[39 Pa.B. 4501]
[Saturday, August 1, 2009]
[Continued from previous Web Page]
PUBLIC WELFARE
(Editor's Note: Statements of Policy are in upper and lower case. Notices of Rule Change are in all capitals. Notices of Rule Change adopted more than 180 days before deposit are starred (*).
Office of Income Maintenance--Contact: Edward J. Zogby (717) 787-4081
POLICY STATEMENTS:
Year Code Citation Subject Date Issued Bulletin Number 1983 Ch. 166 Computation of CWEP Hrs. 10/25/83 166-83-57 Ch. 275 Postmark Date as the Receipt Indicator for Appeals and for Requests for Reconsideration 03/15/84 275-84-10 1993 *CH. 166 PROVIDING SUPPORTIVE SERVICES TO PARTICIPANTS IN THE COMMUNITY WORK EXPERIENCE PROGRAM 08/21/93 166-93-01 1995 *CH. 257 MA ESTATE RECOVERY--CHAPTER 178--MEDICAL ASSISTANCE RESOURCES; CHAPTER 257--REIMBURSEMENT 06/01/95 257-95-01 1996 CH. 125 ACT 1995-20 PROVISIONS RELATING TO PERSONS SENTENCED OR CHARGED FOR A FELONY OR MISDEMEANOR 04/05/96 125-96-01 CH. 285 INCREASES IN PAYMENT FOR BURIAL AND/OR CREMATION AND MAXIMUM AMOUNT OF EXCLUDED CONTRIBUTIONS 06/10/00 285-00-01 GUIDANCE MANUALS:
* Cash Assistance Handbook
* Supplemental Nutrition Assistance Program (SNAP) Handbook
* Medical Assistance Eligibility Handbook
* Long Term Care Handbook
* Supplemental Handbook
* Medicaid in Pennsylvania
* Low-Income Home Energy Assistance Program Final State Plan
* Actions for Support
* TANF State Plan
* Homeless Assistance Program-Instructions and Requirements (Note: Revised/Reissued Annually)
* BETP Master Guidelines
* Summary of Pennsylvania's State Food Stamp Employment and Training Program
* TANF Work Verification Plan
* LIHEAP HandbookOffice of Medical Assistance--Contact: Leesa Allen (717) 772-6341
POLICY STATEMENTS:
Year Code Citation Subject Date Issued Bulletin Number 1981 Ch. 1251 Clarification of M.A. Bulletin # 22-80-01 08/19/81 22-81-01 Ch. 1121 Info. Concerning Claims Submitted as Compounded Prescriptions 06/30/82 19-82-02 1984 Ch. 1251 Revisions to MA Chapter 1251 (Funeral Directors' Services) 05/11/84 22-84-01 1984 Ch. 1101 Third Party Resource and Copay 11/01/84 99-84-15 1985 Ch. 1141 Physician Assistant Use 04/22/85 01-85-05 Ch. 1245,
1163Ambulance Transportation 04/22/85 11-85-08 Ch. 1163 Psych. Inpatient Adm of Patients with D/A and Psychiatric Diagnoses 05/31/85 13-85-04 Ch. 1153 Requirements for Treatment Plans & Doc. of Treatment 10/31/85 29-85-02
33-85-02Ch. 1149 Clarification of Treatment Plan Requirements for Orthodontists 02/11/86 03-86-1 Ch. 1163
Ch. 1151Offset of Investment Income 02/21/86 11-86-04
12-86-02
13-86-011986 Ch. 1101.75
(a)(5)Policy Clarification 07/23/86 19-86-06 Ch. 1101 Policy Clarification Re: Provider's Signature 09/19/86 99-86-06 Ch. 1101 Professional License No. 10/13/86 11-86-12
12-86-05Ch. 1101 Preclusion of Convicted Persons, Not Providers, from Participation or Involvement in the MA Program 10/24/86 99-86-09 Ch. 1123 Durable Medical Equipment Warranties 10/28/86 05-86-02
19-86-07Ch. 1101 Records Maintenance and Avail. Requirements 11/05/86 23-86-02 1987 Ch. 1101 Physicians' Response. Home Health Services 01/12/87 01-87-01 Ch. 1223 Single County Authorities 28-87-01
13-87-01Ch. 1149 Palliative Emerg. Treat. 04/24/87 03-87-02
27-87-01Ch. 1223 Nonrecompensable Services
Drug Screens07/29/87 11-87-05
12-87-04
16-87-01
28-87-02Ch. 1101/
Ch. 1123Coverage for Motorized Wheelchairs 07/30/87 05-87-02
01-87-08
19-87-06Ch. 1123 Policy Relating to Apnea Monitors 09/02/87 01-87-15
05-87-04
19-87-09
Ch. 1150 Spec. Enroll. Req. to Bill Tech. Comp. of Ped. Pneumograms 10/07/87 05-87-05
19-87-101988 Ch. 1101 Policy Clarification Regarding Physician License 07/01/88 1101-88-01 1989 Ch. 1101 Policy Reminder Regarding Practitioner License Requirements 09/09/89 1101-89-02 1990 Ch. 1150 Payment Policy for Consultations 04/27/90 1150-90-01 1991 *CH. 1101 EPSDT-OBRA '89 08/02/91 1101-91-01
CH. 1121 1121-91-02 CH. 1123 1123-91-01 CH. 1241 1241-91-01 1992 *CH. 1141 CLOZAPINE SUPPORT SERVICES 01/31/92 1141-92-01 *CH. 1153 1153-92-01 Ch. 1241 Revised EPSDT Immunization Guidelines 12/11/92 1241-92-01 1993 *CH. 1165 PAYMENT FOR MENTAL HEALTH SERVICES PROVIDED IN A RESIDENTIAL TREATMENT FACILITY FOR ELIGIBLE INDIVIDUALS UNDER 21 YEARS OF AGE 01/01/93 1165-93-01 *CH. 1121 CHANGES IN THE MEDICAL ASSISTANCE PHARMACEUTICAL BENEFITS 07/09/93 1121-93-01 *CH. 1149 DENTAL SERVICES FOR ADULTS 07/09/93 1149-93-01 *CH. 1101 BASIC HEALTH CARE FOR ADULT GENERAL ASSISTANCE RECIPIENTS (FELIX ET. AL. V. CASEY ET. AL.)
STIPULATION OF SETTLEMENT07/21/93 1101-93-03 *CH. 1101 UPDATE TO EXCEPTIONS PROCESS AND CRITERIA UNDER THE GENERAL ASSISTANCE BASIC HEALTH CARE PACKAGE 07/21/93 1101-93-04 Ch. 1241 Centers for Disease Control Blood Lead Testing 09/03/93 1241-93-01 Ch. 1101 Business Arrangements Between Nursing Facilities and Pharmacy Providers 10/08/93 1101-93-05 1994 Ch. 1241 Update to Blood Lead Testing Guidelines 04/08/94 1241-94-01 *CH. 1239 M.A. CASE MANAGEMENT SERVICES FOR RECIPIENTS UNDER THE AGE OF 21 05/17/94 1239-94-01 *CH. 1121 PHARMACEUTICAL SERVICES DRUG COVERAGE FOR MEDICALLY NEEDY IN NURSING FACILITIES 06/24/94 1121-94-01 *CH. 1121 PHARMACEUTICAL SERVICES PRIOR AUTHORIZATION REQUIREMENT MULTISOURCE BRAND NAME DRUGS 08/26/94 1121-94-02 *CH. 1121 TREATMENT OF INFERTILITY - 08/30/94 1121-94-03 CH. 1126 DISCONTINUED COVERAGE FOR 1126-94-01 CH. 1129 DRUGS AND RELATED SERVICES 1129-94-01 CH. 1141 1141-94-01 CH. 1163 1163-94-01 CH. 1221 1221-94-01 CH. 1225 1225-94-01 CH. 1242 1242-94-01 *CH. 1101 GENERAL ASSISTANCERESTRUCTURE AS A RESULT OF ACT 49 09/02/94 1101-94-01 1995 CH. 1153 ACCESSING OUTPATIENT WRAPAROUND MENTAL HEALTH SERVICES 09/08/95 1153-95-01 CH. 1157 MENTAL HEALTH SERVICES PROVIDED IN NON-JCAHO 09/08/95 1157-95-01 CH. 1165 UPDATE-JCAHO-ACCREDITED RTF SERVICES 09/08/95 1165-95-01 *CH. 1153 PRIOR AUTHORIZATION OF PARTIAL HOSPITALIZATION 12/30/94 1153-94-01 CH. 1163 PAYMENT POLICY FOR ABORTION SERVICES 12/15/95 1163-95-02 1997 Ch. 1141 Revision to Physician Assistant and Nurse Midwife Supervision Requirement 07/30/97 1141-97-01 1998 Ch. 1187 Nursing Facility Exception Requests-- Statement of Policy 01/10/98 Ch. 1163 Revision of Utilization Guidelines for Inpatient Hospital Drug and Alcohol Services Under the Medical Assistance Program 05/18/98 1163-98-01 Ch. 1101 Regulation Changes Regarding 07/01/98 1101-98-01 Ch. 1141 ''Emergency Medical Condition'' 1141-98-01 Ch. 1150 1150-98-01 Ch. 1221 1221-98-01 Ch. 1141 Clozapine Support Services 12/29/98 33-98-08 Ch. 1153 29-98-08 01-98-19 1999 Ch. 1187 Capital Component Payments for Post-Moratorium Beds 04/17/99 1187-99-01 Ch. 1101 ''Payment in Full'' 09/17/99 99-99-06 2001 Ch. 1101 Clarification of Coverage for 02/16/01 01-01-02 Motorized Wheelchairs and 05-01-01 Other Durable Medical Equipment 17-01-01 19-01-02 49-01-02 50-01-01 1101-01-01 1123-01-01 Ch. 1241 Revision to the Early and Periodic 7/1/01 01-01-10 Screening, Diagnosis and Treatment 10-01-03 (EPSDT) Program 11-01-05 17-01-04 26-01-03 49-01-07 -- Breast and Cervical Cancer Prevention and Treatment Program 12/26/01 99-01-12 2002 Ch. 1223 Drug and Alcohol Clinics with Provisional Licenses 10/26/02 28-02-02 Ch. 1241 Revision to the Early and Periodic 1/22/02 01-02-01 Screening, Diagnosis and Treatment 10-02-01 (EPSDT) Program 11-02-01 17-02-01 26-02-01 49-02-01 -- Breast and Cervical Cancer Prevention and Treatment Program 5/3/02 99-02-06 Ch. 1241 Addition of Procedure Code 90732 11/18/02 01-02-13 to Medical Assistance Fee Schedule 10-02-04 for Administration of Pneumococcal 11-02-06 Vaccine 17-02-07 26-02-04 49-02-06 2003 Ch. 1241 2003 Recommended Childhood 3/31/03 01-03-04 Immunization Schedule 10-03-01 11-03-01 17-03-01 26-03-01 49-03-02 Ch. 1241 Coverage of Pediarix and Addition 5/15/03 01-03-06 of Procedure Code 90723 to 10-03-02 Medical Assistance Fee Schedule for 11-03-02 Administration of Pediarix Vaccine 17-03-03 26-03-02 49-03-03 Ch. 1241 Elimination of the Pennsylvania 9/5/03 01-03-08 Children's Check-up (EPSDT) 10-03-03 Form (MA-517) 11-03-05 17-03-04 26-03-03 49-03-05 Ch. 1223 limination of the Requirement for the Outpatient Drug and Alcohol Clinic's Supervisory Physician to Perform a Comprehensive Medical Examination Within 15 days following the Intake and Before the Provision of Treatment 10/1/03 28-03-02 Ch. 1101 Liability for Cost Sharing for Recipients Enrolled in Medical Assistance through Fee for Service or Managed Care and a Private Third Party Insurer 9/1/03 99-03-12 -- Continuity of Care for Recipients Transferring Between and Among Fee for Service and Managed Care Organizations 9/1/03 99-03-13 2004 Ch. 1223 Methadone Take-Home Services 2/1/04 28-04-01 2005 Ch. 1121 Pen and Ink Change-Medical Assistance Handbook, Prior Authorization of Pharmaceutical Services, Preferred Drug List 12/30/05 02-05-06 Ch. 1121 Preferred Drug List--Phase 3 12/1/05 30-05-06 Ch. 1121 Scope of Coverage of Pharmacy Services for Dual Eligibles in the Medical Assistance (MA) Program 11/17/05 99-05-21 Ch. 1121 Preferred Drug List--Phase 2 11/8/05 02-05-03 Ch. 1241 Revisions to the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Periodicity Schedule 10/25/05 01-05-04 Ch. 1121 Preferred Drug List--Phase 1 10/7/05 02-05-01 Ch. 1121 Prior Authorization of Drugs That Exceed Established Quantity Limits--Phase 2 Enforcement 9/16/05 99-05-17 Ch. 1101 Copayment of Changes for Brand Name and Generic Prescription Drugs 8/26/05 24-05-05 Ch. 1121 Prior Authorization of Drugs That Exceed Established Quantity Limits--Phase 1 Enforcement 8/10/05 99-05-14 Ch. 1153 Psychological/Psychiatric/Clinical Re-Evaluations and Re-Authorization For Behavioral Health Rehabilitation (BHR) Services for Children and Adolescents with Behavioral Health Needs Compounded by Developmental Disorders 6/24/05 07-05-01 2005 Recommended Childhood & Adolescents Immunization Schedule 5/26/05 33-05-01 2006 Implementation of the CMS-1500 Health Insurance Claim Form (Version 08/05) 12/18/06 99-06-16 Ch. 1101 Change to copayment requirements for recipients eligible under the Breast and Cervical Cancer Prevention and Treatment coverage group and Titles IV-B & IV-E Foster Care and Adoption Assistance 12/10/06 99-06-12 Ch. 1101 Clarification of Exclusions from Copayment Requirements 12/10/06 99-06-13 Ch. 1153 Mobile Mental Health Treatment 11/30/06 08-06-18 Ch. 1153 Clarification of Payment Policy for Abortion Services 11/28/06 99-06-15 Ch. 1245 Reimbursement for Non-Emergency Transportation Services 11/17/06 03-06-15 Ch. 1245 Implementation of ACCESS Plus Referral Requirements 10/20/06 99-06-11 Ch. 1101 Revised HealthCare Benefits Packages Provider Reference Chart (MA 446) 10/6/06 99-06-10 Ch. 1163 Medical Assistance Payment for Services of Teaching Physicians in Hospitals, Clinics and Emergency Rooms 9/16/06 1141-06-01 Ch. 1153 Revision to Minimum Staff Qualifications of Therapeutic Staff Support (TSS) Workers 8/24/06 08-06-15 Ch. 1153 Federal Medicaid Citizenship and Identity Eligibility Requirements 7/24/06 99-06-07 Ch. 1121 Preferred Drug List--Quarterly Update 4/24/06 02-06-07 Ch. 1241 2006 Recommended Childhood and Adolescent Immunization Schedule 4/16/06 01-06-03 Ch. 1150 Prudent Payment of Claims 4/3/06 99-06-04 Ch. 1121 Federal Clarification-Elimination of Medicaid Coverage of Drugs for Treatment of Erectile Dysfunction 3/7/06 03-06-03 Ch. 1150 Disenrollment of Dual Eligibles from Physical Health Managed Care 1/27/06 99-06-01 Ch. 1121 Federal Clarification-Elimination of Medicaid Coverage of Drugs for Treatment of Erectile Dysfunction 3/7/06 03-06-03 Ch. 1150 Disenrollment of Dual Eligibles from Physical Health Managed Care 1/27/06 99-06-01 Ch. 1121 Prior Authorization of Drugs that 01/27/06 02-06-03 Exceed Est. Quantity Limits--Phase 03-06-02 3 Enforcement and Additional Drugs 08-06-02 With Quantity Limits 09-06-02 11-06-02 14-06-03 24-06-02 27-06-05 30-06-02 31-06-04 32-06-02 Ch. 1121 Preferred Drug List--Phase 4 1/25/06 02-06-02 Ch. 1163 Place of Service Review Procedures 1/3/06 14-06-01 2007 Ch. 1249 Rescission of the Statement of Policy Clarifying the Conditions Under Which Medical Assistance Recipients May Be Considered Homebound 1249-07-04 Ch. 1150 The Addition of Isentress (raltegravir) to 12/21/07 09-07-16 the Special Pharmaceutical Benefits 21-07-04 Program 24-07-16 31-07-22 Ch. 1150 Medical Assistance Program Fee Schedule: Addition of Telehealth Technology Code and Informational Modifier for Consultations Performed Using Telecommunication Technology 11/30/07 09-07-15 Ch. 1123 MA Program Outpatient Fee Schedule 11/29/07 24-07-11 Revisions for Speech Generating Devices 25-07-05 31-07-18 Ch. 1121 Preferred Drug List--Fall Update-- 11/29/07 02-07-06 Part 2 11-07-07 30-07-07 03-07-09 14-07-06 31-07-20 08-07-15 24-07-14 32-07-07 09-07-14 27-07-09 Ch. 1101 Childhood Nutrition and Weight Management Services for Recipients Under 21 Years of Age 11/1/07 99-07-19 Ch. 1121 Preferred Drug List--Fall 2007 Update 11/01/07 02-07-05 11-07-06 30-07-05 03-07-08 14-07-05 31-07-17 08-07-14 24-07-13 32-07-06 09-07-12 27-07-07 Ch. 1121 Delay in Implementation of the Tamper-Resistant Pad Requirements 10/29/07 99-07-18 Ch. 1121 Special Pharmaceutical Benefits 10/15/07 09-07-10 Program (SPBP) Income Ceiling for 21-07-03 HIV Applicants 24-07-10 31-07-14 Ch. 1121 Tamper Resistant Prescription Pads 9/28/07 99-07-16 Ch. 1123 2007 Power Mobility Device HCPCS Updates; Prior Authorization Requirements 9/19/07 99-07-15 Ch. 1163 Medicare Inpatient Pricing Logic Modification 8/17/07 01-07-08 Ch. 1123 Provider Specialty 220 (Hearing Aid 8/3/07 01-07-07 Dispenser Requirement and Updated 24-07-09 Medical Assistance Program Fee 1-07-12 Schedule for Hearing Aid Supplies 20-07-03 25-07-04 Ch. 11221 Preferred Drug List--May 2007 7/31/07 02-07-04 Technical Correction 11-07-05 30-07-04 03-07-07 14-07-04 31-07-11 08-07-12 24-07-08 32-07-05 09-07-09 27-07-06 Ch. 1149 Discontinuance of the Prior Authorization Requirement for Dental Procedure Codes D7140 and D7210 7/11/07 27-07-04 Ch. 1121 Preferred Drug List--Updates to Prior 7/2/07 02-07-03 Authorization of Pharmaceutical Services 11-07-04 Handbook Pages 30-07-03 14-07-03 31-07-10 08-07-11 24-07-07 32-07-04 09-07-08 27-07-05 Ch. 1123 Special Pharmaceutical Benefits 7/1/07 09-07-05 Program (SPBP) Income Ceiling Increase 21-07-02 for HIV Applicants 24-07-04 31-07-07 Ch. 1101 The Elimination of Paper Vouchers 6/14/07 99-07-10 Ch. 1123 Requirements for Coverage of Enteral 6/1/07 08-07-10 Nutritional Supplements and Issuance of 09-07-07 Enteral Nutritional Supplements MA 24-07-06 Program Outpatient Fee Schedule 25-07-03 31-07-09 Ch. 1121 Preferred Drug List--July 2007 6/1/07 02-07-02 Quarterly Update 03-07-03 08-07-08 09-07-06 11-07-02 14-07-02 24-07-05 27-07-03 30-07-02 31-07-08 32-07-03 Ch. 1101 Co-pay/Deductibles on Exceptional Durable Medical Equipment (DME) 6/1/07 03-07-04 Ch. 1153 Peer Support Services 5/22/07 08-07-09 Ch. 1249 Rescind MA Program Statement of Policy Regarding the Clarification of Conditions Under Which MA Recipients May be Considered Homebound 7/10/07 1249-07-01 Ch. 1150 Medical Assistance Program Fee Schedule Revision; Change to Conversion Factor for Anesthesia Services 5/10/07 31-07-05 Ch. 1121 Preferred Drug List--Quarterly Update 5/1/07 02-07-01 03-07-02 08-07-07 09-07-04 11-07-01 14-07-01 24-07-03 27-07-02 30-07-01 31-07-06 32-07-02 Ch. 1101 Clarification Regarding the Definition of Medically Necessary--Statement of Policy 4/21/07 99-07-04 Ch. 1241 2007 Recommended Childhood and Adolescent Immunization Schedules 3/23/07 01-07-05 Ch. 1123 Provider Specialty 220 (Hearing Aid Dispenser) Requirement 3/1/07 01-07-03 Ch. 1123 Behavioral Health Fee For Service (BH-FFS) Transfer from Office of Medical Assistance Programs (OMAP) To Office of Mental Health and Substance Abuse Services (OMHSAS) 1/31/07 OMHSAS-06-07 Ch. 1150 Policy Reinforcement Regarding Billing For Tobacco Cessation Counseling Services 1/4/07 99-07-02 2008 Ch. 1121 Preferred Drug List--Fall 2007 Update 1/11/08 02-07-08 Part 2 Technical Correction 03-07-11 08-07-17 09-07-17 11-07-08 14-07-07 24-07-17 27-07-10 30-07-08 31-07-23 32-07-08 Ch. 1149 Implementation of ADA Claim Form-- Version 2006 and Elimination of Dental Prior Authorization Forms 1/11/08 17-08-01 Ch. 1163 Preventable Serious Adverse Events 1/14/08 01-07-11 Ch. 1101 Implementation of SelectPlan for Women 2/1/08 01-08-02 Ch. 1241 Clarification of Childhood Nutrition and Weight Management Services for Recipients Under 21 Years of Age 2/15/08 99-08-01 Ch. 1241 The Addition of Selzentry (maraviroc) 2/29/08 09-08-03 and Intelence (etavirine) to the Special 24-08-04 Pharmaceutical Benefits Program 21-08-01 31-08-04 Ch. 1121 Medical Necessity Guidelines for Lyrica 3/5/08 02-08-01 for Fibromyalgia 03-08-01 08-08-01 09-08-01 11-08-01 14-08-01 24-08-02 27-08-02 30-08-01 31-08-02 32-08-01 Ch. 1121 Tamper Resistant Prescription Pads 3/21/08 99-08-03 Ch. 1101 SelectPlan for Women Program-- Addition of Covered Services 4/23/08 01-08-05 Ch. 1150 Prudent Payment of Claims--Updated 4/25/08 99-08-05 Ch. 1121 Preferred Drug List-Spring 2008 6/2/08 02-08-03 Update 03-08-03 08-08-07 09-08-08 11-08-03 14-08-03 24-08-07 27-08-04 30-08-03 31-08-10 32-08-03 Ch. 1149 ADA Claim Form--Version 2006 and Discontinuance of P. O. Box 8186 6/16/08 17-08-02 Ch. 1150 Medical Assistance Program Fee 07/22/08 18-08-04 Ch. 1141 Increase for Select Ophthalmological 31-08-12 Ch. 1147 Examinations Ch. 1150 Medical Assistance (MA) Program Fee 7/22/08 05-08-02 Ch. 1249 Increases for Select Home Health Agency Services Ch. 1150 Medical Assistance Program Fee 7/22/08 18-08-03 Ch. 1141 Increases for Select Office Visits and Ch. 1147 Consultations for Vision Services Ch. 1150 Medical Assistance Program Fee 7/22/08 05-08-03 Ch. 1249 Increases for Select Private Duty/ 16-08-01 Shift Nursing Services to MA Recipients Under 21 Years of Age Ch. 1150 Medical Assistance Program Fee 7/22/08 27-08-06 Ch. 1149 Increases for Select Dental Services Ch. 1150 Medical Assistance Program Fee 7/22/08 09-08-09 Increases for Select Office Visits 31-08-11 and Consultations 33-08-05 Ch. 1150 Medical Assistance Program Fee 7/22/08 08-08-09 Ch. 1243 Schedule Changes for Select 09-08-10 Laboratory Procedure Codes 28-08-04 31-08-13 33-08-06 Ch. 1150 Medical Assistance Program Outpatient 7/22/08 01-08-07 Ch. 1141 Fee Schedule Increase for a Select Colonoscopy Procedure Ch. 1150 Fee Increases for Select Healthy 7/25/08 05-08-04 Beginnings Plus Services 08-08-13 31-08-17 33-08-08 47-08-11 Ch. 1150 Screening for Developmental Delays 7/25/08 99-08-10 Ch. 1241 and Autism Spectrum Disorders Ch. 1145 Recipient Access to Chiropractic Services 8/4/08 99-08-11 Ch. 1150 Prior Authorization of Advanced Radiologic Imaging Services 8/5/08 99-08-08 Ch. 1150 Medical Assistance Program Family 8/29/08 08-08-08 Ch. 1225 Planning Clinic Select Fee Increases and Updates Ch. 1101 SelectPlan for Women Updated 9/5/08 01-08-09 Ch. 1150 Covered Services Chart 08-08-17 Ch. 1221 09-08-17 24-08-12 28-08-06 31-08-21 33-08-09 Ch. 1163 Payment Policy for Hospital 9/12/08 01-08-10 Readmissions Ch. 1241 Updates for Early Periodic Screening, 9/18/08 99-08-13 Diagnosis and Treatment Program Ch. 1150 Reminder of Implementation of Tamper 9/24/08 99-08-14 Ch. 1121 Resistant Prescription Pad Requirements Ch. 1101 Implementation of Claim Check 10/2/08 99-08-17 Ch. 1150 Ch. 1150 Addition of Procedure Code 67820 to 11/14/08 18-08-07 Ch. 1147 Optometrist Medical Assistance Program Outpatient Fee Schedule Ch. 1150 Preventable Serious Adverse Events 11/26/08 01-08-11 Ch. 1150 Addition of Procedure Codes to the 12/29/08 18-09-01 Ch. 1147 Medical Assistance Program Fee Schedule for Office Visits for Optometrists 2009 Ch. 1150 Removal of Prior Authorization 2/9/09 18-09-02 Ch. 1123 Requirement for Eyeglass Lenses 24-09-01 Ch. 1147 25-09-01 31-09-01 Ch. 1101 Pentacel® (DTaP-IPV/Hib), Kinrix® 2/9/09 01-09-01 Ch. 1150 (DTaP-IPV) and Rotarix® (Rotavirus) 08-09-01 Ch. 1241 Vaccines 09-09-01 31-09-02 33-09-01 Ch. 1101 2009 Recommended Childhood and 2/20/09 01-09-04 Ch. 1150 Adolescent Immunization Schedules 08-09-04 Ch. 1241 09-09-04 31-09-05 33-09-02 Ch. 1150 Medical Assistance Program Fee 3/27/09 99-09-04 Schedule Procedure Code End-dating of Keratomileusis Ch. 1149 Implementation of the Pediatric Dental 4/24/09 27-09-02 Periodicity Schedule Ch. 1150 Revisions to Medical Assistance 6/15/09 99-09-05 Program Fee Schedule Rates for Select Services GUIDANCE MANUALS:
* Provider Handbook 01--Physician (update effective 07/18/08)
* Provider Handbook 03--Dentist
* Provider Handbook 04--Podiatrist
* Provider Handbook 05--Medical Supplier
* Provider Handbook 06/08--Short Procedure Unit/Ambulatory Surgical Center
* Provider Handbook 07--Chiropractor
* Provider Handbook 09--Birth Centers
* Provider Handbook 10-I--Independent Medical/Surgical Clinic
* Provider Handbook 11-I--Inpatient Hospital (Encompasses provider types General Hospital, Rehabilitation Hospital, Private Mental Hospital, State Mental Hospital and Extended Acute Psychiatric Care)
* Provider Handbook ll-O--Outpatient Hospital (Encompasses provider types General Hospital, and Rehabilitation Hospital)
* Provider Handbook 15--Optometrist
* Provider Handbook 16--Independent Laboratory
* Provider Handbook 18--Ambulance Company
* Provider Handbook 19--Pharmacy
* Provider Handbook 20--Portable X-Ray Provider
* Provider Handbook 21--Renal Dialysis Center
* Provider Handbook 22--Funeral Director
* Provider Handbook 23--Home Health Agency
* Provider Handbook 26--Rural Health Clinic (update 12/24/08)
* Provider Handbook 28--Drug and Alcohol Clinic
* Provider Handbook 29--Outpatient Psychiatric Clinic
* Provider Handbook 30--Family Planning Clinic
* Provider Handbook 31--Midwives
* Provider Handbook 33--Psychiatric Partial Hospitalization Facility
* Provider Handbook 36-L--Nursing Facility Services only applies to County Nursing Facilities and Private Nursing Facilities. Nursing facility case mix regulations implemented in 1996 (Pa. Code Chapter 1187) do not encompass provider types State Mental Retardation Center, Private ICF/MR, or State Restoration Center (update effective 04/09)
* Provider Handbook 37--Hospice
* Provider Handbook 41--Psychologist
* Provider Handbook 42--Comprehensive Outpatient Rehabilitation Facility
* Provider Handbook 43--Physical Therapist
* Provider Handbook 44--Certified RN Anesthetist
* Provider Handbook 49--Certified RN Practitioner
* Provider Handbook 50--Early Periodic Screening, Diagnosis and Treatment (EPSDT) Provider (update effective 12/24/08)
* Provider Handbook 54--Nutritionist
* Provider Handbook 55--PA Department of Aging (PDA) Waiver
* Provider Handbook 59--COMMCARE Waiver (update effective 09/22/08)
* Medical Assistance Transportation Program--Instructions and Requirements (Note: Revised/Reissued Annually)Office of Long-Term Living--Contact: Robert McNamara (717) 705-3705
GUIDANCE MANUALS:
Bureau of Home and Community Based Services
* Attendant Care Program Requirements
* Attendant Care Medicaid Waiver #0277
* Attendant Care Program Policy and Program Directives and Clarifications
* Community Services Program for Persons with Physical Disabilities (CSPPPD) Program Requirements
* OBRA Medicaid Waiver #0235
* Independence Medicaid Waiver #0319
* COMMCARE Waiver #0386
* Community Services Program for Persons with Physical Disabilities Policy and Program Directives and ClarificationsOffice of Children, Youth & Families--Contact: Cathy Utz (717) 705-2912
POLICY STATEMENTS:
Code Year Citation Date Subject Bulletin Issued Number 1980 Ch. 3140 Funding of Basic Ed. 10/29/80 99-80-22 Components of Private Day Treatment Center Programs 1981 -- OCYF Licensing Procedures: 10/29/81 99-81-38 Clarification of Provider's Right to Appeal DPW Issuance of a Provisional Certification of Compliance 1982 Ch. 3130 Notice of Right to Appeal for 12/30/82 3130-82-01 Spanish-Speaking Clients 1983 Ch. 3130 Clarification of the 02/04/83 3130-83-03 Definition of ''Accept for Service'' Ch. 3700 Waiver for Foster Family Homes 02/04/83 3700-83-01 by Foster Family Care Agencies Ch. 3130 Clarification of County C & Y 02/04/83 3130-83-04 Agency Requirements with Respect to Fee Setting Ch. 3130 Clarif. on Caseworker-to- 02/04/83 3130-83-07 Family Case Load Ratio & Case Management Functions Ch. 3140 Clarif. of Adoption Asst. 05/02/83 3140-83-07 to Relatives in Adoption Cases Ch. 3140 Chapter 3140.22 02/04/83 3140-83-02 Reimbursement Regulations Alternative Programs 3140.22(e) Ch. 3140 Chapter 3140.22 02/04/83 3140-83-03 Reimbursement Regulations Community Residential Service 3140.22(d)(3) Ch. 3140 3130.64(b)(2), 3130.67(9), 08/15/83 3130-83-11 3140.131(7), 3700.35(b)(1) 3140-83-13 Reimbursement to Parents for the 3700-83-03 Cost of Child Visits 1984 Ch. 3140 Reimbursement Rates for 01/12/84 3140-84-01 Placements in VisionQuest Wilderness & Wagon Train Programs Ch. 3001 Transmittal of Interdpt. Memo. 07/08/84 99-84-13 on Nonimmunized Students Excluded from Attending School Ch. 3490 Release of Child Abuse Info. 08/15/84 99-84-20 to the Media Ch. 3140 VisionQuest Policy 09/07/84 3140-84-05 1985 Ch. 3001.5 Unannounced Visits to Licensed 08/20/85 99-85-18 & Approved Facilities/Agencies Ch. 3130 Interstate Compact on Juveniles 09/30/85 99-85-27 Ch. 3490 Providing Copies of Child 11/20/85 99-85-28 Abuse Reports to Subjects 1986 Ch. 3490 Law Enforcement Officials as 07/15/86 3490-86-04 Perpetrators of Suspected Child Abuse Ch. 3490 Policy Clarifications Regarding 04/01/86 3490-86-02 Child Protective Services Law and Regulations as Related to Act 33 Ch. 3490 Policy Clarifications Regarding 06/16/86 3490-86-05 Child Protective Services Law and Regulations as Related to Act 33--Part II Ch. 3490 Policy Clarifications Regarding 11/01/86 3490-86-08 Child Protective Services Law and Regulations as Related to Act 33--Part III 1987 Ch. 3490 Implementation of Child Protective 05/01/87 3490-87-01 Service Policies Relating to Alleged Medical Neglect of Disabled Infants Ch. 3490 Sharing Child Abuse Info 09/01/87 3490-87-03 Among DPW Offices Ch. 3490 Policy Clarification of the Child 06/01/87 3490-87-02 Protective Services Law and Regulations Ch. 3140 Personal Incident Costs 10/01/87 3140-87-05 Ch. 3140 OCYF Financial Participation 08/31/87 3140-87-02 in Costs of County Human Service Departments 1988 -- Special Medical Assistance--Healthy 11/02/88 99-88-08 Beginnings--for Pregnant Women and Qualified Children Ch. 3490 Screening Student Interns 05/88 3490-88-01 1989 Ch. 3350 Adoption Record Disclosure 06/06/89 3350-89-01 1991 Ch. 3130 Regulatory Interpretation Guidelines 3130-91-03 for Revisions to Chapter 3130 1992 Ch. 3140 Title XX Invoicing Procedures for 09/25/92 99-92-02 the Youth Development Centers and Youth Forestry Camps (YDCs/YFCs) 1994 -- Site Visits and Access to Records 08/22/94 00-94-19 by PA Protection and Advocacy, Inc. 1995 Ch. 3490 Amendments to the Child Protective 09/05 3490-95-02 Services Law that Become Effective July 1, 1995 1996 Ch. 3490 Certification and Training for 3490-96-03 Children and Youth Workers 00 Update of Policies and Procedures 00-96-03 for Juveniles in Detention 00 Maximization of the OCYF's 00-96-04 Grant Funds 00 Surveying and Evaluating Child 00-96-06 Welfare Agencies Implementation and Compliance with MEPA 1997 Ch. 3140 Availability of Federal Financial 3140-97-02 Participation For Profit Residential Child Care Facilities -- Access to Pennsylvania State 10/01/97 00-97-09 Police Records -- Priority Placement Request 12/01/97 00-97-12 Procedures for the Interstate Compact on the Placement of Children 1998 Ch. 3140 NMEPA 1994--Small Business 02/07/98 3140-98-03 -- 1997 Association of Juvenile Compact 06/01/98 00-98-06 Administrators Rules and Regulations Amended Travel Permit 1999 Ch. 3140 Adoption Assistance Questions 3140-99-01 and Answers Ch. 3490 Drug Convictions Prohibiting Hiring 02/03/99 3490-99-01 and Approving Foster/Adoptive Parent Applications Ch. 3490 Implementation of Revisions to the 10/01/99 3490-99-02 Child Protective Services Law as Amended by Act 127 of 1998 2000 Ch. 3140 TANF--Retroactive Eligibility 04/15/00 3140-00-01 Determinations Ch. 3140 Invoicing Procedures--Child 04/15/00 3140-00-03 Welfare TANF Ch. 3140 AFCARS Planning, Budgeting and 08/15/00 3140-00-02 Invoicing Procedures Ch. 3490 Child Death Review and Report 10/10/00 3490-00-01 Protocols Ch. 3800 Child Residential and Day Treatment 05/30/00 3800-00-01 Facilities Licensing Measurement Instrument Revisions 2001 Ch. 3130 The Second Revised Interim 01/02/01 3130-01-01 Guidelines for the Adoption and and Safe Families Act of 1997 Ch. 3140 Revised Policies and Procedures: 04/09/01 140-01-01 Title IV-E Placement Maintenance Eligibility and Reimbursability, Title IV-E Adoption Assistance Eligibility and Title XX Medicaid Eligibility Ch. 3490 Revised Certification and Training 09/25/01 3490-01-02 Requirements for Children and Youth Supervisors 2003 -- Kinship Care Policy 06/30/03 00-03-03 -- Megan's Law 04/13/03 00-03-02 Ch. 3140 Interstate Compact on Adoption 06/30/03 3140-03-02 and Medical Assistance Ch. 3350 Statewide Adoption Network 01/01/03 3350-03-01 Policies and Procedures Ch. 3490 A.Y. v. DPW/Allegheny County 03/10/03 3490-03-01 Ch. 3490 Federal Criminal History 04/25/03 3490-03-02 Clearances for PA Residents 2004 -- Annual Bulletin Update 7/01/04 00-04-01 -- MH/MR Services for Children Placed 7/19/05 00-04-02 Out-of-County In Pre-Adoptive or Foster Homes Ch. 3140 Child Welfare TANF Services 5/17/04 3140-04-06 Policies and Procedures Ch. 3140 Approval/Licensing of Foster 4/1/04 3140-04-02 Family Homes Ch. 3140 Child Placements with Emergency 7/01/04 3140-04-05/ Ch. 3490 Caregivers 3490-04-01 Ch. 3700 Medical Foster Care Services for 7/1/04 Special Children Served by County Children Transmittal and Youth Agencies 2005 Ch. 3800 Storage and Use of Syrup of Ipecac 1/19/05 Special Transmittal Ch. 3490 Implementation of Act 160 of 2004 9/1/05 3490-05-01 Amending the Child Protective Services Law 2006 -- Federal Financial Participation Rate 10/18/06 00-06-05 Change for Title IV-E Placement Maintenance and Adoption Assistance Costs Ch. 3140 Random Moment Time Study Policy 7/28/06 3140-06-03 and Procedures--Juvenile Probation Offices Ch. 3140 Random Moment Time Study Policy 6/30/06 3140-06-04 and Procedures--County Children and Youth Agencies Ch. 3140 Federal Title IV-E and Medicaid 9/12/06 3140-06-05 Administrative Invoicing Procedures Ch. 3140 Act 148 Invoicing Procedures for 10/11/06 3140-06-06 County Child Welfare Services Ch. 3140 Random Moment Time Study 10/11/06 Special Requirements Family Service Plan Transmittal Documentation Ch. 3800 Strategies and Practices to Eliminate 1/30/06 Special Unnecessary Use of Restraint Transmittal Ch. 3490 Safety Assessment and Planning Process 3/15/06 3490-06-01 2007 -- FFP Rate Change for Title IV-E 4/16/07 00-07-01 Placement Maintenance and Adoption Assistance Costs Ch. 3490 Protocol to Address Domestic Violence 8/3/07 Special in Families with Child Welfare Transmittal Involvement 2008 Ch. 3140 2008-2009 Title IV-E Youth February 3140-08-01 Independent Living Grant Application 2008 Guidelines Ch. 3350 Expanded Ground for Involuntary 4/3/08 Special Termination of Parental Rights Transmittal Ch. 3490 Frequency and Tracking of Caseworker 5/1/08 3490-08-05 Visits to Children in Federally Defined Foster Care Ch. 3140 Title IV-E Foster Case Maintenance 5/12/08 3140-08-01 and Adoption Assistance Program Costs Allowable for Federal Financial Participation (FFP) Ch. 3350 Implementation of Safe and Timely 5/12/08 99-08-01 Ch. 3490 Placement of Foster Children Act Ch. 3700 (P. L. 109-239) Ch. 3140 Title IV-E Foster Care Maintenance 5/12/08 3140-08-01 and Adoption Assistance Program Costs Allowable for Federal Financial Participation Ch. 3490 Implementation of Act 126 of 2006 3/24/08 3490-08-02 Amending the Child Protective Services Law Ch. 3490 Developmental Evaluation and Early 3/21/08 3490-08-01 Intervention Referral Policy Ch. 3490 Implementation of Act 179 of 2008 6/27/08 3490-08-03 And Act 72 of 2007 Amending the Child Protective Services Law Ch. 3130 Educational Stability and Continuity 10/1/08 3130-08-01 Ch. 3140 For Children in Substitute Care Ch. 3490 Implementation of New Reporting 10/1/08 3490-08-04 Requirements As Required by Act 146 of 2006 and Act 179 of 2006 Ch. 3700 Implementation of Act 68 of 2005 10/1/08 3700-08-01 (The Resource Family and Adoption Process Act), Act 73 of 2005 (The Resource Family Care Act), and Act 78 of 2007 2009 Act 76 of 2007 1/7/09 Special Transmittal Ch. 3130 Fostering Connections to Success and 2/24/09 Special Ch. 3140 Increasing Adoptions Act of 2008 Transmittal Ch. 3700 Ch. 3130 Implementation of the Indian Child 3/9/09 3130-09-01 Welfare Act of 1978 Ch. 3170 Out of Home Placement Services-- 4/7/09 3170-09-01 Contract Documentation YDC/YFC Interim Per Diem Rates 5/14/09 00-09-01 Ch. 3130 Fiscal Year 2010-11 Children, Youth 5-21-09 3140-09-02 Ch. 3140 and Families Needs-Based Plan and Ch. 3170 Fiscal Year 2009-10 Implementation Plan Instructions
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