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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 Hos