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2011 Memos and Bulletins

Issue Date Title To:
8-Dec-11 Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program - Effective January 1, 2012 All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
23-Nov-11 Intellectual Disability On-line System (IDOLS): Service Authorization All Medicaid Enrolled Providers of Intellectual Disability (ID) and Day Support (DS) Waiver Services Participating in the Virginia Medical Assistance Programs
9-Nov-11 Service Authorization (SA) Requirement for the Use of Atypical Antipsychotics in Children Under the Age of 6 All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
27-Oct-11 Changes in Pharmacy Billing for Influenza Vaccine — Effective October 17, 2011 All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
21-Oct-11 Entry of Managed Care Organizations (MCOs) for the Medicaid/FAMIS Programs in the Roanoke and Alleghany Regions All Providers and Managed Care Organizations (MCOs) Participating in the Impacted Localities/Surrounding Areas in the Virginia Medical Assistance Programs
21-Oct-11 Transition of City of Richmond DSS Foster Care Children to Managed Care-Effective December 1, 2011 Medicaid Providers Including Managed Care Organizations Providing Services to Foster Care Children Under the Custody of the City of Richmond Department of Social Services
3-Oct-11 Update on the Independent Clinical Assessment (ICA) Process for Medicaid Children's Behavioral Health Services Providers of Community Mental Health Rehabilitative Services, Community Service Boards, and Managed Care Organizations
3-Oct-11 Notification of the Implementation of KePRO’s New Provider Portal System & Web-Ex Sessions — Effective Monday, October 31, 2011 All Medicaid Enrolled Providers Who Submit Service Authorization Requests to KePRO, DMAS’ Service Authorization Contractor
28-Sep-11 Notice of Implementation of Personal Care Cap-Revised Exception Criteria All Medicaid Enrolled Providers of Personal Care Services and Service Facilitation under the Elderly or Disabled with Consumer Directed Services (EDCD) and AIDS Waiver Programs and AIDS Case Managers
23-Sep-11 Request for Proposals for Coordination of Community Mental Health Rehabilitative Services Providers of Behavioral Health Services and Managed Care Organizations
19-Sep-11 Changes to Plan First, Virginia’s Family Planning Services Program- Effective October 1, 2011 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
16-Sep-11 Money Follows the Person (MFP) Program: Program Extension Through 2016 and Eligibility Changes - Effective Jun 1, 2011 All In-State Hospitals, Long Stay Hospitals, Skilled Nursing Homes, Intermediate Care Facilities, and Case Management Waiver Providers participating in the Virginia Medical Assistance Program
14-Sep-11 Coverage of Medicaid Fee-for-Service Compound Drugs-Effective October 1, 2011 All Prescribing Providers, Pharacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
12-Sep-11 Early Intervention (EI) Targeted Case Management Program – Effective October 1, 2011 Early and Periodic Screening, Diagnosis, and Treatment Providers, Infant & Toddler Connection Providers, and DMAS-Enrolled Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
6-Sep-11 Intellectual Disability On-line System – Effective Immediately All Medicaid Enrolled Providers of Intellectual Disability (ID) and Day Support (DS) Waiver Services Participating in the Virginia Medical Assistance Programs
22-Aug-11 Revision in Medicaid and FAMIS Physician Rates — Effective July 1, 2011 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.
16-Jun-11 New Service Authorization Requirement for an Independent Clinical Assessment for Medicaid and FAMIS Children’s Community Mental Health Rehabilitative Services Providers of Community Mental Health Rehabilitative Services and Managed Care Organizations
6-Jun-11 Clarification of Inpatient Hospital Admissions vs. Observations All Providers of Hospital Services and Managed Care Organizations Participating in the Virginia Medical Assistance Program
1-Jun-11 Notice of Changes to Service Limits for Respite Care Services-Effective July 1, 2011 All Medicaid Enrolled Providers of Respite Care Services and Service Facilitators under the Home and Community Based Waiver Programs, the Childrens Mental Health Demonstratin Grant, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
1-Jun-11 Changes to the estimated acquisition cost (EAC) for single source, innovator drugs, elimination of the unit dose add-on fee, clarification of pharmacy coverage for active pharmaceutical ingredients (APIs), modifications to the Virginia Medicaid Preferred Drug List (PDL), new service authorization (SA) requirement for Synagis®, placement of Synagis® in the DMAS specialty maximum allowable cost (SMAC) program, and notification to pharmacies about the coverage of smoking cessation counseling for pregnant women All Prescribing Providers and Pharmacists Participating in the Virginia Medical Assistance Programs and MCOs
31-May-11 Rate Changes for Home and Community Based Care Services and Mental Health Therapeutic Day Treatment All Providers of Home and Community Based Care and Mental Health Therapeutic Day Treatment Services and Managed Care Organizations (MCOs)
31-May-11 Rate Changes for Community-Based Residential Services (Level A) and Therapeutic Behavioral Services (Level B) for Children and Adolescents All Providers 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
11-May-11 2011 General Assembly of Virginia Appropriation Act - 300H-Electronic Participation With Virginia Medicaid All Providers Participating in the Virginia Medical Assistance Programs
14-Apr-11 Clarification on Medicaid Coverage of Progesterone Supplementation All Obstetric/Gynecological and Prenatal Care Providers, Pharmacists, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
6-Apr-11 Outpatient Hospital Coding of Procedure Codes and Modifiers All Hospital and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
21-Mar-11 Medicaid Coverage of Makena (17 Alpha Hydroxyprogesterone Carproate)-Effective March 14, 2011 All Obstetric/Gynecological and Prenatal Care Providers, Pharmacists, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs