginia Medicaid PDL Program ? Effective July 1, 2009 All Medical Providers Participating in the Virginia Medical Assistance Programs.
1-Jun-09 Discontinuation of Environmental Modification Service and Assistive Technology Service in the Elderly or Disabled with Consumer-Direction Waiver and the HIV/AIDS Waiver - Effective July 1, 2009 All Home and Community Based Waiver Providers, Developmental Disabilities Waiver Support Coordinators, Managed Care Organizations (MCOs) participating in the Virginia Medical Assistance Program, Area Agencies on Aging (AAA), Community Service Boards (CSBs), Local Departments of Social Services, Local Departments of Health, Durable Medical Equipment and Supplies Providers, Screening Teams, and Community Independent Living Centers
1-Jun-09 Rate Changes for Certain Contraceptive Supplies - Effective May 1, 2009 All 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
27-May-09 Update on Outpatient Reimbursement Rates and Billing for Rehabilitation Agencies and CORFs ? Effective July 1, 2009 All Medicaid Outpatient Rehabilitation Agencies and Comprehensive Outpatient Rehabilitation Facilities (CORF) providers participating in the Virginia Medical Assistance Program, Managed Care Organizations, and holders of the Rehabilitation Provider Manual
20-May-09 Revision of the Present on Admission Indicator, Implementation of Never Events Policy, and Information on Hospital Acquired Conditions Policy - May 20, 2009 All Fee-for-Service In-State and Out-of-State Hospitals and Managed Care Organizations Participating in the Virginia Medical Assistance Program
30-Apr-09 Delayed Remittance Scheduled for June 26, 2009 Medicaid and FAMIS Providers
23-Apr-09 Suspension of the SLH Program - Effective May 1, 2009 Virginia Medicaid Participating Providers and Managed Care Organizations.
7-Apr-09 Excluded Individuals/Entities from State/Federal Healthcare Programs Virginia Medicaid Participating Providers and Managed Care Organizations.
4-Mar-09 Patient Pay Information for Medicaid Enrollees ? Effective March 1, 2009 All Long-term Care (LTC) Providers Participating in the Virginia Medical Assistance Program.
17-Feb-09 Direct Enrollment Of Licensed School Psychologists All Providers of Psychiatric, Psychological, and Substance Abuse Services, Medicaid Enrolled School Divisions, and Medicaid Contracted Managed Care Organizations Participating in the Virginia Medical Assistance Programs
13-Feb-09 Changes to Certified Registered Nurse Anesthetist (CRNA) Supervision Requirements All Medical Doctors, Nurse Practitioners, Hospitals, Outpatient Health Facilities, Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program.
10-Feb-09 Notice of Changes to the Process for Obtaining Patient Pay Information for Medicaid Enrollees ? Effective March 1, 2009 All Long-term Care (LTC) Providers Participating in the Virginia Medical Assistance Program.
10-Feb-09 Recommended Developmental Screening Tools for Well-child and Early Periodic Screening Diagnosis and Treatment (EPSDT) Visits Early and Periodic Screening, Diagnosis, and Treatment Providers, Infant and Toddler Connection Providers and DMAS-Enrolled Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program.