Top Mobile Menu Bottom Mobile Menu

Search For:

2018 Memos and Bulletins

Note: Memos and Bulletins for 2018 are only available in PDF format


Issue Date Title To:
28-Dec-18 Overview of the Use of Civil Monetary Penalty (CMP) Funds Nursing Facilities Across the Commonwealth
5-Dec-18 Virginia Medicaid Expansion All Medicaid Providers
20-Nov-18 Updates to Community Mental Health Rehabilitative Services (CMHRS) All Community Mental Health and Rehabilitation Service Providers and Managed Care Organizations
19-Nov-18 Preadmission Screening and Resident Review Process Medicaid Long-Term Services and Supports (LTSS) Screening Entities (Community-Based and Hospital Teams) and LTSS Providers- Commonwealth Coordinated Care Plus (CCC Plus) Waiver Providers and Nursing Facilities (NF)
19-Nov-18 Ending the Governor's Access Plan for the Seriously Mentally Ill (GAP) Program Fee-for-Service Providers Serving the GAP Population
15-Nov-18 Virginia Medicaid Preferred Drug List / Common Core Formulary Changes, Effective January 1, 2019, and Drug Utilization Review Board-Approved Drug Service Authorization All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
1-Nov-18 Electronic Visit Verification All Personal Care, Respite Care, Companion Care and Home Health Providers, Services Facilitation Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program
19-Oct-18 Coverage of Physical and Occupational Therapy Evaluation Current Procedural Terminology (CPT) Codes 97161, 97162, 97165 and 97166 for Medicaid Managed Care and Fee-for-Service Members All Physicians, Outpatient Rehab Facilities, Rehab Agencies and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
1-Oct-18 Consumer-Directed (CD) Services Fiscal/Employer Agent- Effective January 1, 2019 - Update All Services Facilitation Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program
26-Sep-18 Final Regulations Pertaining to Medicaid Long-Term Services and Support Screenings - Effective November 1, 2018 Medicaid Long-Term Services and Supports (LTSS) Screening Entities (Community-Based and Hospital Teams) and LTSS Providers [Commonwealth Coordinated Care Plus (CCC Plus) Waiver Providers, Nursing Facilities (NF), CCC Plus Health Plans], Fee-for-Services (FFS) Providers, Hospitals; and Medicaid Managed Care Organizations
20-Sep-18 Addiction and Recovery Treatment Services (ARTS) Updates All Substance Use Disorder Providers, Prescribers, Managed Care Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program
17-Sep-18 Clarification of Coverage of Medicaid Fee-for-Service Compound Drugs and Home Intravenous Therapy-Effective September 15, 2018 All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
4-Sep-18 Three New Services Added to the Developmental Disabilities (DD) Waivers All Providers of Developmental Disabilities (DD) Waivers Services
14-Aug-18 Update to Appeal Settlement Process All Medicaid Service Providers
17-Jul-18 Implementation of Common Core Formulary in the Medallion 4.0 Managed Care Program - Effective August 1, 2018 All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
11-Jul-18 Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services and CCC Plus Waiver - Effective September 1, 2018 All Commonwealth Coordinated Care (CCC) Plus Waiver Services Providers and CCC Plus Managed Care Organizations (MCOs)
5-Jul-18 Inflation for Outpatient Rehabilitation Rates, Effective July 1, 2018 All Providers of Outpatient Rehabilitation Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
5-Jul-18 Hospital Reimbursement Payments - Effective July 1, 2018 All Hospitals and Managed Care Organizations (MCO) Participating in the Virginia Medical Assistance Program
25-Jun-18 Consumer-Directed (CD) Services Fiscal/Employer Agent and Electronic Visit Verification - Effective January 1, 2019 All Services Facilitation Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program
18-Jun-18 Update to the Reimbursement Methodology for Long Acting Reversible Contraceptives (LARC) and FAMIS Effective for Dates of Service in an Inpatient Hospital for Members in Medicaid Fee-for-Service Programs and Managed Care Organizations - On or After July 1, 2018 All Acute Care Facilities, All Providers, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
14-Jun-18 Updated Nursing Facility and Specialized Care Rates - Effective July 1, 2018 All Providers of Nursing Facility and Specialized Care Services and Nursing Facility-Based Hospice Services; Commonwealth Coordinated Care (CCC) Plus Managed Care Plans
14-Jun-18 Inflation for Home Health Rates - Effective July 1, 2018 All Providers of Home Health Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
11-Jun-18 Transitioning Community Mental Health Rehabilitation Services (CMHRS) and Behavioral Therapy into the Medallion 4.0 Program All Community Mental Health and Rehabilitation Service Providers, Behavioral Therapy Providers, Residential Treatment Services Providers, Magellan Healthcare of Virginia, and Managed Care Organization
8-Jun-18 Updates to the Addiction and Recovery Treatment Services (ARTS) Service Authorization for ASAM Levels 2.1 to 4.0 - Effective July 1, 2018; and Virginia Medicaid's Implementation of the Centers for Medicare and Medicaid Services (CMS) Requirement for Medicated Assisted Treatment (MAT) in ARTS Intensive Outpatient Programs, Partial Hospitalization Programs, and Residential Treatment Settings (RTS) - Effective December 1, 2018 All Substance Use Disorder Providers, Prescribers, Managed Car Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program
1-Jun-18 Drug Utilization Review (DUR) Board-Approved Drug Service Authorization (SA) Requirements and Virginia Medicaid Preferred Drug List (PDL) Program Changes - Effective July 1, 2018 All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
9-May-18 Updates to Behavioral Health Residential Treatment Services (RTS) for Children Under the Age of 21 - Effective June 1, 2018 Residential Treatment Services Providers, Magellan Healthcare of Virginia, and Managed Care Organizations
10-Apr-18 Virginia Medicaid Providers Cannot Charge Cash to Medicaid Enrolled Members for Covered Substance Use Disorder Treatment All Substance Use Disorder Providers, Prescribers, Managed Care Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program
30-Mar-18 Changes for Service Authorization Requirement of Molecular Pathology Codes, Effective May 1, 2018 All Physicians, Nurse Practitioners, Independent Laboratories, Hospitals, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
28-Feb-18 Safeguards Against Disclosure of Protected Health Information (PHI) Safeguards Against Disclosure of Protected Health Information (PHI)
2-Feb-18 Overview of the Use of Civil Monetary Penalty (CMP) Funds All Long Term Care Providers Participating in the Virginia Medical Assistance Program and Managed Care Organizations (Health Plans)
11-Jan-18 Changes to Procedure Code for Community Coaching, Effective January 1, 2018 Providers of the Developmental Disabilities Waiver Service Community Coaching
10-Jan-18 Informal Appeal Settlement Process All Medicaid Service Providers
9-Jan-18 Reduction in Inpatient Stay Cost-Sharing Amounts from $100 to $75, Effective December 15, 2017 All Hospitals and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
9-Jan-18 Clarification to Emergency Regulations: Support Coordination/Case Management Services for Individuals with a Developmental Disability (DD) Other than Intellectual Disability on the DD Waiver Waitlist Experiencing a Special Service Need All Providers of Targeted Case Management Services for Individuals with Developmental Disabilities Other than Intellectual Disability
8-Jan-18 Medallion 4.0 Program All Providers Participating in the Virginia Medicaid Program and FAMIS Program
5-Jan-18 Ordering, Referring and Prescribing Providers with Local Education Agencies - Implementation of the Affordable Care Act Provider Enrollment and Screening Requirements Local Education Agencies (School Divisions) Participating in the Virginia Medical Assistance Program