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