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2019 Memos and Bulletins

Issue Date Title To:
30-Dec-19 Transitioning from the Commonwealth Coordinated Care Plus (CCC Plus) Waiver to a Developmental Disabilities Waiver All Providers of Developmental Disabilities (DD) Waivers Services
13-Dec-19 Provider Reimbursement for Licensed Mental Health Professionals All Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) MCOs and Providers
18-Nov-19 Mandatory Use of Electronic Portal for Submission of Long-Term Services and Supports (LTSS) Hospitals Screening for Medicaid Long Term Services and Supports
6-Nov-19 Enhanced Process for Hospice Providers to Enter Fee-For-Service (FFS) Hospice Admissions and Disenrollments into the Long Term Care (LTC) Portal All Providers of Hospice Services, Nursing and Intermediate Care Facilities; Commonwealth Coordinated Care (CCC) Plus Managed Care Plans
23-Oct-19 Clarification of DMAS Requirements Related to the Use of Telemedicine in Providing Medication Assisted Treatment for Opioid Use Disorder All Addiction and Recovery Treatment Services (ARTS) Providers, Prescribers, Managed Care Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program
7-Oct-19 Medicaid Nursing Facility Reimbursement Policy in Response to Medicare's Patient Driven Payment Model (PDPM), Effective October 1, 2019 All Nursing Facility Providers; Commonwealth Coordinated Care (CCC) Plus Health Plans
25-Sep-19 Electronic Visit Verification (EVV) UPDATE All Personal Care, Respite Care, Companion Services, Home Health Providers, Services Facilitation Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
4-Sep-19 Authorization of Personal Assistance Services in the Developmental Disability Waiver Developmental Disability Waiver Services Providers
4-Sep-19 CCC Plus Claims Processing Commonwealth Coordinated Care (CCC) Plus MCOs and Providers
21-Aug-19 Electronic Visit Verification (EVV) Provider and Vendor Testing All Personal Care, Respite Care, Companion Services, Home Health Providers, Services Facilitation Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
20-Aug-19 Prohibition to Charge Medicaid Members Out-of-Pocket for Covered Substance Use Disorder Services All Substance Use Disorder Providers, Prescribers, Managed Care Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program
14-Aug-19 Revisions to Medicaid Payments for Medicare Coinsurance, Copays, and Deductibles (Crossover Claims)-Effective July 5, 2019 All Providers with Crossover Claims; Medallion 4.0 and Commonwealth Coordinated Care (CCC) Plus Managed Care Plans
1-Aug-19 DMAS Recognition of Certified Substance Abuse Counselor Supervisees All Substance Use Disorder Providers, Prescribers, Managed Care Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program
2-Jul-19 Inflation for Outpatient Rehabilitation Rates, Effective July 1, 2019 All Providers of Outpatient Rehabilitation Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
2-Jul-19 New Reimbursement for Hospice Services Provided in Nursing Facilities and Intermediate Care Facilities-Effective July 1, 2019 All Providers of Hospice Services, Nursing and Intermediate Care Facilities; Commonwealth Coordinated Care (CCC) Plus Managed Care Plans
27-Jun-19 Hospital Inpatient and Outpatient Rates and Hospital Lump Sum Reimbursement for Disproportionate Share Hospitals and Graduate Medical Education, Effective July 1, 2019 All Hospitals and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
21-Jun-19 Professional and Telehealth Services Rate Increases, Effective July 1, 2019 Professional Services Providers and Medicaid Managed Care Organizations (MCOs)
21-Jun-19 Inflation for Home Health Rates, Effective July 1, 2019 All Providers of Home Health Services participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
21-Jun-19 Personal, Respite and Companion Care Rate Increases, Effective July 1, 2019 Providers of Home and Community Based Services Waivers (HCBS) and Early Periodic Screening, and Diagnosis and Treatment (EPSDT) services participating in Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
21-Jun-19 Nursing Facility and Specialized Care Rate Updates; Fair Rental Value (FRV) Rates for New and Renovated Facilities; Institutional Hospice Reimbursement Changes Effective July 1, 2019 Nursing Commonwealth Coordinated Care (CCC) Plus Managed Care Plans Facility, Specialized Care, and Hospice Service Providers;
20-Jun-19 Update to Reimbursement for Ambulatory Surgical Centers; Implementation of a New Enhanced Ambulatory Patient Group Grouper Version, New Weights and Base Rate, for Claims Payment, Effective July 1, 2019 Ambulatory Surgical Centers and Managed Care Organizations
11-Jun-19 Clarification to Mandatory Training for Screeners for Long-Term Services and Supports (LTSS) Screening Medicaid LTSS Screening Agencies (Community-Based Teams); Hospitals involved in LTSS Screening Process; other Local and State Agencies Involved in the Screening Process [DBHDS, DSS Eligibility]; Nursing Centers, Home Health Agencies that Serve LTSS, and PACE Sites; Medicaid Health Plans Providing Care Coordination for LTSS; and other Public Partners Affected by Medicaid LTSS Screening Process
10-Jun-19 Virginia Medicaid Preferred Drug List / Common Core Formulary Changes, and Drug Utilization Review Board-Approved Drug Service Authorizations All Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
8-May-19 All Assessors for Public Pay Individuals: Community Services Boards (CSB)/Behavioral Health Authorities (BHA), Local Departments of Social Services, Local Departments of Health, Centers for Independent Living (CIL), and Area Agencies on Aging (AAA) Claims for Assisted Living Facility Initial Assessments and Annual Reassessments Entities (Community-Based and Hospital Teams)
22-Apr-19 Electronic Visit Verification (EVV) Update-REVISED All Personal Care, Respite Care, Companion Services, Home Health Providers, Services Facilitation Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
12-Apr-19 Mandatory Training for Screeners for Long-Term Services and Supports (LTSS) Screening Medicaid LTSS Screening Agencies (Community Based Teams); other Local and State Agencies Involved in the Screening Process [DBHDS, DSS Eligibility]; Nursing Centers, Home Health Agencies that Serve LTSS, and PACE Sites; Medicaid Health Plans Providing Care Coordination for LTSS; and other Public Partners Affected by Medicaid LTSS Screening Process
12-Apr-19 Screening Prior to Nursing Facility Admission or No Medicaid Reimbursement and Implementation of Verification of Screening- Effective July 1, 2019 Medicaid Long-Term Services and Supports (LTSS) Providers –Commonwealth Coordinated Care (CCC Plus) Waiver Providers and Nursing Facilities and LTSS Screening Entities (Community-Based and Hospital Teams)
4-Mar-19 Federally Qualified Health Centers Coverage of Telemedicine All Federally Qualified Health Centers and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
11-Feb-19 Evidence-Based Practices and Medication Assisted Treatment for Opioid Use Disorder All Addiction and Recovery Treatment Services (ARTS) Providers, Prescribers, Managed Care Organizations (MCOs) and Magellan of Virginia Participating in the Virginia Medical Assistance Program