NOTICES
GOVERNOR'S OFFICE
Catalog of Nonregulatory Documents
[26 Pa.B. 3692] __________
Pursuant to Governor Ridge's Executive Order 1996-1, agencies under the jurisdiction of the Governor must catalog and publish all nonregulatory documents such as policy statements, guidance manuals, decisions, rules and other written materials that provide compliance related information. The following compilation is the first list of the Administration's nonregulatory documents. This list will be updated and published annually on the first Saturday in August.
This catalog is being provided to insure that the public has complete access to the information necessary to understand and comply with State regulations. Facilitating access to information is a critical component of the Ridge Administration's initiative to enhance to the partnership between the regulated community and the State.
AGING
DECISIONS:
Office of Chief Counsel
* Reynolds vs. Department of Aging, (570A.2d 1373 (PA Commw. 1990)).
Contact: Jacqueline Welby, Assistant Counsel (717)-783-2529
INTERNAL GUIDELINES: * Pharmaceutical Program (PACE)
Contact: Gretchen Beard, Chief of Compliance Division (717)-787-7313
PACE Provider Bulletins: 1996 * 1/08/96: Prilosec and Prevacid: Notified Providers these drugs would be edited for maximum duration for all claims dispensed on or after January 8, 1996.
* 1/26/96: Non-Participating Manufacturer List.
* 5/24/96: Biaxin Filmtabs (NDC: 00074248660): Notified providers of an error on the formulary file from 1/22/96 to 3/21/96.
* 5/24/96: Solopak Pharmaceuticals: Notified providers that Labeler Codes 39769 and 59747 would be participating in the PACE Program.
* 7/12/96: PACE Cardholders with PEBTF Prescription Coverage: Notified Providers that PACE Cardholders with drug coverage through the Commonwealth's Retired Employees Health Plan had been notified they were being canceled from the PACE Program.
PACE Provider Bulletins: 1995 * 1/6/95: Drug Utilization Review Program: Addition of new criteria for antidepressants, antipsychotics and benzodiazepines.
* 2/17/95: Antidepressants, Antipsychotics and Benezodiazepines: Reminder to Pharmacy to carefully review both the reject codes and accompanying messages.
* 2/24/95: Toradol: Reimbursement restrictions.
* 2/24/95: Minitran: 30-day supply limit.
* 3/95: PACE Drug Utilization Review Criteria.
* 3/3/95: Medicare Update: Extended coverage for prescription drugs used in immunosuppressive therapy to three years following hospital discharge for an organ transplant.
* 3/3/95: Maximum Initial Dose for selected antipsychotic, antidepressant or benezodiazepine agents.
* 3/27/95: Non-Sedating Antihistamines and Oral Antifungals Coadministration is Contraindicated. PACE will reject claims for Seldane, Seldane-D, Hismanal, Claritin, Claritin-D, Diflucan, Nizoral and Sporanox.
* 3/95: Third Party Billing Reminder: PACE is payer of last resort, pharmacy must bill other third parties first.
* 5/5/95: Brand Patent Expirations/Generic Substitutions.
* 7/95: CellCept Billing Instructions.
* 7/1/95: Claims Submissions: 90-day limit to file claims for reimbursement.
* 8/1/95: Injectable Chemotherapeutics: Effective 9/1/95 PACE Reimbursement for list of injectable chemotherapeutics limited to 20% of AWP.
* 8/18/95: Non-Participating Manufacturer List.
* 8/18/95: Drug Utilization Review Program: New maximum dose criteria added to the PACE ProDur Program effective 8/28/95 - Nefazodone (Serzone) 600 mg/day; Fluvoxamine (Luvox) 50 mg/day (initial) and 300 mg/day (maximum); Lansoprazole (Prevacid) 30 mg/day.
* 9/1/95: Common Package Size Reimbursement Listing.
* 9/1/95: Epoetin Alfa (EPO) Injections: Effective 9/11/95 PACE reimbursing only 20% of AWP for Epogen and Procrit.
* 9/6/95: Early Refill Edit: Additional classes added to the Early Refill Edit.
* 9/22/95: Drug Utilization Review Program: Effective 9/25/95 duplicate therapy edit applied to the following class of drugs: Proton Pump Inhibitors - Prilosec and Prevacid.
* 10/95: PACE POCAS Telecommunications Number: New direct number available to pharmacy providers for Primary Claim Submission: 950-5545.
PACE Provider Bulletins: 1994 * 2/8/94: Reimbursement Criteria for Temazepam (effective 3/1/94).
* 5/23/94: Glyburide: Mandatory Substitution of Micronase and Diabeta.
* 5/94: Prograf Billing Instructions
* 5/94: Ophthalmics: Days Supply Provisions
* 5/94: Betaseron Billing Instructions
* 7/1/94: Ophthalmics: Noted billing discrepancies regarding pharmacies reporting of the days supply.
* 7/23/94: Narrow Therapeutic Index Exemption Listing (Revised)
* 8/94: Incorrect Physician License Numbers: Notice to Pharmacy Providers of Procedures to Disallow Claims Submitted with Wrong Prescriber I.D.
* 8/19/94: Physician/Medical Assistants: PACE Reimbursement of Prescriptions Written by Physician Assistants.
* 9/23/94: Serevent: PACE will no longer reimburse for more than 13 gm of Serevent per prescription.
* 9/26/94: Febatol - No PACE Reimbursement after 12/26/94.
* 9/30/94: Manufacturers' Rebate Update
* 10/3/94: DAW/Product Selection Code (Revised)
* 10/21/94: Oral Contraceptives: Effective 10/30/94 PACE no longer reimburses except through the Medical Exception process.
* 10/21/94: New Maximum Dose Criteria Added to the PACE ProDUR Program: Maximum daily dose and duplicate therapy criteria for NSAIDs (Trilisate; Disalcid; and Cataflam) and maximum daily dose criteria for miscellaneous anti-ulcer preparations (Propulsid and Reglan).
* 11/18/94: Oral Chemotherapeutics: Effective 12/15/94 PACE reimburses only 20% of AWP for Cyclophosphamide 25 mg/oral; Cytoxan 50 mg/oral; Etoposide/Vepesid 50 mg/oral; and Melphalan/Alkeran 2 mg/oral.
* 12/2/94: 30-Day Supply Requirement: Humulin and Solganal.
PACE Provider Bulletins: 1993 * 1/1/93: PACE Legislative Changes Effective 1/1/93
- Dispense as Written (DAW) Codes
- Mandatory Generic Substitution when an ''A'' rated generic therapeutically equivalent drug is available.
- Pricing Information
- Consultation Fee Discontinued* 2/28/93: Deadline for PACE Provider Reenrollment and Conversion to 3.2 NCPDP
Telecommunications Standard for PACE.
Telecommunications Standard for Claims Submission.* 3/1/93: Standard Error Codes
* 3/1/93: Early Refill Edit
* 3/1/93: Halcion Error Code Revisions
* 3/1/93: Processing Requirements: Conversion to NCPDP Version 3.2
* 3/19/93: POCAS System Maintenance on 4/10/93 and 4/11/93.
* 5/14/93: Delay in Provider Reimbursement
* 5/21/93: Change in the ProDUR screening criteria for H2 Receptor Antagonists effective 6/1/93.
* 6/28/93: Implementation of PACE ProDUR Changes:
- Maximum daily dose for NSAIDs
- Maximum daily dose for Omeprazole, Sucralfate and Misoprostrol.
- Maximum daily dosage allowed for Famotidine (Pepcid) changed from 80 mg/day to 40 mg/day.* 6/28/93: Claims Processing Procedures When POCAS Is Not Available.
* 7/1/93: Non-Participating Manufacturers List
* 7/23/93: 30-Day Supply Requirements
* 7/23/93: Narrow Therapeutic Index Exemption Listing (Revised)
* 9/28/93: Manufacturers Rebate Update (Non-Participating Manufacturer List, effective 10/5/93 was attached.)
PACE Provider Bulletins: 1992 * 4/92: Provider Training Seminars (5/11/92 through 7/2/92)
* 5/29/92: Manufacturers' Rebate News: Center Laboratories
* 6/19/92: Manufacturers' Rebate News: Roxane Laboratories, Inc.
- Astra Pharmaceutical Products
- Ocumed
- IPR Pharmaceutical
- Immunex Corporation* 8/16/92: PACE Rescue Plan: Implementation of ProDUR; NCPDP Version 3.2 and related Program Changes
* 9/92: Dixon-Shane recoupments/pharmacy credits.
* 11/9/92: PACE Pharmacy Provider Manual
* 12/23/92: Narrow Therapeutic Index Exemption Listing
* 12/92: Generic Substitution on Oral Prescriptions (Included Poster and Informational Flyers).
PACE Provider Bulletins: 1991 * 6/21/91: Co-Pay Change ($4 to $6 effective 7/1/91)
* 8/14/91: General Program Issues:
- Claims Payment
- Cardholder Eligibility Changes (Income Eligibility Changed to $13,000 for Single and $16,200 for Married Couples)
- Nursing Home Providers
- Cosmetic Drugs (Effective 10/1/91 claims for Rogaine and Retin-A no longer paid)
- Paper Claims (Only claims for Compound Drugs or claims whose Quantity is in Excess of 9999 accepted as paper claims)
- Persantine and Dipyridamole (These two drugs must have an indication on the prescription that it is being used as an adjunct to Coumadin anticoagulants for the prevention of postoperative thromboembolic complications of cardiac valve replacement in order to be allowed payment by (PACE).
- Audit Issues (Telephone Prescriptions and Brand Medically Necessary Requirements).* 8/21/91: Final Instructions Concerning the PACE On-line Claims Adjudication System (POCAS).
* 9/27/91: Billing Instructions
- Cosmetic Drugs
- Exception Claim Processing
- POCAS, post payment review
- Nursing Home ClaimsDivision of Program & Regulatory Coordination
Contact: Robert Hussar, Division Chief (717)-783-8975
Current Aging Program Directives
Provided below is a comprehensive list of current Aging Program Directives and LAMP/OPTIONS Bulletins. Directives which do not appear on the list are no longer in effect. Current directives are as follows:
Program Area 01 - ''AAA Administration''
* 88-01-06 County Human Service Plan for FY 1990-93
* 88-01-07 Personnel Action Plan for Private Non-Profit Area Agencies on Aging (AAA)
* 90-01-01 County Human Service Plan Update for FY 91-93 (supplements APD #88-01-06)
* 90-01-05 Contract Management and Direct Service Provision by AAAs
* 91-01-01 Certification and Disclosure Regarding Lobbying
* 91-01-02 County Human Service Plan Update for FY 92-93 (supplements APD #88-01-06)
* 91-01-05 Area Agency on Aging Involvement in Corporate Eldercare Activities
* 92-01-01 Single Audit Act Audit Requirements
* 92-01-05 FY 1993-96 Three Year Area Plan Requirements
* 92-01-06 Minimum Standards for Governing Boards of Private Non-Profit Area Agencies on Aging
* 93-01-04 Providing AAA Funded Services to Domiciliary Care and Personal Care Home Residents
* 94-01-01 Fiscal Year 1994-1995 Area Plan Update Requirements (supplements APD #92-01-05)
* 94-01-02 Indirect Cost Policy for Department of Aging Contracts
* 94-01-04 Department of Aging Heat Emergency Plan
* 95-01-02 PrimeTime Health Program--Program Requirements and Allocations for FY 1995-1996) rescinds APD #94-01-06)
* 95-01-03 APPRISE Program--Program Requirements and FY 95/96 Allocations (rescinds APD #94-01-05)
* 95-01-05 Emergency Cooling Project
* 95-01-06 1915(c) Medicaid Waiver Under 60 Attendant Care Program (ACP) assessment Protocols
* 95-01-07 Addendum to APD #95-01-06
* 95-01-08 FY 1996-99 Three Year Plan Requirements
* 95-01-09 Assessments of Persons With ''An Other Related Condition'' Who Are Exceptional Admissions
* 96-01-01 Accounting Manual For Area Agency on Aging Programs
* 96-01-02 AAA Program Requirements, Planning Allocations, and Aging Services Block Grant For FY 1996-97
* 96-01-03 AAA Program Income Policies
* 96-01-04 FY 1996-97 Program And Financial Reporting Requirements
Program Area 02 - ''Home Delivered Meals''
See Program Area 03.
Program Area 03 - ''Congregate Meals''
* 90-03-01 Policies and Standards for the Department of Aging Funded Nutrition Service Programs
Program Area 04 - ''Socialization/Recreation/Education/Health Promotion''
* 85-04-03 The Senior Center Grant Program
* 86-04-01 Revisions to the Senior Center Grant Program
* 86-04-02 Senior Center Grant Program Extension
* 96-04-01 Senior Community Center And Satellite Center Policies and Standards
Program Area 05 - ''Employment Services''
* 92-05-01 Title V Agreement, Allocation Schedule and Reporting Requirements for FY 1992-93
* 95-05-01 Title V Agreement, Allocation Schedule and Reporting Requirements for FY 1994-95 (supplements APD #94-05-01)
* 95-05-02 Title V Senior Community Service Employment Program: Final Rule
Program Area 06 - ''Volunteer Services''
* 85-06-01 Volunteer Services
Program Area 07 - ''Passenger Transportation Services''
* 85-07-01 Policies for Transportation Services
Program Area 11 - ''Information and Referral''
* 85-11-01 Policies and Procedures for the Provision of I & R Services by AAAs
Program Area 23 - ''Care Management''
* See OPTIONS-Level II Bulletin #93-01.
Program Area 24 - ''Protective Services Intake/Investigation''
* 88-24-01 Older Adults Protective Services Program Requirements, Funding Provisions, Reporting Requirements and Grant Format
* 89-24-01 Protective Services for Older Adults Regulations
* 89-24-02 Required Standard Forms for Protective Services
* 92-24-01 Change in Report of Need Form (Supplements APD #89-12-02)
* 93-24-01 Protective Services Investigations
* 93-24-02 Protective Services Investigations (supplements APD #93-18-01)
Program Area 13 - ''Personal Care''
* See OPTIONS-Level II Bulletin #93-01.
Program Area 12 - ''Home Health''
* See OPTIONS-Level II Bulletin #93-01.
Program Area 19 - ''Home Support''
* See OPTIONS-Level II Bulletin #93-01.
Program Area 20 - ''Adult Day Care''
* See 6 Pa. Code Chapter 11, Sections 11.1 to 11.292.
Program Area 25 - ''Domiciliary Care''
* 85-25-01 Revised Social Adjustment Assessment Form and Reassessment Form for Domiciliary Care
* 85-25-02 Statewide Expansion of Domiciliary Care Program
* 85-25-03 State Supplement Security Income for Licensed Personal Care Boarding Home Residents
* 90-25-01 Domiciliary Care Services for Adults--Final Rulemaking
* 93-25-01 Keys Amendment Implementation as It Relates to the Domiciliary Care Program
* 95-25-01 Domiciliary Care Consumer Payment to Providers
Program Area 09 - ''Legal Assistance''
* 85-09-01 AAA Program of Legal Services to the Elderly
Program Area 10 - ''Ombudsman''
* 90-10-01 Long Term Care Ombudsman Program (rescinds APD #85-19-01)
* 95-10-01 Pennsylvania Ombudsman Reporting System (rescinds Reporting Section, PFR95-16 of APD #94-01-07)
Program Area 14 - ''Personal Assistance Service''
* 86-14-01 Program Instructions for Attendant Care for the Elderly
Program Area 18 - ''Medical Equipment, Supplies and Adaptive Devices''
* 89-18-01 Durable Medical Equipment, Supplies and Adaptive Devices
Program Area 29 - ''Other''
* 85-29-01 Changes in PSA Boundaries
* 85-29-02 Generic Policies and Procedures for the Request and Consideration of Waivers of PDA Policies
* 85-29-03 Statement of Departmental Policy Regarding the Allocation of Funds to Redesignated AAAs
* 85-29-04 PDA Fair Hearings and Appeals Regulations
* 85-29-06 Interdepartmental Cooperative Agreement between the PDA and DPW, Office of Mental Health
* 85-29-08 New Format for APDs and a List of Currently-Effective APDs
* 86-29-01 PACE Regulations
* 91-29-05 Department of Aging Energy Emergency Plan
* 92-29-03 Final Regulations -Family Caregiver Support Program (replaces Sections I-V of APD 92-22-02)
* 92-29-07 Advance Notice to Health Care Facilities Prior to Termination of Utility Service
* 94-29-01 Fiscal Year 1992-1993 Area Agency on Aging Self Evaluation Report (rescinds APD #92-22-06)
* 94-29-03 Family Caregiver Support Program--Program Requirements and Planning Allocations for FY 1994-95 (rescinds APD #93-22-02)
* 94-29-04 Emergency Operations Plan for the Department of Aging (rescinds APD #92-22-04)
* 95-29-01 Updated List of Currently Aging Program Directives, LAMP/OPTIONS Bulletins, 1994 Aging Information Memoranda and 1994 Technical Assistance Bulletins
* 95-29-02 Area Agency on Aging Annual Self Evaluation Report (rescinds APD #94-22-01)
* 95-29-03 Family Caregiver Support Program--Program Requirements and Planning Allocations for FY 1995-96
CURRENT OPTIONS/LONG TERM CARE ASSESSMENT AND MANAGEMENT PROGRAM (LAMP) Bulletins
* 84-01 Pre-Admission Assessment Bulletin
* 84-02 Transmit Mental Health Bulletin
* 84-03 Funding Ceilings for Services for Level II Clients Diverted from Nursing Homes through LAMP
* 85-01 Level of Care Changes Procedures
* 85-02 LAMP and State Mental Hospital System (supplements LAMP Bulletin #85-05)
* 85-05 LAMP Residency Issues
* 89-01 LAMP Alternative Community Care Services Standards
* 89-03 Pre-Admission Assessment Site Requirements for Level of Care Decisions or Recommendations Regarding Heavy Care/Intermediate Services (replaces LAMP Decision Narrative and Instructions; LAMP Determination Report and Instructions; and Page 3, LAMP Assessment Instruction Manual)
* 89-08 Pre-Admission Assessment and Management Program: 1989-90 Reporting Requirements and Instructions for Provision of Services to Alternative Community Care Clients (revises LAMP Bulletin #84-04)
* 89-10 Interim Operations Manual, Volumes I & II
* 90-02 Pre-Admission Assessment (PAA) Site Requirements for Requesting Payment for PAA Assessment Activities for the July 1, 1990 through June 30, 1991 PAA Contract Period (rescinds LAMP Bulletin #89-05)
* 90-03 LAMP Site Requirements for Requesting Payment for Alternative Community Care Services (rescinds LAMP Bulletin #89-07)
* 90-04 Revised PA Pre-Admission Assessment Form (PPAF) and the Assessment Manual (rescinds PA Long Term Care Assessment and Management Program Assessment Instruction [Rev. 11/88] and PA Long Term Care Assessment and Management Program Assessment Manual [Rev. 1988 & 1989])
* 90-05 Protocol Requirements for Serving Medicaid Nursing Home Applicants and Medical Assistance Recipients with Acquired Immune Deficiency Syndrome (AIDS) or Symptomatic Immune Deficiency Virus (HIV)
* 90-07 Transmit DPW/OMA Memo (8/30/90)
* 90-08 Policy Change in Referral Procedures for Individuals with Mental Retardation/Other Related Condition Diagnosis
* 91-01 Supplement 1 to OPTIONS-Level II Site Requirements for Requesting Payment for
OPTIONS-Level II Assessment Activities for the July 1, 1990 through June 30, 1991
OPTIONS-Level II Contract Period* 91-02 OPTIONS-Level II Program Requirements, Planning Allocations and Budget Format for the Twelve (12) Month Period July 1, 1991 through June 30, 1992 (supplements OPTIONS-Level II Bulletin #90-06)
* 91-04 Definitions of OPTIONS-Level II Assessment Categories
* 91-05 Evaluation of PASARR-ID's
* 92-01 Amendments to the Omnibus Budget Reconciliation Act of 1987 (OBRA)
* 92-02 OPTIONS-Level II Program Requirements, Planning Allocations and Budget Format for the Twelve (12) Month Period July 1, 1992 through June 30, 1993 (supplements OPTIONS-Level II Bulletin #90-06 and #91-02)
* 92-04 Nursing Facility ''Yes'' or ''No'' Determinations
* 92-05 Pseudo MA Case Number
* 93-01 OPTIONS-Level I/Level II Integration (rescinds LAMP Bulletin #90-01, APD #90-10-01, APD #89-13-01, APD #89-14-01 and APD #89-15-01)
Supplement #1, Update to the Level I/Level II Integration Bulletin #93-01
Supplement #2, Office of Mental Health/OPTIONS/Office of Income Maintenance Protocols
Supplement #4, Update to the Level I/Level II Integration Bulletin #93-01
Supplement #5, OPTIONS Site Signature on MA51* 93-02 OPTIONS-Level II Program Requirements, Planning Allocations and Contract Format for the Thirty-Six (36) Month Period July 1, 1993 through June 30, 1996 (rescinds OPTIONS-Level II Bulletin #90-06)
Supplement #1, OPTIONS-Level II Program Requirements, Planning Allocations and Contract Format for the Thirty-Six (36) Month Period July 1, 1993 through June 30, 1996* 94-01 The Revised Pennsylvania P readmission Screening and Annual Resident Review Identification (PA-PASARR-ID) Form (supplements OPTIONS-Level II Bulletin #93-01)
* 94-02 Instructions for the Completion of F orms for OPTIONS Level II Assessment Activity: OPT01 Client Reports, OPT01X Correction to Client History Forms, Administrative Review Reports, Transmittal Form for Tape Invoicing, Definitions for Assessment Categories (replaces OPTIONS-Level II Bulletin #92-03)
* 94-03 OBRA Procedures to be Followed for the Preadmission Screening of Individuals with Mental Illness (Supplements OPTIONS-level II Bulletin #93-01)
* 94-04 OBRA Procedures for Individuals with Mental Retardation (Supplements OPTIONS-level II Bulletin #93-01)
* 94-05 Procedure for Applying for the Personal Care/Domiciliary care Supplement (Supplements OPTIONS-Level II Bulletin #93-01)
* 94-06 OPTIONS-Level II Program Requirements, Planning Allocations and Budget Format for the Twelve (12) Month Period July 1, 1994 through June 30, 1995.
* 95-01 Medical Assistance (MA) Estate Recovery Program (supplements OPTIONS-Level II Bulletin #93-01)
* 95-02 OPTIONS-Level II Program Requirements, Planning Allocations and Budget format for the Twelve (12) Month Period July 1, 1995 through June 30, 1996
* 95-03 Nursing Facilities (NF) Requesting OPTION Sites to Assess NF Residents for Discharge
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