2021 Memos and Bulletins
Issue Date | Title | To: |
30-Dec-21 | COVID-19 Vaccine Administration by Pharmacists, Pharmacy Interns, and Pharmacy Technicians under the Federal PREP Act Declaration and its Amendments | All Providers Participating in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations Developmental Disability Waivers, Commonwealth Coordinated Care Plus Waiver programs, and Managed Care Organizations |
30-Dec-21 | Inter-Rater Reliability Study of LTSS Screenings | Long Term Services and Supports (LTSS) Screening Teams; Hospitals, Nursing Facilities and Community Based Screening Teams Developmental Disability Waivers, Commonwealth Coordinated Care Plus Waiver programs, and Managed Care Organizations |
17-Dec-21 | One-time COVID-19 Support Payment for Attendant/Aides | All Providers of Personal Care, Attendant/Aide Care, Respite Care, and Companion Care Services for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Developmental Disability Waivers, Commonwealth Coordinated Care Plus Waiver programs, and Managed Care Organizations |
16-Dec-21 | Mandatory Medicaid Coverage of Routine Patient Costs Furnished in Connection with Participation in Qualifying Clinical Trials | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
14-Dec-21 | One-time COVID-19 Support Payment for Attendant/Aides | All Providers of Personal Care, Attendant/Aide Care, Respite Care, and Companion Care Services for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Developmental Disability Waivers, Commonwealth Coordinated Care Plus Waiver programs, and Managed Care Organizations |
10-Dec-21 | Coverage of gender dysphoria services | All Providers Participating in the Virginia Medicaid and FAMIS Programs, all Medicaid Managed Care Organizations |
10-Dec-21 | Federal Vaccination Requirement | All Medicaid Providers and Managed Care Organizations |
1-Dec-21 | Project BRAVO: Behavioral Health Redesign for Access, Value & Outcomes, New Enhanced Behavioral Health Services, Effective December 1, 2021 and Applied Behavior Analysis | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Fee-for-Service Contractor (Magellan of Virginia) |
23-Nov-21 | Federal Vaccination Requirement | All Medicaid Providers and Managed Care Organizations |
23-Nov-21 | Update: Janssen (Johnson & Johnson), Moderna COVID-19 and Pfizer COVID-19 Vaccine Boosters | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
22-Nov-21 | Direct Support Professional (DSP) and Supervisor Orientation Test | All Providers Developmental Disability (DD) Waiver Services |
19-Nov-21 | Coverage of Pfizer COVID-19 Vaccination, Members Aged 5-11 | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
19-Nov-21 | Face-To-Face Supervisory and Case Management Visits | All Providers of Personal Care, Attendant/Aide Care, Respite Care, and Companion Care Services for the Early Periodic Screening, and Diagnosis and Treatment (EPSDT), Developmental Disability Waivers (DDW), Commonwealth Coordinated Care (CCC) Plus Waiver programs, DMASContracted Managed Care Organizations, Department of Behavioral Health Developmental Services (DBHDS), and Virginia Department of Health (VDH) |
18-Nov-21 | Civil Monetary Penalty (CMP) Reinvestment Program Funding Opportunity | All Long-Term Care Providers Participating in the Virginia Medical Assistance Program and Managed Care Organizations (Health Plans) |
9-Nov-21 | Updated coverage of COVID-19 Antibody Products & COVID-19 Vaccine Home Administration | All Providers Participating in the Virginia Medicaid and FAMIS Programs |
1-Nov-21 | One-time COVID-19 Support Payment for Attendant/Aides | All Providers of Personal Care, Attendant/Aide Care, Respite Care, and Companion Care Services for the Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Developmental Disability Waivers, Commonwealth Coordinated Care Plus Waiver programs, and Managed Care Organization |
28-Oct-21 | COVID-19 Federal Public Health Emergency Extended Until January 16, 2022 | All Providers Participating in the Virginia Medicaid and FAMIS Programs |
19-Oct-21 | Coverage of Additional COVID Vaccine Dose for Certain Immunocompromised Individuals | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS ProgramsVirginia) |
13-Oct-21 | Update to the Enrollment of Afghan Immigrants | All Hospital Providers Participating in Virginia’s Medicaid and FAMIS Programs |
6-Oct-21 | Temporary Home and Community Based Services (HCBS) rate update effective July 1, 2021 | 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) |
5-Oct-21 | Eligibility of Pregnant Individuals at the End of their Postpartum Period | All Providers Participating in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations |
1-Oct-21 | Coverage of Pfizer COVID-19 Vaccine Administration Booster | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
24-Sep-21 | Enrollment of Afghan Immigrants | All Hospital Providers Participating in Virginia’s Medicaid and FAMIS Programs |
10-Sep-21 | Medicaid Fee-For-Service Enrollment of Physician Assistants and Nurse Practitioners Practicing as Certified Registered Nurse Anesthetists | All Virginia Licensed Physicians, Physician Assistants, Nurse Practitioners and Certified Registered Nurse Anesthetists, and Managed Care Organizations participating in the Virginia Medicaid and FAMIS Programs |
25-Aug-21 | Provider Appeals For Medicaid Members - Reminder that Authorization Is Required | All Providers Participating in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations |
25-Aug-21 | Care for Excluded Inpatient Psychiatric Unit Patients in the Acute Care Unit of a Hospital during the Federal Public Health Emergency due to COVID-19 Required | Hospitals, Managed Care Organizations (MCOs), and Magellan of Virginia Participating in the Virginia Medical Assistance Program |
20-Aug-21 | Allowance of licensed school psychologists as outpatient psychiatric services providers | All Behavioral Health Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
1-Aug-21 | Addition of buprenorphine/naloxone tab SL to the Virginia Common Core Formulary/Preferred Drug List | All Prescribers and Providers of Pharmacy Services Participating in the Virginia Medical Assistance Program, Managed Care Organizations Providing Services to Virginia Medicaid Recipients |
14-Jul-21 | Update of Coverage of Routine Contraceptives | All Providers and Managed Care Organizations Participating in the Virginia Medicaid, FAMIS, and Plan First Programs |
13-Jul-21 | Psychiatric Residential Treatment Facilities, Medallion 4.0 and Commonwealth Coordinated Care (CCC) Plus Managed Care Plans | Residential Treatment Facility Rate Changes - Effective July 1, 2021 |
1-Jul-21 | Skilled and Private Duty Nursing Rate Update effective July 1, 2021 | 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) |
1-Jul-21 | Project BRAVO: Behavioral Health Redesign for Access, Value & Outcomes, New Enhanced Behavioral Health Services, Effective December 1, 2021 and Applied Behavior Analysis | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Fee-for-Service Contractor (Magellan of Virginia) |
1-Jul-21 | Update on claims processing for Temporary Home and Community Based Services (HCBS) rate update effective July 1, 2021 | Providers of Home and Community Based Services Waivers (HCBS), Home Health, Behavioral Health, Early Intervention and Early Periodic Screening, and Diagnosis and Treatment (EPSDT) services participating in Virginia Medical Assistance Programs and Medicaid |
1-Jul-21 | Funding for Psychiatric Residential Treatment Facilities (PRTF) Placements and new and updated forms for Children's Services Act (CSA) Referrals and Transfer of Jurisdiction for Residential Treatment Services (effective date 7/1/2021) | All Residential Treatment Services, Local Children’s Services ACT (CSA) Programs, Locals Departments of Social Services |
1-Jul-21 | Dental Coverage for Medicaid Enrolled Adults (21 years of age and older) Effective July 1, 2021 | Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations, Except Dental |
1-Jul-21 | Skilled and Private Duty Nursing Rate Update effective July 1, 2021 | 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) |
1-Jul-21 | Updates to Coverage of COVID-19 Testing | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
1-Jul-21 | Durable Medical Equipment and Supplies Rate Floor | All Durable Medical Equipment and Supplies providers participating in the Virginia Medical Assistance Program, Managed Care Organizations |
1-Jul-21 | Nursing Facility and Specialized Care Rate Updates Effective July 1, 2021 | Nursing Facility, Specialized Care, and Hospice Service Providers; Commonwealth Coordinated Care (CCC) Plus Managed Care Plans |
1-Jul-21 | Clarifications of Registration Requirements Covering Peer Recovery Support Services for Medicaid Members – Effective July 1, 2021. | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
1-Jul-21 | Coverage of Substance Use Disorder (SUD) Treatment Services in Institutions for Mental Diseases (IMD) Settings for FAMIS MOMS Members | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
1-Jul-21 | Hospital Reimbursement - Effective July 1, 2021 | All Hospitals and Managed Care Organizations (MCO) Participating in the Virginia Medical Assistance Program |
1-Jul-21 | Professional Services Rate Increases - Effective July 1, 2021 | Professional Services Providers and Medicaid Managed Care Organizations (MCOs) |
1-Jul-21 | Inflation for Home Health Rates Effective July 1, 2021 | All Providers of Home Health Services participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs) |
1-Jul-21 | Inflation for Outpatient Rehabilitation Rates, Effective July 1, 2021 | All Providers of Outpatient Rehabilitation Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs) |
30-Jun-21 | Developmental Disabilities (DD) Waivers Rate Updates Effective July 1, 2021 | All Providers of Developmental Disabilities (DD) Waivers Services |
30-Jun-21 | COVID Flexibilities Update – Expiration of State PHE on 6/30/2021 | All Medicaid Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
28-Jun-21 | Coverage of COVID-19 Vaccine Administration for Plan First | All Medicaid Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
11-Jun-21 | New FAMIS Prenatal Coverage for Pregnant Individuals Previously Ineligible Due to Immigration Status | All Providers Participating in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations |
11-Jun-21 | Dental Coverage for Medicaid Enrolled Adults (21 years of age and older) Effective July 1, 2021 Due to Immigration Status | Virginia Medicaid Participating Healthcare Providers and Managed Care Organizations, Except Dental |
11-Jun-21 | Employment and Community Transportation (ECT) | All Providers Developmental Disability (DD) Waiver Services |
1-Jun-21 | Changes to the enforcement of requirements related to Ordering, Referring and Prescribing (ORP) provider enrollment and screening | Local Education Agencies (School Divisions) Participating in the Virginia Medical Assistance Program |
10-May-21 | Information Regarding DMAS Client Appeals (State Fair Hearing) | All Virginia Medicaid Providers, Members, and Managed Care Organizations |
7-May-21 | Project BRAVO: Behavioral Health Redesign for Access, Value & Outcomes, Reimbursement Rates for New Enhanced Behavioral Health Services Effective July 1, 2021 and the new Mental Health Services Manual (Formerly Community Mental Health Rehabilitation Servi | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
1-May-21 | Consumer Directed and Agency Directed Personal Care, Respite Care, and Companion Care Update Effective May 1, 2021 | Providers of Home and Community Based Services Waivers (HCBS) and Early and Periodic, Screening, Diagnosis and Treatment (EPSDT) services, Program of All Inclusive Care for the Elderly (PACE), participating in Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs) |
30-Apr-21 | Allowance of Preferred Office-Based Opioid Treatment (OBOT) Services Delivery via Mobile Units | Preferred Office Based Opioid Treatment (OBOT) Programs, Managed Care Organizations (MCOs), and Magellan of Virginia Participating in the Virginia Medical Assistance Program |
28-Apr-21 | United States Department of Health and Human Services updated practice guidelines for the prescribing of buprenorphine. | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
21-Apr-21 | Updates to Coverage of COVID-19 Testing & Antibody Treatment | All Providers Participating in the Virginia Medicaid and FAMIS Programs |
22-Apr-21 | COVID-19 Flexibility Updates Through July 20, 2021 | All Providers Participating in the Virginia Medicaid and FAMIS Programs |
22-Apr-21 | Department of Behavioral Health and Developmental Services (DBHDS) Amendments to 12VAC35-105 and 12VAC35-46 for Behavioral Health Enhancement and American Society of Addiction Medicine (ASAM) Levels of Care Criteria - Service Modifications Processing Star | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
1-Apr-21 | Update for Lawful Permanent Residents: 40 Work Quarter Requirement Removed Organizations | All Medicaid Providers and MCOs ("MCOs") |
1-Apr-21 | Update to Reimbursement Rate for COVID-19 Vaccine Administration Organizations | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs ("MCOs") |
11-Mar-21 | Developmental Disabilities (DD) and Commonwealth Coordinated Care (CCC) Plus Waivers: Provider Flexibilities Related to COVID-19 | All Providers of Home and Community Based Services Waivers (HCBS) and Early Periodic Screening, Diagnosis, and Treatment (EPSDT) services participating in Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs) |
9-Mar-21 | Information Regarding Contract Requirements for Medicaid Managed Care Organizations | All Virginia Medicaid Providers, Members, and Managed Care Organizations ("MCOs") |
5-Mar-21 | COVID-19 Flexibility Updates Through 4/20/2021 Redesign for Access, Value & Outcomes | All Providers Participating in the Virginia Medicaid and FAMIS Programs |
2-Mar-21 | Coverage of Single-Dose COVID-19 Vaccine Administration | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
2-Mar-21 | Enhanced Behavioral Health Services / Project BRAVO: Behavioral Health Redesign for Access, Value & Outcomes | All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator |
24-Feb-21 | Update to Reimbursement Rate for COVID-19 Antigen Testing | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
8-Feb-21 | Updates to Coverage of High-Throughput COVID-19 Testing | All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs |
14-Jan-21 | COVID-19 Flexibility Continuations Until 4/20/2021 | All Medicaid Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
11-Jan-21 | Implementation of Medicaid Long Term Services and Supports (LTSS) Screening Conducted by Nursing Facilities | Medicaid Long Term Services and Supports (LTSS) Screening Agencies (Community Based Teams, Hospitals and Nursing Facilities); other State Agencies involved in the Screening Process: Department for Aging and Rehabilitative Services (DARS); Program of All Inclusive Care for the Elderly (PACE); Medicaid Managed Care Organizations (MCOs) and other public partners affected by Medicaid LTSS Screening Process |
7-Jan-21 | Electronic Visit Verification Live-In Caregiver Exemption and Consumer-Directed Personal Care Overtime | Services Facilitation Providers, Agency Personal Care Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
5-Jan-21 | Pharmacy Procedure For COVID-19 Vaccine | All Medicaid Providers and Managed Care Organizations Participating in the Virginia Medical Assistance Program |
4-Jan-21 | Update Developmental Disabilities (DD) and Commonwealth Coordinated Care (CCC) Plus Waivers: Provider Flexibilities Related to COVID-19 | All Providers of Home and Community Based Services Waivers (HCBS) and Early Periodic Screening, Diagnosis, and Treatment (EPSDT) services participating in Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs) |
1-Jan-21 | Developmental Disabilities (DD) Waivers Rate Changes Effective January 1, 2021 | All Providers of Developmental Disabilities (DD) Waivers Services |