| Issue Date |
Title |
To: |
| 8-Dec-10 |
Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program-Effective January 1, 2011 and the addition of the over the counter drugs (OTC) to the Virginia Maximum Allowable Cost Program (MAC)-Effective January 5, 2011 |
All Prescribing Providers and Pharmacists Participating in the Virginia Medical Assistance Programs |
| 24-Nov-10 |
Coverage of Tobacco Cessation Counseling for Pregnant Women-Effective October 1, 2010 |
Medicaid Providers Including Managed Care Organizations providing Services to Virginia Medicaid and FAMIS Members |
| 25-Oct-10 |
Changes to the Process for Obtaining Service Authorization for Services Available Under the Childrens Mental Health Program-Effective November 1, 2010-This Memo replaces the Medicaid Memo of the same name, which was originally dated October 13, 2010 |
All Childrens Mental Health Program Providers Participating in the Virginia Medical Assistance Program. |
| 1-Oct-10 |
Changes to Required Documentation Submitted to KePRO for IFDDS Waiver Services-Effective November 1, 2010 |
Case Management Providers for Individual and Family Developmental Disabilities Support (IFDDS) Waiver |
| 15-Sep-10 |
Service Authorization Request Process Through KePro Electronic Submission of SA Requests through iEXCHANGE |
All Home and Community Based Care Case Managers, Waiver Service Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 9-Sep-10 |
Changes to Licensing Requirements for Hospice, Personal Care, and Respite Care Providers --This memo replaces the Changes to the Licensing Requirements for Hospice, Personal Care, and Respite Care Providers Memo, dated August 4, 2010. |
All Hospice Providers participating in the Viriginia Medical Assistance Program and all Personal Care and Respite Care Providers participating in the Home and Community Based Waiver Program with the Viriginia Medical Assistance Program. |
| 2-Sep-10 |
Rate Changes Effective October 1, 2010 as a Result of Additional Medicaid Funding and Other Program Changes |
Medicaid Providers Including Managed Care Organizations Providing Services to Virginia Medicaid and FAMIS Members and PACE Organizations |
| 18-Aug-10 |
Revisions to Newborn Eligibility Notification Form (DMAS-213 and DMAS-213 MCO) for Hospitals and Managed Care Organizations |
All Hospitals and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
| 17-Aug-10 |
CareNet/Southern Health Services, Inc. MCO Plan Exits From Eleven (11) Localities-Effective September 1, 2010 |
All Providers and Managed Care Organizations (MCOs) participating in the impacted localities/surrounding areas in the Virginia Medical Assistance Programs |
| 23-Jul-10 |
Changes to Children Community Mental Health Rehabilitative Services, Childrens Services, July 1, 2010, September 1, 2010 |
Providers of Community Mental Health Rehabilitative Services and Managed Care Organizations |
| 23-Jul-10 |
Changes to Community Mental Health Rehabilitative Services, Adult Oriented Services, July 1, 2010, September 1, 2010 |
Providers of Community Mental Health Rehabilitative Services and Managed Care Organizations |
| 23-Jul-10 |
Day Support Services Billing Changes September 1, 2010 |
All Day Support Providers |
| 23-Jul-10 |
Billing Guidance for DMAS Fee-For-Service Coverage of Physician/Practitioner Administered Contraception and Rate Changes for Mirena IUD Effective March 1, 2010 |
All Medical Doctors, Nurse Practitioners, Health Departments, Rural Health Clinics, Federally Qualified Health Centers, Outpatient Clinics and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
| 14-Jul-10 |
MEDALLION Option for Warren County Effective August 1, 2010 |
All Providers and Managed Care Organizations (MCOs) participating in the impacted localities/surrounding areas in the Virginia Medical Assistance Programs |
| 9-Jul-10 |
Rate Changes for EPSDT Personal Care and Nursing Services |
Providers of EPSDT Personal Care and Nursing Services |
| 29-Jun-10 |
Notice of Service Authorization Requirements for Outpatient Rehabilitation Services Provided by Physicians and Professionals Effective August 1, 2010 |
All Medicaid Enrolled Providers of Outpatient Rehabilitation Services and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 9-Jun-10 |
Changes to Community Mental Health Rehabilitation Services-July 1, 2010 & September 1, 2010 |
Providers of Community Mental Health Rehabilitative Serviceds and Managed Care Organizations |
| 9-Jun-10 |
Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program Effective July 1, 2010 |
All Providers (including pharmacies), MCO |
| 27-May-10 |
Physician Rate Changes and Medicaid Coverage of the Current Procedural Terminology (CPT) Consultation Codes and Adult Vision Services |
All Physicians and other providers billing CPT codes participating in the Virginia Medical Assistance Program, FAMIS, and Managed Care Organizations providing services to Virginia Medicaid and FAMIS recipients |
| 27-May-10 |
No Inflation Adjustment for Home Health Providers Effective July 1, 2010 |
All Home Health Providers and Managed Care Organizations (MCOs) |
| 27-May-10 |
Rate Changes for Home and Community Based Care Waiver Services and Mental Health Therapeutic Day Treatment |
All Home and Community Based Care Waiver Providers and Mental Health Day Treatment Providers |
| 26-May-10 |
No Inflation Adjustment for Outpatient Rehabilitation Agencies Effective July 1, 2010 |
All Medicaid Outpatient Rehabilitation providers participating in the Virginia Medical Assistance Program, Managed Care Organizations, and holders of the Rehabilitation Medicaid Provider Manual |
| 26-May-10 |
Transition of Virginia Medicaid Fiscal Agent and Provider Enrollment Services to ACS State Healthcare (ACS) - UPDATED |
All Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Programl |
| 14-May-10 |
Delayed Remittance Scheduled for June 25, 2010 |
Medicaid and FAMIS Providers |
| 10-May-10 |
New Codes Approved, Billing Guidance for Plan First Family Planning Services Program as well as the Essure Sterilization Procedure. Effective April 1, 2010 |
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 |
| 14-Apr-10 |
Clarification of Cost Sharing for Dually Eligible Medicaid/Medicare Recipients |
Medicaid Enrolled Providers |
| 6-Apr-10 |
Elimination of Medicare Part B Point of Sale Drug Claims Submissions for Coinsurance and Deductibles for Dually Eligible Medicare and Medicaid Recipients ? Effective June 1, 2010 |
All Medicaid Enrolled Pharmacists |
| 5-Mar-10 |
Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program & Changes to the Enhanced Prospective Drug Utilization Review Program (Maximum Quantity Limits and Dose Optimization) |
All Providers Participating in the Virginia Medical Assistance Program |
| 5-Mar-10 |
Update to the Community Mental Health Rehabilitative Services (CMHRS) Manual |
All Providers of Community Mental Health Rehabilitative Services Participating in the Virginia Medical Assistance Program and Managed Care Organizations |
| 4-Mar-10 |
Enhanced Ambulatory Patient Group (EAPG) for Ambulatory Surgery Centers |
All Ambulatory Surgery Centers and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 24-Feb-10 |
Clarification on 17 Alpha Hydroxyprogesterone Caproate (17P) Coverage ? Effective Immediately |
All Obstetric/Gynecological and Prenatal Care Providers, Pharmacists, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs |
| 13-Jan-10 |
Rate Change for Intensive In-Home Assessment ? 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 |
| 5-Jan-10 |
Transition of Virginia Medicaid Fiscal Agent and Provider Enrollment Services to ACS State Healthcare (ACS) |
All Providers Participating in the Virginia Medical Assistance Program |
