[42 Pa.B. 5011]
[Saturday, August 4, 2012]
[Continued from previous Web Page]
PENNSYLVANIA HIGHER EDUCATION
ASSISTANCE AGENCY
2010-2011 State Higher Education Grant Program Manual
Contact: Jay Pagni- 717-720-7670 jpagnipheaa.org
PENNSYLVANIA HOUSING FINANCE AGENCY
POLICY STATEMENTS
Rental Housing Program 12 Pa. Code, Sections 31.11— 31.25
Contact: Holly Glauser (717.780.3876)Owner-Occupied Residential Housing Program 12 Pa. Code, Sections 31.101—31.105
Contact: Kate Newton (717.780.3891)Mortgage Loan Program 12 Pa. Code, Sections 31.111— 31.117
Contact: Kate Newton (717.780.3891)Policy Statement on Homeowners' Emergency Mortgage Assistance Program (including Program Guidelines, Act 91 Notice) 12 Pa. Code, Section 31.201 et seq.
Contact: Daryl Rotz (717.780.3940)HEMAP Consumer Credit Counseling Agencies on PHFA website at www.phfa.org Privacy Policy
Contact: Tony Julian (717.780.3824)GUIDANCE MANUALS
Development Division
PHFA Multifamily Housing Application and Guidelines (contains PennHOMES, Taxable and Tax-Exempt Fi nancing and Low Income Housing Tax Credit Guide lines)
PHFA Preprocessing Manual for Projects with Agency Federal HOME Funds
PHFA Preprocessing Manual for Projects with Agency Reserve Funds
Contact: Lisa Lutz (717.780.3876)Technical Services Division
Architectural Submission Guide
Submission Guide for Small Projects
PHFA Preconstruction Meeting Guide
General Payout Procedures for Mortgagors & Contractors
Contact: Kristy Provost (717.780.1846)Housing Management Division
PHFA Property Operations Manual
PHFA Section 8 Non-Performance Based Property Opera tions Manual
PHFA Low-Income Housing Tax Credit Compliance Manual
Contact: Barbara Huntsinger (717.780.3818)
PHFA Financial Reporting Manual for Agency Financed Properties and Tax Credit Only Properties (No Agency Financing)
Contact: Kathy Hughes (717.780.3819)Housing Services Department
Senior Supportive Services Program Manual with PennHOMES/Low Income Tax Credit Requirements
Supportive Services Program Manual with Section 8 Requirements
Family Supportive Services Program Manual with PennHOMES/Low Income Tax Credit Requirements
Family Supportive Services Program Manual with Philadelphia Family Resource Center Initiative Requirements
Family Supportive Services Program Manual with Philadelphia Escrow/Waiver Requirements
Quick Connections (supportive services newsletter)
Contact: Crystal Baker (717.780.1808)Single Family Housing Division
PHFA Seller's Guide
Contact: Kate Newton (717.780.3891)
Renovate & Repair Program Guidelines
Contact: Roberta Schwalm (717.780.3838)INTERNAL GUIDELINES
PHFA Board Agenda, Minutes and Resolutions
Bylaws of the Pennsylvania Housing Finance Agency
PHFA Right To Know Act Policy
PHFA Investment Policy
PHFA Interest Rate Swap Guidelines
Contact: Carrie Barnes (717.780.3911)
PHFA Employee Manual
PHFA Procurement Guide
Contact: Susan Heilig (717.780.4335)OTHER
Anti-Predatory Lending
Anti-Predatory Lending Workbook
Anti-Predatory Lending and Foreclosure Prevention Pre sentation-CD-Rom
Anti-Predatory Lending and Foreclosure Prevention- Trainer's Guide
Contact: Andrea Cunningham (717.780.3839)
PENNSYLVANIA INFRASTRUCTURE INVESTMENT AUTHORITY-PENNVEST
GUIDELINES
• PENNVEST: Financing Clean Water for Pennsylvania, 2008.
• On-Lot Sewage Disposal System for the Individual Homeowner Funding Program, 2012.
• PENNVEST Annual Report, 2010-2011.
• Brownfield Redevelopment Guidelines & Forms
• Handbook for PENNVEST Waste Water Projects
• Handbook for PENNVEST Drinking Water Projects
• PENNVEST Nutrient Credit Clearinghouse Rulebook
• PENNVEST ONLINE 2012
• Mission
• Publications
o Growing Greener Notification
o On Lot Sewage Disposal System Funding Program Brochure
o PENNVEST General Information Brochure
• Webcasts
o Buy America Webcasts-Substantially Made in America
o Reserve Webinar
o How to: Funds Disbursement
o PENNVEST New Application
o How to Implement: DBE Requirement
o How to Implement: Davis Bacon Requirement
• Regulations
o State Regulations for PENNVEST Guidelines
o State Regulations for PENNVEST Funded Projects
• Financial Assistance
• Available Funding
o Drinking Water, Wastewater and Storm water Loans and Non-Point Source Financing
o On-Lot Sewage Disposal Loans
o Brownfield Redevelopment Loans
o Growing Greener Grants
o ARRA
• Subsidy Calculator
• Financial Assistance Simulator (FAS)
• County Cap Rate
• FAQs
• Documents and Forms
• Process Guidelines and Flowcharts
• Application Planning Documents
• Legal Conditions and Guidance
• Brownfield Development Loans
• ARRA Requirements
• Programs
• Approved Projects
• Drinking Water State Revolving Fund
• Clean Water State Revolving Fund
• Commonwealth Funding
• American Recovery and Reinvestment Act (ARRA) 2009 Funding
• Green Initiatives
• Non-Point Source
• Performance Measures
• Nutrient Credit Trading
• Loan Servicing
• Payment Tracking
• Continuing Education
• Annual Financial Reporting
Contact: Lou Ann Buffington (717) 787-8138.Public Procedure:
• PENNVEST Right to Know Policy
Contact: Kathlyn Domitrovich (717) 783-4493Internet Policy:
• PENNVEST Privacy Policy
• PENNVEST Site Security
Contact: Laura A. Lewis (717) 783-4491
PUBLIC SCHOOL EMPLOYEES' RETIREMENT SYSTEM & PENNSYLVANIA MUNICIPAL
RETIREMENT SYSTEM
GUIDANCE MANUALS:
• PSERS Active Member Handbook (Current Ed. 4/2007)
• PSERS Retired Member Handbook (Current Ed. 5/2007)
• PSERS Update—Annually (January)
• PSERS Pamphlets:
Let's Talk About: Leaving PSERS & Your Employment Benefits (08/2011) Let's Talk About: Taxes on Your Retirement Benefits (02/2009)
Let's Talk About: Disability Retirement Benefits (04/ 2012)
Let's Talk About: Being Retired (02/2009)
Let's Talk About: Death Benefits During Employment (11/2003)
Let's Talk About: Death Benefits During Retirement (4/2001)
Let's Talk About: Purchasing Credit for Service (06/ 2008)
Let's Talk About: Returning To Service After Retire ment (07/2011)
• Information for New School Employees (06/2011)
• PSERS Divorce Guidelines (12/2010)
• PSERS Active Member Newsletter
• PSERS Retired Member Newsletter
• The Employer Bulletin
• PSERS Employer Reference Manual (10/2011)
• Online Estimate Calculators (03/2010)
Contact: Evelyn Tatkovski (717) 720-4734DECISIONS:
• PSERS Board of Trustees Adjudications Topics:
Beneficiary Change
Change Employment Status
Change of Option
Change Retirement Date
Class T-D Election
Cost of Living Increase
Credited Years of Service
Death Benefit
Disability
Divorce
Effective Date of Retirement
Emergency Return To Service
Final Average Salary
Frozen Present Value
Forced Maternity Leave
Full-Year Service
Health Care Premium Assistance
Mandatory Membership
Membership Eligibility
Military Service (purchase of)
Multiple Service Credit
Non Qualifying Part-Time Service
Overpayment
Payment of Interest
Pension Forfeiture
Purchase of Service
Recalculation of Benefit
Reinstatement
Retirement-Covered Compensation
Return To Public School Service
Service Adjustment
Tax Collector
Miscellaneous
Contact: Evelyn Tatkovski (717) 720-4734INTERNAL POLICY STATEMENTS and GUIDELINES:
• PSERS Board Automation Policy
• PSERS Bylaws
• PSERS Election Procedures and Guidelines
• PSERS Public Market Emerging Investment Manager Program Policy
• PSERS External Board Appointment and Attendance Policy
• PSERS Domestic Proxy Voting Guidelines
• PSERS International Proxy Voting Guidelines
• PSERS Investment Policy Statement, Objectives & Guidelines
• PSERS Public Information Policy
• PSERS Securities Litigation Policy
• PSERS Education Policy
Contact: Evelyn Tatkovski (717) 720-4734OTHER:
• PSERS Website: www.psers.state.pa.us
• PSERS Comprehensive Annual Financial Report (Includes Mission Statement)
• PSERS Board Minutes and Resolutions
• PSERS Asset Allocation Plan
• Annual Actuarial Valuation Report
• Actuarial Experience Study Report (5 year intervals)
• Quarterly Financial Statements
• PSERS SEC Form 13F filing
• Actuarial Tables and Computational Procedures,
Pa. Bulletin, Vol. 31, No. 14, pp. 1930-1945, April 7, 2001
• Pennsylvania School Retiree Health Care Coverage
Website: www.hopbenefits.com
Health Options Program
Premium Assistance Program
Contact: Evelyn Tatkovski (717) 720-4734Pennsylvania Municipal Retirement System
POLICY STATEMENTS (Contact: James B. Allen) (717) 787-2065:
• Actuarial Tables
• Allocation of Excess Interest to Municipal Account, Member's Accounts, and Retired
• Business and Educational Travel Policy
• Calculation of Withdrawing Plan's Portion of Retired Member's Reserve
• Contractor Insurance
• Contract & Purchasing Procedures
• Date of Birth Proof
• Designating Signatories
• Disability Reserve Funding
• DROP—Deferred Retirement Option Program
• Excess Interest Process
• Indemnification Policy
• Investment Guidelines
• Member Contribution Receipts
• Overpayment Policy
• Permanent Employee
• Plan Withdrawal Procedures
• Portability: Individual Member
• Portability: Plan Spin-offs
• Proxy Voting Guidelines
• Refund—Plan Withdrawal
• Return to Work Policy Statement
• Right To Know PolicyGUIDANCE MANUALS (Contact: James B. Allen) (717) 787-2065:
• PMRS Notes & News
• PMRS Pamphlets:
Plan Benefit Summary (individualized for each
municipality)
Evaluating Your Pension Plan
Pennsylvania Municipal Retirement System
• Individual Municipality Plan Benefit Agreements
• PMRS WebSite: www.pmrs.state.pa.usDECISIONS (Contact: James B. Allen) (717) 787-2065:
• PMRS Board of Trustees Adjudications
Topics:
Death Benefit
Disabilities
Pension Forfeitures
Purchase of Service
Vesting
MiscellaneousINTERNAL GUIDELINES (Contact: James B. Allen) (717) 787-2065:
• Actuarial Reports (Annual Evaluation and 5 year Experience Study Report)
• Actuarial Tables
• Comprehensive Annual Financial Report
• Investment Consultant Quarterly Reports
• PMRS Board Minutes and Resolutions
• Sample Domestic Relations Order and Instruction Memo
• Template Pension Plan Contract for Police, Municipal and Firefighter
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
CitationSubject 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 Reconsideration03/15/84 275-84-10 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 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 Handbook
• Pennsylvania Child Support HandbookOffice of Medical Assistance—Contact: Leesa Allen (717) 772-6341
POLICY STATEMENTS:
Year Code
CitationSubject Date Issued Bulletin Number 1981 Ch. 1251 Clarification of M.A.
Bulletin # 22-80-0108/19/81 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 33-85-02
10/31/85 29-85-02 Ch. 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 Signature09/19/86 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
Warranties10/28/86 05-86-02
19-86-07Ch. 1101 Records Maintenance and
Avail. Requirements11/05/86 23-86-02 1987 Ch. 1101 Physicians' Response. Home
Health Services01/12/87 01-87-01 Ch. 1223 Single County Authorities 12-87-01
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 07/30/87 05-87-02
01-87-08
19-87-06
Ch. 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 License07/01/88 1101-88-01 1989 Ch. 1101 Policy Reminder Regarding
Practitioner License Requirements09/09/89 1101-89-02 1990 Ch. 1150 Payment Policy for
Consultations04/27/90 1150-90-01 1991 *CH. 1101
CH. 1121
CH. 1123
CH. 1241
EPSDT - OBRA '89 08/02/91 1101-91-01
1121-91-02
1123-91-01
1241-91-01
1992 *CH. 1141
*CH. 1153CLOZAPINE SUPPORT SERVICES 01/31/92 1141-92-01
1153-92-01Ch. 1241 Revised EPSDT Immunization
Guidelines12/11/92 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 1165-93-07 *CH. 1121 CHANGES IN THE MEDICAL
ASSISTANCE PHARMACEUTICAL
BENEFITS07/09/93 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 SETTLEMENT
07/21/93 1101-93-03 *CH. 1101 UPDATE TO EXCEPTIONS
PROCESS AND CRITERIA UNDER
THE GENERAL ASSISTANCE BASIC
HEALTH CARE PACKAGE07/21/93 1101-93-04 Ch. 1241 Centers for Disease Control
Blood Lead Testing09/03/93 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
Guidelines04/08/94 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 FACILITIES06/24/94 1121-94-01 *CH. 1121 PHARMACEUTICAL SERVICES
PRIOR AUTHORIZATION
REQUIREMENT MULTISOURCE
BRAND NAME DRUGS
08/26/94 1121-94-02 *CH. 1121
CH. 1126
CH. 1129
CH. 1141
CH. 1163
CH. 1221
CH. 1225
CH. 1242
TREATMENT OF INFERTILITY -
DISCONTINUED COVERAGE FOR
DRUGS AND RELATED SERVICES
08/30/94 1121-94-03
1126-94-01
1129-94-01
1141-94-01
1163-94-01
1221-94-01
1225-94-011242-94-01
*CH. 1101 GENERAL ASSISTANCE
RESTRUCTURE AS A RESULT
OF ACT 4909/02/94 1101-94-01 1995 CH. 1153 ACCESSING OUTPATIENT
WRAPAROUND MENTAL
HEALTH SERVICES09/08/95 1153-95-01 CH. 1157 MENTAL HEALTH SERVICES
PROVIDED IN NON-JCAHO09/08/95 1157-95-01 CH. 1165 UPDATE-JCAHO-ACCREDITED
RTF SERVICES09/08/95 1165-95-01 *CH. 1153 PRIOR AUTHORIZATION OF
PARTIAL HOSPITALIZATION12/30/94 1153-94-01 CH. 1163 PAYMENT POLICY FOR
ABORTION SERVICES12/15/95 1163-95-02 1997 Ch. 1141 Revision to Physician Assistant and
Nurse Midwife Supervision
Requirement
07/30/97 1141-97-01 1998 Ch. 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
Ch. 1141
Ch. 1150
Ch. 1221
Regulation Changes Regarding
''Emergency Medical Condition''07/01/98 1101-98-01
1141-98-01
1150-98-01
1121-98-01
Ch. 1141
Ch. 1153Clozapine Support Services 12/29/98 33-98-08
29-98-08
01-98-19
1999 Ch. 1187 Capital Component Payments for
Post-Moratorium Beds04/17/99 1187-99-01 Ch. 1101 ''Payment in Full'' 09/17/99 99-99-06 2001 Ch. 1101 Clarification of Coverage for
Motorized Wheelchairs and
Other Durable Medical Equipment
02/16/01 01-01-02
05-01-01
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
Screening, Diagnosis and Treatment
(EPSDT) Program
07/01/01 01-01-10
10-01-03
11-01-05
17-01-04
26-01-03
49-01-07
— Breast and Cervical Cancer
Prevention and Treatment Program12/26/01 99-01-12 2002 Ch. 1223 Drug and Alcohol Clinics with
Provisional Licenses10/26/02 28-02-02 Ch. 1241 Revision to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program
01/22/02 01-02-01
10-02-01
11-02-01
17-02-01
26-02-01
49-02-01
— Breast and Cervical Cancer
Prevention and Treatment Program05/03/02 99-02-06 Ch. 1241 Addition of Procedure Code 90732
to Medical Assistance Fee Schedule
for Administration of Pneumococcal
Vaccine
11/18/02 01-02-13
10-02-04
11-02-06
17-02-07
26-02-04
49-02-06
2003 Ch. 1241 2003 Recommended Childhood
Immunization Schedule03/31/03 01-03-04
10-03-01
11-03-01
17-03-01
26-03-01
49-03-02
Ch. 1241 Coverage of Pediarix and Addition
of Procedure Code 90723 to
Medical Assistance Fee Schedule for
Administration of Pediarix Vaccine
05/15/03 01-03-06
10-03-02
11-03-02
17-03-03
26-03-02
49-03-03
Ch. 1241 Elimination of the Pennsylvania
Children's Check-up (EPSDT)
Form (MA-517)
09/05/03 01-03-08
10-03-03
11-03-05
17-03-04
26-03-03
49-03-05Ch. 1223 Elimination 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
10/01/03 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
09/01/03 99-03-12 — Continuity of Care for Recipients
Transferring Between and Among
Fee for Service and Managed Care
Organizations09/01/03 99-03-13 2004 Ch. 1223 Methadone Take-Home Services 02/01/04 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 12/01/05 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 11/08/05 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 10/07/05 02-05-01 Ch. 1121 Prior Authorization of Drugs That
Exceed Established Quantity Limits-
Phase 2 Enforcement
09/16/05 99-05-17 Ch. 1101 Copayment Changes for Brand Name
and Generic Prescription Drugs08/26/05 24-05-05 Ch. 1121 Prior Authorization of Drugs That
Exceed Established Quantity Limits-
Phase 1 Enforcement
08/10/05 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 Schedule05/26/05 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 Assistance12/10/06 99-06-12 Ch. 1101 Clarification of Exclusions from
Copayment Requirements12/10/06 99-06-13 Ch. 1153 Mobile Mental Health Treatment 11/30/06 08-06-18 Ch. 1153 Clarification of Payment Policy for
Abortion Services11/28/06 99-06-15 Ch. 1245 Reimbursement for Non-Emergency
Transportation Services11/17/06 03-06-15 Ch. 1245 Implementation of ACCESS Plus
Referral Requirements10/20/06 99-06-11 Ch. 1101 Revised HealthCare Benefits Packages
Provider Reference Chart (MA 446)10/06/06 99-06-10 Ch. 1163 Medical Assistance Payment for Services
of Teaching Physicians in Hospitals,
Clinics and Emergency Rooms
09/16/06 1141-06-01 Ch. 1153 Revision to Minimum Staff
Qualifications of Therapeutic Staff
Support (TSS) Workers08/24/06 08-06-15 Ch. 1153 Federal Medicaid Citizenship and
Identity Eligibility Requirements07/24/06 99-06-07 Ch. 1121 Preferred Drug List-Quarterly Update 04/24/06 02-06-07 Ch. 1241 2006 Recommended Childhood and
Adolescent Immunization Schedule04/16/06 01-06-03 Ch. 1150 Prudent Payment of Claims 04/03/06 99-06-04 Ch. 1121 Federal Clarification-Elimination of
Medicaid Coverage of Drugs for
Treatment of Erectile Dysfunction03/07/06 03-06-03 Ch. 1150 Disenrollment of Dual Eligibles from
Physical Health Managed Care01/27/06 99-06-01 Ch. 1121 Prior Authorization of Drugs that
Exceed Est. Quantity Limits—Phase
3 Enforcement and Additional Drugs
With Quantity Limits01/27/06 02-06-03
03-06-02
08-06-02
09-06-02
11-06-02
14-06-03
24-06-02
27-06-05
30-06-02
31-06-04
32-06-02Ch. 1121 Preferred Drug List-Phase 4 01/25/06 02-06-02 Ch. 1163 Place of Service Review Procedures 01/03/06 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
the Special Pharmaceutical Benefits
Program
12/21/07 09-07-16
21-07-04
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 Technology11/30/07 09-07-15 Ch. 1123 MA Program Outpatient Fee Schedule
Revisions for Speech Generating Devices11/29/07 24-07-11
25-07-05
31-07-18Ch. 1121 Preferred Drug List—Fall Update -
Part 211/29/07 02-07-06
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
27-07-09Ch. 1101 Childhood Nutrition and Weight
Management Services for Recipients
Under 21 Years of Age11/01/07 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
27-07-07Ch. 1121 Delay in Implementation of the Tamper-
Resistant Pad Requirements10/29/07 99-07-18 Ch. 1121 Special Pharmaceutical Benefits
Program (SPBP) Income Ceiling for
HIV Applicants10/15/07 09-07-10
21-07-03
24-07-10
31-07-14
Ch. 1121 Tamper Resistant Prescription Pads 09/28/07 99-07-16 Ch. 1123 2007 Power Mobility Device HCPCS
Updates; Prior Authorization
Requirements09/19/07 99-07-15 Ch. 1163 Medicare Inpatient Pricing Logic
Modification08/17/07 01-07-08 Ch. 1123 Provider Specialty 220 (Hearing Aid
Dispenser Requirement and Updated
Medical Assistance Program Fee
Schedule for Hearing Aid Supplies
08/03/07 01-07-07
24-07-09
31-07-12
20-07-03
25-07-04
Ch. 11221 Preferred Drug List—May 2007
Technical Correction07/31/07 02-07-04
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
27-07-06Ch. 1149 Discontinuance of the Prior Authorization
Requirement for Dental Procedure Codes
D7140 and D721007/11/07 27-07-04 Ch. 1121 Preferred Drug List—Updates to Prior
Authorization of Pharmaceutical Services
Handbook Pages
07/27/07 02-07-03
11-07-04
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
Program (SPBP) Income Ceiling Increase
for HIV Applicants07/01/07 09-07-05
21-07-02
24-07-04
31-07-07Ch. 1101 The Elimination of Paper Vouchers 06/14/07 99-07-10 Ch. 1123 Requirements for Coverage of Enteral
Nutritional Supplements and Issuance of
Enteral Nutritional Supplements MA
Program Outpatient Fee Schedule
06/01/07 08-07-10
09-07-07
24-07-06
25-07-03
31-07-09
Ch. 1121 Preferred Drug List—July 2007
Quarterly Update06/01/07 02-07-02
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
32-07-03Ch. 1101 Co-pay/Deductibles on Exceptional
Durable Medical Equipment (DME)06/01/07 03-07-04 Ch. 1249 Rescind MA Program Statement of
Policy Regarding the Clarification of
Conditions Under Which MA
Recipients May be Considered
Homebound07/10/07 1249-07-04 Ch. 1150 Medical Assistance Program Fee
Schedule Revision; Change to
Conversion Factor for Anesthesia
Services05/10/07 31-07-05 Ch. 1121 Preferred Drug List—Quarterly Update 05/01/07 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
32-07-02Ch. 1101 Clarification Regarding the Definition
of Medically Necessary—Statement of
Policy04/21/07 99-07-04 Ch. 1241 2007 Recommended Childhood and
Adolescent Immunization Schedules03/23/07 01-07-05 Ch. 1123 Provider Specialty 220 (Hearing Aid
Dispenser) Requirement03/01/07 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)01/31/07 OMHSAS-06-07 Ch. 1150 Policy Reinforcement Regarding Billing
For Tobacco Cessation Counseling
Services01/04/07 99-07-02 2008 Ch. 1121 Preferred Drug List—Fall 2007 Update
Part 2 Technical Correction01/11/08 02-07-08
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
01/11/08 17-08-01 Ch. 1163 Preventable Serious Adverse Events 01/14/08 01-07-11 Ch. 1101 Implementation of SelectPlan for
Women02/01/08 01-08-02 Ch. 1241 Clarification of Childhood Nutrition and
Weight Management Services for
Recipients Under 21 Years of Age02/15/08 99-08-01 Ch. 1241 The Addition of Selzentry (maraviroc)
and Intelence (etavirine) to the Special
Pharmaceutical Benefits Program02/29/08 09-08-03
24-08-04
21-08-01
31-08-04
Ch. 1121 Medical Necessity Guidelines for Lyrica
for Fibromyalgia03/05/08 02-08-01
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
32-08-01Ch. 1121 Tamper Resistant Prescription Pads 03/21/08 99-08-03 Ch. 1101 SelectPlan for Women Program—
Addition of Covered Services04/23/08 01-08-05 Ch. 1150 Prudent Payment of Claims—Updated 04/25/08 99-08-05 Ch. 1121 Preferred Drug List—Spring 2008
Update06/02/08 02-08-03
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
32-08-03Ch. 1149 ADA Claim Form—Version 2006 and
Discontinuance of P. O. Box 818606/16/08 17-08-02 Ch. 1150
Ch. 1141
Ch. 1147Medical Assistance Program Fee
Increase for Select Ophthalmological
Examinations07/22/08 18-08-04
31-08-12Ch. 1150
Ch. 1249Medical Assistance (MA) Program Fee
Increases for Select Home Health
Agency Services07/22/08 05-08-02 Ch. 1150
Ch. 1141
Ch. 1147Medical Assistance Program Fee
Increases for Select Office Visits and
Consultations for Vision Services
07/22/08 18-08-03 Ch. 1150
Ch. 1249Medical Assistance Program Fee
Increases for Select Private Duty/
Shift Nursing Services to MA
Recipients Under 21 Years of Age
07/22/08 05-08-03
16-08-01Ch. 1150
Ch. 1149Medical Assistance Program Fee
Increases for Select Dental Services07/22/08 27-08-06 Ch. 1150 Medical Assistance Program Fee
Increases for Select Office Visits
and Consultations07/22/08 09-08-09
31-08-11
33-08-05Ch. 1150
Ch. 1243Medical Assistance Program Fee
Schedule Changes for Select
Laboratory Procedure Codes07/22/08 08-08-09
09-08-10
28-08-04
31-08-13
33-08-06Ch. 1150
Ch. 1141Medical Assistance Program Outpatient
Fee Schedule Increase for a Select
Colonoscopy Procedure07/22/08 01-08-07 Ch. 1150 Fee Increases for Select Healthy
Beginnings Plus Services07/25/08 05-08-04
08-08-13
31-08-17
33-08-08
47-08-11Ch. 1150
Ch. 1241Screening for Developmental Delays
and Autism Spectrum Disorders07/25/08 99-08-10 Ch. 1145 Recipient Access to Chiropractic
Services08/04/08 99-08-11 Ch. 1150 Prior Authorization of Advanced
Radiologic Imaging Services08/05/08 99-08-08 Ch. 1150
Ch. 1225Medical Assistance Program Family
Planning Clinic Select Fee Increases
and Updates08/29/08 08-08-08 Ch. 1101
Ch. 1150
Ch. 1221SelectPlan for Women Updated
Covered Services Chart09/05/08 01-08-09
08-08-17
09-08-17
24-08-12
28-08-06
31-08-21
33-08-09Ch. 1163 Payment Policy for Hospital
Readmissions09/12/08 01-08-10 Ch. 1241 Updates for Early Periodic Screening,
Diagnosis and Treatment Program09/18/08 99-08-13 Ch. 1150
Ch. 1121Reminder of Implementation of Tamper
Resistant Prescription Pad Requirements09/24/08 99-08-14 Ch. 1101
Ch. 1150Implementation of Claim Check 10/02/08 99-08-17 Ch. 1150
Ch. 1147Addition of Procedure Code 67820 to
Optometrist Medical Assistance Program
Outpatient Fee Schedule11/14/08 18-08-07 Ch. 1150 Preventable Serious Adverse Events 11/26/08 01-08-11 Ch. 1150
Ch. 1147Addition of Procedure Codes to the
Medical Assistance Program Fee
Schedule for Office Visits for Optometrists12/29/08 18-09-01 2009 Ch. 1150
Ch. 1123
Ch. 1147Removal of Prior Authorization
Requirement for Eyeglass Lenses02/09/09 18-09-02
24-09-01
25-09-01
31-09-01Ch. 1101
Ch. 1150
Ch. 1241Pentacel® (DTaP-IPV/Hib), Kinrix®
(DTaP-IPV) and Rotarix® (Rotavirus)
Vaccines02/09/09 01-09-01
08-09-01
09-09-01
31-09-02
33-09-01Ch. 1101
Ch. 1150
Ch. 12412009 Recommended Childhood and
Adolescent Immunization Schedules
02/20/09 01-09-04
08-09-04
09-09-04
31-09-05
33-09-02
Ch. 1150 Medical Assistance Program Fee
Schedule Procedure Code End-dating
of Keratomileusis03/27/09 99-09-04 Ch. 1149 Implementation of the Pediatric Dental
Periodicity Schedule04/24/09 27-09-02 Ch. 1121 Spring 2009 Preferred Drug List (PDL)
Pharmacy Update06/05/09 01-09-06
09-09-07
27-09-04
02-09-03
11-09-03
30-09-03
03-09-03
14-09-08
31-09-08
08-09-07
24-09-06
32-09-03Ch. 1150 Revisions to Medical Assistance
Program Fee Schedule Rates for Select
Services06/15/09 99-09-05 Ch. 1150 2008 HCPCS Updates and Other
Procedure Code and Procedure Code/
Modifier Combination Changes
07/06/09 99-09-06 Ch. 1105
Ch. 1150Revised Medical Assessment Form
(PA 635)8/10/09 31-09-38
19-09-01
09-09-34
Ch. 1101
Ch. 1150Changes to Procedure Codes for the
Administration Fees for Kinrix®
(DTaP-IPV) and Rotarix® (Rotavirus
Vaccines08/13/09 01-09-38
08-09-39
09-09-40
31-09-41
33-09-03
Ch. 1101
Ch. 1150
Ch. 1141
Ch. 1221SelectPlan for Women Program
Forumulary09/01/09 01-09-39
08-09-40
09-09-41
24-09-38
28-09-04
31-09-42
33-09-04
Ch. 1101
Ch. 1150
Ch. 1141
Ch. 1221SelectPlan for Women Program—
Addition of Covered Services09/08/09 01-09-40
08-09-41
09-09-42
24-09-39
28-09-05
31-09-43
33-09-05Ch. 1150
Ch. 1241Structured Screening for Developmental
Delays and Autism Spectrum Disorders09/08/09 99-09-07 Ch. 1150 Billing for the Administration of the
Influenza A (H1N1) 2009 Monovalent
Vaccine10-9-09 99-09-10 Ch. 1101
Ch. 1141
Ch. 1142
Ch. 1143
Ch. 1144
Ch. 1145
Ch. 1147
Ch. 1149Revision of the PROMISe® Individual
Practitioner Enrollment Application and
Implementation of Credentialing for Certain
Providers Types10/16/09 99-09-08 Ch. 1121 Fall 2009 Preferred Drug List (PDL) and
Quantity Limits Update—Pharmacy
Services11/02/09 01-09-43
09-09-45
27-09-36
02-09-35
11-09-35
30-09-35
03-09-35
14-09-35
31-09-46
08-09-44
24-09-41
32-09-35Ch. 1141
Ch. 1145Recipient Access to Chiropractic
Services11/30/09 99-09-11 Ch. 1101
Ch. 1150
Ch. 1241Hiberix®, Haemophilus Influenzae
Type b (Hib) Vaccine
12/31/09 01-09-62
08-09-61
09-09-62
31-09-64
33-09-072010 Ch. 1187 Nursing Facility Participation Review
Process and Guidelines—Statement of
Policy04/03/10 Ch. 1150 Health Care Benefit Package 12
Updated Employability Assessment
Procedure Code List2-5-10 01-10-02
08-10-03
09-10-03
18-10-01
28-10-01
29-10-01
31-10-03Ch. 1150 Medical Assistance Program Fee
Schedule Revisions02/19/10 99-10-01 Ch. 1101
Ch. 1150
Ch. 12412010 Recommended Childhood and
Adolescent Immunization Schedules03/15/10 01-10-06
08-10-07
09-10-07
31-10-09
33-10-01Ch. 1141
Ch. 1144Application of Topical Fluoride
Varnish by Physicians and CRNPs03/15/10 Ch. 1121 Spring 2010 Preferred Drug List (PDL)
Quantity Limits Update—Pharmacy
Services05/03/10 01-10-08
09-10-10
27-10-06
02-10-06
11-10-06
30-10-06
03-10-06
14-10-06
31-10-11
08-10-09
24-10-07
32-10-06Ch. 1150
Ch. 1121Updated Recommendations for
Gardasil® Quadrivalent Human
Papillomavirus (HPV) Vaccine05/03/10 01-10-14
08-10-15
09-10-16
31-10-17
33-10-02
Ch. 1101
Ch. 1150Announcing the Federally Mandated
Change to Electronic Healthcare
Transactions for Healthcare and
Pharmacy Transactions06/08/10 99-10-07 Ch. 1101
Ch. 1150
Ch. 1241Revisions to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program Periodicity Schedule06/14/10 99-10-06 Ch. 1150 2009 HCPCS Updates and Other
Procedure Code and Procedure Code/
Modifier Combination Changes06/14/10 99-10-05 Ch. 1150 Health Care Benefit Package 12
Updated Employability Assessment
Procedure Code List07/09/10 01-10-20
08-10-21
09-10-22
18-10-03
28-10-02
29-10-02
31-10-23Ch. 1101
1102
1121
1123
1149
1151
1163
1181
1187
1230
1243Policy Clarification Regarding Written
Prescriptions—Statement of Policy07/17/10 99-10-03
1101-10-01
1102-10-01
1121-10-01
1123-10-01
1149-10-01
1151-10-01
1163-10-01
1181-10-01
1187-10-01
1230-10-01
Ch. 1150 Revisions to the Medical Assistance
Program Fee Schedule Rates for
Select Services08/30/10 99-10-09 Ch. 1101 Missed Appointments 12/01/10 99-10-14 2011 Ch. 1150 2010 HCPCS Updates and Other
Procedure Code and Procedure01/03/11 99-11-01 Ch. 1150 Code/Modifier Combination Changes
Health Care Benefit Package 12
Updated Employability Assessment
Procedure Code List04/13/11 01-11-02
08-11-04
09-11-03
18-11-02
28-11-01
29-11-01
31-11-03Ch. 1150 Revisions to the Medical Assistance
Program Fee Schedule Rates for
Select Services05/30/11 99-11-02 Ch. 1101
1150
12412011 Recommended Childhood and
Adolescent Immunization Schedules03/18/11 01-11-04
08-11-06
09-11-05
31-11-05
33-11-04
Ch. 1163 Hospital Uncompensated Care
Program and Charity Care Plan08/30/11 99-10-12 Ch. 1145 Recipient Access to Chiropractic
Services10/08/11 99-10-12 Ch. 1129 Dental Encounter payment for Dental
Services Rendered by Rural Health
Clinics and Federally Qualified
Health Centers11/15/10 08-10-50 Ch. 1245
1181
1187Payment for Non-Emergency
Transportation Services11/24/10 26-10-43 Ch. 1123 MA Program Outpatient Fee Schedule
Decrease for Select Incontinence
Products04/15/11 25-11-02 Ch. 1123 Change in Billing of Repairs and
Replacements for Durable Medical
Equipment01/14/11 25-11-01
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)
[Continued on next Web Page]
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