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2009 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:
28-Dec-09Rate Changes for Intensive In-Home, Community-Based Residential Services (Level A), and Therapeutic Behavioral Services (Level B) for Children and Adolescents - Effective February 1, 2010All 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-09Rate Changes for Clinical Laboratory ServicesAll Providers of Clinical Laboratory Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs Assistance Programs
17-Dec-09Prior 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-09Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program, Addition to the Enhanced Prospective Drug Utilization Review Program (Maximum Quantity limits) - Effective January 1, 2010All Prescribing Providers and Pharmacists Participating in the Virginia Medical Assistance Programs
2-Dec-09Implementation of Medicaid Reimbursement Process for Never Events ? Effective January 1, 2010All 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-09Implementation of Medicaid Reimbursement Process for Hospital Acquired Conditions ? Effective January 1, 2010All Fee-for-Service In-State and Out-of-State Hospitals and Managed Care Organizations Participating in the Virginia Medical Assistance Program
20-Nov-09AMERIGROUP Community Care?s Expansion into Three Localities (Madison, Orange, and Rappahannock Counties) ? Effective December 1, 2009All Providers and Managed Care Organizations (MCOs) participating in the impacted localities/surrounding areas in the Virginia Medical Assistance Programs
30-Oct-09Reimbursement 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-09Notice of Changes to the Prior Authorization Process for Intensive In-Home Program  Effective December 1, 2009All Medicaid Enrolled Intensive In-Home Service Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
6-Oct-09Termination of Virginia Medicaid Healthy ReturnsSM Disease Management Program ? Effective October 31, 2009All Physicians and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
2-Oct-09Medicaid Transportation Billing: Changing to a 2 Code System ? Effective November 1, 2009All 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-09Expansion of DMAS Telemedicine Coverage ? Effective November 1, 2009Physicians, 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-09Virginia Premier Health Plan Exits From Six (6) Localities Effective October 1, 2009All Providers and Managed Care Organizations (MCOs) participating in the impacted localities/surrounding areas in the Virginia Medical Assistance Programs
16-Sep-09Federal Targeted Case Management Regulations ? Effective May 6, 2009All Providers of Targeted Case Management Services
10-Sep-09Early Intervention ServicesEarly 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-09Prior Authorization Request Process Through KePRO--Electronic Submission of PA Requests through iEXCHANGEAll Inpatient Acute, Inpatient Psychiatric, and Inpatient Rehabilitation Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs Assistance Programs.
4-Sep-09Specific Guidance for Hospital Outpatient Clinics Billing on UB-04-CMS-1450 Claim Form for the Plan First Family Planning Services Program ? Effective October 1, 2009All 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-09Revision of the Present on Admission Indicator, Implementation of Never Events Policy, and Information on Hospital Acquired Conditions PolicyTo Inpatient Private Mental Hospitals.
23-Jun-09Notice 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, 2009All Medicaid Enrolled Providers of Mental Health Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
9-Jun-09Rate Changes for Home Health Providers  Effective July 1, 2009All Home Health Providers Participating in the Virginia Medical Assistance Program.
8-Jun-09Rate Changes for Congregate Residential and Personal Care Services ? Effective July 1, 2009All Personal Care and Related Services Providers; Intellectual Disabilities (ID) Waiver Providers.
2-Jun-09Reduction of the Dispensing Fee for Brand and Generic Name Drug Products and Modifications to the Virginia Medicaid PDL Program ? Effective July 1, 2009All Pharmacists and Managed Care Organizations Participating in the Virginia Medical Assistance Programs.
2-Jun-09Modifications to the Virginia Medicaid PDL Program ? Effective July 1, 2009All Medical Providers Participating in the Virginia Medical Assistance Programs.
1-Jun-09Discontinuation 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, 2009All 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-09Rate Changes for Certain Contraceptive Supplies - Effective May 1, 2009All 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-09Update on Outpatient Reimbursement Rates and Billing for Rehabilitation Agencies and CORFs ? Effective July 1, 2009All 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-09Revision of the Present on Admission Indicator, Implementation of Never Events Policy, and Information on Hospital Acquired Conditions Policy - May 20, 2009All Fee-for-Service In-State and Out-of-State Hospitals and Managed Care Organizations Participating in the Virginia Medical Assistance Program
30-Apr-09Delayed Remittance Scheduled for June 26, 2009Medicaid and FAMIS Providers
23-Apr-09Suspension of the SLH Program - Effective May 1, 2009Virginia Medicaid Participating Providers and Managed Care Organizations.
7-Apr-09Excluded Individuals/Entities from State/Federal Healthcare ProgramsVirginia Medicaid Participating Providers and Managed Care Organizations.
4-Mar-09Patient Pay Information for Medicaid Enrollees ? Effective March 1, 2009All Long-term Care (LTC) Providers Participating in the Virginia Medical Assistance Program.
17-Feb-09Direct Enrollment Of Licensed School PsychologistsAll 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-09Changes to Certified Registered Nurse Anesthetist (CRNA) Supervision RequirementsAll Medical Doctors, Nurse Practitioners, Hospitals, Outpatient Health Facilities, Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program.
10-Feb-09Notice of Changes to the Process for Obtaining Patient Pay Information for Medicaid Enrollees ? Effective March 1, 2009All Long-term Care (LTC) Providers Participating in the Virginia Medical Assistance Program.
10-Feb-09Recommended Developmental Screening Tools for Well-child and Early Periodic Screening Diagnosis and Treatment (EPSDT) VisitsEarly 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.