[45 Pa.B. 4493]
[Saturday, August 8, 2015]
[Continued from previous Web Page] (Editor's Note: This document continues from Part II which begins at 45 Pa.B. 4493 (August 8, 2015).)
Department of HUMAN SERVICES (DHS)
(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: Cathy Buhrig (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 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—REIMBURSEMENT06/01/95 257-95-01 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
• Summary of Pennsylvania's State Food Stamp Employment and Training Program
• TANF Work Verification Plan
• LIHEAP Handbook
• Pennsylvania Child Support Handbook
• Employment, Advancement and Retention Network (EARN) Program and Policy Procedures Manual
• WORK READY Program and Policy Procedures Manual
• Keystone Education Yields Success (KEYS) Program Policy and Procedures Manual
• Maximizing Participation Project (MPP) Program Policy and Procedures Manual
• Human Services Development Fund Instructions and Requirements
• Early Intervention Annual Expenditure Report Instructions
• Human Services Block Grant Annual Expenditure Report Instructions
• Human Services Non-Block Grant Annual Expenditure Report InstructionsOffice of Medical Assistance—Contact: Dan De Lellis (717) 772-6341
POLICY STATEMENTS:
Year Code
CitationSubject 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. 1101 Allergy Testing—Exemptions from From Co-Payments 10/15/85 01-85-18
11-85-20
12-85-11
10-85-02Ch. 1101 Professional Component Billing Regarding Patient Transport 10/15/85 01-85-16 Ch. 5100 Requirements for Treatment Plans Documentation of Treatment 10/31/85 29-85-02
33-85-021986 Ch. 1141 Payment Policy for Abortion Clinic
Visits09/10/86 10-86-02
11-86-10Ch. 1101 Policy Clarification Re: Provider's Signature 09/19/86 99-86-06 Ch. 1150 Payment Policy for Consultations 10/23/86 03-86-07 Ch. 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
19-86-071987 Ch. 1101 Physicians' Responsibility when Ordering Home Health Services 01/12/87 01-87-01 Ch. 1149 Palliative Emergency Treatment 04/24/87 03-87-02
27-87-01Ch. 1187 Barber and Beauty Costs 05/15/87 35-87-04
36-87-01Ch. 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
19-87-09Ch. 1187 Barber and Beauty Costs 10/22/87 35-87-07
36-87-08Ch. 140 Use of the PA 162 Forms for Notification of Medical Assistance Eligibility 10/22/87 99-87-10 Ch. 5310 Medical Assistance Coverage for Recipients Residing in Community Residential Facilities 10/23/87 99-87-11 Ch. 1150 Time Limit for Claim Resubmissions And Recovery of Overpayments 11/03/87 99-87-12 1988 Ch. 1150 Place of Service Review (PSR) Program 01/04/88 01-88-01
03-88-01
04-88-01
06-88-01
08-88-01
11-88-01Ch. 1150 Place of Service Review (PSR) Program 03/04/88 01-88-02
03-88-02
04-88-02
06-88-02
08-88-02
11-88-03Ch. 140 Healthy Beginning—Presumptive Eligibility Program 04/01/88 99-88-04 Ch. 1123 List of Accredited Rehabilitation Facilities to be used for Motorized Wheelchair Evaluation 04/06/88 01-88-04
05-88-02
19-88-03Ch. 150 Medical Assistance Eligibility Change For Aliens 04/13/88 99-88-05 Ch. 1151 Revisions to Chapters 1151 and 1163 1163 Regulations 06/29/88 11-88-02
12-88-05
13-88-05
1151-88-02
1163-88-02Ch. 1101 Policy Clarification Regarding Physician License 07/01/88 1101-88-01 Ch. 1223 Revision of Inpatient Hospital Drug And Alcohol Detoxification Payment Policy 09/09/89 01-88-11
11-88-11
1163-88Ch. 1150 Desk Reference 10/06/88 29-88-01
33-88-011989 Ch. 140 Healthy Horizons and Medicare Cost Sharing 01/04/89 99-89-02 Ch. 1150 Billing Instructions—Services Covered Only By Medicare 05/18/89 99-89-03 — Signature Requirements and Encounter Forms 05/26/89 99-89-05 Ch. 1150 Proper Use of Place of Service Codes 07/05/89 03-89-05 Ch. 1101 Policy Reminder Regarding Practitioner License Requirements 1101-89-02
03-89-08
04-89-07
07-89-02
15-89-02
31-89-02Ch. 1101 1150 Penalty for Bypassing Place of Service Review 11/03/89 01-89-09
03-89-06
04-89-05 06-89-04
08-89-04
11-89-10
Ch. 1150 Michael Dallas Model Waiver Program For Technology—Dependent Children 11/03/89 99-89-13 Ch. 1247 Targeted Case Management Services 11/13/89 99-89-12
1247-89-01— Additional Category Eligible for Medicare-Cost Sharing Benefits 12/27/89 99-89-15 1990 Ch. 1121 Special Billing Instructions for Persantine 01/19/90 01-90-01 Ch. 1150
1163
1249
1121
1126AIDS Waiver Program 04/02/90 01-90-02
02-90-01
05-90-02
19-90-01
23-90-01
38-90-01
39-90-01Ch. 1150 Payment Policy for Consultations 04/27/90 1150-90-01 Ch. 1150 The Medicare Catastrophic Coverage Act of 1988 the Medicare Catastrophic Coverage Repeal Act of 1989 05/18/90 34-90-09 Ch. 1140 Provider Participation Requirements for Healthy Beginning Plus 06/12/90 1140-90-01
01-90-06
09-90-01
10-90-02
11-90-04
23-90-05
26-90-02
30-90-02
31-90-01Ch. 1163 Inpatient Hospital Services Retrospective Review Findings 07/09/90 11-90-08
12-90-03
13-90-02
Ch. 1144 Certified Registered Nurse Practitioner 07/31/90 99-90-05
1144-90-01— Increase in Eligibility Guidelines 08/15/90 99-90-06 Ch. 1241 EPSDT Services 10/15/90 99-90-07
1241-90-01Ch. 1141 Allergen Immunotherapy 1991 Ch. 1141
1149
1143
1221Billing Procedures—Multiple Surgical Surgical/Obstetrical and Anesthesia Procedures 03/01/91 01-91-01
03-91-01
04-91-01
10-91-01
11-91-01
44-91-01
49-91-01Ch. 1150 180-day Exception Request and Invoice Submission Time Frame 03/01/91 99-91-02 Ch. 1123 Incontinence Products and Diapers 03/21/91 01-91-02
02-91-01
05-91-01
19-91-01
23-91-01Ch. 1121 Manufacturers' Rebate Program Corrections and Clarifications 05/20/91 01-91-07
02-91-03
03-91-05
04-91-05
10-91-04
11-91-06
12-91-03
19-91-05
26-91-03
28-91-02
29-91-02
30-91-02
33-91-02
49-91-03
Ch. 1121 Manufacturers' Rebate Program 05/31/91 01-91-08
02-91-04
03-91-06
04-91-06
10-91-05
11-91-07
12-91-04
19-91-06
26-91-04
28-91-03
29-91-03
30-91-03
33-91-03
49-91-04— Certification of Need—Medical Assistance Patients Under the Age of 21 06/24/91 13-91-01 Ch. 1101 Lock-In Enhanced Recipient Restriction Program 07/12/91 99-91-04 — Third Party Resources Edits 608 and 616 07/26/91 99-91-05 *CH. 1101
CH. 1121
CH. 1123
CH. 1241EPSDT—OBRA '89 08/02/91 1101-91-01
1121-91-02
1123-91-01
1241-91-01Ch. 1123 Repair and Replacement of Durable Medical Equipment (DME), Orthotics And Prosthetics 10/01/91 05-91-04
19-91-14Ch. 1101
1150
1241Payments for Vaccines 11/06/91 1221-91-01 Ch. 1121 Clorazil Monitoring and Evaluation Visit 11/06/91 29-91-07
1153-91-011992 Ch. 1221 Billing for Emergency Room Services for Recipients Who are Hospitalized On the Same Day 01/17/92 11-92-02
13-92-01
12-92-01
53-92-01Ch. 1147 Increased Fees for Vision Services 01/31/92 01-92-02
05-92-01
15-92-01
19-92-02*CH. 1141
*CH. 1153CLOZAPINE SUPPORT SERVICES 01/31/92 1141-92-01
1153-92-01
01-92-04
29-92-02
33-92-04— Independent Team—Certification of Need—Medical Assistance Patients Under the Age 21 02/21/92 13-92-03 Ch. 1149 Dental Management Fee Guidelines 02/21/92 03-92-03 Ch. 1147 Clarification of Vision Services 04/17/92 01-92-05
05-92-02
15-92-03
19-92-04Ch. 1181 Reimbursement for Hospital Reserved Bed Days During A Medicare Benefit Period 05/01/92 1181-92-04 — Qualified Medicare Beneficiary Healthy Horizons Program 06/19/92 99-92-03 Ch. 1163 Inpatient Hospital Services Retrospective Review Findings 07/03/92 11-92-11
12-92-11
13-92-07
53-92-05Ch. 1163 Automated Admission Certification 07/22/92 01-92-12
03-92-05
04-92-04Ch. 1163 Hospital Utilization Review Changes 07/22/92 06-92-01
08-92-01
11-92-12
12-92-12
13-92-08
53-92-06Ch. 1126 Increase in Hospital Special Treatment Room Support Component—Payment For Observation and Monitoring in ASC's and SPU's 08/11/92 06-92-02
08-92-02
11-92-13Ch. 1121 Norplant Coverage 12/07/92 01-92-20
10-92-10
11-92-21
30-92-06Ch. 1101 Basic Health Care for Adult General Assistance Recipients 12/23/92 99-92-07 Ch. 1121 Changes in Medical Assistance Pharmaceutical Benefits 12/23/92 01-92-19
02-92-03
03-92-08
04-92-09
10-92-09
11-92-20
12-92-16
19-92-15
26-92-05
28-92-03
29-92-03
30-92-05
33-92-04
49-92-081993 — Accessing Mental Health Services Not Currently Included in the Medical Assistance Fee Schedule for Eligible Children and Adolescents Under 21 Years Of Age 01/19/93 01-93-03
29-93-02
33-93-02
41-93-01
48-93-01— Payment for Mental Health Services Provided in a Residential Treatment Facility for Eligible Individuals Under 21 Years of Age 01/19/93 01-93-04
11-93-02
13-93-02
41-93-02
53-93-02
1165-93-07— Enrollment Procedure Changes 01/22/93 29-93-01
33-93-01Ch. 1101 Interim Agreement Felix et al. v. Casey et al. 01/28/93 99-93-01
1101-93-02Ch. 1123 Reminder that Medical Equipment And Supplies Must be Prescribed 01/29/93 01-93-02
03-93-01
04-93-01
05-93-01
07-93-01
19-93-02Ch. 1101 Additional Copayment Expenses 02/17/93 01-93-01
19-93-01
1101-93-01Ch. 1123 Prior Authorization Rental of Of Nebulizers 04/09/93 01-93-06
05-93-03
19-93-04Ch. 1121 Intrauterine Devices 05/13/93 01-93-09
10-93-01
11-93-04Ch. 1101
1150Voucher System For the General Assistance Basic Health Care Package Update 06/30/93 01-93-12
04-93-04
07-93-03
10-93-04
11-93-07
15-93-02
19-93-09
26-93-04
30-93-03
49-93-04*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. 1150 Revised Definition for Established Patient Evaluation and Management Visit and Consultation 07/13/93 01-93-14
04-93-05*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 PACKAGE 07/21/93 1101-93-04 Ch. 1147 Specific Procedure Code for Deluxe Eyeglass Frames 08/02/93 01-93-16
05-93-05
15-93-04
19-93-12Ch. 1163 Change in Automated Utilization Review Toll-Free Telephone Number 08/04/93 01-93-17
03-93-06
04-93-07
06-93-01
08-93-01
11-93-10
12-93-05
13-93-04
26-93-05
53-93-03
Ch. 1241 Centers for Disease Control Blood Lead Testing 09/03/93 1241-93-01
01-93-18
10-93-06
11-93-12
17-93-02
26-93-06
49-93-06
Ch. 1101 Business Arrangements Between Nursing Facilities and Pharmacy Providers 10/08/93 1101-93-05
19-93-16
25-93-01
35-93-03
36-93-03Ch. 1101
1150Payment Policy for the Professional Component of Radiology Services And Electrocardiograms 10/29/93 01-93-19
11-93-13
12-93-06
13-93-05
53-93-04Ch. 1101
1150Procedures for Submitting Invoices For Services Provided to Retroactively Eligible Newborns 12/06/93 99-93-11 Ch. 1241 Environmental Lead Investigations 12/15/93 99-93-12 Ch. 1101
1150Newborn Eligibility Update and Corrections to Previous Bulletins 12/20/93 09-93-02
11-93-15
31-93-02Ch. 1101
1150Newborn Eligibility Update 12/20/93 99-93-14 Ch. 1245 Payment for Non-emergency Transportation for Nursing Home Patients 12/27/93 18-93-01 — OBRA Procedures for Individuals with Mental retardation 12/30/93 00-93-30 1994 EVS Response Worksheet (MA 464) 01/20/94 99-94-01 Ch. 1101 General Assistance (GA) Basic Health Care Package Voucher System and Rejected Invoices 03/02/94 01-94-03
04-94-01
07-94-01
10-94-01
11-94-02
15-94-01
19-94-02
26-94-01
30-94-01
49-94-02Ch. 1101 General Assistance (GA) Basic Health Care Package Voucher System and Rejected Invoices 03/02/94
04-49-01
07-94-01
10-94-01
11-94-02
15-94-01
19-94-02
26-94-01
30-94-01
49-94-02— 1. ACCESS to Medical Assistance for Children, Pregnant Women and Their Families (PA 600C)
2. Provider Application For Benefits (PA 600P)03/31/94 99-94-05 — Implementation of the Family Care Network: A Primary Care Case Management Program for Children and Adolescents 04/01/94 99-94-06 — Plan of Care Summary 04/01/94 01-94-05
41-94-02
48-94-02
49-94-03
50-94-02Ch. 1241 Update to Blood Lead Testing Guidelines 04/08/94 1241-94-01 Ch. 1123 Audiological Services 04/28/94 01-94-08
05-94-03
11-94-06
19-94-04
50-94-03— Billing Procedures for Partial Hospitalization Services that Exceed The Total Number of Hours 04/29/94 33-94-01 Ch. 1149 Provider Training on Completing The Dental Services Invoice (MA 300D) 05/05/94 03-94-02 — Medicare Part B Crossover 05/05/94 99-94-07 *CH. 1239 MA CASE MANAGEMENT SERVICES FOR RECIPIENTS UNDER THE AGE OF 21 05/17/94 1239-94-01
99-94-08Ch. 1249 Procedures for Prior Authorization Of Home Health Services 06/10/94 23-94-04 Ch. 1121 Discontinuance of Pharmacy Vouchers For General Assistance Recipients and Enforcement of Limits 06/24/94 01-94-13
19-94-09*CH. 1121 PHARMACEUTICAL SERVICES DRUG COVERAGE FOR MEDICALLY NEEDY IN NURSING FACILITIES 06/24/94 1121-94-01 Ch. 1121 Brand Medically Necessary Drugs Prior Authorization Billing Procedure And Drug List 07/01/94 19-94-10 Ch. 1121 Brand Medically Necessary Drugs Prior Authorization Request Procedure And Drug List 07/01/94 01-94-15
03-94-03
04-94-04— Medical Case Management Recordkeeping Forms 07/06/94 99-94-11 Ch. 1147 Proper Billing of Tonography and Provocative Test for Glaucoma 07/14/94 01-94-14
15-94-03*CH. 1121 PHARMACEUTICAL SERVICES PRIOR AUTHORIZATION REQUIREMENT MULTISOURCE BRAND NAME DRUGS 08/26/94 1121-94-02
01-94-17
03-94-04
04-94-05
19-94-11*CH. 1121
CH. 1126
CH. 1129
CH. 1141
CH. 1163
CH. 1221
CH. 1225
CH. 1242TREATMENT 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
1225-94-01
1242-94-01
99-94-13*CH. 1101 GENERAL ASSISTANCE RESTRUCTURE AS A RESULT OF ACT 49 09/02/94 1101-94-01
99-94-14Medicare Deductible and Coinsurance Amounts for Medical Supplies for Residents in a Nursing Home 09/02/94 05-94-07
19-94-13Ch. 1141
1143Selected Office Surgical Procedures Performed in the Office 09/02/94 01-94-19
04-94-06— Clarification Bulletin 18-93-01 09/23/94 18-94-01 Ch. 1150 Revised Billing Instructions for the HCFA1500 11/14/94 99-94-15 *CH. 1153 PRIOR AUTHORIZATION OF PARTIAL HOSPITALIZATION 12/30/94 1153-94-01 1995 — Signature Requirements 02/01/95 01-95-01
29-95-01
33-95-01
41-95-01
49-95-01
50-95-01— Payment of Partial Hospitalization Services After Medicare 02/14/95 33-95-02 — AIDS Waiver Program (0192 Waiver Program); the Physician's Role In Recipient Enrollment 02/23/95 01-95-02
02-95-01
10-95-01
11-95-01— Implementation of the Lancaster Community Health Plan 03/27/95 99-95-02 — Reimbursement of Nurse Aide Training And Testing Fees 04/06/95 34-95-01
35-95-01
36-95-01
1181-95-01— Nutritional Consultations under the AIDS Waiver Program (0192 Waive) 04/26/95 01-95-05
02-95-03
10-95-02
11-95-02
23-95-02
27-95-01
28-95-01
30-95-01
38-95-01
39-95-01— Changes to the Services Available Under the AIDS (0192) Waiver Program 05/12/95 01-95-06
02-95-05
05-95-02
10-95-03
11-95-03
17-95-01
19-95-03
23-95-03
27-95-02
28-95-02
30-95-02
38-95-02
39-95-02Ch. 1141 Mammography Quality Standards Act (MQSA) 06/02/95 01-95-09
10-95-05
11-95-06
12-95-02
20-95-02
30-95-05— 1. Announcement of New Forms Printing Contractor
2. Instructions on Ordering Medical Assistance (MA) Forms07/14/95 99-95-06 Ch. 1121 Prescription Payment Systems Revisions 09/22/95 01-95-14
19-95-05Ch. 1141 Payment for Cleft Palate Services For Individuals Under 21 Years of Age 10/06/95 01-95-16
03-95-03
41-95-05
50-95-05Ch. 1221 Non-Emergency Use of the Emergency Room 10/13/95 01-95-19
11-95-11
12-95-06— Announcement of the Pennsylvania Department of Aging (PDA) Waiver 10/16/95 01-95-17
05-95-04
18-95-01
19-95-06Changes to the Eligibility Verification System 11/22/95 99-95-08 — Additional Benefits Covered by the Special Pharmaceutical Benefits Program 11/30/95 01-95-22
02-95-07
05-95-06
11-95-14
13-95-03
14-95-03
19-95-08
23-95-10
26-95-03
27-95-03
29-95-06
32-95-09
33-95-07
35-95-08
36-95-08
49-95-03CH. 1163 Payment Policy For Abortion Services 12/15/95 1163-95-02 Ch. 1221 Change in Billing Procedure for Emergency Room Visits 12/28/95 01-95-23 1996 Ch. 1121 Brand Name Drugs Prior Authorization 0 Updated List 1/19/96 01-96-01
02-96-01
03-96-01
04-96-01
10-96-01
11-96-01
12-96-01
19-96-01
26-96-01
28-96-01
29-96-01
30-96-01
33-96-01
49-96-01Ch. 1141 Rate Change for Pediatric Office Visits 02/05/96 01-96-02
10-96-02
11-96-02
26-96-02
49-96-02
50-96-01— Continuity of Prior Authorized Services Between Fee-for-Service and Managed CarePlans for Individuals Under Age 21 02/29/96 99-96-01 — Revisions to Billing Instructions for the Pennsylvania Department of Aging (PDA) Waiver 04/01/96 01-96-07
05-96-02
18-96-01
19-96-07
23-96-03
28-96-05
29-96-04
33-96-04
39-96-01Ch. 1121 Procedure to Request Prior Authorization For Anti-Ulcer Drugs 04/02/96 01-96-05
02-96-03
03-96-03
04-96-03
10-96-04
11-96-04
12-96-03
26-96-04
28-96-03
29-96-03
30-96-03
33-96-03
49-96-04Ch. 1121 Procedure to Bill Anti-Ulcer Drugs Drugs Requiring Prior Authorization 04/02/96 19-96-05 Ch. 1121 Prior Authorization of Anti-Ulcer Drugs 04/02/96 01-96-08
02-96-05
03-96-04
04-96-04
10-96-05
11-96-07
12-96-05
19-96-08
26-96-06
28-96-06
29-96-05
30-96-06
33-96-05
49-96-06Ch. 1101
1150Hearing Aid Batteries Added to Medical Assistance Program Fee Schedule 04/02/96 03-96-09
05-96-03
11-96-08
19-96-09
50-96-02Procedure for Service Description 04/29/96 01-96-11
41-96-01
48-96-01
50-96-04
— InterQual Intensity/Severity/Discharge (ISD) Criteria for Review of Hospital Admissions 05/22/96 01-96-13
11-96-12
13-96-01— Provider Billing Information for the Family Care Network (FCN) Program 05/23/96 99-96-04 — Implementation of Act No. 1996-35 06/14/96 99-96-05 Ch. 1141 Clarification of the Rate Change for Pediatric Office Visits Bulletin 07/19/96 01-96-16
10-96-08
11-96-15
26-96-09
49-96-08
50-96-06— HealthCare Benefits Package 12 Employability Assessment Procedure Code List 08/19/96 01-96-17
10-96-09
11-96-17
12-96-11
15-96-02
16-96-03
20-96-02
26-96-10
28-96-08
29-96-07
49-96-09— Additions to the Special Pharmaceutical Benefits Program Drug Formulary 09/03/96 01-96-18
02-96-06
05-96-05
11-96-18
13-96-04
14-96-03
19-96-15
23-96-06
26-96-11
27-96-01
29-96-08
32-96-01
33-96-06
35-96-08
36-96-08
49-96-10Ch. 1101 GA and GA-related Medical Assistance Deductible Procedures 09/30/96 06-96-03
08/96-03
11-96-20
12-96-13
13-96-06
53-95-02Ch. 1241 Statewide Implementation of the Vaccines for Children (VFC) Program 10/04/96 01-96-19
10-96-10
11-96-21
26-96-12Ch. 1149 Information on New Procedures for Submitting Evaluating Orthodontic Prior Authorization Requests 10/21/96 03-96-06 Ch. 1163
1141Neonatal Intensive Care Procedure Costs 10/25/96 01-96-20 — Healthcare Benefit Package 12 Employability Assessment Update 11/15/96 01-96-22
10-96-12
11-96-23
12-96-15
15-96-03
16-96-04
20-96-03
26-96-14
28-96-09
29-96-09
49-96-11— Implementation of the HealthChoices Program 11/18/96 99-96-08 Ch. 1141 Revision to Physician Assistant and Midwife Supervision Requirements 11/22/96 01-96-21
02-96-07
06-96-04
08-96-04
09-96-01
10-96-11
11-96-22
12-96-14
25-96-02
26-96-13
30-96-08
37-96-02
38-96-01
1141-96-01— Clarification of Act 35 Issues 12/04/96 01-96-23
10-96-13
11-96-24
12-96-16
13-96-07
14-96-04
26-96-15
28-96-10
29-96-10— Special Pharmaceutical Benefits Program Automated Claims Processing System 12/11/96 01-96-24
02-96-08
05-96-06
11-96-25
13-96-08
14-96-05
19-96-16
23-96-07
26-96-16
29-96-11
32-96-02
33-96-07
49-96-121997 Ch. 1145 Change in Recipient Access to Chiropractic Services in the Family Care Network (FCN) Program 02/12/97 99-97-02 Ch. 1121 HealthChoices Protease Inhibitors Special Billing Procedure 02/21/97 19-97-02 Ch. 1121 Prospective Drug Use Review Therapeutic Duplication Screening 02/21/97 19-97-01 — Expansion of the Pennsylvania Department of Aging (PDA) Waiver 02/28/97 23-97-01
28-97-01
29-97-01
33-97-01— Expansion of the Pennsylvania Department of Aging (PDA) Waiver 02/28/97 01-97-02
05-97-01
18-97-01
19-97-03
55-97-01— Pennsylvania Department of Aging (PDA) Waiver Program Handbook 02/28/97 35-97-03
36-97-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions 02/28/97 23-97-03
28-97-03
29-97-03
33-97-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions 02/28/97 01-97-03
05-97-02
18-97-02
19-97-04— Pennsylvania Department of Aging (PDA) Waiver Program Handbook 02/28/97 55-97-02 — Pennsylvania Department of Aging (PDA) Waiver Certification Process 02/28/97 23-97-02
28-97-02
29-97-02
33-97-02
35-97-02
36-97-02— Expansion of the Pennsylvania Department of Aging (PDA) Waiver 02/28/97 35-97-01
36-97-01Ch. 1121 Brand Name Drugs Prior Authorization Updated List 03/17/97 01-97-06
02-97-01
03-97-02
04-97-02
10-97-01
11-97-03
12-97-01
19-97-06
26-97-02
28-97-04
29-97-04
30-97-01
33-97-04
49-97-01Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 03/21/97 01-97-04
19-97-05Ch. 1150
1141Discontinuance of the Mandatory Second Program (SOP) 03/25/97 01-97-05
03-97-01
04-97-01
06-97-01
08-97-01
11-97-02
12-97-02
26-97-01
1150-97-01Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1997 HCPCS Updates 04/10/97 05-97-03
19-97-07
23-97-04Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1997 HCPCS Updates 04/10/97 01-97-07
03-97-03
04-97-03
10-97-02
11-97-04
12-97-03
15-97-01
16-97-01
17-97-02
20-97-01
30-97-02
43-97-01
49-97-02
50-97-01Ch. 1221 Change in Billing Procedure for Emergency Room Visits 05/12/97 11-97-05
12-97-04
13-97-01Ch. 1141
1144
1241Diagnostic and Psychological Evaluations 05/28/97 01-97-08
17-97-03
41-97-01
48-97-01
49-97-03
50-97-02— Pennsylvania Department of Aging (PDA) Waiver Procedure Code Update 06/06/97 01-97-09
05-97-04
18-97-03
19-97-08
23-97-05
28-97-05
29-97-05
33-97-05— Coverage of COMVAX 06/11/97 01-97-10
10-97-03
11-97-06
17-97-04
19-97-09
26-97-03Ch. 1101
1150Provider Produced Invoices 06-11-97 99-97-03 — HealthChoices Phase 2 Extension Of Enrollment Period 06/17/97 99-97-04 Ch. 1101
1150Changes to the Medical Assistance Program 1997 HCPCS Updates 06/30/97 01-97-11
03-97-04
04-97-04
10-97-04
11-97-07
12-97-05
15-97-02
16-97-02
17-97-05
20-97-02
30-97-03
43-97-02
49-97-04
50-97-04— InterQual Intensity/Severity/Discharge (ISD) Criteria for Review of Hospital Admissions 07/01/97 01-97-12
11-97-08
12-97-06
13-97-02Ch. 1241 Training for EPSDT Expanded Services (Provider Type 50) on Completing Medical Assistance Invoices 07/07/97 50-97-03 Ch. 1241 Revised Recommended Childhood Immunization Guidelines 07/23/97 1241-97-01
01-97-13
01-97-13
10-97-05
11-97-09
17-97-06
26-97-04
49-97-05
Ch. 1141 Revision to Physician Assistance and Midwife Supervision Requirements 07/30/97 01-97-14
02-97-02
06-97-02
08-97-02
09-97-01
10-97-06
11-9711
12-97-07
25-97-01
26-97-05
30-97-04
31-97-01
37-97-01
38-97-01
1141-97-01Ch. 1121 Pharmacy Recordkeeping Requirements 08/04/97 19/97/10 — Revised Social Security Administration Definition of Disability for Children 08/08/97 99-97-05 Ch. 1163 Cost Outlier Payments for Certain Burn And Neonate Cases 08/11/97 11-97-10 — Reporting Procedures for Residents Targeted Under OBRA '87 and OBRA '90 08/29/97
34-97-01
35-97-04
36-97-04Ch. 1101
1150Accurate Billing for Units of Service Based on Periods of Time 09/17/97 99-97-06 Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 09/17/97 01-97-15
19-97-11— The Addition of Viracept to the Special Pharmaceutical Benefits Program Formulary 11/10/97 01-97-18
02-97-03
11-97-12
19-97-13
23-97-06
26-97-06
28-97-07
30-97-05
35-97-05
36-97-05
37-97-02
45-97-01
46-97-01—-. Ammendment to Medical Assistance Bulletin #99-96-08 11/20/97 99-96-11 Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 11/21/97 01-97-17
19-97-12— Amendment to Medical Assistance Bulletin #99-96-08 11/27/97 99-96-09 Ch. 1101
1150Billing Instructions for Medicare Part B Claims 11/27/97 99-96-10 Ch. 1147 Revisions to the HealthCare Benefits Packages Reference Chart (MA 446) 12/18/97 99-97-07 — HealthChoices Southwest Mandatory Managed Care Program Iplementation Schedule 12/19/97 99-97-08 1998 Ch. 1141 Physician Services Handbook Replacement Pages 01/20/98 01-98-01 Ch.1150 Clarification of Procedures for Requesting Copies of Medical Assistance Recipients' Bills 02/27/98 99-98-01 Training for Nursing Facilities on Completing Medical Assistance Invoices 03/03/98 35-98-02
36-98-02— Medical Assistance (Medicaid) Financial Eligibility Application For Long Term Care, Supports and Services (PA 600L) 03/03/98 11-98-01
12-98-01
14-98-01
24-98-01
25-98-01
34-98-01
35-98-01
36-98-01
51-98-01
53-98-01
55-98-01
56-98-01— Second Expansion of the Pennsylvania Department of Aging PDA Waiver 03/13/98 01-98-03
05-98-02
18-98-02
19-98-02
55-98-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 01-98-02
05-98-01
18-98-01
19-98-01— Second Expansion of the Pennsylvania Department of Aging (PDA) Waiver 03/13/98 35-98-05
36-98-05— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 55-98-02 — Pennsylvania Department of Aging (PDA) Waiver Certification Process (2nd Expansion 03/13/98 23-98-02
28-98-02
29-98-01
33-98-01
35-98-03
36-98-03— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 35-98-04
36-98-04— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (2nd Expansion) 03/13/98 23-98-03
28-98-03
29-98-02
33-98-02— Second Expansion of the Pennsylvania Department of Aging (PDA) Waiver 03/13/98 23-98-04
28-98-04
29-98-03
33-98-03Ch. 1101
1150Announcement of Revised Millennium Medical Assistance Claims Forms 03/16/98 99-98-02 Ch. 1101
1150Medical Assistance Program Fee Schedule Revision 1998 HCPCS Updates 03/25/98
05-98-03
04/06/98 01-98-04
03-98-01
04-98-01
10-98-01
11-98-02
12-98-02
15-98-01
16-98-01
17-98-01
20-98-01
30-98-01
43-98-01
49-98-01
50-98-01Ch. 1101
1150Revisions to and Instructions for Completing & Submitting Revised ''Millennium'' Medical Assistance (MA) Claim Forms 04/22/98 99-98-04 — Clarification of the HealthChoices Recipient Coverage Policy for Behavioral Health Services 04/30/97 01-98-05
17-98-02
41-98-01
48-98-01
49-98-02
50-98-02
53-98-02
80-98-01— Medical Assistance Surety Bonds Interim Procedures 05/01/97 23-98-06 Ch. 1163 Revision of Utilization Guidelines for Inpatient Hospital Drug and Alcohol Services under the Medical Assistance Program 05/18/98 01-98-06
11-98-03
12-98-03
17-98-03
1163-98-01— Revised Case-Mix Reimbursement System Cost Report (MA-11) 05/20/98 35-98-07 — Revised Medical and Treatment Self—Directive Statement 06/19/98 11-98-04
12-98-04
13-98-02
14-98-02
17-98-04
23-98-07
34-98-02
35-98-08
36-98-08
37-98-01
38-98-01
53-98-03Ch. 1101
Ch. 1141
Ch. 1150
Ch. 1221Regulation Changes Regarding ''Emergency Medical Condition'' 07/01/98 1101-98-01
1141-98-01
1150-98-01
1121-98-01Medical Assistance Tele-Response System 07/01/98 99-98-05 — The Addition of Viramune and Rescriptor to the Special Pharmaceutical Benefits Program Formulary 07/01/98 01-98-08
02-98-01
11-98-05
19-98-05
23-98-08
26-98-01
28-98-05
30-98-02
35-98-09
36-98-09
37-98-02
45-98-01
46-98-01Ch. 1150
1241Increase in the Fees for the Administration Of Vaccines 07/01/98 01-98-09
10-98-02
11-98-06
12-98-05
49-98-03Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 07/06/98 01-98-07
19-98-04— Preparation of Statements of Claim For Recipients Enrolled in Managed Care 07/07/98 99-98-07
258-98-01Ch. 1150 Implementation of ''Millennium'' Claims Submission 07/10/98 99-98-08 — Change in Billing Procedure for Behavioral Health Rehabilitation Services 07/10/98 01-98-10
41-98-02
48-98-02
49-98-04
50-98-03Ch. 1101 Revisions to the HealthCare Benefits Packages Reference Chart (MA 446) 07/17/98 99-98-09 Ch. 1123 Nebulizer Codes 07/24/98 01-98-11
05-98-04
10-98-03
11-98-07
12-98-06
19-98-06
23-98-09Ch. 1121 Updates to State Maximum Allowable (State MAC) List 08/14/98 01-98-12
19-98-07Ch. 1121 Brand Name Drugs Prior Authorization Updated List 08/24/98 01-98-13
02-98-02
03-98-02
04-98-02
10-98-04
11-98-08
12-98-07
19-98-08
26-98-02
28-98-07
29-98-04
30-98-03
33-98-04
49-98-05— InterQual Intensity/Sensitivity Discharge (ISD) Criteria for Review of Hospital Admissions 08/24/98 01-98-14
11-98-09
12-98-08
13-98-03
— The Office of Social Program's (OSP)/Independence Waiver 09/11/98 99-98-10 — Billing Instructions for the Community Services Program for Persons with Physical Disability Waivers 09/11/98 51-98-01 Ch. 1150 Revised Billing Instructions for Medicare Part B Claims that Do Not Cross Over to Medical Assistance 09/14/98 99-98-11 Ch. 1150 Medical Assistance Program Fee Schedule Revision 1998 HCPCS Updates 09/21/98 07-98-01 Ch. 1150 Revision to Attachment Type Codes on Invoice Submissions 10/14/98 24-98-03
25-98-03
34-98-04
35-98-12
36-98-12— Change in Medical Assistance (MA) Bulletin Mailing Procedure 10/14/98 01-98-15
03-98-03
04-98-03
07-98-02
15-98-02
31-98-01
41-98-03
44-98-01
49-98-06— Statewide Expansion of the Pennsylvania Department of Aging (PDA) Waiver 11/17/98 10-98-05
11-98-10
12-98-09
13-98-04
14-98-03
17-98-05
20-98-02
23-98-10
26-98-03
28-98-08
29-98-05
33-98-05
37-98-03
41-98-04
43-98-02
45-98-02
46-98-02
48-98-03
49-98-07
51-98-03— Statewide Expansion of the Pennsylvania Department of Aging (PDA) Waiver 11/17/98 01-98-16
05-98-05
18-98-03
19-98-09
55-98-04— Statewide Expansion of the Pennsylvania Department of Aging (PDA) Waiver 11/17/98 35-98-13
36-98-13— Pennsylvania Department of Aging (PDA) Waiver Certification Process (Statewide Expansion) 11/17/98 10-98-06
11-98-11
12-98-10
13-98-05
14-98-04
17-98-06
20-98-03
23-98-11
26-98-04
23-98-09
29-98-06
33-98-06
35-98-14
36-98-14
37-98-04
41-98-05
43-98-03
45-98-03
46-98-03
48-98-04— Accurate Billing for Units of Service Based on Periods of Time 11/17/98 99-98-12 Ch. 1243 Clinical Laboratory Improvements Amendments (CLIA) Requirements 11/25/98 01-98-17
11-98-12
16-98-02
17-98-07— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 35-98-15
36-98-15— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 01-98-18
05-98-06
18-98-04
19-98-10— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98
10-98-07
11-98-13
12-98-11
13-98-06
14-98-05
17-98-08
20-98-04
23-98-12
26-98-05
28-98-10
29-98-07
33-98-07
37-98-05
41-98-06
43-98-04
45-98-04
46-98-04
48-98-05
49-98-09
51-98-05— Pennsylvania Department of Aging (PDA) Waiver Program Billing Instructions (Statewide Expansion) 12/22/98 55-98-05
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