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2022 Memos and Bulletins

Issue Date Title To:
28-Dec-22 Face-To-Face Supervisory, Services Facilitation and ID/DD Case Management Visits 1/1/2023 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 p
21-Dec-22 Civil Money Penalty (CMP) Reinvestment Program Funding Opportunity All Long-Term Care Providers Participating in the Virginia Medical Assistance Program and Managed Care Organizations (Health Plans)
16-Dec-22 Implementation of ClaimsXten – Effective December 19, 2022 All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Program
9-Dec-22 Increased Reimbursement of Medications for the Treatment of Opioid Use Disorder All Prescribers and Pharmacies in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations
5-Dec-22 Updates to the Pharmacy Provider Manual Appendix D and E All prescribing Providers, Pharmacists and Managed Care Organizations Participating in the Virginia Medical Assistance Program
2-Dec-22 12 Months Postpartum Continuous Coverage; removal of co-payments; Behavioral Health services; technical updates to Emergency Services and Appeals sections All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
22-Nov-22 Virginia Medicaid Preferred Drug List / Common Core Formulary Changes, and New Drug Utilization Review Board Approved Drug Service Authorizations All prescribing Providers, Pharmacists and Managed Care Organizations Participating in the Virginia Medical Assistance Program
3-Nov-22 Coverage of COVID services for Emergency Medicaid All Providers Participating in the Virginia Medicaid and FAMIS Programs
1-Nov-22 Updates to the Home and Community Based Services (HCBS) Developmental Disability Waivers Manual All Support Coordinators/Case Managers and Providers of Community Living (CL), Family and Individual Supports (FIS) and Building Independence (BI) Waiver Services
24-Oct-22 Removal of Co-Payments for Medicaid and FAMIS Enrollees All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
18-Oct-22 Federal Public Health Emergency Extended Until January 11, 2023 All Providers Participating in the Virginia Medicaid and FAMIS Programs
13-Oct-22 Updates to the Private Duty Nursing Chapter of the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Supplement Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Providers, Developmental Disabilities Waivers Providers, and DMAS-Enrolled Managed Care Organizations (MCOs) Participating in Virginia Medical Assistance Program
5-Oct-22 Coverage of Moderna and Pfizer-BioNTech bivalent COVID-19 Boosters and Expanded Coverage of Novavax COVID-19 Vaccine All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
4-Oct-22 New Automated Claims Processing for Emergency Medical Certifications (EMC) for Undocumented Individuals Inpatient Hospitals, Emergency Departments, Behavioral Health and Professional Providers
4-Oct-22 Hospital & Ambulatory Surgical Centers (ASCs) 3M Grouper Updates– Effective July 1, 2022 All Hospitals and Ambulatory Surgical Centers (ASCs) Participating in the Virginia Medical Assistance Program
3-Oct-22 Reimbursement for a Telemedicine Originating Site Fee for Emergency Ambulance Transport Providers Emergency Ambulance Transport Providers Participating in the Virginia Medicaid Program
21-Sep-22 Expanded Coverage of Preventive Services Available to Medicaid Adults All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
15-Sep-22 Updated Coverage of Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
15-Sep-22 Medicaid Home Health Care Services (HHCS) Electronic Visit Verification (EVV) Project Update All Home Health Providers, Services Facilitation Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
1-Sep-22 Updates to Comprehensive Crisis Services (Appendix G) of the Mental Health Services Manual All Providers of Behavioral Health Services, Commonwealth Coordinated Care (CCC) Plus Managed Care Plans and Medallion 4 Managed Care Plans
25-Aug-22 Update to the Nursing Facility Provider Manual Chapter All Providers in Nursing Facilities Participating in the Nursing Facility Value Based Purchasing Program, Managed Care Organizations Providing Services to Virginia Medicaid Members, and All Holders of the Nursing Facility Provider Manual
5-Aug-22 Developmental Disabilities (DD) Waiver Services and Home and Community Based Services (HCBS) Rate Updates – Effective July 1, 2022 Providers of Home and Community Based Services Waivers (HCBS), Developmental Disabilities (DD) Waivers, Addition and Recovery Treatment Services, Community Mental Health Rehabilitation Services and Early Periodic Screening, and Diagnosis and Treatment
27-Jul-22 Coverage of Pfizer and Moderna COVID-19 Vaccines For Children and Novavax COVID-19 Vaccine for Adults All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
19-Jul-22 Federal Public Health Emergency Extended Until October, 13, 2022 All Providers Participating in the Virginia Medicaid and FAMIS Programs
13-Jul-22 Updates to Chapter V of the Physician/Practitioner Manual All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator
13-Jul-22 Psychiatric Residential Treatment Facility, Addiction and Rehabilitation Treatment Services, Peer Recovery and Family Support Services Rate Changes Effective July 1, 2022 Psychiatric Residential Treatment Facilities, Addiction and Rehabilitation Treatment Services Providers, All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations, and the Behavioral Health Services Administrator
13-Jul-22 Inflation for Home Health Rates Effective July 1, 2022 All Providers of Home Health Services participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
13-Jul-22 Inflation for Outpatient Rehabilitation Rates Effective July 1, 2022 All Providers of Outpatient Rehabilitation Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
13-Jul-22 Personal Care Rate Update Effective July 1, 2022 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)
13-Jul-22 Professional and Children’s Vision Rate Increases Effective July 1, 2022 Professional Services Providers and Medicaid Managed Care Organizations (MCOs)
13-Jul-22 Ambulatory Surgical Center Reimbursement - Effective July 1, 2022 Ambulatory Surgical Centers and Medicaid Managed Care Organizations (MCOs)
13-Jul-22 Nursing Facility and Specialized Care Rate Updates Effective July 1, 2022 Nursing Facility, Specialized Care, and Hospice Service Providers; Commonwealth Coordinated Care (CCC) Plus Managed Care Organizations (MCO)
12-Jul-22 Update to the Durable Medical Equipment and Supplies Provider Manual, Appendix B Update All Providers of Behavioral Health Services, Commonwealth Coordinated Care (CCC) Plus Managed Care Plans and Medallion 4 Managed Care Plans
1-Jul-22 Updates to the Mental Health Services Manual All Providers of Behavioral Health Services, Commonwealth Coordinated Care (CCC) Plus Managed Care Plans and Medallion 4 Managed Care Plans
30-Jun-22 Coverage of COVID-19 Vaccine Boosters And Alternative COVID-19 Vaccine Formulations and Preparations All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
28-Jun-22 Implementation of new rates from 2022 State Budget Appropriations All Providers Participating in the Virginia Medicaid, Temporary Detention Order (TDO), and FAMIS Programs
28-Jun-22 Peer Recovery Support Services Supplement All Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator
27-Jun-22 Virginia Medicaid Preferred Drug List / Common Core Formulary Changes, 90 Day Supply List 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
24-Jun-22 Changes in the Emergency Medical Certification process for Eligible Nonresident Aliens All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
14-Jun-22 Updates to the HCBS Developmental Disability Waivers Manual Chapter 2 All Support Coordinators/Case Managers and Providers of Community Living (CL), Family and Individual Supports (FIS) and Building Independence (BI) Waiver Services
10-Jun-22 Update to the Pharmacy Provider Manual Chapter IV and Appendix D and Addition of Appendix E All Providers of Pharmacy Services Participating in the Virginia Medical Assistance Program, Managed Care Organizations Providing Services to Virginia Medicaid Members, and All Holders of the Pharmacy Provider Manual
10-Jun-22 Medicaid Long Term Services and Supports Screening in Nursing Facilities, Screening Restoration after COVID-19 Flexibilities Medicaid Long-Term Services and Supports (LTSS) Screening Entities (Nursing Facility, Community-Based and Hospital Teams) and Commonwealth Coordinated Care Plus (CCC Plus) Waiver Providers
10-Jun-22 Medicaid Long Term Services and Support Screening (LTSS) Training for Physicians Medicaid Long Term Services and Supports (LTSS) Screening Agencies (Community Based Teams, Hospitals and Nursing Facilities)
9-Jun-22 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
1-Jun-22 Money Follows the Person (MFP) Program: Program Extension Through 2016 and Eligibility Changes — Effective June 1, 2011 All In-State Hospitals, Long Stay Hospitals, Skilled Nursing Homes, Intermediate Care Facilities, and Case Management Waiver Providers participating in the Virginia Medical Assistance Program
19-May-22 Coverage of Vaccine Counseling Services for EPSDT-Eligible Members All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
22-Apr-22 Federal Public Health Emergency Extended & End of Nursing Facility Flexibility All Providers Participating in the Virginia Medicaid and FAMIS Programs
6-Apr-22 Coverage of additional COVID-19 antibody product and convalescent plasma for outpatient use All Providers Participating in the Virginia Medicaid and FAMIS Programs
1-Apr-22 Coverage of Virtual Check-In and Audio Only Services/Updates to Telehealth Services Supplement All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
18-Mar-22 DMAS Transition from VAMMIS To Medicaid Enterprise System (MES) Reminders and Frequently Asked Questions Answered All Providers Participating in the Virginia Medicaid and FAMIS Programs, including Managed Care, Fee-For-Service, Pharmacies, PACE Providers and HCBS Waiver Services Providers, and Managed Care Organizations and the Behavioral Health Services Administrators
17-Mar-22 Update 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 p
17-Mar-22 Coverage of Medications for the Treatment of Opioid Use Disorder All Prescribers and Pharmacies in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator
11-Mar-22 Preparations to Resume Normal Eligibility and Enrollment Operations: Member Toolkit and Resource Information All Providers Participating in the Virginia Medicaid and FAMIS Programs
11-Mar-22 DMAS Transition from VAMMIS To Medicaid Enterprise System (MES): Key Functions for Fee for Service Providers All Providers Participating in the Virginia Medicaid and FAMIS Programs, including Managed Care, Fee-For-Service, Pharmacies, PACE Providers and HCBS Waiver Services Providers, and Managed Care Organizations and the Behavioral Health Services Administrator
10-Mar-22 Update to the Durable Medical Equipment and Supplies, Appendix B Update All Durable Medical Equipment and Supplies providers participating in the Virginia Medical Assistance Program, Managed Care Organizations, and holders of the Durable Medical Equipment and Supplies Provider Manual
10-Mar-22 Coverage of Remote Patient Monitoring/Update to Telehealth Services Supplement All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
10-Mar-22 Medicaid Long Term Services and Support Screening (LTSS) Training for Physicians Medicaid Long Term Services and Supports (LTSS) Screening Agencies (Community Based Teams, Hospitals and Nursing Facilities)
8-Mar-22 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
4-Mar-22 DMAS Replacing VAMMIS With Medicaid Enterprise System (MES): Key Dates For Providers All Providers Participating in the Virginia Medicaid and FAMIS Programs, including Managed Care, Fee-For-Service, Pharmacies, PACE Providers and HCBS Waiver Services Providers, and Managed Care Organizations and the Behavioral Health Services Administrator
23-Feb-22 Coverage of COVID-19 Oral Antiviral Products (Paxlovid and Molnupiravir) All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
16-Feb-22 Updated coverage of COVID-19 Antibody Products, Antiviral Products & Vaccine Booster Eligibility All Providers Participating in the Virginia Medicaid and FAMIS Programs
15-Feb-22 Federal Public Health Emergency Extended Until April 16, 2022; New State Public Health Emergency All Providers Participating in the Virginia Medicaid and FAMIS Programs
28-Jan-22 Updates to Coverage of COVID-19 Home Testing All Providers Participating in the Virginia Medicaid and FAMIS Programs
19-Jan-22 Federal Public Health Emergency Extended Until April 16, 2022; New State Public Health Emergency All Providers Participating in the Virginia Medicaid and FAMIS Programs
13-Jan-22 Update on Claims Re-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 Managed Care Organizations (MCOs) or the Behavioral Health Services Administrator (BHSA)
13-Jan-22 Temporary Virginia Public Health Emergency Due to COVID-19 Services (HCBS) rate update effective July 1, 2021 All Providers Participating in the Virginia Medicaid and FAMIS Programs
5-Jan-22 Consumer Directed and Agency Directed Personal Care, Respite Care, and Companion Care Update Effective January 1, 2022 Providers of Home and Community Based Services Waivers (HCBS) and Early Periodic Screening, Program of All Inclusive Care for the Elderly (PACE), and Diagnosis and Treatment (EPSDT) services participating in Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)