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2022 Memos and Bulletins

Issue DateTitleTo:
28-Dec-22Face-To-Face Supervisory, Services Facilitation and ID/DD Case Management Visits 1/1/2023All 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-22Civil Money Penalty (CMP) Reinvestment Program Funding OpportunityAll Long-Term Care Providers Participating in the Virginia Medical Assistance Program and Managed Care Organizations (Health Plans)
16-Dec-22Implementation of ClaimsXten – Effective December 19, 2022All Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Program
9-Dec-22Increased Reimbursement of Medications for the Treatment of Opioid Use DisorderAll Prescribers and Pharmacies in the Virginia Medicaid and FAMIS Programs and Managed Care Organizations
5-Dec-22Updates to the Pharmacy Provider Manual Appendix D and EAll prescribing Providers, Pharmacists and Managed Care Organizations Participating in the Virginia Medical Assistance Program
2-Dec-2212 Months Postpartum Continuous Coverage; removal of co-payments; Behavioral Health services; technical updates to Emergency Services and Appeals sectionsAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
22-Nov-22Virginia Medicaid Preferred Drug List / Common Core Formulary Changes, and New Drug Utilization Review Board Approved Drug Service AuthorizationsAll prescribing Providers, Pharmacists and Managed Care Organizations Participating in the Virginia Medical Assistance Program
3-Nov-22Coverage of COVID services for Emergency MedicaidAll Providers Participating in the Virginia Medicaid and FAMIS Programs
1-Nov-22Updates to the Home and Community Based Services (HCBS) Developmental Disability Waivers ManualAll Support Coordinators/Case Managers and Providers of Community Living (CL), Family and Individual Supports (FIS) and Building Independence (BI) Waiver Services
24-Oct-22Removal of Co-Payments for Medicaid and FAMIS EnrolleesAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
18-Oct-22Federal Public Health Emergency Extended Until January 11, 2023All Providers Participating in the Virginia Medicaid and FAMIS Programs
13-Oct-22Updates to the Private Duty Nursing Chapter of the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) SupplementEarly 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-22Coverage of Moderna and Pfizer-BioNTech bivalent COVID-19 Boosters and Expanded Coverage of Novavax COVID-19 VaccineAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
4-Oct-22New Automated Claims Processing for Emergency Medical Certifications (EMC) for Undocumented IndividualsInpatient Hospitals, Emergency Departments, Behavioral Health and Professional Providers
4-Oct-22Hospital & Ambulatory Surgical Centers (ASCs) 3M Grouper Updates– Effective July 1, 2022All Hospitals and Ambulatory Surgical Centers (ASCs) Participating in the Virginia Medical Assistance Program
3-Oct-22Reimbursement for a Telemedicine Originating Site Fee for Emergency Ambulance Transport ProvidersEmergency Ambulance Transport Providers Participating in the Virginia Medicaid Program
21-Sep-22Expanded Coverage of Preventive Services Available to Medicaid AdultsAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
15-Sep-22Updated 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-22Medicaid Home Health Care Services (HHCS) Electronic Visit Verification (EVV) Project UpdateAll Home Health Providers, Services Facilitation Providers, and Managed Care Organizations Participating in the Virginia Medical Assistance Program
1-Sep-22Updates to Comprehensive Crisis Services (Appendix G) of the Mental Health Services ManualAll Providers of Behavioral Health Services, Commonwealth Coordinated Care (CCC) Plus Managed Care Plans and Medallion 4 Managed Care Plans
25-Aug-22Update to the Nursing Facility Provider Manual ChapterAll 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-22Developmental Disabilities (DD) Waiver Services and Home and Community Based Services (HCBS) Rate Updates – Effective July 1, 2022Providers 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-22Coverage of Pfizer and Moderna COVID-19 Vaccines For Children and Novavax COVID-19 Vaccine for AdultsAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
19-Jul-22Federal Public Health Emergency Extended Until October, 13, 2022All Providers Participating in the Virginia Medicaid and FAMIS Programs
13-Jul-22Updates to Chapter V of the Physician/Practitioner ManualAll Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator
13-Jul-22Psychiatric Residential Treatment Facility, Addiction and Rehabilitation Treatment Services, Peer Recovery and Family Support Services Rate Changes Effective July 1, 2022Psychiatric 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-22Inflation for Home Health Rates Effective July 1, 2022All Providers of Home Health Services participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
13-Jul-22Inflation for Outpatient Rehabilitation Rates Effective July 1, 2022All Providers of Outpatient Rehabilitation Services Participating in the Virginia Medical Assistance Programs and Medicaid Managed Care Organizations (MCOs)
13-Jul-22Personal Care Rate Update Effective July 1, 2022Providers 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-22Professional and Children’s Vision Rate Increases Effective July 1, 2022Professional Services Providers and Medicaid Managed Care Organizations (MCOs)
13-Jul-22Ambulatory Surgical Center Reimbursement - Effective July 1, 2022Ambulatory Surgical Centers and Medicaid Managed Care Organizations (MCOs)
13-Jul-22Nursing Facility and Specialized Care Rate Updates Effective July 1, 2022Nursing Facility, Specialized Care, and Hospice Service Providers; Commonwealth Coordinated Care (CCC) Plus Managed Care Organizations (MCO)
12-Jul-22Update to the Durable Medical Equipment and Supplies Provider Manual, Appendix B UpdateAll Providers of Behavioral Health Services, Commonwealth Coordinated Care (CCC) Plus Managed Care Plans and Medallion 4 Managed Care Plans
1-Jul-22Updates to the Mental Health Services ManualAll Providers of Behavioral Health Services, Commonwealth Coordinated Care (CCC) Plus Managed Care Plans and Medallion 4 Managed Care Plans
30-Jun-22Coverage of COVID-19 Vaccine Boosters And Alternative COVID-19 Vaccine Formulations and PreparationsAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
28-Jun-22Implementation of new rates from 2022 State Budget AppropriationsAll Providers Participating in the Virginia Medicaid, Temporary Detention Order (TDO), and FAMIS Programs
28-Jun-22Peer Recovery Support Services SupplementAll Providers Participating in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator
27-Jun-22Virginia Medicaid Preferred Drug List / Common Core Formulary Changes, 90 Day Supply List Changes, and Drug Utilization Review Board Approved Drug Service AuthorizationsAll Prescribing Providers, Pharmacists, and Managed Care Organizations (MCOs) Participating in the Virginia Medical Assistance Program
24-Jun-22Changes in the Emergency Medical Certification process for Eligible Nonresident AliensAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
14-Jun-22Updates to the HCBS Developmental Disability Waivers Manual Chapter 2All Support Coordinators/Case Managers and Providers of Community Living (CL), Family and Individual Supports (FIS) and Building Independence (BI) Waiver Services
10-Jun-22Update to the Pharmacy Provider Manual Chapter IV and Appendix D and Addition of Appendix EAll 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-22Medicaid Long Term Services and Supports Screening in Nursing Facilities, Screening Restoration after COVID-19 FlexibilitiesMedicaid 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-22Medicaid Long Term Services and Support Screening (LTSS) Training for PhysiciansMedicaid Long Term Services and Supports (LTSS) Screening Agencies (Community Based Teams, Hospitals and Nursing Facilities)
9-Jun-22One-time COVID-19 Support Payment for Attendant/AidesAll 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-22Money Follows the Person (MFP) Program: Program Extension Through 2016 and Eligibility Changes — Effective June 1, 2011All 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-22Coverage of Vaccine Counseling Services for EPSDT-Eligible MembersAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
22-Apr-22Federal Public Health Emergency Extended & End of Nursing Facility FlexibilityAll Providers Participating in the Virginia Medicaid and FAMIS Programs
6-Apr-22Coverage of additional COVID-19 antibody product and convalescent plasma for outpatient useAll Providers Participating in the Virginia Medicaid and FAMIS Programs
1-Apr-22Coverage of Virtual Check-In and Audio Only Services/Updates to Telehealth Services SupplementAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
18-Mar-22DMAS Transition from VAMMIS To Medicaid Enterprise System (MES) Reminders and Frequently Asked Questions AnsweredAll 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-22Update Face-To-Face Supervisory and Case Management VisitsAll 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-22Coverage of Medications for the Treatment of Opioid Use DisorderAll Prescribers and Pharmacies in the Virginia Medicaid and FAMIS Programs, Managed Care Organizations and the Behavioral Health Services Administrator
11-Mar-22Preparations to Resume Normal Eligibility and Enrollment Operations: Member Toolkit and Resource InformationAll Providers Participating in the Virginia Medicaid and FAMIS Programs
11-Mar-22DMAS Transition from VAMMIS To Medicaid Enterprise System (MES): Key Functions for Fee for Service ProvidersAll 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-22Update to the Durable Medical Equipment and Supplies, Appendix B UpdateAll 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-22Coverage of Remote Patient Monitoring/Update to Telehealth Services SupplementAll Providers and Managed Care Organizations Participating in the Virginia Medicaid and FAMIS Programs
10-Mar-22Medicaid Long Term Services and Support Screening (LTSS) Training for PhysiciansMedicaid Long Term Services and Supports (LTSS) Screening Agencies (Community Based Teams, Hospitals and Nursing Facilities)
8-Mar-22One-time COVID-19 Support Payment for Attendant/AidesAll 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-22DMAS Replacing VAMMIS With Medicaid Enterprise System (MES): Key Dates For ProvidersAll 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-22Coverage 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-22Updated coverage of COVID-19 Antibody Products, Antiviral Products & Vaccine Booster EligibilityAll Providers Participating in the Virginia Medicaid and FAMIS Programs
15-Feb-22Federal Public Health Emergency Extended Until April 16, 2022; New State Public Health EmergencyAll Providers Participating in the Virginia Medicaid and FAMIS Programs
28-Jan-22Updates to Coverage of COVID-19 Home TestingAll Providers Participating in the Virginia Medicaid and FAMIS Programs
19-Jan-22Federal Public Health Emergency Extended Until April 16, 2022; New State Public Health EmergencyAll Providers Participating in the Virginia Medicaid and FAMIS Programs
13-Jan-22Update on Claims Re-processing for Temporary Home and Community Based Services (HCBS) rate update effective July 1, 2021Providers 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-22Temporary Virginia Public Health Emergency Due to COVID-19 Services (HCBS) rate update effective July 1, 2021All Providers Participating in the Virginia Medicaid and FAMIS Programs
5-Jan-22Consumer Directed and Agency Directed Personal Care, Respite Care, and Companion Care Update Effective January 1, 2022Providers 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)