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2011 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.alexander@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:
8-Dec-11Modifications to the Virginia Medicaid Preferred Drug List (PDL) Program - Effective January 1, 2012All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
23-Nov-11Intellectual Disability On-line System (IDOLS): Service AuthorizationAll Medicaid Enrolled Providers of Intellectual Disability (ID) and Day Support (DS) Waiver Services Participating in the Virginia Medical Assistance Programs
9-Nov-11Service Authorization (SA) Requirement for the Use of Atypical Antipsychotics in Children Under the Age of 6All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
27-Oct-11Changes in Pharmacy Billing for Influenza Vaccine — Effective October 17, 2011All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
21-Oct-11Entry of Managed Care Organizations (MCOs) for the Medicaid/FAMIS Programs in the Roanoke and Alleghany RegionsAll Providers and Managed Care Organizations (MCOs) Participating in the Impacted Localities/Surrounding Areas in the Virginia Medical Assistance Programs
21-Oct-11Transition of City of Richmond DSS Foster Care Children to Managed Care-Effective December 1, 2011Medicaid 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-11Update on the Independent Clinical Assessment (ICA) Process for Medicaid Children's Behavioral Health ServicesProviders of Community Mental Health Rehabilitative Services, Community Service Boards, and Managed Care Organizations
3-Oct-11Notification of the Implementation of KePRO’s New Provider Portal System & Web-Ex Sessions — Effective Monday, October 31, 2011All Medicaid Enrolled Providers Who Submit Service Authorization Requests to KePRO, DMAS’ Service Authorization Contractor
28-Sep-11Notice of Implementation of Personal Care Cap-Revised Exception CriteriaAll 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-11Request for Proposals for Coordination of Community Mental Health Rehabilitative ServicesProviders of Behavioral Health Services and Managed Care Organizations
19-Sep-11Changes to Plan First, Virginia’s Family Planning Services Program- Effective October 1, 2011All 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-11Money Follows the Person (MFP) Program: Program Extension Through 2016 and Eligibility Changes - Effective Jun 1, 2011All 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-11Coverage of Medicaid Fee-for-Service Compound Drugs-Effective October 1, 2011All Prescribing Providers, Pharacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Programs
12-Sep-11Early Intervention (EI) Targeted Case Management Program – Effective October 1, 2011Early 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-11Intellectual Disability On-line System – Effective ImmediatelyAll Medicaid Enrolled Providers of Intellectual Disability (ID) and Day Support (DS) Waiver Services Participating in the Virginia Medical Assistance Programs
22-Aug-11Revision in Medicaid and FAMIS Physician Rates — Effective July 1, 2011All 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-11New Service Authorization Requirement for an Independent Clinical Assessment for Medicaid and FAMIS Children’s Community Mental Health Rehabilitative ServicesProviders of Community Mental Health Rehabilitative Services and Managed Care Organizations
6-Jun-11Clarification of Inpatient Hospital Admissions vs. ObservationsAll Providers of Hospital Services and Managed Care Organizations Participating in the Virginia Medical Assistance Program
1-Jun-11Notice of Changes to Service Limits for Respite Care Services-Effective July 1, 2011All 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-11Changes 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 womenAll Prescribing Providers and Pharmacists Participating in the Virginia Medical Assistance Programs and MCOs
31-May-11Rate Changes for Home and Community Based Care Services and Mental Health Therapeutic Day TreatmentAll Providers of Home and Community Based Care and Mental Health Therapeutic Day Treatment Services and Managed Care Organizations (MCOs)
31-May-11Rate Changes for Community-Based Residential Services (Level A) and Therapeutic Behavioral Services (Level B) for Children and AdolescentsAll 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-112011 General Assembly of Virginia Appropriation Act - 300H-Electronic Participation With Virginia MedicaidAll Providers Participating in the Virginia Medical Assistance Programs
14-Apr-11Clarification on Medicaid Coverage of Progesterone SupplementationAll Obstetric/Gynecological and Prenatal Care Providers, Pharmacists, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
6-Apr-11Outpatient Hospital Coding of Procedure Codes and ModifiersAll Hospital and Managed Care Organizations Participating in the Virginia Medical Assistance Programs
21-Mar-11Medicaid Coverage of Makena (17 Alpha Hydroxyprogesterone Carproate)-Effective March 14, 2011All Obstetric/Gynecological and Prenatal Care Providers, Pharmacists, and Managed Care Organizations Participating in the Virginia Medical Assistance Programs