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BMS Program Instructions

 
Year 2008
Program Instruction Description Effective Date
MA-08-01 Chapter 500, DME Medical Supplies January 1, 2008
Year 2007
MA-07-05 Chapter 500, Aged & Disabled Waiver  Services January 1, 2008
MA-07-05 Chapter 500, MR/DD Waiver Services January 1, 2008
MA-07-03 Chapter 500, Aged & Disabled Waiver Services May 1, 2007
MA-07-02 Chapter 300, Provider Participation Requirements March 1, 2007
MA-07-01 Chapter 500, O & P Services March 1, 2007
Year 2006
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MA-06-01 Chapter 500, Practitioner Services February 15, 2006
MA-06-02 Chapter 500, Freestanding Ambulatory Surgical Center and Birthing Center Services February 15, 2006
MA-06-03 Chapter 500, Hospital Services February 15, 2006
MA-06-04 Chapter 500, Podiatry Services February 15, 2006
MA-06-05 Chapter 500, DME Medical Supplies February 16, 2006
MA-06-06 Chapter 500, Behavioral Health Rehabilitation Services January 1, 2006
MA-06-07 Chapter 500, Behavioral Health Clinic Services January 1, 2006
MA-06-08 Chapter 500, Psychological Services January 1, 2006
MA-06-09 Pharmacy Services, Preferred Drug List Update, Effective April 1, 2006 April 1, 2006
  MA-06-10 Chapter 500, Pharmacy Services April 17, 2006
  MA-06-12 Chapter 500, Vision Care Services April 14, 2006
  MA-06-13 Chapter 500, DME Medical Supplies May 1, 2006
  MA-06-14 Chapter 500, DME Medical Supplies July 1, 2006
  MA-06-15 Chapter 500, MR/DD Waiver Services July 1, 2006
  MA-06-16 Chapter 500, Aged Disabled Waiver August 1, 2006
  MA-06-17 Chapter 500, A/D Waiver Services October 1, 2006
  MA-06-18 Chapter 500, Nursing Facility Services October 1, 2006
  MA-06-19 Chapter 500, MR/DD Waiver Services October 1, 2006
  MA-06-20 Chapter 300 Provider Participation Requirements
 		 November 1, 2006
  MA-06-21 Chapter 500, Covered Services, Limitations and Exclusions for MR/DD Waiver Services December 1, 2006
Year 2005
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MA-05-01 Chapter 500 - MR/DD Waiver Services December 1, 2004
503.1 - April 1, 2005
MA-05-02 Increase in Mileage Rate to 41 Cents Per Mile January 1, 2005
MA-05-04 Chapter 500, Pharmacy Services Upon Receipt
MA-05-05 Chapter 500, Nursing Facilities Services  January 1, 2005
MA-05-06 Chapter 500, Hospital Services May 1, 2005
MA-05-08 Chapter 500, Dental Services January 1, 2005
MA-05-09 Chapter 500, Occupational/Physical Therapy Services May 1, 2005
MA-05-10 DME/Medical Supplies Manual, Chapter 500 May 1, 2005
MA-05-11 Chapter 500, Practitioner Services June 1, 2005
MA-05-14 Chapter 500, Practitioner Services-Including Physicians, Physicians Assistants and Advanced Registered Nurse Practitioners June 1, 2005
MA-05-15 Pharmacy Services, Preferred Drug List Update July 1, 2005
MA-05-16 Chapter 500, Pharmacy Services July 1, 2005
MA-05-17 Pharmacy Services, Preferred Drug List Update July 1, 2005
MA-05-18 Chapter 500, Vision Care Services August 15, 2005
MA-05-19 Chapter 500, Transportation Services September 15, 2005
MA-05-20 Chapter 500, Home Health Services August 15, 2005
MA-05-21 Pharmacy Services, Preferred Drug List Update Effective October 1, 2005 October 1, 2005
MA-05-22 Chapter 500, Chiropractic Services October 1, 2005
MA-05-23 Chapter 500, Hospital Services October 1, 2005
MA-05-24 Chapter 500, Practitioner Services October 1, 2005
MA-05-25 Chapter 500, Laboratory & Radiology Services October 1, 2005
MA-05-26 Chapter 500, Nursing Facility Services November 1, 2005
MA-05-27 Chapter 500, Aged and Disabled Waiver Services November 1, 2005
MA-05-28 Chapter 500, Personal Care Services November 1, 2005
Memorandum Increase in Mileage Rate to 49 Cents Per Mile Upon Receipt
MA-05-29 Chapter 500, Lab and Radiology Services January 1, 2005
MA-05-30  Chapter 500, Freestanding Ambulatory Surgical Center and Birthing Center Services November 1, 2005
MA-05-31 Chapter 500, Chiropractic Services October 1, 2005
MA-05-32 Chapter 500, Podiatry Services November 1, 2005
MA-05-33 Chapter 500, Practitioner Services October 2005
MA-05-34 Chapter 500, Behavioral Health Rehabilitation Services November 1, 2005
MA-05-35 Chapter 500, Behavioral Health Clinic Services November 1, 2005
MA-05-36 Chapter 500, Hospital Services November 1, 2005
MA-05-37 Chapter 500, Freestanding Ambulatory Surgical Center and Birthing Center Services November 1, 2005
MA-05-38 Chapter 500, Podiatry Services November 1, 2005
MA-05-39 Chapter 500, Practitioner Services November 1, 2005
MA-05-40 Chapter 600, Reimbursement Methodologies January 1, 2005
MA-05-41 Chapter 500, Targeted Case Management Services January 1, 2006
MA-05-42 Chapter 500, Nursing Facility Services January 1. 2006
MA-05-43 Chapter 600, Reimbursement Methodologies January 1, 2006
Year 2004
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Memorandum 2004 Billing Schedule Upon Receipt
MA-04-01 Replacement Codes for Diabetes Disease State Management Program Upon Receipt
MA-04-02

Dual Eligibility for the Home and Community Based MR/DD and Aged/Disabled Waiver Programs

 February 1, 2004
MA-04-03
Revised 		Changes In Billing Instructions For Services Rendered Due To Required HIPAA Compliance - Healthcheck Program (EPSDT) February 1, 2004
MA-04-04 Outpatient Billing - Surgery, Recovery, Observation, Partial Hospitalization and Emergency Department January 1, 2004
MA-04-05 Change in Effective Date for National Codes April 1, 2004
Memorandum Prilosec OTC and Claritin for Nursing Home Residents Upon Receipt
MA-04-07 Procedure Code For Speech Therapy January 1, 2004
MA-04-08 Changes in Billing Instructions for Services Rendered Due to Required HIPAA Compliance - Right From The Start Program January 1, 2004
Memorandum Patient Care Documentation Upon Receipt
MA-04-12 Preferred Drug List - Update April 1, 2004
MA-04-13 DME Code Closure and Activation Upon Receipt
MA-04-14 Admission and Continued Stay Review Upon Receipt
MA-04-15 Provider Participation/Provider Enrollment Requirements Rural Health Clinic (RHC) Federally Qualified Health Center (FQHC) Upon Receipt
MA-04-16 Targeted Case Management Services, Chapter 500 May 1, 2004
MA-04-19 Pharmacy Policy Changes - New Fiscal Agent, Unisys June 18, 2004
Document Alternatives for ASAP-AP Submitters June 15, 2004
Document Nursing Facility Billing Instructions June 10, 2004
MA-04-20 Behavioral Health Clinic Services Manual, Chapter 500 July 1, 2004
MA-04-21 Behavioral Health Rehabilitation Services, Chapter 500 July 1, 2004
MA-04-23 Home Health Services, Chapter 500 July 01, 2004
MA-04-24 Hospice Services, Chapter 500 July 1, 2004
MA-04-25 Dental Services, Chapter 500 July 1, 2004
MA-04-30 Hospital to Hospital Transport June 13, 2004
MA-04-32 Immunizations Administration for Vaccines/Toxoids July 1, 2004
MA-04-33 Hospice in Nursing Home Benefit for Medicaid-Only Residents July 01, 2004
MA-04-34 Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Services Manual, Chapter 500 July 01, 2004
MA-04-35 Transmits Billing Instructions Effective for Services Rendered On and After June 28, 2004 July 01, 2004
MA-04-36 Updates to Chapter 500, Behavioral Health Rehabilitation Services Manual July 01, 2004
MA-04-37 Occupational/Physical Therapy Services Manual, Chapter 500 July 1, 2004
MA-04-38 Pharmacy Services Manual, Chapter 500 June 18, 2004
MA-04-39 Changes in Billing Instructions for Services Rendered Due to Required HIPAA Compliance July 1, 2004
MA-04-40 Vision Services Manual, Chapter 500 July 1, 2004
MA-04-41 Orthotics and Prosthetics Services Manual, Chapter 500 July 1, 2004
MA-04-43 Laboratory and Radiology Services Manual, Chapter 500 July 1, 2004
MA-04-44 Elimination of Transportation Code W1510 July 1, 2004
MA-04-45 Appendix M, Contact List January 1, 2005
MA-04-46 Chapter 100, General Information January 1, 2005
MA-04-47 Chapter 500, ICF/MR Services Manual July 1, 2004
MA-04-48 Chapter 400, Member Eligibility January 1, 2005
MA-04-50 Chapter 300, Provider Participation Requirements January 1, 2005
MA-04-51 Chapter 600, Reimbursement Methodologies January 1, 2005
MA_04-52 Chapter 700, General Administration January 1, 2005
MA-04-53 Chapter 500, MR/DD Waiver Services October 1, 2004
MA-04-54 Preferred Drug List - Update October 1, 2004
MA-04-55 Chapter 500, Podiatry Services July 1, 2004
MA-04-58 Member Date of Birth Edit, Pharmacy Point-of-Sale System Upon receipt
MA-04-59 Chapter 500, Hospital Services November 1, 2004
MA-04-61 Home & Community Based Aged/Disabled Waiver November 1, 2004
MA-04-62 Chapter 500, Nursing Facility Services November 1, 2004
MA-04-63 Chapter 500, MR/DD Waiver Services November 1, 2004
MA-04-64 Bariatric Surgery January 1, 2005
MA-04-65 Preferred Drug List - Update January 3, 2005
MA-04-68 Outpatient Drugs No Longer Covered By Medicaid January 1, 2005
Year 2003
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MA-03-01 2003 Current Procedural Terminology (CPT) Procedure Code Upon Receipt
MA-03-02   HCPCS Dental Procedure Code Changes Upon Receipt
MA-03-03 Hospice Services June 1, 2003
MA-03-04 Respite Care Services April 1, 2003
MA-03-05 National Level II Medicare Codes March 1, 2003
MA-03-07 Change in Eye Care Procedure Codes April 1, 2003
MA-03-08   Coverage of Hyperbaric Oxygen Therapy (HBO) (Supersedes MA-02-21 dated August 1, 2002) Upon Receipt
MA-03-09 MR/DD Waiver Special Projects October 1, 2003
MA-03-10 Preferred Drug List - Phase III March 5, 2003
MA-03-11   Continued Stay Review DRG Exempt Units April 1, 2003
MA-03-12 Home and Community Based Aged/Disabled Waiver Recipients July 1, 2003
MA-03-13   New HCPCS Procedure Codes Upon Receipt
MA-03-15 Preferred Drug List - Phase IV Including Previously Implemented Phases April 9, 2003
MA-03-16 Pre-Admission Screening and Resident Review Level II Evaluations Upon Receipt
Memorandum Quality Assurance Review:  FQHC and RHC Documentation Upon Receipt
MA-03-18 Aged/Disabled Waiver Eligibility Upon Receipt
MA-03-20   Clarification of Bed Reservation Policy Upon Receipt
MA-03-21 Client Transfers from one Agency to Another July 1, 2003
MA-03-23   HIPAA Compliance/Procedure Codes for DME, Orthotics, Prosthetics September 30, 2003
MA-03-24 Change in Quantity Limits of 5HT-1 Receptor Agonists and Discontinuation of Prior Authorization Requirements on Imitrex Injectables Upon Receipt
MA-03-25 Skeletal Muscle Relaxant Prior Authorization Requirement for Recipients over 65 years of age. July 30, 2003
MA-03-26 5 HT-3 Receptor Antagonist Quantity Limits Upon Receipt
MA-03-27 Discontinuation of Step Therapy for the Non-Steroidal Anti-inflammatory Agents Upon Receipt
MA-03-28 Discontinuation of Prior Authorization requirements for Tramadol Upon Receipt
MA-03-30 Clinical and Diagnostic Laboratory Update for the Year 2003 June 5, 2003
MA- 03-31 Preferred Drug List - Update June 15, 2003
MA-03-32 HIPAA Compliance/Procedure Codes for DME, Orthotics, and Prosthetics-Update October 1, 2003
MA-03-34 Positron Emission Tomography (PET) Scans August 1, 2003
MA-03-35 RBRVS Policy and Procedure Update July 1, 2003
MA-03-36 Smoking Cessation  Counseling - Dentists November 1, 2003
MA-03-37 Smoking Cessation Counseling November 1, 2003
MA-03-38 Policy Changes for Orthotic and Prosthetic Services October 1, 2003
MA-03-39 Recipient Co-payment Increase for Pharmacy Services November 17, 2003
MA-03-42 Third Party Liability for Pharmacy Claims - Hospice Upon Receipt
MA-03-43 New HCPCS Codes for Wheelchairs - Tilt-In-Space-
Revised October 1, 2003		 Upon Receipt
MA-03-44 HIPAA Compliance/Procedure Codes For DME, Orthotics and Prosthetics - Update October 1, 2003
MA-03-40 Preferred Drug List Upon Receipt
MA-03-48 Payer Sheet/Record Layout for HIPAA Compliant Pharmacy Point-of Sale (POS) Processing System October 8, 2003
MA-03-50 Medical Supplies - Update November 1, 2003
MA-03-51 Medicaid Claims Payment and HIPAA Compliance Issues Update October 15, 2003
MA-03-54 National Procedure Codes for MR/DD Waiver Services February 1, 2004
MA-03-55 Discontinuation of Prior Authorization Policy for the Generic Form of the H2RA Class of Medications Upon Receipt
MA-03-56 Prior Authorization Criteria for COX-II Inhibitors Upon Receipt
MA-03-57 Prior Authorization Criteria for Brand Name Drugs having Available Generic Equivalents Upon Receipt
MA-03-60 Procedural Changes for Requesting Medical Necessity Determination in the Aged/Disabled Waiver Program November 1, 2003
MA-03-61 National Procedure Codes for Behavioral Health Services February 1, 2004
MA-03-63 Reasonable Limits on Amounts for Necessary Medical or Remedial Care Not Covered Under Medicaid Upon Receipt
MA-03-64 West Virginia Medicaid Program Coverage for Bariatric Surgery Procedures January 1, 2004
MA-03-65 Eligibility Guide for Children with Disabilities Community Services Program Upon Receipt
MA-03-73 Preferred Drug List - Update January 2, 2004
MA-03-74 Medicaid Program Coverage Influenza Virus Vaccine Upon Receipt

 

Year 2002
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MA-02-01 Mandatory Electronic Funds Transfer July 1, 2002
Letter w/Enclosure Follow-up to MA-02-01, Transmitting Revised Form July 1, 2002
MA-02-05 Current Procedural Terminology (CPT) Procedure Codes October 1, 2003
MA-02-06 Patient Days in Residential Settings and Crisis Support in Level IV Shelters February 1, 2002
MA-02-07 Pharmacy Enrollment Requirements Upon Receipt
Memorandum Reimbursement Methodology for Influenza Vaccine not provided by the VFC (Vaccine for Children) Program Upon Receipt
MA-02-08 Clinical and Diagnostic Laboratory Update for the Year 2002 February 1, 2002
MA-02-09 Change in Procedure Codes for Psychological Services October 1, 2002
MA-02-10 Nurse Aide Abuse Registry Check for Hospice Direct Care Staff Upon Receipt
MA-02-12 Clarification of the Certain Issues Discussed in January 2002 Aged/Disabled Waiver Training Effective February 1, 2002 February 1, 2002
MA-02-13 Hearing Aid Services and Supplies July 1, 2002
MA-02-14 Clarification of Credentialing for Providers of Orthotics/Prosthetics and Fitters Upon Receipt
MA-02-15 Clarification of Medicaid Coverage for Hospital Beds Upon Receipt
MA-02-16 Prior Authorization Criteria for linezolid (Zyvox®) Upon Receipt
MA-02-17 Prior Authorization Criteria for the Oral Antifungal Agents and for Penlac® Upon Receipt
MA-02-19 Cost Avoidance of Medicare Covered Drugs September 15, 2002
MA-02-20 Community Focused Treatment - W0363 April 15, 2002
MA-02-21 Coverage of Hyperbaric Oxygen Therapy (HBO) Upon Receipt
MA-02-22 Billing of Diabetic Supplies by Pharmacy Providers July 1, 2002
MA-02-23 Clarification of the Policy for Prior Authorization of Drugs in the Outpatient Pharmacy Program Upon Receipt
Memorandum Public Employees Insurance Agency's (PEIA) and Bureau for Medical Services' (BMS) Roll in Disaster Relief Recovery Efforts in Mingo, McDowell, Mercer and Wyoming Counties Upon Receipt
MA-02-25 Change in Process for Recipients to Initiate Financial Eligibility Determination for Aged/Disabled Waiver Upon Receipt
MA-02-27 Medicaid Coverage Issues Upon Receipt
MA-02-28 Criteria for Enrollment in West Virginia Medicaid Program as a Durable Medical Equipment Supplier, Medical Supplier, Orthotic, Prosthetic Provider and Pharmacy August 1, 2002
MA-02-29 Medicaid Ambulance Service Coverage and Reimbursement July 1, 2002
Memorandum Section U of MDS Upon Receipt
MA-02-31 HCPCS Codes - Medical Supplies, Enteral and Parenteral Therapy Durable Medical Equipment and Prosthetics August 31, 2002 & September 2, 2002
MA-02-34 Prior Authorization Criteria for the Non-Sedating Antihistamines July 1, 2002
MA-02-35 Voluntary Reduction in Bed Size of Medicaid Certified Nursing Facilities Upon Receipt
MA-02-36 Prior Authorization Criteria for Oral Ribavirin (Rebetol) July 1, 2002
MA-02-37 West Virginia Medicaid Program Coverage and Reimbursement for Partial Hospitalization Services October 1, 2002
MA-02-39 Changes in Prescription Limits Upon Receipt
MA-02-40 Assertive Community Treatment (ACT) - W0366 August 1, 2002
MA-02-41 Policy Change regarding Aged/Disabled Waiver Manual, Revised October 1, 2001 Chapter 300 - Section 320.2 Upon Receipt
MA-02-42 Rational Drug Therapy Program (RDTP) July 1, 2002
MA-02-43 Medicare/Medicaid Ambulance Services Reimbursement Upon Receipt
MA-02-44 Annual Physicals September 1, 2002
MA-02-45 RBRVS Policy and Procedures Update July 15, 2002
MA-02-46 HCPCS Codes - Medical Supplies, Enternal and Parenteral Therapy, Durable Medical Equipment, Prosthetics and Orthotics - Revised Upon Receipt
MA-02-48 Quantity Limits of 5HT-1 Receptor Agonists October 15, 2002
MA-02-49 Use of Medical Certification Codes in the Pharmacy Point-of-Sale System Upon Receipt
MA-02-50 Provider Payment Policy September 15, 2002
MA-02-53 Medicaid Reimbursement for Clinical Laboratory Services October 1, 2002
MA-02-54 Sterilization / Hysterectomy Forms October 1, 2002
MA-02-55 Requirements for County Offices for Aged/Disabled Waiver Recipients and Personal Care Providers February 1, 2003
MA-02-56 Conversion Factor For Anesthesia Services October 1, 2002
MA-02-57 MR/DD Waiver Eligibility Upon Receipt
MA-02-58 Billing for Drugs with Decimal Units November 1, 2002
MA-02-60 West Virginia EPSDT Healthcheck Program Provider Manual Revisions Upon Receipt
MA-02-62 Medicaid Ambulatory Surgery Center Procedure Fee Update January 1, 2003
MA-02-64 Dental Services Upon Receipt
MA-02-65 Changes in the Aged/Disabled Waiver Program Case Management February 1, 2003
MA-02-66 Medicaid Preferred Drug List - Phase 1 January 7, 2003
MA-02-68 Changes in the Aged/Disabled Waiver Program Community Activities February 1, 2003
MA-02-69 Changes in the Aged/Disabled Waiver Program Informal Support February 1, 2003
MA-02-70 Changes in the Aged/Disabled Waiver Program Chore Services December 31, 2002
MA-02-71 Change in Obstetrical (OB) Conversion Factor December 1, 2002
MA-02-73 AIDS Drug Assistance Program (ADAP, Ryan White)/Special Pharmacy Program for HIV/AIDS Patients January 1, 2003
MA-02-74 Client Transfers from One Agency to Another February1, 2003
MA-02-77 Medicaid Preferred Drug List - Phase II January 2, 2002

 

Year 2001
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MA-01-01 Self Administered Drugs Upon Receipt
MA-01-02 Revision to Chapter 600 of the West Virginia Medicaid Program Regulations for Transportation Services Upon Receipt
MA-01-03 Elimination of Rehabilitation Service Coded February 1, 2001
MA-01-04 Revised Chapters 300 and 500, Targeted Case Management for Mental Illness, Developmental Disabilities and Substance Abuse February 1, 2002
MA-01-05 School Based Health Services Expansion; Claims Submission Upon Receipt
MA-01-06 West Virginia Medicaid Program Coverage and Reimbursement for Physician
Assistant (PA) Services		 Upon Receipt
Memorandum Travel/Transportation Mileage Reimbursement Rate Change January 1, 2001
MA-01-07 Internal and External Authorization for Crisis Stabilization Services May 1, 2001
MA-01-08 Procedure Codes for Psychiatric Services April 1, 2001
MA-01-09 Change in Service Limits for Diabetic Supplies and Clarification of Current Policy for Diabetic Supplies April 1, 2001
MA-01-10 Reimbursement Rates for Transportation Services Upon Receipt
MA-01-11 Changes in Rules and Regulations for Multi-Passenger Van and Specialized Multi-Patient Medical Transport Services Upon Receipt
MA-01-12 Implementation WVPCA-WVDHHR Education and Enrollment Initiative March 15, 2001
MA-01-14 Continuous Positive Airway Pressure System (CPAP) BIPAP Coverage Policy August 1, 2001
MA-01-16 Criteria for Coverage of Oxycodone Sustained Release (Oxycontin© or others) April 16, 2001
MA-01-17 Therapeutic Shoes for Diabetics October 1, 2001
MA-01-20 Augmentative Communication Devices November 1, 2001
MA-01-21 (Revised) Medical Necessity Review and Payment Authorization for Private Duty Nursing (W1990) Upon Receipt
MA-01-23 Disease State Management (DSM) for Diabetes July 1, 2001
MA-01-24 Attendance at Delivery (99436) July 1, 2001
MA-01-25 Coverage Guidelines for Hospital Beds by the West Virginia Medicaid Program Upon Receipt
MA-01-26 ASO Utilization Management Guidelines; Changes in Chapter 500 Behavioral Health Rehab and Clinic Services Manual May 1, 2001
MA-01-27 Change in Requirements for Physician's Order to Authorize or Continue Crisis Support (W0311) Upon Receipt
MA-01-28 Chapter 500, Section 530, items 530.1 and 530.2/Nursing Assessment Updating the Personal Care Standards to include Vital Signs Upon Receipt
MA-01-29 Annual Recertification of Individuals Residing in ICF/MR Facilities Upon Receipt
MA-01-30 Pharmacy Usage of Dispensed As Written (DAW) Codes A Quality Assurance Special Project Upon Receipt
DSH-2002 SFY 2002 Disproportionate Share Hospital Survey Forms
MA-01-32 Medicaid Program Coverage for the Drug RU-486 for Pregnancy Termination November 16, 2001
MA-01-33 Clinical and Diagnostic Laboratory Update for the Year 2001 July 1, 2001
MA-01-34 Implementation of Utilization Management Contract July 1, 2001
MA-01-35 New MR/DD Waiver Operations Manual July 1, 2001
MA-01-36 Registered Nurse First Assistant July 15, 2001
MA-01-37 RHC and FQHC Reimbursement for Family Planning and EPSDT HealthCheck Services July 1, 2001
MA-01-38 Change in Billing Code for RHO(D) Immune Globulin July 1, 2001
MA-01-39 West Virginia Medicaid Program Coverage and Reimbursement for Partial Hospitalization Outpatient Services August 1, 2001
MA-01-41 ICAP Policy and Procedures August 1, 2001
MA-01-42 Resource Based Relative Value Scale (RBRVS) Payment System – 2001 Update November 1, 2001
MA-01-43 2001 HCPCS Procedure Codes for Negative Pressure Wounds Therapy August 1, 2001
MA-01-45 Duplicate Submissions of PAS-2000 for Aged/Disabled Waiver Recipients Upon Receipt
MA-01-46 Clarification of Third Party Liability for Pharmacy Claims August 15, 2001
MA-01-47 Clarification of Changes in Rules and Regulations for Multi-Passenger Van and Specialized Multi-Patient Medical Transport Services Upon Receipt
MA-01-48 Reimbursement Methodology for MR/DD Waiver Special Project Homes October 1, 2001
MA-01-49 In-Patient Psychiatric Facility for Under 21 and Psychiatric Residential Treatment Facility Attestation of Facility Compliance With Use of Restraints and Seclusion Upon Receipt
MA-01-50 Reimbursement for Insulin Pumps August 1, 2001
MA-01-51 Casting and Splint Supplies November 1, 2001
MA-01-52 Personal Care Updates on RN Code W0306 Upon Receipt
MA-01-53 Definition of Admission Upon Receipt
RBRVS Provider Reimbursement Changes October 1, 2001
MA-01-57 Changes in Criteria for Coverage of Tramadol (Ultram) and Tramadol/Acetaminophen (Ultracet) Upon Receipt
MA-01-60 Policy Changes and Rate Increases: Aged and Disabled Waiver Program and Personal Care Services Rate Change 11/01/01 Policy Change 12/01/01
MA-01-64 Coverage of Insulin Pens and Cartridges Upon Receipt
MA-01-65 Dispensed As Written (DAW) Codes Upon Receipt
MA-01-68 Medicaid Procedure Fee Update January 1, 2002
MA-01-69 Leave Day Policy January 1, 2002
MA-01-70 Addendum to MA-01-60 Regarding Aged/Disabled Waiver Policy with the Addition Of Two New Procedure Codes February 1, 2002
MA-01-71 AIDS Drug Assistance Program (ADAP, Ryan White)/Special Pharmacy Program for HIV/AIDS Patients Upon Receipt

 

Year 2000
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MA-00-02 Changes in Personal Care Services and Manual Immediately
MA-00-03 Electronic Submission of Medicare Crossover Claims and Third Party Liability Claims Immediately
MA-00-04 Billing of Diabetic Supplies February 1, 2000
MA-00-05 Reimbursement Rates Dialysis Facility Services Immediately
MA-00-06 Use of Miscellaneous or Unlisted Procedure Codes in Billing for Hospital Outpatient Services Immediately
MA-00-07 Hospital Outpatient Services Immediately
MA-00-09 Medical Necessity Review and Payment Authorization Durable Medical Equipment and DME Supplies and Orthotic and Prosthetic Services Immediately
MA-00-10 RBRVS 2000 Policy and Procedures Manual Update April 1, 2000
MA-00-12 Prior Authorization Request Form and a Change in Service Limits for Physical Therapy and Occupational Therapy Services October 1, 2000
MA-00-13 Changes in Dental Services April 1, 2000
MA-00-14 Medicaid Reimbursement for Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Physician Services Provided Outside the Clinic Setting April 21, 2000
MA-00-15 Reimbursement to Transplant Centers for Organ Procurement Costs Immediately
MA-00-16 Sterilization (Male or Female) and Hysterectomy Services June 1, 2000
MA-00-17 Electronic Submission of Medicare Crossover Claims and Third Party Liability Immediately
MA-00-20 Pharmacy Usate of Override Code 8 A Quality Assurance Special Project May 1, 2000
MA-00-21 Transportation and Set-Up of Portable X-Ray Equipment June 1, 2000
MA-00-22 Revised Estate Recovery Regulations July 1, 2000
MA-00-23 Hospice Care for Medicare/Medicaid Eligible Nursing Home Residents June 1, 2000
MA-00-24 Medicaid Drug Federal Upper Limit (FUL) June 1, 2000
MA-00-25 Rebate Requirement for Over-the-Counter Drugs June 15, 2000
MA-00-27 Pharmacy Reimbursement for Multi-Source Drugs Immediately
MA-00-28 AIDS Drug Assistance Program (ADAP, Ryan White)/Special Pharmacy Program for HIV/AIDS Patients July 1, 2000
MA-00-29 Tobacco Cessation Program Immediately
MA-00-30 Personal Needs Allowance for Medicaid Beneficiaries of Nursing Homes and ICFs/MR July 1, 2000
SFY 2001 DSH State Fiscal Year 2001 Disproportionate Share Hospital Survey Forms Immediately
MA-00-31 Medicaid Coverage of Substance Abuse/Chemical Dependency Partial Hospitalization Services August 1, 2000
MA-00-32 Home Health Medical Necessity Criteria August 15, 2000
MA-00-34 Pilot Project Disease State Management for Diabetics October 1, 2000
MA-00-35 Physician Assured Access System (PAAS) Program Referral Process October 1, 2000
MA-00-36 Multi-Passenger Van Transportation Services Immediately
MA-00-37 Evaluation and Management Procedure Code 99211 October 1, 2000
MA-00-38 Medical Necessity Review and Payment Authorization for Private Duty Nursing (W1990) January 1, 2001
Memorandum Follow-up to Program Instruction MA-00-38: Medical Necessity Review and Payment Authorization for Private Duty Nursing (W1990) February 1, 2001
MA-00-39 Medicaid Reimbursement for Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Physician Services Provided Outside the Clinic Setting Immediately
MA-00-40 Clarification of Federal Requirements Regarding Sterilizations Upon Receipt
MA-00-41 Clinical and Diagnostic Laboratory Update for the Year 2000 September 1, 2000
MA-00-42 Personal Care Policies Discharge Policy, Clarification of PAS-2000 and Billing of Procedure Code W0306 Upon Receipt
MA-00-43 Medicaid Reimbursement For The New Pneumococcal Vaccine PREVNAR September 15, 2000
MA-00-44 Outpatient Hospital and Physician Emergency Services Reimbursement September 14, 2000
MA-00-45 Third Party Liability for Pharmacy Claims November 1, 2000
MA-00-46 West Virginia Medicaid Program Coverage and Reimbursement for Physician Assistant (PA) Services Upon Receipt
MA-00-47 Dental Practitioner Participation in Medicaid Covered Tobacco Cessation Program Upon Receipt
MA-00-48 Medicaid-Eligible Individuals Who Have Reached Their 21st Birthday Upon Receipt
MA-00-50 MR/DD Waiver Rate Changes November 1, 2000
Memorandum Quality Assurance Review of Waiver Supported Employment Services Upon Receipt
MA-00-51 Coverage of Palivizumab (Synagis) Upon Receipt
MA-00-52 Payor Sheet / Record Layout for Pharmacy Point-of-Sale (POS) Processing System November 15, 2000
MA-00-53 Medicaid Reimbursement Rates for Ground Ambulance Services November 1, 2000
MA-00-54 State Plan Change Related to Aged/Disabled Waiver Case Management Upon Receipt
MA-00-55 Changes in Aged /Disabled Waiver Manual Upon Receipt
MA-00-56 Change in Pricing Methodology for Prescription Drugs January 1, 2001
MA-00-57 Medicaid Program Reimbursement Rates - Dental Services January 1, 2001
MA-00-60 Personal Care Manual - Definition of Extenuationg Environmental Circumstances Upon Receipt
MA-00-61 Provider Remittance Distribution January 1, 2001
MA-00-62 2001 Current Procedural Terminology (CPT) Procedure Codes January 1, 2001
MA-00-64 Nursing Home Cost Report Changes Upon Receipt
MA-00-65 Criteria for Coverage of Neuraminidase Inhibitors January 4, 2001
MA-00-66 Changes in Personal Care Standards and Forms in the Personal Care Manual Upon Receipt

 

Year 1999
top of page
MA-99-01 Documentation of Patient Records Immediately
MA-99-02 Clarification of Policy Regarding the Prior Authorization Process April 1, 1999
MA-99-03 Prospective Payment System (PPS) Annual Update January 1, 1999
MA-99-04 Equitable Distribution of A/D Waiver Slots April 1, 1999
MA-99-05 Clarification New Directions Functional Assessment Data Submission Time Frames Immediately
Memorandum Medicaid Eligible Hospital/Patient Cost Sharing Issue Immediately
MA-99-07 Changing Effective Date of Program Instruction MA-99-04 and the A/D Waiver Program Manual Immediately
MA-99-08 Provider Re-Enrollment Immediately
MA-99-09 Procedure Codes W2005 and D9230 May 1, 1999
MA-99-11 Observation Services Upon Receipt
MA-99-13 Review of PAS-95 for A/D Waiver Waiting List April 1, 1999
MA-99-15 Revised Chapters 500 of the Behavioral Health    Clinic and Behavioral Health Rehabilitation Manuals May 1, 1999
MA-99-17 Payment Options for Critical Access Hospitals Immediately
MA-99-18 Criteria for Coverage of COX-2 Inhibitor (NSAIDs) Immediately
MA-99-19 Criteria for Coverage of Ultram (Tramadol) Immediately
MA-99-20 Vaccines June 1, 1999
MA-99-21 Habilitation Provider   Immediately
Workbook Case-Mix Classification Workbook May 4, 1999
MA-99-22 Long Term Care Electronic Claims May 4, 1999
MA-99-23 Reimbursement for Professional Component of Radiology November 1, 1999
Q&A MA-99-25 Q&A from Transportation Seminar Immediately
MA-99-25 Revised Medicaid Transportation Regulations June 1, 1999
MA-99-27 Policy Clarification on Discrete Trail Training Immediately
MA-99-28 Other State Required Minimum Data Set Assessment July 1, 1999
MA-99-29 Single Visit Code for Home Health Skilled Nurse Service July 1, 1999
MA-99-34 Travel Transportation Mileage Reimbursement Rate Change Immediately
MA-99-37 Special Pharmacy Program for HIV/AIDS Patients Immediately
MA-99-38 1999 RBRVS View Manual September 1, 1999
MA-99-41 Pancreas Transplantations Immediately
MA-99-44 PAS 2000 November 1, 1999
MA-99-46 Updating of CPT Codes used by Psychiatrists October 28, 1999
MA-99-48 Revision of Hospice Rates December 1, 1999
MA-99-49 Reimbursement for Outpatient Newborn Hearing Screening Immediately
MA-99-50 Nationwide Medicare B Crossover Claims Immediately
MA-99-51 Billing for ALS Transportation February 2, 2000
MA-99-52 2000 Current Procedural Terminology (CPT) January 1, 2000

 

Year 1998
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MA-98-53 Medicare Part A October 30, 1998
MA-98-56 Medicare Part B October 19, 1998
MA-98-63 Revised Pages Behavioral Health Clinic & Rehabilitation Services Provider Manuals November 1, 1998
MA-98-64 DRG Validation Review November 9, 1998
MA-98-65 WVMI Validation Review of Approved PAS Applications Immediately
MA-98-66 Delay of Implementation of Behavioral Health Clinic & Rehabilitation Manual Revision November 1, 1998
MA-98-67 Nursing Facility Medicare Part A November 1, 1998
MA-98-69 1999 CPT Procedure Codes November 1, 1998
MA-98-71 ICAP Administration & Data Submission February 15, 1999