Pennsylvania Bulletin

PA Bulletin, Doc. No. 21-1268d

F02-09-21 -3
[51 Pa.B. 4433]
[Saturday, August 7, 2021]

[Continued from previous Web Page]

(Editor's Note: This document continues from Part II which begins at 51 Pa.B. 4433 (August 7, 2021).)

Year Code Citation Subject Date Issued Bulletin Number

Interim Technical Guidance for Claim and Service Documentation 07-25-18 00-18-04

Fee Schedule Rates and Methodology for Waiver Services TSM and Base-Funded Program Services 09-13-18 00-18-05

Variance Form and Process: Requesting a Variance 09-17-18 00-18-06

2019 OVR Referrals for ODP Employment Related Services 02-14-19 00-19-01

OVR Referrals During a Period When OVR's Order of Selection is Closed 7-1-19 00-19-02

Prioritization of Urgency of Need for Services (PUNS) Manual 7-23-19 00-19-03

Individual Eligibility for the Consolidated, P/FDS and Community Living Waivers 11-26-19 00-19-04

2020 Regulatory Compliance Guide for Community Homes for Individuals with an Intellectual Disability or Autism 2-3-20 00-20-01

Individual Support Plans for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services, or Who Reside in an ICF/ID 2-7-20 00-20-02

Electronic Visit Verification (EVV) for Personal Care Services (PCS) 9-10-20 00-20-03

Participant-Directed Services: Agency with Choice Financial Management Services Model 12-16-20 00-20-04

2021 Guidance for Human Rights Teams and Human Rights Committees 2-5-21 00-21-01

Incident Management 3-1-21 00-21-02

GUIDANCE MANUALS:

• Everyday Lives, Values in Action

• Office of Developmental Programs Quality Assessment and Improvement Process

• Pennsylvania's Guide to Participant-Directed Services

• Individual Support Plan (ISP) Manual for Individuals Receiving Targeted Services Management, Base Funded Services, Consolidated Waiver Services, Community Living, P/FDS Services or Who Resides in an ICF/ID

• Office of Developmental Programs Supports Coordinator Orientation

• Independent Monitoring for Quality (IM4Q) Manual

• Enterprise Incident Management System (EIM) Manual

• Certified Investigator Manual

• PUNS Manual

• Supports Intensity Scale^TM (SIS^TM) and PA Plus User's Manual

• Gold Book

• AAW Provider Manual—Bureau of Supports for Autism and Special Populations (BSASP)

• AAW Provider Information Table

• Practice Guidelines—BSASP

• Supports Coordinator Manual—BSASP

• Behavioral Specialist Manual—BSASP

• Participant Handbook—BSASP

• Goal Attainment Scaling (GAS) Manual—BSASP

• Reference Manual on Community HealthChoices (CHC)

• ACAP Participant Handbook—BSASP/Keystone Autism Services

• ACAP Provider Manual—BSASP/Keystone Autism Services

• Best Instructional Practices Manual—BSASP

• Periodic Risk Evaluation (PRE) Manual—BSASP

INFORMATIONAL PACKETS:

• PROMISe Billing Quick Reference Error Status Codes Informational Packet (# 014-09)

• Prudent Pay of Claims Policy Enforcement Informational Packet (# 075-11)

• Use of SNAP for Individuals Residing in GLAs Informational Packet (# 015-12)

• Emergency Respite Procedure Informational Packet (# 066-12)

• Residential Vacancy Management Procedure Informational Packet (# 098-12)

• Request for Waiver of Provision of Chapter 51 Informational Packet (# 002-13)

• Incident Management Clarification of Responsibilities for the Supports Coordination
Organizations (# 072-13)

• Amendments to 55 Pa. Code Chapter 6000, Statements of Policy, Subchapter Q as a result of Adult Protective Services (# 031-15)

INFORMATIONAL MEMOS:

• Viewing Service Utilization in HCSIS for AEs Informational Memo (# 005-09)

• Electronic Funds Transfer Option Informational Memo (# 006-09)

• Remittance Advice Quicktip # 7 Informational Memo (# 015-09)

• Individual Purchases and Item Storage Informational Memo (# 049-10)

• Incident Management Reporting Informational Memo (# 115-11)

• How to Request a Reissue or Copy of Cashed Check Informational Memo (# 138-11)

• Uniform Construction Code Clarification for Licensed Providers Informational Memo (# 180-11)

• DRN Review Informational Memo (# 019-12)

• Admissions to State Operated ICFs/ID Informational Memo (# 045-12).

• Reporting Unauthorized Restrictive Interventions Informational Memo (# 080-12)

• Clarification to ODP Communication # 098-12 Residential Vacancy Management Informational Memo (# 103-12).

• Implementation Instructions on QM Plans Informational Memo (# 107-12)

• Incident Investigation Determination Informational Memo (# 110-12)

• NPI Number Required on All Claim Types Informational Memo (# 001-13)

• Secondary Transition Website Informational Memo (# 059-13)

• Communication Assistance Compliance Standards for Individuals who are Deaf (# 018-15)

• Incident Report Finalization (# 025-15)

• Helpful Resources from the PA Department of Transportation (# 034-15)

• Implementation Instructions for Providers, including SCOs on Quality Management Plans (# 038-15)

• Enforcement Actions against Noncompliant ODP Intellectual Disability Waiver Providers (# 062-15)

ODP ANNOUNCEMENTS

• Update to the Frequently Asked Questions (FAQ) Targeted Services Management Bulletin Document (# 047-16)

• Provider Payment for Start-Up (Per Chapter 51) And Family Living Initiative (# 055-16)

• Scheduling Support Service Workers to Work More than 40 Hours per Week in the Consolidated and P/FDS Waivers
(# 068-16)

• Clarifying the Provision of Home and Community Habilitation and/or Companion Services by Relatives and Legal Guardians in the Consolidated and P/FDS Waivers (# 069-16)

• Everyday Lives Conference Session Materials Now Available (# 070-16)

• CMS Quality Review Reports for the Consolidated and P/FDS Waivers Available Online (# 071-16)

• ODPs Quality Management (QM) Certification Program Prerequisite Courses Available (# 079-16)

• Professional Development Opportunities: SELN Employment Webinars (# 081-16)

• MyODP.org Registration (# 086-16)

• Individual Monitoring Tool Clarification of the New Employment Questions (# 088-16)

• Policy clarification surrounding the role of Direct Care Workers (# 094-16)

• Adding Communication Assessment Report Recommendations to Individuals Support Plans for Harry M Class Members (# 099-16)

• Updated Administrative Fee Services Related to the Delivery of Vendor Services (# 100-16)

• Everyday Lives Webinar Recording and Transcript Posted to MyODP (# 101-16)

• Everyday Lives: Values in Action—Information Sharing and Advisory Committee Recommendations, Strategies, and Performance Measures is Available on MyODP.org (# 004-17)

• Voter Registration Responsibilities (# 011-17)

• Chapter 51: Office of Developmental Programs Home and Community-Based Services Regulation Questions and Answers (# 021-17)

• Ordering or Prescribing Provider: National Provider Index Number Required on Claims (# 022-17)

• New Resource for Individuals and Families Available: Find, Choose, and Keep Great DSPs (# 023-17)

• Quality Management Planning Resources Available on MyODP (# 025-17)

• 2017 Updated Certified Investigator Manual Now Available (# 029-17)

• Right to be Free from Abuse Notification Handout REISSUE, Update Pending (033-17)

• Process for 180-Day and 365-Day Timely Filing Edits: Exception and Special Handling Requests (Request Form)
(# 037-17)

• Discontinuation of Life Sharing Ineligible Fees (# 046-17)

• Provider Closure Notification Form (DP 1061) (# 050-17)

• Guidance, Information and Resource Materials for Administrative Entities to Support the Inclusion of Individuals with the Diagnosis of Autism Spectrum Disorder (ASD) in Targeted Services Management (TSM), Consolidated and P/FDS Waivers (056-17)

• Now Available: The ''Why''—Everyday Lives Module 1 of the Required Community Participation Supports Training
(# 075-17)

• Issuance of the Corrected Waiver Level of Care Reevaluation Form (079-17)

• FAQs Updated for Quality Assurance and Improvement Process Now Posted on My ODP (080-17)

• NOW AVAILABLE: Transition of Behavioral Support in Residential Services Question and Answer Document (083-17)

• REISSUE SIS^TM Urgent Request Process Quick Tips Sheet (084-17)

• New Courses on Person Centered Thinking and Dementia Care Are Available on MyODP (085-17)

• Community Participation Support Training Module 4: Inclusion/Integration Now Available on MyODP (090-17)

• Now Available: New Community Participation Supports Training Module 5, Person Centered Planning (106-17)

• Guidance for Supports Coordinators and Administrative Entities for the Transition of Behavioral Supports for People Who Receive Residential Services in the Consolidated Waiver (111-17)

• Now Available: New Community Participation Supports Training Module 6: Introduction to Community Mapping (112-17)

• 117-17: Now Available: New Community Participation Supports Training Module 7 Building Relationships That Sustain a Community Life

• 119-17 Required Deaf Services Trainings on MyODP

• 120-17: New Supports Coordinator (SC) Orientation

• 125-17: Guidance for Individual Cap Exceptions for Person/Family Directed Support Waiver

• 126-17: CMS Approves the Targeted Support Management State Plan Amendment Effective August 20, 2017

• 016-18: Everyday Lives Conference Presentations Now Available

• 018-18: Supports Coordinator Orientation Curriculum New Course: You are the Keystone for Individuals and Families

• 026-18: Clarifications on Residential Service Staffing Ratios and Supplemental Habilitation in Residential Habilitation Services

• 028-18: Now Available: Life Sharing and Respite Question and Answer Document

• 029-18: REISSUE Community Participation Support ISP FY 2018-2019 Renewal Template

• 037-18: Launch of the ISAC hub

• 039-18: Charting the Life Course Webcasts Now Available on MyODP

• 040-18: Guidance Fiscal Year (FY) 2018-2019 ISP Renewal Period

• 041-18: College of Employment Services

• 046-18: College of Employment Services ACRE Supplement Update

• 053-18: Certified Investigator Report Administrative Review Manual and Supporting Items Are Now Available

• 066-18: Palco, Inc. to be Statewide Vendor Fiscal/Employer Agent

• 071-18 Addendum: Request for Approved Program Capacity and Noncontiguous Clearance

• 072-18: KEPRO to Administer SIS Assessments

• 073-18: Updated Contact MyODP Resource Accounts and New Listing of Archived Communications

• 076-18: Required Dual Diagnosis Training for Providers Newly Enrolling to Provide Residential Habilitation Services

• 079-18: College of Employment Services Webinar: (ACRE) Basic Employment Certification Overview August 28, 2018

• 080-18: Now Available: Quality Assessment and Improvement (QA&I) Annual Statewide Report for Cycle 1 Year 1 Fiscal Year (FY) 2017-2018

• 083-18: Housing Transition and Tenancy Sustaining Services

• 087-18: ODP Announces KEPRO's New SIS Scheduling Portal

• 090-18: College of Employment Services ACRE Update Unlimited Seats Available

• 092-18: Clarification on Declining a Communication Assessment Report

• 096-18: Office of Developmental Program's First Comprehensive Employment Report

• 099-18: Requesting an Enhanced Communication Rate for Services for Individuals Who Use Sign Language

• ODP 101-18 (REISSUE): Support People Who Are Deaf or Hard of Hearing Special Training Series

• ODP 103-18: ISAC Action Plan for Sexual Abuse Prevention Now Available

• ODP 105-18: Expectations for Supports Coordinators Regarding the Right to Be Free from Abuse

• ODP 106-18: Final Public Notice for Fee Schedule Rates and Department-Established Fees for Fiscal Year 2018-2019

• ODP 108-18: Home & Community-Based Services Settings Provider Self-Assessment Update 5

• ODP 109-18: Fair Hearing Request Form & Instructions

• ODP 19-001: 2017 ODP Quality Management (QM) Certificate Holders Now Due For

• Recertification by Dec. 31, 2019

• ODP 19-003: New Process for Residential Habilitation Vacancies

• ODP 19-007: Improving the Quality of Residential Services Report Available

• ODP 19-008: Social Security Administration Announces 2019 Cost of Living Adjustment

• ODP 19-010: The Office of Developmental Programs (ODP) Provides Written Notice of Provider Re-qualification Requirements

• ODP-19-011: 2018 Everyday Lives: Values in Action—Information Sharing and Advisory Committee Recommendations, Strategies, and Performance Measures Now Available on MyODP.org

• ODP 19-012: UPDATED New Documentation Requirements for Individual Support Plans (ISPs) Within the Consolidated Waiver

• ODP 19-013: Now Available-Interim PUNS Guidance and Revised PUNS Form

• ODP 19-014: Rate Exception Request Process Re-issue, Consolidated Waiver

• ODP 19-016: Notice to the Increase to the Federal Reimbursement of Transportation Costs for 2019

• ODP 19-017: Transition of Individuals from a Nursing Facility into an ODP Waiver

• ODP 19-018: Chapter 6100 Quality Management Planning Requirements for Adult Autism Waiver Supports Coordination Organizations and Providers

• ODP 19-025: Now Available—Updated ID/Waiver Employment Service Definition Question and Answer Document and ID/A Waiver Employment Service Definition Quick Guide

• ODP 19-029: Quality Investigation Unit at Temple University

• ODP 19-030: 2019-20 Fiscal Year (FY) Renewal Guidance

• ODP 19-032: Launch of the Quality Assessment and Improvement (QA&I) Process for the Adult Autism Waiver (AAW)

• ODP 19-033: ODP Releases 2017-2018 Annual Data Report

• ODP 19-036: Process to Implement Participant Direction Transfers from the Adult Autism Waiver to an ID/A Waiver

• ODP 19-039: AAW SCO and Provider Contact Information for the Quality Assessment and Improvement Process

• ODP 19-041: ODP Releases Quality Assessment & Improvement Annual Statewide Report of Self-Assessments for Fiscal Year (FY) 2018-2019

• ODP 19-042: Generation of EIM Notifications for Supports Coordinators and Supports Coordination Supervisors

• ODP 19-043: EIM Alerts for Incidents not submitted within 72 hours of Creation

• ODP 19-044: Qualification Process for New Providers UPDATE

• ODP 19-045: Updated Employment Resources Page on MyODP

• ODP 19-047: Quality Assurance Analyst Employment Positions through Autism2Work

• ODP 19-049: ''Getting Connected to the Community'' Training Available

• ODP 19-051: Additional (2nd) FY 2019-2020 Renewal Guidance

• ODP 19-052: Health Risk Screen Tool Implementation

• ODP 19-053: Announcing the Relaunch of Positive Approaches Journal

• ODP 19-057: Special Populations Unit's Virtual Targeted Trainings Now Posted and Accessible on MyODP.org

• ODP 19-059: Clarification of the Health Risk Screening Tool (HRST) Implementation for AAW and ACAP

• ODP 19-060: NOW AVAILABLE: FAIR HEARING REQUEST FORM (DP 458) TRANSLATED INTO SPANISH

• ODP 19-061: Final Fee Schedule Rates and Fiscal Year Renewal Guidance for Community

• Participation Support

• ODP 19-063: IM4Q and NCI Reports Now Available

• ODP 19-065: Health Risk Screening Tool Implementation Update—Identifying Raters and User Accounts

• ODP 19-069: Process Modification in the Office of Developmental Programs (ODP) Provider Enrollment Process

• ODP 19-071: Process for Updating Entity Contact Information for Quality Assessment and Improvement (QA&I) Process

• ODP 19-078: Exceptions to the Annual Fiscal Limit for the Person/Family Directed Support Waiver

• ODP 19-080: Quality Assessment & Improvement Process, Cycle 1, Year 3: Changes for Fiscal Year 2019-2020

• ODP 19-082: Waiver Amendment Webinar Recording Now Available on MyODP

• ODP 19-083: New Regulations to be Explored During Human Services Licensing Renewal Inspections

• ODP 19-084: Delay for Requirements Regarding the Number of Individuals Served in Licensed Facilities that Provide Community Participation Support or Day Habilitation Services

• ODP 19-085: Quality Assessment & Improvement Process, Cycle 1, Year 3: All Self-Assessments Begin July 1, 2019

• ODP 19-086: ODP Launches Online Provider Profiles

• 19-089: Clarifying the Requirement for the Master Provider Index Number for Claim and Service Documentation

• ODP 19-090: Continued Guidance: Community Participation Support Implementation

• ODP 19-091: Revisions to the Annotated ISP and Related Trainings

• ODP 19-098: Clarification on Identification of Staffing Ratios for Facility Time in the Community Participation Support Service

• ODP 19-099: Clarification to AAW and ACAP Providers and SCOs about the New SPeCTRUM 2.0 Training

• ODP 19-105 Office of Vocational Rehabilitation (OVR) Contact Information for ID/Autism Coordinators—Updated 8-14-19
Bulletin 00-19-01 Attachment Updated 8-14-19

• ODP 19-107: Now Available Version 3 of the Community Participation Support Question and Answer Document

• ODP 19-110: e-CIS Business Partner Access Key Registration Dates

• ODP 19-111: ODP Responds to Nationwide Shortage of Tuberculin Skin Test Antigens

• ODP 19-115: e-CIS Business Partner Access—Registration Open

• ODP 19-119: Now Available—ODP Comprehensive Employment Report—3rd Quarter, Fiscal Year 2018-2019

• ODP 19-120: Electronic Visit Verification (EVV) Training Registration and ODP Technical Guidance

• ODP 19-121: SpeCTRUM 2.0 Training Deadline Extended

• ODP 19-123: Update to the Quality Assessment and Improvement Process: Claim and Service Documentation Review

• ODP 19-126: Adult Autism Waiver Amendment Webinar Recording Now Available on MyODP

• ODP 19-127: REVISED Investigations by an ODP-Certified Investigator Required by Chapter 6100: ODP's Expectations and Implementation Strategy

• ODP 19-129: Publication of New Chapter 6100 Regulations and Revisions of Licensing Chapters

• ODP 19-130: Now Available—Amendments to the Consolidated, Community Living and P/FDS Waivers Approved by CMS

• ODP 19-131: Residential Individual Support Plan (ISP) Staffing Training

• ODPANN 19-135: Support Coordinators' Guide to the Communication Assessment and Reassessment

• ODPANN 19-137: Additional Information for eCIS Business Partner Transition

• ODP 19-138: Approved Program Capacity (APS) and updated Noncontiguous Clearance Form

• ODP 19-142: Delegated Admin Registration Reminder—CIS to eCIS Transition

• ODP 19-143: Electronic Visit Verification (EVV) Error Status Codes (ESCs) to Become Active November 1, 2019

• ODP 19-144: Bureau of Autism Services—New Name Announced

• ODP 19-145: Free Online Orientation Training Meets Regulatory Requirement

• ODP 19-146: Health Risk Screen Tool Statewide Progress Update

• ODP 19-147: Clarification of the Billing Process of Respite Services in Non-Residential Setting

• ODP 19-148: Revised: Community HealthChoices (CHC) to ODP Service Form Instructions

• ODP 19-149: Now Available—Residential and Non-Residential HCBS Provider Settings Self-Assessment Reports

• ODP 19-150: Electronic Visit Verification (EVV) Good Faith Effort (GFE) Update

• ODP 19-152: Final Public Notice for Fee Schedule Rates and Department-Established Fees

• ODP 19-153: Revisions to SC Individual Monitoring Tool for AAW Supports Coordinators

• ODP 19-154: Individual User Registration Reminder—CIS to eCIS Transition

• 19-155: NOW AVAILABLE! Positive Approaches Journal: Volume 8, Issue 3: ''Rights, Risks, and Restrictions.''

• ODP 19-156: New ODP Regulation Updates for Incident Management, Med Admin Annual Training

• 19-157: Open For Public Comment: Proposed Transportation Trip Fee Schedule Rates in the Adult Autism Waiver

• 19-158: Announcing MyODP News Online

• 19-159: Updated Variance Form DP 1086 and Instructions

• 19-160: Enrolling as an AAW Transportation Provider

• 19-162 Now Available Amendment to the Adult Autism Waiver Approved by CMS

• 19-163: Independent Monitoring for Quality (IM4Q) Interviews to include Adult Autism Waiver

• 19-164: Delay in Implementation of the Transportation—Trip Service in the Adult Autism Waiver

• 19-166: Bureau of Supports for Autism and Special Populations (BSASP) Required Program Assessment: Changes to Scales of Independent Behavior-Revised (SIB-r) Administration

• 20-002 Open for Public Comment: Proposed Heightened Scrutiny Information for Residential Service Locations and Accompanying Attachments

• 20-003: Now Available—The Quality Assessment and Improvement (QA&I) Annual Statewide Report for Cycle 1, Year 2 Fiscal Year 2018-2019

• 20-004: Clarifications and Training Requirements for AAW Employment Services

• 20-005: Notice for Administrative Entities (AEs) Regarding Level of Care Evaluations (LOC) for the Adult Autism Waiver

• 20-006: e-CIS Business Partner Access—Individual User Approval

• 20-007: Provider Qualification Process

• 20-008: What the Office of Vocational Rehabilitation's Announcement Regarding the Order of Selection Waiting List Means for Office of Developmental Programs' (ODP) Services

• 20-009: Provider Closure Notification Form (DP 1061)

• ODPANN 20-010: The Office of Developmental Programs (ODP) Provides Written Notice of Provider Requalification Requirements

• 20-011: Revision to the Enhanced Communication Rate for Services

• 20-012 Broadening Provider Qualifications for the Benefits Counseling Service

• 20-013: Quality Management (QM) Recertification for 2016 and 2018 ODP QM Certificate Holders

• 20-014 New ODP Regulation Update Clarification Regarding Medication Administration Requirements

• 20-015: Using the Correct Medication Administration Website and Spring 2020 Face-to-Face Training Information

• 20-016: Open for Public Comment: Electronic Visit Verification for Personal Care Services

• 20-017: Business Partner Access—eCIS Transition Planning—User Materials

• 20-018 Social Security Administration Announces 2020 Cost of Living Adjustment

• 20-019: UPDATE—COVID-19 Operational Recommendations for Providers of Intellectual Disability and Autism

• 20-020: COVID-19 Guidance Mont-Del-Bucks-Chester County—03-16-2020—UPDATE

• 20-021: Heightened Scrutiny Onsite Tools for Residential Service Locations Finalized and Now Available Online

• UPDATED ODP Announcement 20-023: COVID-19 Statewide Suspension of ODP Functions—Updated 4-3-2020

• ODP Announcement 20-025: Registration Information Update for eCIS-ODP Business Partners

• 20-026: Provider Re-qualification Deadline Extension of for Cycle 1 Year 3

• 20-028: Post Acute and Long Term Care COVID-19 Toolkit

• 20-029 UPDATE: Auto Authorizations for Residential Without Day Services

• 20-030: Provider Tracking ISP Revisions

• 20-031: Coronavirus Disease 2019 (COVID-19) Retainer Payments for Community Participation Supports (CPS)

• ODP Announcement 20-032: Coronavirus Disease 2019 (COVID-19) Temporary Modifications to Waiver and Regulatory Requirements to Support Adequate Staffing

• ODP Announcement 20-033: Now Available—Supports and Services Directory for Shift Nursing in the Adult Autism Waiver (AAW)

• ODP Announcement 20-034: Coronavirus Disease 2019 (COVID-19): Provisional Hiring Process for staff serving Older Adults

• ODP Announcement 20-035: Guidance for Preventing and Responding to Behavioral Crises

• ODP Announcement 20-036: Coronavirus Disease 2019 (COVID-19): ISP Revisions in the Adult Autism Waiver (AAW)

• ODP Announcement 20-037: Coronavirus Disease 2019 (COVID-19): Modification of Key Tasks and Activities in Response to Incidents

• ODP Announcement 20-038: Guidance and Alerts on Mitigating COVID-19 in Long Term Care Facility Settings 4-4-2020

• ODP Announcement 20-039 COVID 19: Response to Requests for Provider Retainer Payments

• ODPANN 20-041 UPDATE: COVID-19—Provider Guidance for Reporting Cases of COVID-19

• ODP Announcement 20-042: Final Public Notice for Transportation Trip Fee Schedule Rates in the Adult Autism Waiver

• ODP Announcement 20-043: Coronavirus Disease 2019 (COVID-19) and Communication

• Attachment: COVID-19 Communication Toolkit

• ODP Announcement 20-044: Coronavirus Disease 2019 (COVID-19) Supports Coordinator Check-In for Well Being Tool

• ODP Announcement 20-045: Adding the Transportation Service to an Individual Support Plan in the Adult Autism Waiver

• ODP Announcement 20-046: Adult Autism Waiver Provider Information Table Reissued

• ODP Announcement 20-047 Coronavirus Disease 2019 (COVID-19): Facilitating Personal Relationships When Visitors are Restricted in Residential Settings

• ODP Announcement 20-048: Temporary Changes to the College of Employment Services ACRE Fieldwork Assignments During COVID-19 Pandemic

• ODP Announcement 20-049 UPDATE—Coronavirus Disease 2019 (COVID-19): Reporting Cases of COVID-19

• ODP Announcement 20-050—Coronavirus 2019 (COVID-19): Requesting Personal Protective Equipment (PPE) for Licensed Residential Facilities from the Pennsylvania Department of Health

• ODP Announcement 20-051: Coronavirus Disease 2019 (COVID-19): Available Behavioral Specialists

• ODP Announcement 20-053: Revised Timeline for Incident Management Bulletin and Enterprise Incident Management System Enhancements

• ODP Announcement 20-054—Coronavirus Disease 2019 (COVID-19): Guidance for Modifications to Medical Examinations for Residential Staff and Individuals and to Service Delivery During the COVID-19 Pandemic

• ODP Announcement 20-055: Fiscal Year (FY) 2020-2021 Renewal Guidance

• ODP Announcement 20-056 (UPDATE)—Individual Transition Guide with Spanish Edition

• ODP Announcement 20-057: Health Risk Screening Tool Timeline Update

• ODP Announcement 20-058: Additional Fields in HCSIS Service Notes Now Available for the Adult Autism Waiver (AAW)

• ODP Announcement 20-059: COVID-19—Appendix K FAQ—IDA Waivers and AAW

• ODP Announcement 20-060: COVID-19 Reinstatement of Quality Assessment & Improvement Cycle 1 Year 3 Activities

• ODP Announcement 20-061: Requesting Provider Information—New Process for Reporting COVID-19 for Provider Staff Due June 4

• ODP Announcement 20-062: ODP Administrative Entity (AE) Facility Based Community Participation Supports Readiness Tool for COVID-19

• ODP Announcement 20-063 UPDATE: Coronavirus Disease 2019 (COVID-19): Reinstatement of the Supports Intensity Scale-Adult^TM and Pennsylvania Supplement Assessments

• ODP Announcement 20-064: AAW and ACAP Periodic Risk Evaluation (PRE) Revisions and Training

• ODP Announcement 20-065: Coronavirus Disease 2019 (COVID-19)—Clarification for Reporting Cases of COVID-19

• 20-067: COVID19—IHCS Companion Readiness Guide

• ODP Announcement 20-069 Update: Coronavirus Disease 2019 2020-2021 Waivers Cap Exceptions Guidance for the Person/Family Directed Support and Community Living Waivers

• ODP Announcement 20-070: Coronavirus Disease 2019 (COVID-19)—Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Funding for Providers of ODP Waiver Services

• ODP Announcement 20-071: Pennsylvania ODP—Provider Staff COVID-19 Tracking Forms

• ODP Announcement 20-072: COVID-19 At-a-Glance By Level of Community Spread 3-26-21

• ODP Announcement 20-073: New Procedure Codes for AAW Behavioral Specialist Services

• MyODP Announcement 20-074: Coronavirus Disease 2019 (COVID-19)—Community Participation Support (CPS) Retainer Payments Update

• ODP Announcement 20-076: Coronavirus Disease—Diagnoses Associated with Elevated Risk of Severe Illness or Death Following COVID-19 Infection 6-18-2020

• ODP Announcement 20-077: Vendor Fiscal/Employer Agent (VF/EA) Wage Ranges and Benefit Allowance for Specific Participant Directed Services

• ODP Announcement 20-078: Agency with Choice (AWC) Wage Ranges and Benefit Allowance for Specific Participant Directed Services Effective July 1, 2020

• ODP Announcement 20-079: Agency with Choice (AWC) Financial Management Services (FMS) Organization Listing

• ODP Announcement 20-080: EIM Enhancements

• ODP Announcement 20-081: Functional Behavioral Assessment (FBA) Virtual Training Now Available on MyODP

• ODP Announcement 20-082: Update to the Adult Autism Waiver Provider Information Table

• ODP Announcement 20-083: Provider Requalification for Cycle 1 Year 3

• ODP Announcement 20-084: Update—AAW and ACAP Restriction Intervention Plan Indicator

• ODP Announcement 20-085 UPDATE: Provider Attestation Form for Retainer Payments—Clarification for CPS Providers added

• ODP Announcement 20-086: COVID-19—Notifying Designated Persons and Providers of an Individual's COVID-19 Exposure or Diagnosis (UPDATE)

• ODP Announcement 20-87: Coronavirus Disease 2019 (COVID-19): Managing Situations Where Masks are Not Worn During the Provision of Services

• ODP 20-088 UPDATE: Coronavirus Disease 2019 (COVID-19): Guidance on Masks, Close Contact, Screening, and Handwashing

• ODP Announcement 20-089: COVID-19 Guidance for Community Participation Support Providers in Counties in the Green Phase of the Process to Reopen Pennsylvania

• ODP Announcement 20-090: COVID-19 Clarification Regarding Hours of Intellectual Disability/Autism (ID/A) Waiver Services Provided by Relatives or Legal Guardians

• ODP Announcement 20-091: Adult Autism Waiver (AAW) Delay in Employment Credentials and Certificates

• ODP Announcement 20-093: Coronavirus Disease 2019 (COVID-19)—Solving Disagreements and Individualized Planning for Individuals Receiving Residential Habilitation and Community Participation Support or Day Habilitation

• ODP Announcement 20-094: Coronavirus Disease 2019 (COVID-19) Quality Assessment & Improvement Interim Review Process

• ODP Announcement 20-095 Update: Coronavirus Disease 2019 (COVID-19): Community Participation Support (CPS) Retainer Payments—New Updates 9-21-2020

• ODP Announcement 20-096: Government Benefits and Representative Payee Services Frequently Asked Questions

• ODP Announcement 20-097: Appendix K Second Submission and Approval: Emergency Preparedness and Response for ODP Waivers

• ODP Announcement 20-098: Coronavirus Disease 2019 (COVID-19): Appendix K Update: Waiver Services Provided to Individuals in Hospital Settings and Specialized Supplies

• ODP Announcement 20-099: Coronavirus Disease 2019 (COVID-19)—Clarification of Staff Reporting of COVID-19

• ODP Announcement 20-100 REMINDER: Adult Autism Waiver (AAW) Quarterly Progress Notes (QPNs) Updates

• ODP Announcement 20-101 UPDATE: Coronavirus Disease 2019 (COVID-19): Temporary Closure of Older Adult Daily Living Centers, Structured Day Habilitation, and Licensed Facilities Where CPS is Provided Due to Community Spread or When Staff or Individuals are Diagnosed with COVID-19

• ODP Announcement 20-103: Adult Autism Waiver (AAW) New Individual Support Plan (ISP) Signature Form

• ODP Announcement 20-104: Coronavirus Disease 2019 (COVID-19): Version 2 of the Operational Guide for Appendix K: Emergency Preparedness and Response for the Community Living, Consolidated, and Person/Family Directed Support (P/FDS) Waivers

• ODP Announcement 20-105: Coronavirus Disease 2019 (COVID-19): Version 2 of the Operational Guide for Appendix K: Emergency Preparedness and Response for the Adult Autism Waiver (AAW)

• ODPANN 20-106 REISSUE: ODP Non-Residential Heightened Scrutiny Announcement

• ODP Announcement 20-107: Revised Timeline for Incident Management Bulletin and Enterprise Incident Management (EIM) System Enhancements

• ODP Announcement 20-108: Coronavirus Disease 2019 (COVID-19): Version 3: Frequently Asked Questions (FAQ) About the Office of Developmental Programs' (ODP) Requirements During the COVID-19 Pandemic

• ODP Announcement 20-109: Coronavirus Disease 2019 (COVID-19): Guidance for Providing the Life Sharing Service During the COVID-19 Pandemic

• ODP Announcement 20-110: New Adult Autism Waiver (AAW) Provider Qualification Process

• ODP Announcement 20-111: New Adult Autism Waiver (AAW) Supports Coordination Organizations (SCOs) Qualification Process

• ODP Announcement 20-112: Now Available: Registration for the Department—Certified Incident Investigator (CI) Initial Certification Course

• ODP Announcement 20-113: Public Comment Starts December 18, 2020 for Proposed Amendments to the ID/A Waivers and Adult Autism Waiver

• ODP Announcement 20-114: COVID-19 UPDATE—Frequently Asked Questions (FAQs) About Modifications to Medication Administration Course Requirements as a Result of the COVID-19 Pandemic

• ODP Announcement 20-115: Open for Public Comment: Proposed Amendments to the Office of Developmental Programs' Waivers

• ODP Announcement 20-116: Medication Administration Train-the-Trainer Course—Scheduled Maintenance

• ODP Announcement 21-001: ODP Quality Management (QM) Certification Virtual Classes: 2021 Interest Survey

• ODP Announcement 21-002: Social Security Administration Announces 2021 Cost of Living Adjustment

• ODP Announcement 21-003: Medication Administration—System Access and Required Maintenance

• ODP Announcement 21-004: The Office of Developmental Programs (ODP) Provider Qualification (PQ) Form (DP 1088) for the Adult Autism Waiver (AAW)

• ODP Announcement 21-005: Health Risk Screening Tool (HRST) Protocol Update

• ODP Announcement 21-006: Coronavirus Disease 2019 (COVID-19): Guidance for Individual Support Plans That Are Effective Through June 30, 2021

• ODP Announcement 21-007: The Office of Developmental Programs (OD) Provides Written Notice of Provider Requalification Requirements

• ODP Announcement 21-008: Waiver Amendment Public Comment Period Extended and Webinar Recordings Now Available on MyODP

• ODP Announcement 21-009: Medication Administration: Webcast Access and Extended Maintenance

• ODP Announcement 21-010: Office of Developmental Programs (ODP) Quality Management (QM) Virtual Certification Classes: Registration Now Open for Spring 2021

• ODP Announcement 21-011: Invitation to Apply for the Capacity Building Institute (Year 5)

• ODP Announcement 21-012: Medication Administration: Student Course Access and System Restore Error

• ODP Announcement 21-013: AAW Written Notice of SCO Requalification Requirements

• ODP Announcement 21-014: Notice of a Change to the Federal Requirement of Transportation Costs for 2021

• ODP Announcement 21-015: New Orientation for Adult Autism Waiver Supports Coordination Organizations

• ODP Announcement 21-016: COVID-19—Guidance for Maintaining Regulatory Compliancy in CPS facilities

• ODP Announcement 21-017: Coronavirus Disease 2019 (COVID-19)—Temporary Fee Schedule Rates for Community Participation Support and Transportation Trip Services

• ODP Announcement 21-018 REISSUE: Quality Management (QM) Recertification for ODP QM Certificate Holders

• ODP Announcement 21-019: COVID-19—Updated Government Benefits and Representative Payee Services Frequently Asked Questions (FAQs)

• ODP Announcement 21-020: Incident Management Bulletin Webinars

• ODP Announcement 21-021: Covid 19—Managing the Impact of Temporary Enhanced Rates for Community Participation Support and Transportation Trip on Individual Support Plans (ISP) and Annual Fiscal Limits

• ODP Announcement 21-022 Coronavirus Disease 2019 (COVID-19): Department of Human Services (DHS) COVID019 Vaccine Administration Tracker Now Available for Immediate Use

• ODP Announcement 21-023: Human Rights Webcasts

• ODP Announcement 21-024 Reissue: Open for Public Comment: Renewal of the Adult Autism Waiver (AAW)

• ODP Announcement 21-025: Respite for a Participant Receiving Life Sharing Services

• ODP Announcement 21-026: Medication Administration—Webcast Guidance

• ODP Announcement 21-027 REISSUE: COVID-19—Approval of Appendix K Extension

• ODP Announcement 21-028: Now Available: Adult Autism Waiver Renewal Public Comment Webinar Recording

• ODP Announcement ODPANN 21-029—Quality Management (QM) Virtual Certification Classes: Registration Now Open for July—December 2021

• ODP Announcement 21-030: Open for Public Comment: Temporary Fee Schedule Rate Changes in Community Participation Support and Transportation Trip Services

• ODP Announcement 21-031: Prudent Payment of Claims Suspended April 2022

• ODP Announcement 21-032: Fiscal Year (FY) 2021-2022 Individual Support Plan (ISP) Renewal Guidance

• ODP Announcement 21-033: Office of Developmental Programs (ODP) to Participate in the 2020 National Core Indicators (NCI) Staff Stability Survey

• ODP Announcement 21-034: Regulation Update Orientation Annual Training Question and Answer Document and Annual Training Clarifications

• ODP Announcement 21-035: Now Available—Amendments to the Consolidated, Community living and Person/Family Directed Support (P/FDS) Submitted to the Centers for Medicare and Medicaid Services (CMS)

• ODP Announcement 21-036: 2018-2019 Independent Monitoring for Quality (IM4Q) Statewide Reports Added to MyODP

• ODP Announcement 21-037: 2019-2020 Independent Monitoring for Quality (IM4Q) Provider Reports and Profiles Update

• ODP Announcement 21-038: Incident Management Bulletin Training Now Posted on MyODP

OTHER:

• Providing Services to Persons with Autism/Pervasive Developmental Disorder

• Therapeutic Services & the AAW-7/8/12

• AAW Annual Review Plan Process Timelines—8/20/12

• Additional info about Monthly Progress Notes for SCs—10/03/2012

• AAW Quarterly Summary Reports: Which months to include?—1/18/2013

• New PROMISe Applications—2/20/2013

• AAW Service Utilization Calculator for SCs—4/19/2013

• Excluded Parties List System database migrated to System for Award Management—4/23/2013

• Fiscal Year End Activities—5/30/2013

• Cost Report Instructions for the Consolidated and P/FDS Waiver Programs

• ACT 62 Letter for Families September 2016

• ACT 62 General Information for Families infographic

• What Is ACT 62? Infographic

• Differences Between Private Insurance & Medical Assistance infographic

• Autism Insurance Act Fact Sheet

• Autism Insurance Act FAQs

• Filing Health Insurance Appeals, a brochure by the Pennsylvania Insurance Department

• How to Appeal

• Appeal: Sample Letter to Request an Internal Review

• Appeal: Sample Letter to Request an External Review

• Act 62 Statute

• Act 62 Letter and Guidelines for Colleges and Universities: How Colleges and Universities Can Help Students Graduate with the Qualifications Needed for a Behavior Specialist License
Electronic Visit Verification (EVV)—''What SCs and AEs Need to Know'' webinar July 27, 2020, Questions and Answers
Critical Information for ODP CPS, Residential, and ICF Providers: Pharmacy Partnership (COVID-19 vaccination)
Everyday Lives 2020: Recommendations, Strategies & Performance Measures
BEST PRACTICE STANDARDS IN BEHAVIORAL SUPPORT

Bureau of Supports for Autism and Special Populations Administrative Notices

2013 Service Utilization Calculator for Supports Coordinators 4/22/2013 BAW13-08

AAW Samples of Monthly Progress Notes & Quarterly Summary Report 4/23/2013 BAW13-09

ADULT AUTISM WAIVER (AAW) PROVIDER NEED-TO-KNOW (NTK)—SCs 4/30/2013 BAW13-12

Provider Qualification Verification (PQV) Process 6/4/2013 BAW13-15

AAW Provider Billing and Claims Resolution Issues 6/10/2013 BAW13-16

55 Pa. Code Chapter 51 Room and Board Contract is available to Residential Habilitation Providers 6/21/2013 BAW13-17

Adding Behavioral Specialist Services (BSS) to an Individualized Service Plan (ISP)—For SC providers 6/21/2013 BAW13-19

Adding Behavioral Specialist Services (BSS) to an Individualized Service Plan (ISP)—For BSS providers 6/26/2013 BAW13-20

Update & Clarification Regarding AAW Assessments 9/13/2013 BAW13-24

2014 Assistive Technology (AT) Resource Reminder 2/28/2014 BAW-14-06

Coordination of Supports Coordination (SC), Behavioral Specialist (BS), and Community Inclusion (CI) Services 6/23/2014 BAW14-16

Adult Protective Services (APS) Reporting Requirements 7/2/2014 BAW14-18

2015

Adult Protective Services (APS) Act and SC Agency Responsibilities 5/22/2015 BAW15-09

Behavioral Specialist Providers' Functional Behavioral Assessment Review 9/11/2015 BAW15-18

BSP-CIP Review Checklist 11/20/2015 BAW15-22

Quarterly Summary Report Guidance 12/7/2015 BAW15-25

NEW Adult Autism Waiver (AAW) MA 51 Process 12/11/2015 BAW15-26

AAW Provider Certified Investigator Requirements 12/21/2015 BAW15-27

2016 Changes to the Adult Autism Waiver (AAW) Annual Review Plan (ARP) Process 3/14/2016 BAW16-07

Functional Behavioral Assessment (FBA) Documentation Requirements 3/17/2016 BAW16-10

Updated AAW Supports Coordination (SC) Manual is now available 3/22/2016 BAW16-11

Updated Adult Autism Waiver Provider Manual is now available 4/1/2016 BAW16-12

Obsolete BAS Administrative Notices 4/1/2016 BAW16-13

SSD Intent to Enroll Form 4/21/2016 BAW16-14

New Insurance Requirements 5/16/2016 BAW16-15

Proposed rates for expanded services added to the Adult Autism Waiver 5/23/2016 BAW16-17

Informing AAW Participants of Renewal Changes 6/8/2016 BAW16-21

Admin Notice HCSIS Changes 6/14/2016 BAW16-23

Admin Notice: New ISP Signature Page 6/24/2016 BAW16-26

SC Individual Monitoring Form Template and Guidance 6/24/2016 BAW16-28

Changes to ISP resulting from AAW Renewal 6/24/2016 BAW16-29

Changes to Initial Individual Support Plan (ISP) and Annual Review Plan (ARP) Checklists 6/24/2016 BAW16-30

Request for an Exception to Established Service Limits 7/1/2016 BAW16-31

Admin Notice: Developing a Vocational Profile 7/26/2016 BAW16-34

New and Revised Resources for Developing a Skill Building Plan (SBP) 8/3/2016 BAW16-35

Adding the SSD/Systematic Skill Building (SSB) service to an ISP & Progress Reporting for SCs 8/10/2016 BAW16-36

Adding the SSD/Systematic Skill Building (SSB) service to an ISP & Progress Reporting for SSB Providers 8/10/2016 BAW16-37

Clarifications regarding Adult Autism Waiver (AAW) Employment Services 8/12/2016 BAW16-39

AAW Renewal FAQs Available 8/24/2016 BAW16-43

New Training Platform Launch Date—Reminder to Access Training Certificates 9/9/2016 BAW16-44

Revised Definition of Crisis Event 9/14/2016 BAW16-45

New Best Instructional Practices Manual 9/14/2016 BAW16-46

MyODP Launch and Reminder 9/29/2016 BAW16-48

Submitting and Entering the Vocational Profile into HCSIS 10/5/2016 BAW16-49

SC Individual Monitoring and new Employment Info Detail Report 11/10/2016 BAW16-50

2017 Admin Notice: PRE Training 1/4/2017 BAW17-01

G.A.S. Communication to All Providers 1/19/2017 BAW17-03

Admin Notice: Employment Training and Voc Profile 2/27/2017 BAW17-06

PRE Reminder 2/28/2017 BAW17-07

Info Memo: Waiver Amendment Public Comment Period 3/6/2017 BAW17-09

Admin Notice: Room and Board Contracts 3/13/2017 BAW17-12

Admin Notice: Res Hab Request Form and Guidance 3/20/2017 BAW17-13

Admin Notice: SIB-R Summary Report Process Change 3/21/2017 BAW17-14

Admin Notice: GAS Training Available 3/22/2017 BAW17-15

Informational Memo: Pathways to Employment 4/14/2017 BAW17-17

Admin Notice: PRE Next Steps 5/1/2017 BAW17-18

Informational Memo: AAW Amendment Submitted to CMS 6/2/2017 BAW17-21

Admin Notice: New Service Utilization Review Signature Form 6/20/2017 BAW17-22

Info Memo: Capacity Increase Amendment Approval 6/30/2017 BAW17-24

Goal Attainment Scaling (GAS): Next Steps and Reminders 7/12/2017 BAW17-25

Updated Employment Services 8/16/2017 BAW17-29

Ensuring DSPs Meet AAW Qualifications 8/28/2017 BAW17-30

PRE: Updated Resources and Upcoming Training 9/27/2017 BAW17-32

ISP and ARP Checklists 10/27/2017 BAW17-33

2018 AAW Progress Report Changes—Webinars Scheduled 1/29/2018 BAW18-04

AAW Service Utilization Review FAQs 2/13/2018 BAW18-05

QSR—Roles and Responsibilities 2/23/2018 BAW18-08

QSR—SC Guidance 2/23/2018 BAW18-09

Entering SIB-r into Question Pro 4/30/2018 BAW18-13

QSR FAQs for AAW Providers 6/14/2018 BAW18-15

Required Monthly Contact Guidance and Timeframe 8/9/2018 BAW18-19

REISSUE AND CLARIFICATION: Definition of Billable Units 8/9/2018 BAW18-20

Revised QSR SC Process 8/17/2018 BAW18-21

IT Employment Positions through Autism2Work 12/17/2018 BAW18-25

AAW Supports & Services Directory (December 2018) 12/5/18 BAW18-26

Adult Autism Waiver Amendment Update 12/19/2018 BAW18-27

Office of Income Maintenance—Contact: Cathy Buhrig (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

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

• Disaster Supplemental Nutrition Assistance Program Plan

• Supplemental Nutrition Assistance Program Ed (SNAP ED) State Plan

• Supplemental Nutrition Assistance Program (SNAP) Outreach State Plan

• County Assistance Office Employee and Visitors Access Policy

• Homeless Assistance Program—Instructions and Requirements

• Pennsylvania's State SNAP Employment and Training Program State Plan

• 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 Instructions

• CAOAA Procedures Manual

• Pennsylvania WorkWear (PAWW) Manual

• Education Leading to Employment and Career Training (ELECT) DHS Manual

• Refugee State Plan

• SNAP Employment, Advancement and Retention Network (EARN) Program and Policy
Procedures Manual

• SNAP E&T Procedures Manual

Office of Long-Term Living—Contact: Jennifer Hale (717) 346-0495

Year Code
Citation Subject Date Issued Bulletin Number

1998 — Respite Care Nursing Facility Admissions 04/17/98 35-98-06
36-98-06

— Medicare Cost-Sharing Payment for Nursing Facility Residents 07/31/98 35-98-10
36-98-10

1999 Ch. 1187 Capital Component Payments for Post-Moratorium Beds 06/28/99 1187-99-01
35-99-05
36-99-05

2008 Nursing Facility Documentation Requirements for Movable Equipment that is Rented or Leased 07/07/08 03-08-04

2009 Provider Rates for Services Funded through the OBRA, Independence and COMMCARE Waivers 06/25/09 05-09-02
17-09-02
36-09-02
41-09-02
43-09-02
55-09-02
59-09-02

2010 Office of Long-Term Living Home and Community Based Program Policy Clarification Update (Omnibus Bulletin) 11/23/10 05-10-08
51-10-08
55-10-08
59-10-08

Nursing Home Transition Outreach Form 10/08/10 05-10-05
51-10-05
52-10-05
55-10-05
59-10-05

Standards and Reimbursement Rates for the Enhanced Older Adult Daily Living Center Program for Medicaid Aging Waiver Participants 04/20/10 03-10-02
41-10-02
55-10-02

Ch. 2600 Evacuation of Hospice Residents During Fire Drills—Statement of Policy 03/13/2010 40 Pa.B. 1411

2011 Accessibility Adaptations and Assistive Technology 10/11/11 05-11-07
51-11-07
52-11-07
54-11-07
55-11-07
59-11-07

Community Integration Changes provided in the MA Home and Community—Based Waiver Program 09/29/11 05-11-05
51-11-05
52-11-05
55-11-05
59-11-05

Program Fraud & Financial Abuse in Office of Long Term Living MA Home and Community Based Services (HCBS) Programs 08/08/11 05-11-04
51-11-04
52-11-04
54-11-04
55-11-04
59-11-04

Recession of OLTL Bulletin 05-10-07, 51-10-07, 52-10-07, 5-10-075, 59-10-07 06/30/11 05-11-03
51-11-03
52-11-03
55-11-03
59-11-03

2012 CH. 1187 Nursing Facility Participation Review Process and Guidelines—statement of policy 06/30/12 42 Pa.B. 3748

CH 52
CH 52 OLTL Service Coordination Rate in Effect
OLTL Rate for Enrollment 07/14/12
06/30/12 42 Pa.B.4545
42 Pa.B. 381

CH 52 OLTL Fee Schedule Rates established 06/09/12 42 Pa.B. 3343

2013 CH 52 Rescission of Office of Long-Term Living HCBS Directives, Bulletins and Other Policy Documents 12/04/13 05-13-11
51-13-11
55-13-11
59-13-11

CH 52 Statewide Waiting List Guidelines for Office of Long-Term Living Medicaid Waivers and the Act 150 Program 11/05/13 05-13-08
51-13-08
55-13-08
59-13-08

CH 52 Clarification of type, scope, amount, duration and frequency of services 05/16/13 05-13-05
08-13-05
11-13-05
17-13-05
19-13-05
25-13-05
26-13-05
41-13-05
51-13-05
54-13-05
55-13-05
59-13-05

CH 52 Providing for Absence Policies in the Enhanced Adult Daily Living Centers 03/22/13 03-13-03
41-13-03
55-13-03

CH 52 Billing Instructions-Home and Community Based Waiver Provider's Billing of Procedure Codes Based on Authorized Service Plans through PROMISe^TM 02/07/13 05-13-02
51-13-02
54-13-02
55-13-02
59-13-02

CH 52
CH 52 OLTL Enrollment Fee Increase
OLTL Service Coordination Rate Increase 01/26/13
01/26/13 43 Pa.B. 589
43 Pa.B. 590

CH 52 Maintaining Waiver Eligibility While in an Institution 01/24/13 05-13-01
51-13-01
52-13-01
55-13-01
59-13-01

— Preventable Serious Adverse Events in Nonpublic and County Nursing Facilities 09/13/14 03-14-08

2014
CH 52 Final Fee Schedule Rates for Personal Assistance Services (Agency) Final Fee Schedule Rates for Personal Assistance Services
(Consumer) Final Fee Schedule Rates for Service Coordination Services
Service Coordination After-Hours Coverage 09/13/14 09/13/14
09/13/14 06/19/14 44 Pa.B. 5935
44 Pa.B. 5935
44 Pa.B. 5935 51-14-07
55-14-07
59-14-07

Financial Management Services Information 05/12/14 51-14-07
54-14-07
55-14-07
59-14-07

Revised Target Resident (MI, ID, ORC) Reporting Form (MA 408) 02/12/14 03-14-12

CH 52 Release of OLTL Home and Community-Based Services Provider Handbook 01/30/14 03-14-02
05-14-02
08-14-02
11-14-02
17-14-02
19-14-02
23-14-02
25-14-02
26-14-02
41-14-02
51-14-02
54-14-02
55-14-02
59-14-02

OLTL Home and Community-Based Services Service Authorization Form 01/15/14 51-14-01 55-14-01 59-14-01

CH 52 Critical Incident Management 04/16/15 05-15-02
51-15-02
54-15-02
55-15-02
59-15-02

2015 CH 52 Rescission of HCBS Directives, Bulletins and other Policy Documents 10/27/2015 54-15-03, 59-15-03

Medical Assistance Fee Schedule; Addition of Maximum Overtime Rates for Personal Assistance Services (Consumer) and Respite (Consumer) 01/02/16 46 Pa.B. 106

2016 Medical Assistance Fee Schedule Revisions in the Aging, COMMCARE, Independence and OBRA Waivers 01/02/16 46 Pa.B. 107

Overtime and Minimum Wage Requirements in Participant-Directed Models of Service 01/11/2016 54-16-01, 59-16-01

Electronic Submission of Nursing Facilities' MA-11 Cost Reports, Supporting Documentation and Signed Certification Report 03/01/2016 03-16-02

Provider Choice Protocol 03/08/2016 59-16-03

Act 150 Program Guidelines 05/12/2016 54-16-04, 59-16-04

Organized Health Care Delivery System 08/29/2016 59-16-11

Guidance for Nursing Facilities—MDS Section Q 10/03/2016 03-16-10 59-16-10

Individual Service Plan Development, Review, and Implementation Nursing Home Transition Program Changes Participant Reviews Home and Community-Based Settings Requirements 10/14/2016 10/28/2016 12/28/2016 12/28/2016 59-16-13 59-16-09 59-16-12 59-16-14

Medical Assistance Fee Schedule; Final Rates for Additional Services Added to the COMMCARE and Independence Waivers 11/19/16 46 Pa.B. 7398

2018 Standardized Participant Information Packet 01/16/2018 59-18-01

Revised Pennsylvania Preadmission Screening Resident Review (PASRR) Level I Identification Form (MA 376) 08/01/2018 01-18-03 03-18-03 07-18-03 59-18-03

Revised Pennsylvania Preadmission Screening Resident Review (PASRR) Level II Evaluation Form (MA 376.2) 08/01/2018 01-18-04 03-18-04

Electronic Submission of the Cost Report (MA-11) Form for Reporting Periods Ending 12/31/18 and Thereafter 09/04/2018 03-18-05

Rescission of HCBS Directives, Bulletins and Other Policy Documents 09/17/2018 59-18-06

Ch. 2800 Assisted Living Residence Per Bed Fee Adjustment 06/19/18 48 Pa.B 3493

2019 Hearings and Appeals 02/11/2019 59-19-03

Implementation of the Functional Eligibility Determination Process 04/01/2019 IEB-19-04 IAE-19-04 07-19-04

CH 52 Medical Assistance Fee Schedule Revisions in the OBRA Waiver 08/24/2019 49 Pa.B. 4913

CH 52 Medical Assistance Fee Schedule Revisions to the Act 150 Program 11/30/2019 49 Pa.B. 7136

Revised Target Resident (MH, ID/DD, ORC) Reporting Form 12/30/2019 03-19-05

2020 Employment and Employment Related Services 07/09/2020 17-20-02

Revised Standardized Physician Certification Form (MA 570) 08/10/2020 59-20-03

Electronic Visit Verification (EVV) for Personal Care Services (PCS) 09/10/2020 07-20-04, 54-20-04, 59-20-04, 00-20-03

2021 Act 150 Program Sliding Fee Scale for Calendar Year 2021 03/25/2021 54-21-01, 59-21-01

GUIDANCE MANUALS:

Fee-for-Service/Home and Community Based Services

• OBRA Medicaid Waiver # 0235

Community HealthChoices Managed Care Program

• Community HealthChoices 1915(b)/(c) waiver—effective January 1, 2021

• Community Health Choices Agreement 2021

Nursing Facility

• Interpretive Guidelines—interpretations of the 1187 Nursing Facility regulations used during audits of the MA-11 Cost Reports

• Instructions for Financial and Statistical Report-Form MA-11

• MA-11 Cost Report Submission System—End User Manual V.6.0

• Nursing Facility Assessment End User Manual

• Resident Data Reporting Manual

• UB-04 Billing Guide for PROMISe^TM Nursing Facilities for County and Nonpublic Nursing

• Facilities and State Restoration Centers—Nursing facility services only applies to county

• Nursing facilities and nonpublic nursing facilities. Regulations related to payment for nursing facility services can be found under 55 Pa. Code Chapters 1187 and 1189 and does not include intermediate care facilities for persons with an intellectual disability, Federal or State-owned long-term care nursing facilities or Veteran's homes.

• Data Book (Participation Review Workbook)

Personal Care Homes/Assisted Living Residences

• Regulatory Compliance Guide for 55 Pa. Code Chapter 2600 (relating to Personal Care Homes) Revised April 1, 2013 (Anticipated to be revised in June 2021)

• Personal Care Home Regulatory Interpretations—Questions/Answers, DHS BHSL website publications: September, October, November, and December 2014; January, February, March, April, May, June, July, August, October, and December 2015; January, February, April, October, November, and December 2016; April and October 2017; July and November 2018; January 2019.

• Regulatory Compliance Guide for 55 Pa. Code Chapter 2800 (relating to Assisted Living Residences) effective March 1, 2015 (Anticipated to be revised in June 2021)

• Assisted Living Residence Regulatory Interpretations—Questions/Answers, DHS BHSL website publications: October, November, and December 2014; January, February, March, April, May, July, August, October, and December 2015; January, February, April, October, November, and December 2016; April and October 2017; July and November 2018; January, March, and March 2019.
Policy for Administrative Fines in Personal Care Homes
Sale or change of legal entity process for Personal Care Homes

• Licensing References Manual for Personal Care Homes, Assisted Living, Child Residential, Intellectual Disabilities, and Mental Health Service Providers

Covid19 Guidance

• Licensing Regulation Suspension: Personal Care Homes (2600) and Assisted Living Residences (2800)—March 30, 2020

• Operational Recommendations for Long-Term Service and Support (LTSS) Providers—March 13, 2020

• Guidance Suspending and Restricting License Requirements for Personal Care Homes and Assisted Living Residences—March 29, 2020

• Temporary Changes to 811 Project Rental Assistance (PRA) Program—March 31, 2020

• Electronic Visit Verification (EVV) Implementation Timeline Update—April 8, 2020

• Temporary Medication Administration Training Alternative for Personal Care Homes and Assisted Living Residences and Certified Trainer Extension—April 10, 2020

• Clarification Guidance for Pennsylvania Pre-Admission Screening Resident Review (PASRR)—April 14, 2020

• How Do Economic Impact Payments Affect Office of Long-Term Living (OLTL) Participants?—April 17, 2020

• Diabetes Training for Unlicensed Staff to Administer Insulin in Personal Care Homes and Assisted Living Residences—May 1, 2020

• Direct Care Staff Orientation Training Program for Personal Care Homes and Assisted Living Residences—May 18, 2020

• Guidance for Modifications to Nursing Facility Bed Increase Requests During the COVID-19 Pandemic—June 4, 2020

• 180-Day Claims Exception Requests Process During the COVID-19 Pandemic—June 4, 2020

• Personal Care Home and Assisted Living Residence Administrator Continuing Education—June 15, 2020

• CARES Act Funding for OLTL Home and Community-Based Services Providers—June 22, 2020

• CARES Act Funding for OLTL Community HealthChoices Managed Care Organizations (CHC-MCOs) and Living Independence for the Elderly (LIFE) Organizations—June 22, 2020

• CARES Act Funding for OLTL Nursing Facility Providers—June 22, 2020

• CARES Act Funding for OLTL for Licensed Personal Care Home (PCH) and Licensed Assisted Living Residences (ALR) Providers—June 22, 2020

• CARES Act Funding for OLTL Nursing Facility Providers—July 6, 2020

• Universal Testing of Long-Term Care Facilities—Personal Care Homes (PCH), Assisted Living Residences (ALR), and Private Intermediate Care Facilities (ICF)—Updated: August 3, 2020

• Vaccination Information for Office of Long-Term Living Home and Community-Based Providers—January 12, 2021

• Guidance for Adult Daily Living Providers Delivering Telephonic or Remote Services During the COVID-19 Public Health Emergency—January 13, 2021

• Guidance on COVID-19 for Personal Care Homes, Assisted Living Residences and Private Intermediate Care Facilities—Updated: April 5, 2021

• Transition Plan to Phase Out Temporary Changes to the OBRA 1915(c) Waiver—Updated: March 25, 2021

• Temporary Changes to the OBRA 1915(c) Waiver—Updated: March 25, 2021

• Transition Plan to Phase Out Temporary Changes to the Community HealthChoices 1915(c) Waiver—Updated: March 25, 2021

• Temporary Changes to the Community HealthChoices 1915(c) Waiver—Updated: March 25, 2021

• Transition Plan to Phase Out Temporary Changes to the Act 150 1915(c) Waiver—Updated: March 25, 2021

• Temporary Changes to the Act 150 Program—Updated: March 25, 2021

Office of Medical Assistance Programs—Contact: Eve Lickers (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. 1101 Allergy Testing—Exemptions from Co-Payments 10/15/85 01-85-18
11-85-20
12-85-11
10-85-02

Ch. 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
33-85-02

1986 Ch. 1141 Payment Policy for Abortion Clinic
Visits 09/10/86 10-86-02
11-86-10

Ch. 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
19-86-07

1987 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
27-87-01

Ch. 1187 Barber and Beauty Costs 05/15/87 35-87-04
36-87-01

Ch. 1101
Ch. 1123 Coverage for Motorized Wheelchairs 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. 1187 Barber and Beauty Costs 10/22/87 35-87-07
36-87-08

Ch. 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
11-88-01

Ch. 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
11-88-03

Ch. 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
19-88-03

Ch. 150 Medical Assistance Eligibility Change for Aliens 04/13/88 99-88-05

Ch. 1151 Revisions to Chapters 1151 and 1163 Regulations 06/29/88 11-88-02
12-88-05
13-88-05
1151-88-02
1163-88-02

Ch. 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
1163-88

Ch. 1150 Desk Reference 10/06/88 29-88-01
33-88-01

1989 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
31-89-02

Ch. 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
1126 AIDS Waiver Program 04/02/90 01-90-02
02-90-01
05-90-02
19-90-01
23-90-01
38-90-01
39-90-01

Ch. 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
31-90-01

Ch. 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
1241-90-01

Ch. 1141 Allergen Immunotherapy

1991 Ch. 1141
1149
1143
1221 Billing 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
49-91-01

Ch. 1123 Incontinence Products and Diapers 03/21/91 01-91-02
02-91-01
05-91-01
19-91-01
23-91-01

Ch. 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. 1241 EPSDT—OBRA '89 08/02/91 1101-91-01
1121-91-02
1123-91-01
1241-91-01

Ch. 1123 Repair and Replacement of Durable Medical Equipment (DME), Orthotics and Prosthetics 10/01/91 05-91-04
19-91-14

Ch. 1101
1150
1241 Payments for Vaccines 11/06/91 1221-91-01

Ch. 1121 Clorazil Monitoring and Evaluation Visit 11/06/91 29-91-07
1153-91-01

1992 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
53-92-01

Ch. 1147 Increased Fees for Vision Services 01/31/92 01-92-02
05-92-01
15-92-01
19-92-02

*Ch. 1141
*Ch. 1153 Clozapine 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
19-92-04

Ch. 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
53-92-05

Ch. 1163 Automated Admission Certification 07/22/92 01-92-12
03-92-05
04-92-04

Ch. 1163 Hospital Utilization Review Changes 07/22/92 06-92-01
08-92-01
11-92-12
12-92-12
13-92-08
53-92-06

Ch. 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
11-92-13

Ch. 1121 Norplant Coverage 12/07/92 01-92-20
10-92-10
11-92-21
30-92-06

Ch. 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
49-92-08

1993 — 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
33-93-01

Ch. 1101 Interim Agreement Felix et al. v. Casey et al. 01/28/93 99-93-01
1101-93-02

Ch. 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
19-93-02

Ch. 1101 Additional Copayment Expenses 02/17/93 01-93-01
19-93-01
1101-93-01

Ch. 1123 Prior Authorization Rental of Nebulizers 04/09/93 01-93-06
05-93-03
19-93-04

Ch. 1121 Intrauterine Devices 05/13/93 01-93-09
10-93-01
11-93-04

Ch. 1101
1150 Voucher 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
19-93-12

Ch. 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
36-93-03

Ch. 1101
1150 Payment 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
53-93-04

Ch. 1101
1150 Procedures for Submitting Invoices for Services Provided to Retroactively Eligible Newborns 12/06/93 99-93-11

Ch. 1101
1150 Newborn Eligibility Update and Corrections to Previous Bulletins 12/20/93 09-93-02
11-93-15
31-93-02

Ch. 1101
1150 Newborn 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
49-94-02

Ch. 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
50-94-02

Ch. 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
99-94-08

Ch. 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. 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
1225-94-01
1242-94-01
99-94-13

*CH. 1101 GENERAL ASSISTANCE RESTRUCTURE AS A RESULT OF ACT 49 09/02/94 1101-94-01
99-94-14

Medicare Deductible and Coinsurance Amounts for Medical Supplies for Residents in a Nursing Home 09/02/94 05-94-07
19-94-13

Ch. 1141
1143 Selected 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
39-95-02

Ch. 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) Forms 07/14/95 99-95-06

Ch. 1121 Prescription Payment Systems Revisions 09/22/95 01-95-14
19-95-05

Ch. 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
50-95-05

Ch. 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
19-95-06

Changes 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
49-95-03

CH. 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 01/19/96 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
49-96-01

— The Addition of Invirase to the Special Pharmaceutical Benefits Program Formulary 03/01/96 01-96-06 02-96-04
11-96-05
19-96-06
23-96-02 26-96-05 28-96-04 30-96-04 35-96-03 36-96-03 37-96-01 45-96-01 49-96-05

Ch. 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 Care Plans 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
39-96-01

Ch. 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
49-96-04

Ch. 1121 Procedure to Bill Anti-Ulcer 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
49-96-06

Ch. 1101
1150 Hearing Aid Batteries Added to Medical Assistance Program Fee Schedule 04/02/96 03-96-09
05-96-03
11-96-08
19-96-09
50-96-02

Procedure 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
49-96-10

Ch. 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
53-95-02

Ch. 1241 Statewide Implementation of the Vaccines for Children (VFC) Program 10/04/96 01-96-19
10-96-10
11-96-21
26-96-12

Ch. 1149 Information on New Procedures for Submitting Evaluating Orthodontic Prior Authorization Requests 10/21/96 03-96-06

Ch. 1163
1141 Neonatal 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
49-96-12

1997 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
36-97-01

Ch. 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
49-97-01

Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) List 03/21/97 01-97-04
19-97-05

Ch. 1150
1141 Discontinuance 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
1150-97-01

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 1997 HCPCS Updates 04/10/97 05-97-03
19-97-07
23-97-04

Ch. 1101
1150 Medical 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
50-97-01

Ch. 1221 Change in Billing Procedure for Emergency Room Visits 05/12/97 11-97-05
12-97-04
13-97-01

Ch. 1141
1144
1241 Diagnostic 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
26-97-03

Ch. 1101
1150 Provider Produced Invoices 06/11/97 99-97-03

— HealthChoices Phase 2 Extension of Enrollment Period 06/17/97 99-97-04

Ch. 1101
1150 Changes 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
13-97-02

Ch. 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
1141-97-01

Ch. 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
36-97-04

Ch. 1101
1150 Accurate 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

—-. Amendment 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
1150 Billing 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 Implementation 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
33-98-03

Ch. 1101
1150 Announcement of Revised Millennium Medical Assistance Claims Forms 03/16/98 99-98-02

Ch. 1101
1150 Medical 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
50-98-01

Ch. 1101
1150 Revisions 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
53-98-03

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

Medical 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
46-98-01

Ch. 1150
1241 Increase in the Fees for the Administration of Vaccines 07/01/98 01-98-09
10-98-02
11-98-06
12-98-05
49-98-03

Ch. 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
258-98-01

Ch. 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
50-98-03

Ch. 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
23-98-09

Ch. 1121 Updates to State Maximum Allowable (State MAC) List 08/14/98 01-98-12
19-98-07

Ch. 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

Ch. 1141
Ch. 1153 Clozapine Support Services 12/29/98 33-98-08
29-98-08
01-98-19

Procedure for Requesting Prior Authorization of Medical Assistance Case Management Services for Recipients Under the Age of 21 12/31/98 05-98-04

1999 Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for which Registration has been denied or approval withdrawn 01/01/99 88-99-01

— Address Change for Provider Inquiry 01/27/99 99-99-01

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in The Medical Assistance Program (2) Shared Health Facilities for which Registration has Been Denied or Approval Withdrawn 02/01/99 88-99-02

— Change in Procedure for Billing Administration of DT and Td Vaccines 02/09/99 01-99-02
10-99-01
11-99-02
26-99-02
49-99-01

Ch. 1140 New Procedure Code for Healthy Beginnings Plus Program 02/12/99 01-99-01
11-99-01
23-99-01
26-99-01
30-99-01
31-99-01

— Continued Existence of the Fee-For-Service (FFS) Delivery System in the HealthChoices Zones and Use of HealthChoices Zones and Use of Access Cards 02/12/99 99-99-03

— The addition of Sustiva (efavirenz) and Ziagen (abacavir) to the Special Pharmaceutical Benefits Program Formulary 02/15/99 01-99-03
02-99-01
11-99-03
19-99-01
23-99-02
26-99-03
28-99-01
30-99-02
35-99-01
36-99-01
37-99-01
45-99-01
46-99-01

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 1999 HCPCS updates 02/26/99 99-99-02

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 03/01/99 88-99-03

Ch. 1225 Price Increase and Additional Services for Family Planning Clinics 03/04/99 34-99-01
35-99-02
36-99-02

Ch. 1221 Change in Podiatric Billing Procedure for Emergency Room Visits 03/22/99 04-99-01

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 04/01/99 88-99-04

Ch. 1101 Revised HealthCare Benefits Packages Reference Chart 04/20/99 99-99-04

Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 05/01/99 88-99-05

— Severity Two Hour Supply HealthChoices Southeast 05/28/99 19-99-02

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 06/01/99 88-99-06

Capital Component Payments for Post Moratorium Beds 06/28/99 35-99-05
36-99-05
1187-99-01

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 07/01/99 88-99-07

Ch. 1121 Prescriptions NOT received by the Medical Assistance (MA) Recipient 07/05/99 19-99-04

Ch. 1149 Increased Fees for Selected Pediatric Dental Services 07/09/99 33-99-01

— The Addition of Agenerase (amprenavir) To the Special Pharmaceutical Benefits Program Formulary 07/09/99 01-99-04
02-99-02
11-99-04
19-99-03
23-99-03
26-99-04
28-99-04
30-99-03
35-99-03
36-99-03
37-99-02
45-99-02
46-99-02

Ch. 1121 Updates to State Maximum Allowable Cost (State MAC) 07/16/99 01-99-05
19-99-05

— Millennium Compliance 07/27/99 99-99-05

Ch. 1150
1163 Training for Inpatient Facilities on Completing the UB-92 Invoice 07/27/99 11-99-06
12-99-02
13-99-01
53-99-01

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 08/01/99 88-99-08

— Additions and Corrections of Fee Increases for Specific Services Rendered by Outpatient Psychiatric clinics, Psychiatric partial Hospitalization Programs, and Outpatient Drug and Alcohol clinics 08/30/99 28-99-05
29-99-03
33-99-02

Ch. 1150
1241 Clarification of Enrollment and Billing Procedures for Physical, Speech, and Occupational Therapy 08/30/99 43-99-01
50-99-01

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdraw 09/01/99 88-99-09

Ch. 1101 ''Payment in Full'' 09/17/99 99-99-06

Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 10/01/99 88-99-10

Ch. 1145 Change in Recipient Access to Chiropractic Services in the Managed Care Delivery System 10/22/99 99-99-07

— Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 11/01/99 88-99-11

Ch. 1147 Medical Assistance (MA) Payment Policy for Eyeglasses Coverage 11/05/99 01-99-06
05-99-01
15-99-01

Ch. 1121 Prior Authorization of Viagra and Other Drugs for Erectile Dysfunction Treatment Criteria, Limits and Procedures 11/22/99 99-99-08

Ch. 1225 Price Increase and Additional Services for Family Planning Clinics 11/22/99 30-99-04

Ch. 1121 Fee Increase for the ParaGuard IUD 11/22/99 01-99-07
10-99-02
11-99-07

Medicheck List (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/01/99 88-99-12

Ch. 1241 Coverage of Medically Necessary Services and Equipment for Children in Early Intervention or Special Education Programs 12/03/99 01-99-08
05-99-02
11-99-08
17-99-01
23-99-04
43-99-02
50-99-02

Ch. 1241 Clarification of Enrollment and Billing Procedures for EPSDT Expanded Services Providers of Physical Therapy, Speech Therapy and Occupational Therapy 12/10/99 50-99-04

Ch. 1121 Prescription Refills Maintenance Medications 12/10/99 19-99-06

Ch. 1142 Expanded Procedures Codes for Provider Type 31 Midwives2000 Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/29/99
—
01/01/00 31-99-02

88-00-01

— Expansion of Special Pharmaceutical Benefits Clozaril Program 01/28/00 01-00-01
02-00-01
05-00-01
11-00-01
13-00-01
14-00-01
19-00-01
23-00-01
26-00-01
29-00-01
33-00-01
35-00-01
36-00-01
49-00-01

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 02/01/00 88-00-02

— Revised Billing Instructions for the Community Services Program for Persons with Physical Disabilities (CSPPPD) Waivers 02/15/00 51-00-01

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 03/01/00 88-00-03

— Changes in Terminology in Medical Assistance Program Fee Schedule for Type of Service/Procedure Code AG/W1855 03/13/00 28-00-01

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 03/17/00 01-00-02
19-00-02

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 04/01/00 88-00-04

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 05/01/00 88-00-05

— Continued Existence of the Fee-for-Service (FFS) Delivery System in HealthChoices Zones and Use of ACCESS Cards 05/24/00 99-00-01

Ch. 1121 Prior Authorization List of Brand Name Drugs 05/25/00 01-00-04
02-00-02
03-00-01
04-00-01
10-00-01
11-00-02
12-00-01
19-00-05
26-00-02
28-00-02
29-00-02
30-00-01
33-00-01
49-00-02

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 05/26/00 01-00-03
19-00-04

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 06/01/00 88-00-06

Ch. 1141 Elimination of Physician Attestation Requirement 06/22/00 01-00-05
11-00-03

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 07/01/00 88-00-07

Ch. 1251 Increased Fees for Funeral Director Services 07/03/00 22-00-01

— Implementation of the Medical Assistance Programs' Internet website www.dpw.state.pa.us/omap 07/07/00 99-00-02

Ch. 1145 Change in Recipient Access to Chiropractic Services in the Managed Care Delivery System 07/12/00 99-00-03

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 07/19/00 01-00-06
19-00-06

— Medicheck List: (1) Providers, Entities
and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 08/01/00 88-00-08

Ch. 1121 Clarification of Billing Instructions for Methadone Maintenance Services 08/21/00 28-00-03

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 09/01/00 88-00-09

Ch. 1141
1163 Increased Fees for Selected Neonatal Intensive Care Procedure Codes and the Addition of a New Neonatal Intensive Care Procedure Code 09/01/00 01-00-07

— Prior Authorization Interim Supply of Medication HealthChoices Southwest (Revised) 09/07/00 19-00-07

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 10/01/00 88-00-10

Ch. 1150 Clarification of the 1150 Administrative Waiver Process also known as the Program Exception Process for Prosthetic and Orthotic Providers 10/04/00 01-00-08
05-00-02
19-00-08

— Application for Health Care Coverage 10/13/00 99-00-04

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 11/01/00 88-00-11

Ch. 1241 Pennsylvania Vaccines for Children (VFC) Program 11/15/00 01-00-10
10-00-03
11-00-05
26-00-04

— HealthCare Benefits Package 12 Updated Employability Assessment Procedure Code List 11/15/00 01-00-09
10-00-02
11-00-04
12-00-02
15-00-01
16-00-01
20-00-01
26-00-03
28-00-04
29-00-03
49-00-03

Ch. 1243 Change in Payment Amount and Payment Method for the HIV-1 Viral Load Test (CPT Code 87536) 11/17/00 11-00-06
12-00-03
16-00-02

— The Addition of Kaletra (lopinavir/ritonavir) to the Special Pharmaceutical Benefits Program Formulary 11/21/00 01-00-11
02-00-03
11-00-07
19-00-09
23-00-02
26-00-05
28-00-05
30-00-02
35-00-02
36-00-02
37-00-01
45-00-01
46-00-01

— Consent Forms for the Release of Confidential Information 11/28/00 99-00-05

— Revised Target Resident Reporting Form (MA 408)* 11/28/00 34-00-02
35-00-05
36-00-04

Ch. 1141 Medical Assistance (MA) Payment Policy for Multivisceral Transplants 11/28/00 01-00-12
11-00-08
17-00-02

Ch. 1221 Voluntary Managed Care Organization's Payment Responsibility for Emergency Room Services 11/28/00 17-00-03

— Admissions Notice Packet (MA 401) 11/28/00 24-00-01
25-00-01
34-00-01
35-00-03
36-00-01

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/01/00 88-00-12

— Revised Billing Instructions: Specified Medical Assistance (MA) Services in MA Voluntary Managed Care 12/08/00 01-00-14
03-00-02
04-00-02
05-00-03
08-00-01
10-00-04
11-00-09
12-00-04
16-00-03
17-00-04
20-00-02
23-00-03
31-00-01
40-00-01
41-00-02
44-00-01
45-00-02
49-00-05
50-00-03

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 12/11/00 01-00-15
19-00-10

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 1999/2000 HCPCS Updates 12/22/00 99-00-06

— Freedom of Choice for Medical Assistance Recipients Requiring Behavioral Health Services 12/29/00 01-00-16
29-00-05
33-00-04
41-00-03
48-00-02
49-00-06
50-00-04

Ch. 1149 Dental Fee Increase and Medical Assistance Program Fee Schedule Revisions 12/29/00 03-00-03

— Prior Authorization of Therapeutic Staff Support (TSS) Services 12/29/00 01-00-13
29-00-04
33-00-03
41-00-01
48-00-01
49-00-04
50-00-02

2001 — Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 01/01/01 88-01-01

Ch. 1121 Diabetes Outpatient Self-Management Training and Education 01/15/01 99-01-01

Ch. 1121 List of Brand Name Drugs Requiring Prior Authorization 01/30/01 01-01-01
02-01-01
03-01-01
04-01-01
10-01-01
11-01-01
12-01-01
19-01-01
26-01-01
28-01-01
29-01-01
30-01-01
33-01-01
49-01-01

Ch. 1101
1150 Delete Procedure Codes with Type of Service 35 from the Medical Assistance Program Fee Schedule 02/01/01 10-01-02
11-01-02
26-01-02

Ch. 1149 Issuance of a Replacement Page to the January 1, 2001 Medical Assistance Program Fee Schedule for Dental Services 02/01/01 03-01-02

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 02/01/01 88-01-02

Ch. 1101
1223 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. 1149 Addition of Selected Periodontal Services to the Medical Assistance Program Fee Schedule 02/28/01 03-01-03

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 03/01/01 88-01-03

— Expanded Hours of Operation for the Provider Services Toll-Free Inquiry Lines 03/28/01 99-01-02

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 04/01/01 88-01-04

Ch. 1150
1141 Medical Assistance (MA) Payment Policy for Multivisceral Transplants 04/06/01 01-01-03
11-01-03
17-01-02

— Behavioral Specialist Consultant and Mobile Therapist 04/26/01 01-01-04
17-01-03
29-01-02
33-01-02
41-01-01
48-01-01
49-01-03
50-01-02

Ch. 1149 Implementation of the ADA Claim Form—Version 2000 and Revised Billing Instructions for Assistant Surgeons 04/27/01 03-01-04

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 2001 HCPCS Updates 04/27/01 99-01-03

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 05/01/01 88-01-05

— Automated Clearinghouse (ACH)—Electronic Funds Transfer 05/04/01 99-01-04

— Consent Forms for the Release of Confidential Information 05/18/01 99-01-05

— Additional Place-of-Service (Office) for Psychotherapy 06-01-01 01-01-09
41-01-06

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 06/01/01 88-01-06

— Revisions to Policies and Procedures Relating to Mobile Therapy, Behavioral Specialist Consultant and Therapeutic Staff Support Services 06/01/01 01-01-05
29-01-03
33-01-03
41-01-02
48-01-02
49-01-04
50-01-03

— Section V—Billing Information Nursing Facility Services Handbook 06/04/01 35-01-01
36-01-01

Ch. 1142 Reissue Expanded Procedure Codes for Independent Certified Nurse Midwives 06/15/01 01-01-08
31-01-01

— Addition of Behavioral Health Rehabilitation Service to the Medical Assistance (MA) Program Fee Schedule 06/21/01 01-01-07
29-01-05
33-01-05
41-01-04
48-01-04
49-01-06
50-01-05

Office of Medical Assistance Programs (OMAP) Fraud and Abuse Hotline 06/27/01 99-01-06

Ch. 1243 Training for Outpatient Laboratories on Completing the MA 319 and HCFA 1500 Invoices 06/29/01
11-01-04
16-01-01

Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 07/01/01 88-01-07

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

Ch. 1121 Medicaid Drug Rebate Program Participating Drug Labelers Updated List 07/12/01 01-01-11
02-01-02

03-01-05
04-01-02
10-01-04
11-01-06
12-01-02
19-01-03
26-01-04
28-01-02
29-01-06
30-01-02
33-01-06
49-01-08

— Long Term Care Toll Free Inquiry Lines 07/16/01 24-01-01
25-01-01
34-01-01
35-01-02
36-01-02

— The Use of Restraint and Seclusion in Psychiatric Residential Treatment Facilities (RTF) 07/23/01 53-01-01

Ch. 1145 Recipient Access to Chiropractic Services in the Managed Care Delivery System 07/31/01 99-01-07

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 08/01/01 88-01-08

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 08/09/01 01-01-12
19-01-04

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 09/01/01 88-01-09

Ch. 1101 Revised HealthCare Benefits Packages Reference Chart 09-10-01 99-01-08

Ch. 1121 ON-LINE Pharmacy Extended Reversal Implementation 09/11/01 19-01-05

— Billing for Clozaril and Clozapine in the Voluntary HMOs 09/25/01 01-01-14
19-01-06

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 10/01/01 88-01-10

— The Addition of Geodon Iziprasidone to the Special Pharmaceutical Benefits Program Formulary for Atypical Antipsychotic Medications 10/25/01 01-01-15
02-01-03
05-01-02
11-01-08
13-01-01
14-01-02
19-01-07
23-01-01
26-01-06
27-01-01
29-01-08
32-01-01
33-01-07
35-01-03
36-01-03
49-01-10

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 11/01/01 88-01-11

— Medicheck List: (1) Providers, Entities and Individuals Precluded from Participation in the Medical Assistance Program (2) Shared Health Facilities for Which Registration has been Denied or Approval Withdrawn 12/01/01 88-01-12

— The Addition of Viread (tenofir Disoproxil fumarate) to the Special Pharmaceutical Benefits Program Formulary 12/07/01 01-01-16
02-01-04
11-01-09
19-01-08
23-01-02
26-01-07
28-01-04
30-01-03
35-01-04
36-01-04
37-01-01
45-01-01
46-01-01

Ch. 1149 Revision to Medical Assistance Dental Services 12/19/01 03-01-06

— MCO-FFS Split Billing for Inpatient Services 12/20/01 11-01-10
12-01-04
17-01-05

— Medical Assistance for Workers with Disabilities (MAWD) 12/21/01 99-01-11

Ch. 1121 Prior Authorization of Sustained/Controlled Release Oxycodone/OxyContin 12/11/01 99-01-10

— Breast and Cervical Cancer Prevention and Treatment Program 12/26/01 99-01-12

Ch. 1249 Discontinuance of Prior Authorization Requirement for Home Health Postpartum Visits 12/27/01 01-01-19
11-01-11
23-01-03

Ch. 1150 Ordering Medical Assistance Forms and Invoices 12/27/01 99-01-09

Ch. 1141
1150 Increased Reimbursement for Anesthesia Procedure 12/27/01 01-01-14
44-01-01

— Billing for Protease Inhibitors for HealthChoices Southeast MCOs 12/27/01 01-01-18
19-01-19

Ch. 1123 Coverage of Enteral Nutritional Supplements 12/28/01 99-01-13

2002 — Discontinuance of Hard Copies of Medicheck List 01/01/02 88-02-01

Ch. 1121 Discontinuance Prior Authorization of Proton Pump Inhibitors and Prostaglandins 01/03/02 99-02-01

Ch. 1249 Revisions to the Home Health Agency Enrollment Process 01/04/02 23-02-01

Ch. 1121 Coverage of Tobacco Cessation Drug Products and Counseling Services 01/16/02 99-02-02

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

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 01/28/02 01-02-02
19-02-01

Ch. 1121 List of Brand Name Drugs Requiring Prior Authorization 01/30/02 01-02-03
02-02-01
03-02-01
04-02-01
10-02-02
11-02-02
12-02-01
19-02-02
26-02-02
28-02-01
29-02-01
30-02-01
33-02-01
49-02-02

— The Michael Dallas Waiver 01/30/02 99-02-03

Ch. 1221 Diabetes Outpatient Self-Management Training and Education 02/06/02 99-02-04

Ch. 1130 BPI Retrospective Review of Hospice Services 02/21/02 01-02-04
17-02-02
37-02-01

— Electronic Submission of the Cost Report (MA-11) Form for Reporting Periods Ending 12/21/2011 and Thereafter 02/21/02 35-02-01
36-02-01

— Reissue of Medical Assistance (MA) Bulletin Addition of Behavioral Health Rehabilitation Service to the MA Program Fee Schedule 03/06/02 01-02-05
29-02-02
33-02-02
41-02-01
48-02-01
49-02-03
50-02-01

— Urgent Care Transportation Requests through the Medical Assistance Transportation Program (MATP) 03/14/02 99-02-05

— Stopping Accidental Falls in Elders (SAFE) 03/21/02 01-02-06
11-02-03
12-02-02
13-02-41
14-02-01
35-02-02
36-02-02

— Documentation and Medical Record Keeping Requirements 03/21/02 29-02-03
33-02-03
41-02-02

— Medical Assistance Estate Recovery Program Brochure 04/03/22 34-02-01
35-02-03
36-02-03

— Reminder to Providers Who Prescribe Behavioral Health Rehabilitation Services of Documentation Requirements 04/03/02 01-02-07
29-02-04
33-02-04
41-02-03
48-02-02
50-02-02
09-02-04

Ch. 1123 Exceptional Durable Medical Equipment (DME) 04/04/02 01-02-08
05-02-01
17-02-03
19-02-03
35-02-04
36-02-04

— Breast and Cervical Cancer Prevention and Treatment Program 05/03/02 99-02-06

— Clarification and Update to Bulletin 36-91-01 Regarding Invoice Exception Process for Long Term Care Facilities 05/21/02 25-02-01
35-02-05
36-02-05

— Performance Expectations and Recommended Guidelines for the County Child and Adolescent Services System Program (CASSP) 06/06/02 OMHSAS-02-02

— Health Insurance Portability & Accountability Act (HIPAA) 06/25/02 99-02-07

— Electronic Provider Enrollment Automation Program (ePEAP) 07/18/02 99-02-08

— Section VII—Utilization Management Review Nursing Facility Services Handbook 07/18/02 35-02-06
36-02-06

Ch. 1101 Revision to the HealthCare Benefits Packages Reference Chart (MA 446) 07/18/02 99-02-09

Ch. 1145 Change in Recipient Access to Chiropractic Services in the Managed Care Delivery System 08/12/02 99-02-10

— Residential Treatment facility Services Provided in a Secure Setting 10/01/02 01-02-11
11-02-04
12-02-03
13-02-02
17-02-04
41-02-04
50-02-03
53-02-01

— Prior Authorization Interim Supply of Medication HealthChoices Lehigh/Capital Region 10/10/02 19-02-06

— Community Care (COMMCARE) Waiver Provider
Type 59 10/16/02 05-02-04
17-02-05
19-02-07
23-02-02
28-02-03
29-02-05
38-02-01
39-02-01
41-02-05
43-02-01
51-02-01
55-02-01
56-02-01
59-02-01

— Outpatient Drug and Alcohol Clinics with Provisional Licenses 10/16/02 28-02-02

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

Ch. 1241 2002 Recommended Childhood Immunizations Schedule 11/18/02 01-02-12
10-02-03
11-02-05
17-02-06
26-02-03
49-02-05

— Continued Existence of the Fee-for-Service (FFS) Delivery System in HealthChoices Zones and Use of ACCESS Cards 11/27/02 99-02-11

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revisions: HIPAA Compliant Procedure Codes 11/27/02 99-02-12

Ch. 1121 Misrepresentation of Prescriber on the Drug Claim 11/27/02 19-02-08

Ch. 1101 The Bureau of Program Integrity and the Medical Assistance Provider Self-Audit Protocol 12/02/02 99-02-13

— Home Health Agency Services Fee Increase and Medical Assistance Program Fee Schedule Revisions 12/20/02 23-02-03

— Prior Authorization Update for Interim Supply of Medication HealthChoices Southeast Region 12/27/02 19-02-09

2003 — Additional Place of Service (Office) For Psychotherapy 01/06/03 01-03-01
41-03-01

Ch. 1149 Elimination of the Use of the Dental Service Invoice (MA 300D) and Providing Training on Completion of The ADA Claim Form (Version 2000) 01/08/03 03-03-01

Ch. 1147 Expanded Procedure Codes for Provider Type 15 Optometrist 01/13/03 15-03-01

Ch. 1101 Revised Healthcare Benefit Packages Reference Chart 01/13/03 99-03-02

— Availability of Training for Completion of Provider Behavioral Health Rehabilitation Services Reports 01/31/03 01-03-02
29-03-01
33-03-01
41-03-02
48-03-01
49-03-01
50-03-01

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 03/03/03 01-03-03
19-03-01

— Introduction of the HIPAA Ready Provider Electronic Solutions Software and Statewide Training Seminars 03/11/03 99-03-03

Ch. 1241 2003 Recommended Childhood Immunization Schedule 03/31/03 01-03-04
10-03-01
11-03-01
17-03-01
26-03-01
49-03-02

Ch. 1163 Billing Procedures for Change in Delivery Systems during a Hospital Stay and Subsequent Hospital Admission 04/04/03 11-03-02
12-03-01
13-03-01
17-03-02

Ch. 1249 Revised Prior Authorization and Program Exception Pages for the Home Health Services Handbook 04/08/03 23-03-01

Ch. 1123 Information on Accredited Rehabilitation Facilities to be Used for Motorized Wheelchair Evaluation 04/14/03 01-03-05
05-03-02
19-03-03

Ch. 1150 Elimination of the Use of the Medical Services Invoice 04/24/03 99-03-05

Ch. 1150 Medical Assistance Program Fee Schedule Revision 05/01/03 05-03-01
19-03-02

Ch. 1150 Revisions to the Prior Authorization and Program Exception Notices 05/08/03 99-03-04

Ch. 1149 Medical Assistance Program Fee Schedule for Dental Services Revisions 05/12/03 03-03-02

Ch. 1144 Pharmaceutical Services Prescribed and/or Dispensed by a Certified Registered Nurse Practitioner (CRNP) 05/12/03 99-03-06

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
11-03-03
17-03-03
26-03-02
49-03-03

— Process to Handle Residential Treatment Facility (RTF) Reports of Death, Serious Injury or Attempted Suicide (Serious Occurrences) 06/13/03 53-03-01

— Change of Protocol for Certain Provider Appeals. Appeals must be sent to Bureau of Hearings and Appeals 07/29/03 99-03-08

— Requirement for Medical Assistance (MA) Providers to Submit Accurate and Complete Encounter Data to MA Managed Care Organizations 08/01/03 99-03-10

— The Addition of Fuzeon (enfuvirtide) and Abilify (aripiprazole to the Special Pharmaceutical Benefits Program 08/01/03 99-03-11

— Obligation of Medical Assistance Providers Participating in the Managed Care Delivery System to Comply with MA Regulations 08/01/03 99-03-09

Ch. 1149 Continuity of Care for Orthodontia Treatment—From Managed Care to Fee-For-Service 08/11/03 03-03-03

— Nursing Facility Responsibility to Notify HealthChoices and Voluntary Program MCOs of the Admission of an MCO Enrolled Member 08/27/03 35-03-02
36-03-02

— Revisions to the Medical Evaluation Form 08/27/03 11-03-04
24-03-01
25-03-01
34-03-01
35-03-01
36-03-01

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 Organizations 09/01/03 99-03-13

Ch. 1121 Updated Maximum Allowable Cost (MAC) List 09/03/03 01-03-07
19-03-04
49-03-04

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
49-03-05

Ch. 1121 Medicaid Drug Rebate Program Participating Drug Labelers Updated List 10/01/03 01-03-09
02-03-02
03-03-04
04-03-01
10-03-03
11-03-06
12-03-02
19-03-05
26-03-04
28-03-01
29-03-02
30-03-01
33-03-02
49-03-06

— 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
1150 Replacing and End-dating Local Procedure Codes 10/01/03 99-03-14

— The Addition of Reyataz (atazanavir sulfate) and Emtriva (emtricitabine) to the Special Pharmaceutical Benefits Program 10/15/03 99-03-16

— Special Pharmaceutical Benefits Program Time Sensitive Expansion Tiers Structure 10/17/03 99-03-19

— Changes to Electronic Claims Format 10/17/03 99-03-17

— Revisions to Medical Evaluation Form (MA 51) 10/17/03 01-03-10
11-03-07
24-03-02
25-03-02
34-03-02
35-03-03
36-03-03
99-03-17

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 2002 HCPCS Updates 10/17/03 99-03-18

Ch. 1149 Supernumerary Tooth Enumeration and Quadrant Designation on the American Dental Association Claim Form (ADA Claim Form—Version 2000) 10/31/03 03-03-05

— Introduction to the Provider Reimbursement and Operations Management Information System (PROMISe) 10/31/03 99-03-20

— Clarification of Procedures for Requesting Copies of Medical Assistance Recipients' Bills 11/01/03 99-03-15

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 11/01/03 05-03-04
19-03-06

— Health Insurance Portability and Accountability Act (HIPAA) Transaction and Code Sets Updates 12/01/03 99-03-21

— The Addition of Lexiva (fosamprenavir) to the Special Pharmaceutical Benefits Program 12/03/03 99-03-23

2005 Ch. 1101
1150 Revisions to Prior Authorization of Drugs for Erectile Dysfunction 01/10/05 99-05-02

— Alternative Sanction Guidelines for ICF/MR Medical Assistance Certification 01/28/05 00-04-15

Ch. 1101
1150 2004 HCPCS Updates and Other Revisions to the Medical Assistance Fee Schedule 02/05/05 99-05-04

Ch. 1121 List of Brand Name Drugs Requiring Prior Authorization 02/10/05 01-05-01
08-05-01
09-05-02
11-05-01
14-05-01
21-05-01
24-05-02
27-05-01
31-02-02

Ch. 1121 Updated State Maximum Allowable Cost (MAC) List 02/10/05 0905-01
24-05-01
31-05-01

Ch. 1101 Change in Effective Date for Prior 1150 Authorization of Drugs That Exceed 1121 Established Quantity Limits and Brand Name Single Source Non-Steroidal Ant-Inflammatory Drugs (NSAIDS) 04/26/05 99-05-09

— Implementation of the ACCESS Plus Program 05/23/05 99-05-11

Ch. 1241 2005 Recommended Childhood & Adolescents Immunization Schedule 05/26/05 33-05-01

— Integrated Children's Service Initiative 06/09/05 00-05-05

— Announcement of the National Provider Identifier Number 06/10/05 99-05-13

— Revised Maximum Participation Project Consent for Release of Information Form (PA 1723) 06/15/05 99-05-12

Ch. 1121 Non-Coverage of Drugs for the Treatment of Erectile Dysfunction for Sex Offenders 06/15/05 08-05-03
09-05-04
11-05-02
24-05-03
27-05-03
31-05-04

Ch. 1101
1150 Corrections to MA Bulletin 99-05-04: Addition of HCPCS Codes to Medical Assistance Programs Fee Schedule 06/20/05 99-05-10

— Psychological/Psychiatric/Clinical Re-Evaluations and Re-Authorizations or Behavioral Health Rehabilitation (BHR) Services for Children and Adolescents with Behavioral Health Needs Compounded by Developmental Disorders 06/24/05 07-05-01
08-05-04
09-05-05
11-05-03
19-05-01
31-05-05

— Nursing Facility Assessments/Supplemental Payments 06/24/05 03-05-01

Ch. 1128 Clarification and Instructions for Providers Who Bill Medical Assistance for Dialysis Services When Medicare is the Primary Insurer 06/29/05 30-05-01

Ch. 1121 Revisions to Payment for the Drug Cost Component of Brand Name and Generic Drugs 08/05/05 09-05-06
24-05-06
25-05-01
31-05-06

Ch. 1121 Prior Authorization of Drugs That Exceed Established Quantity Limits—Phase 1 Enforcement 08/10/05 99-05-14

Ch. 1121 Revisions to the State Maximum Allowable Cost for Pharmaceutical Services 08/18/05 09-05-07
24-05-07
25-05-02
31-05-07

Ch. 1149 Dental Fee Increase for Anesthesia and Behavior Management Services 08/22/08 27-05-02

Ch. 1101 Copayment Changes for Brand Name and Generic Prescription Drugs 08/26/05 24-05-05

— Electronic Submission for the Cost Report (MA-11) Form for Reporting Periods Ending 06/30/2005 and Thereafter 08-26-05 03-05-02

Ch. 1101
1150 Medical Assistance Program Fee Schedule Procedure Code Changes for Behavioral Health Services 09/08/05 08-05-05
09-05-08
11-05-04
16-05-01
17-05-01
19-05-02
21-05-02
31-05-08
34-05-01

Ch. 1101
1150 2005 HCPCS Updates and Other Revisions to the Medical Assistance Fee Schedule; Prior Authorization Requirements 09/12/05 99-05-15

Ch. 1121 Prior Authorization of Drugs That Exceed Established Quantity Limits—Phase 2 Enforcement 09/16/05 99-05-17

Ch. 1249 Medical Assistance Program Fee Schedule Procedure Code Changes for Home Health Agency Services 09-16-05 05-05-01

Ch. 1121 Preferred Drug List 09/19/05 99-05-18

— $10,000 Lifetime Limit on Other Medical Expenses Related to Facility Services 09/20/05 03-05-03

— Long Term Care Resource Transfer Penalty 09/20/05 99-05-16

Ch. 1101 Medical Assistance Program Fee 1150 Schedule Procedure Code Changes for Healthy Beginnings Plus Program Services 09/23/05 01-05-03
05-05-02
08-05-06
31-05-09
33-0502
47-05-01

Ch. 1101
1150 Revised Outpatient Service Authorization Request Form (MA-97) 09/26/05 99-05-19

Ch. 1121 Preferred Drug List—Phase 1 10/07/05 02-05-01
03-05-04
08-05-08
09-05-10
11-05-05
14-05-02
24-05-08
27-05-04
30-05-02
31-05-11
32-05-02

Ch. 1225 Medical Assistance Program Fee Schedule Procedure Code Changes for Family Planning Clinic Services 10/14/05 08-05-09

Ch. 1101
1150
1241 Meningococcal Conjugate Vaccine Menactra (MCV4) 10/14/05 01-05-05
08-05-10
09-05-11
31-05-12
33-05-04

Ch. 1241 Revisions to the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Periodicity Schedule 10/25/05 01-05-04
08-05-07
09-05-09
31-05-10
33-05-03

Ch. 1128 Medical Assistance Program Fee Schedule Procedure Code Changes for Renal Dialysis Services 10/27/05 30-05-03
31-05-13

Ch. 1101 Medical Assistance Program Fee 1150 Schedule Procedure Code Changes for Case Management Services 10/27/05 21-05-03

Ch. 1225 Medical Assistance Program Fee Schedule Procedure Code Changes for Federally Qualified Health Centers and Rural Health Clinics 10/27/05 08-05-11

Ch. 1101
1150 Medical Assistance Program Fee Schedule Procedure Code Changes for Medical Foster Care Services 10/27/05 40-05-01

Ch. 1243 Medical Assistance Program Fee Schedule Procedure Code Changes for Laboratory Services 11/01/05 01-05-06
28-05-01

Ch. 125 Title XIX Medical Assistance Program Family Planning Clinic Fee Schedule 11/1/05 08-05-12

Ch. 1121 Tabs for the—Prior Authorization of Pharmaceutical Services—Handbook 11/4/05 02-05-02
03-05-05
08-05-13
09-05-12
11-05-06
14-05-03
24-05-09
27-05-05
30-05-04
31-05-14
32-05-03

Ch. 1121 Preferred Drug List—Phase 2 11/08/05 02-05-03
03-05-06
08-05-14
09-05-13
11-05-07
14-05-04
24-05-10
27-05-06
30-05-05
31-05-15
32-05-03

Ch. 1121 Scope of Coverage of Pharmacy Services for Dual Eligibles in the Medical Assistance (MA) Program 11/17/05 99-05-21

Ch. 1123 Addition of Prosthetic, Orthotic and Medical Supply Procedure Codes to the Medical Assistance Fee Schedule 11/21/05 24-05-11
25-05-03

— Rescind MAB 40-05-02 and Reissue the Medical Assistance Program Fee Schedule Procedure Code Changes for Provider Mileage 11/22/05 31-05-16
27-05-07
14-05-05
15-05-01
18-05-01
05-05-03
08-05-15
33-05-05
09-05-14

Ch. 1121 Preferred Drug List—Phase 3 12/01/05 02-05-04
03-05-07
08-05-16
09-05-15
11-05-08
14-05-06
24-05-12
27-05-06
30-05-06
31-05-06
32-05-04

Ch. 1123 Medical Assistance Program Fee Schedule Procedure Code Changes for Durable Medical Equipment, Medical Supplies, Vision Supplies and Hearing Supplies 12/01/05 05-05-04
24-05-13
25-05-04

Ch. 1101 Changes to the Program Exception 1150 Process as a Result of End-Dating Local Procedure Codes 12/01/05 99-05-22

Ch. 1144 Clarification of Enrollment Policy for CRNPs 12/16/05 09-05-16

Ch. 1121 Prior Authorization of Prilosec Over-the-Counter (OTC) and Loratadine OTC for Dual Eligibles 12/23/05 02-05-05
03-05-08
08-05-17
09-05-17
11-05-09
14-05-07
24-05-13
27-05-07
30-05-07
31-05-18
32-05-05

Ch. 1241 Medical Assistance Program Fee Schedule Procedure Code Changes for Occupational Therapy Services 12/27/05 17-05-02

Ch. 1145 Medical Assistance Program Fee Schedule Procedure Code Changes for Chiropractic Services 12/27/05 15-05-02

Ch. 1121 Pen and Ink Change-Medical Assistance Handbook, Prior Authorization of Pharmaceutical Services, Preferred Drug List 12/30/05 02-05-06
03-05-09
08-05-18
09-05-18
11-05-10
14-05-08
24-05-04
27-05-08
30-05-08
31-05-19
32-05-06

2006 Ch. 1123 Fee Increase for Enteral Nutritional Supplements 12/29/06 24-06-15
25-06-02

Ch. 1243 Medical Assistance Program Fee Schedule Additions of Four Laboratory Codes 12/27/06 01-06-15
08-06-21
28-06-01

Ch. 1101
1150 2006 HCPCS Updates; Prior Authorization Requirements 12/19/06 99-06-17

Ch. 1101
1150 Medical Assistance Program Fee Schedule Revision 12/19/06 99-06-18

— Implementation of the CMS-1500 Health Insurance Claim Form (Version 08/05) 12/18/06 99-06-16

Ch. 1241 Rotavirus Vaccine 12/15/06 01-06-14
08-06-20
09-06-19
31-06-26
33-06-07

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. 1121 Preferred Drug List—Quarterly Update 12/08/06 02-06-10
09-06-18
24-06-14
31-06-25
03-06-16
11-06-09
27-06-13
32-06-08
08-06-19
14-06-11
30-06-08

— Mobile Mental Health Treatment 11/30/06 08-06-18

of the Federal Poverty Income Guidelines

Year Code
Citation Subject Date Issued Bulletin Number

Ch. 1153 Clarification of Payment Policy for Abortion Services 11/28/06 99-06-15

— Instructions for Registering Your National Provider Identifier (NPI) Number to the Department of Public Welfare 11/22/06 99-06-14

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

— Medical Invoice UB-04 09/22/06 01-06-12
02-06-09
03-06-13

Ch. 1241 Pennsylvania Vaccines for Children Program Update 09-22-06 01-06-11
08-06-17
09-06-17
31-06-23
33-06-06

Ch. 1163 Medical Assistance Payment for Services of Teaching Physicians in Hospitals, Clinics and Emergency Rooms 09/16/06 1141-06-01
01-06-13
31-06-24

Ch. 1121 Preferred Drug List—Quarterly Update 08/28/06 02-06-08
03-06-11
08-06-16
09-06-16
11-06-08
14-06-10
24-06-12
27-06-12
30-06-07
31-06-22
32-06-07

— Revision to Minimum Staff Qualifications of Therapeutic Staff Support (TSS) Workers 08/24/06 08-06-15
09-06-15
11-06-07
19-06-04
31-06-21

— The Addition of Atripla (efavirenz/emtricitabine/tenofovir) and Prezista (darunavir) to the Special Pharmaceutical Benefits Program 08/21/06 09-06-14
21-06-02
24-06-11
31-06-20

Ch. 1121 Hepatitis A Vaccine 08/18/06 01-06-10
08-06-14
09-06-12
31-06-19
33-06-05

Ch. 1241 Measles, Mumps, Rubella and Varicella (MMRV) Vaccine 08/10/06 01-06-09
08-06-13
09-06-11
31-06-18
33-06-04

— Federal Medicaid Citizenship and Identity Eligibility Requirements for Medical Assistance Nursing Home Applicants or Recipients 07/28/06 03-06-10

Ch. 1101
1150
141 Medical Assistance Program Fee Schedule Revisions for Medical and Radiological Procedure Codes 07/27/06 01-06-08
03-06-09
08-06-12
14-06-09
29-06-01
31-06-17

Ch. 1153 Federal Medicaid Citizenship and Identity Eligibility Requirements 07/24/06 99-06-07

— Notification of Medicare Appeals Project and Billing Reminders for Home Health Services 07/20/06 05-06-01

Ch. 1101
1150 Medical Assistance Program Fee Schedule Change 06/23/06 01-06-07
08-06-11
17-06-02
20-06-02
31-06-16

Ch. 1163
1221 Medical Assistance Program Fee Schedule Procedure Code Changes for Acute Care General Hospitals and Hospitals Based Medical Clinics 06/17/06 01-06-05

Ch. 1163
1221 Medical Assistance Program Fee Schedule Procedure Code Changes for Medical Rehabilitation Units of General Hospitals and Rehabilitation Hospitals 06/17/06 01-06-06

Ch. 1101
1150 Medical Assistance Program Fee Schedule Procedure Code Changes 06/17/06 99-06-06

Ch. 1123 Medical Assistance Program Fee Schedule Revision for Oxygen and Oxygen Equipment 06/06/06 24-06-10
25-06-01

Ch. 1241 Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine 06/01/06 01-06-04
08-06-10
09-06-10
31-06-15
33-06-03

Ch. 1121 Medicaid Drug Rebate Program Participating Drug Labelers Updated List 05/05/06 08-06-09
09-06-09
24-06-09
31-06-14

Ch. 1123 Ventilator Dependent Respiratory (VDR) Program Preparing Table of Supply and Equipment Costs 04/28/06 03-06-08

Ch. 1121 Preferred Drug List—Quarterly Update 04/24/06 02-06-07
11-06-06
30-06-06
03-06-07
14-06-08
31-06-13
08-06-08
24-06-08
32-06-05
09-06-07
27-06-10

Ch. 1121 Prior Authorization of Revatio 04/24/06 02-06-06
11-06-05
30-06-05
03-06-06
14-06-07
31-06-12
08-06-07
24-06-07
32-06-05
09-06-07
27-06-10

Ch. 1150 Prudent Payment of Claims 04/20/06 99-06-04

Ch. 1241 2006 Recommended Childhood and Adolescent Immunization Schedule 04/16/06 01-06-03
08-06-06
09-06-05
31-06-11
33-06-02

— Continued Existence of the Fee-for-Service (FFS) Delivery System in HealthChoices Zones and Use of ACCESS Cards 04/14/06 99-06-05

Ch. 1149 Elimination of Post-Operative Review of Endodontic Therapy for Individuals 21 Years of Age and Older 03/21/06 27-06-09

Ch. 1121 Prior Authorization of Botox, Synagis and Xolair 03/09/06 02-06-05
03-06-04
08-06-05
09-06-04
11-06-04
14-06-06
24-06-05
27-06-08
30-06-03
31-06-08
32-06-03

— Special Pharmaceutical Benefits Program Revisions to Payment Methodology 03/07/06 19-06-03
24-06-06
31-06-10

Ch. 1121 Federal Clarification—Elimination of Medicaid Coverage of Drugs for Treatment of Erectile Dysfunction 03/07/06 03-06-03
02-06-04
08-06-04
09-06-13
11-06-03
14-06-05
24-06-04
27-06-07
30-06-03
31-06-08
32-06-03

Ch. 1150 Corrections to MA Bulletin 99-05-15 Addition of 2005 HCPCS Codes to Medical Assistance Programs Fee Schedule 03/01/06 99-06-02

Ch. 1127 Medical Assistance Program Fee Schedule Procedure Code Changes for Birth Centers 02/28/06 47-06-01

Ch. 1221 Medical Assistance Program Fee Schedule Procedure Code Changes for Independent Medical-Surgical Clinic Services 02/28/06 08-06-03

Ch. 1121 Pen and Ink Change—Preferred Drug List (PDL), Phase 4 02/20/06 27-06-06

Ch. 1130 Medical Assistance Program Fee Schedule Procedure Code Changes for Hospice Services 01/27/06 06-06-01
31-06-06

Ch. 1150 Disenrollment of Dual Eligibles from Physical Health Managed Care 01/27/06 99-06-01

Ch. 1141 Medical Assistance Program Fee Schedule Procedure Code Changes for Physician Services 01/27/06 31-06-05

Ch. 1143 Medical Assistance Program Fee Schedule Procedure Code Changes for Podiatry Services 01/27/06 14-06-04

Ch. 1121 Prior Authorization of Drugs that Exceed Est. Quantity Limits—Phase 3 Enforcement and Additional Drugs with Quantity Limits 01/27/06 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
32-06-02

Ch. 1142 Medical Assistance Program Fee Schedule Procedure Code Changes for Certified Nurse Midwife Services 01/27/06 33-06-01

Ch. 1144 Medical Assistance Program Fee Schedule Procedure Code Changes for Certified Registered Nurse Practitioner Services 01/27/06 09-06-03

Ch. 1121 Preferred Drug List—Phase 4 01/25/06 02-06-02
03-06-01
08-06-01
09-06-01
11-06-01
14-06-02
24-06-01
27-06-04
30-06-01
31-06-03
32-06-01

Ch. 1221 Removal of Prior Authorization Requirement for Sleep Studies 01/12/06 01-06-02
31-06-02

— Dental Behavior Management Fee Increase 01/03/06 27-06-01

Ch. 1149
1101
1150 Medical Assistance Program Fee Schedule Changes for Orthodontic and Cleft Palate Services: Fee Increases, Procedure Code Changes and New Prior Authorization Requirements 01/03/06 27-06-03
17-06-01
19-06-01
20-06-01
21-06-01

Ch. 1163 Place of Service Review Procedures 01/03/06 14-06-01
01-06-01
02-06-01
31-06-01
27-06-02

Ch. 1150 Prudent Payment of Claims 04/03/06 99-06-04

2007 — ''Issuance of an Updated MA Program Outpatient Fee Schedule for Durable Medical Equipment, Medical Supplies, Orthotics, Prosthetics, Vision and Hearing Supplies'' included in MA Bulletin 05-05-04, et al titled ''Medical Assistance Program Fee Schedule Procedure'' 12/28/07 01-07-12
05-07-03
18-07-02
20-07-06
24-07-15
25-07-07
31-07-21

— Medical Assistance Program Fee Schedule Revision 12/21/07 99-07-21

— Revision to Medical Assistance Program Fee Schedule for Federally Qualified Health Centers and Rural Health Clinics 12/21/07 08-07-16

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

— Nursing Facility Documentation Requirements for Movable Equipment That is Rented or Leased 12/07/07 03-07-10

— Error Reconciliation Recommendations for the National Provider Identifier (NPI) 12/01/07 99-07-20

Ch. 1123 MA Program Outpatient Fee Schedule Revisions for Speech Generating Devices 11/29/07 24-07-11
25-07-05
31-07-18

Ch. 1121 Preferred Drug List—Fall Update—Part 2 11/29/07 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
27-07-09

Ch. 1149 Fee Increase for Select Dental Procedure Codes 11/01/07 27-07-08

Ch. 1101 Childhood Nutrition and Weight Management Services for Recipients Under 21 Years of Age 11/01/07 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
27-07-07

Ch. 1141 Fee Increases for Select Office Visit and Office Consultation Procedure Codes 11/01/07 09-07-13
31-07-16
33-07-04

Ch. 1121 Delay in Implementation of the Tamper—Resistant Pad Requirements 10/29/07 99-07-18

Ch. 1121 Special Pharmaceutical Benefits Program (SPBP) Income Ceiling for HIV Applicants 10/15/07 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 Requirements 09/19/07 99-07-15

— Peer Review Committee 09/14/07 99-07-14

Ch. 1145 Change in Recipient Access to Chiropractic Services 09/14/07 15-07-01

Ch. 1241 Correction of Billing Instructions for Physical and Occupational Therapy Evaluations, and Evaluations of Speech, Language, Voice, Communication and/or Auditory Processing 09/14/07 01-07-09
08-07-13
17-07-01
20-07-04
31-07-13

— Updated Regarding False Claims Provisions of Deficit Reduction Act of 2005—Employee Education About False Claims Recovery 09/07/07 99-07-13

Ch. 1163 Medicare Inpatient Pricing Logic Modification 08/17/07 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

— Clarification of Act 169, also known as the Older Adult Protective Services Act (OAPSA), in regard to hiring Practices for inpatient and residential facilities 08/02/07 OMHSAS-07-01

Ch. 1121 Preferred Drug List—May 2007 Technical Correction 07/31/07 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
27-07-06

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
03-07-06
14-07-03
31-07-10
08-07-11
24-07-07
32-07-04
09-07-08
27-07-05

Ch. 1149 Discontinuance of the Prior Authorization Requirement for Dental Procedure Codes D7140 and D7210 07/11/07 27-07-04

Ch. 1249 Rescission of the Statement of Policy Clarifying the Conditions Under Which Medical Assistance Recipients May Be Considered Homebound 07/10/07 1249-07-04
99-07-12

Ch. 1123 Special Pharmaceutical Benefits Program (SPBP) Income Ceiling Increase for HIV Applicants 07/01/07 09-07-05
21-07-02
24-07-04
31-07-07

— Revised MA Bulletin 03-07-01: Billing Instructions—Medicare Non-Coverage for Medicare Eligible Nursing Facility Residents 06/29/07 03-07-05

Ch. 1101 The Elimination of Paper Vouchers 06/14/07 99-07-10

— Revised Citizenship and Identify Information Form 06/08/07 99-07-09

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 Update 06/01/07 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
32-07-03

Ch. 1101 Co-pay/Deductibles on Exceptional Durable Medical Equipment (DME) 06/01/07 03-07-04

— Responsibility of MA Providers to Provide Requested Medical/Psychological Information to the Disability Advocacy Program (DAP) 05/18/07 99-07-08

— Instructions for Using Your National Provider Identifier (NPI) Number to Bill the Department of Public Welfare (DPW) and Contingency Plan 05/18/07 99-07-07

Ch. 1150 Medical Assistance Program Fee Schedule Revision; Change to Conversion Factor for Anesthesia Services 05/10/07 31-07-05
32-07-0001

Ch. 1243 Medical Assistance Program Fee Schedule Revision of Two Laboratory Procedure Codes 05/03/07 01-07-04
08-07-02
28-07-01

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
32-07-02

Ch. 1101 Clarification Regarding the Definition of Medically Necessary—Statement of Policy 04/21/07 99-07-04
1101-07-03

Ch. 1221 Pen and Ink Change—Medical Assistance Bulletin 'Medical Assistance Program Fee Schedule Procedure Code Changes For Family Planning Clinic Services' 03/30/07 08-07-06
08-05-09

Ch. 1241 2007 Recommended Childhood and Adolescent Immunization Schedules 03/23/07 01-07-05
08-07-04
09-07-02
31-07-03
33-07-01

Ch. 1149 Discontinuance of the Dental Services Handbook 03/23/07 27-07-1

Ch. 1241 Gardasil®, Human Papillomavirus (HPV) Vaccine 03/23/07 01-07-02
08-07-05
09-07-03
31-07-04
33-07-02

Ch. 1129 Revision to Medical Assistance Program Local to National Provider Code Crosswalk for Federally Qualified Health Centers and Rural Health Clinics 03/23/07 08-07-03

Ch. 1123 Medical Assistance Program Fee Schedule Procedure Code Changes For Hearing Aid Supplies 03/01/07 01-07-02
20-07-01
31-07-01

Ch. 1123 Provider Specialty 220 (Hearing Aid Dispenser) Requirement 03/01/07 01-07-03
20-07-02
24-07-01
25-07-01
31-07-02

Ch. 1245 Clarification of Procedure Codes and Modifiers to be Used When Billing For Ambulance Services 02/20/07 26-07-01

— Replace MA Bulletin 03-06-12: Billing Instructions—Medicare Non-Coverage For Medicare Eligible Nursing Facility Residents 02/20/07 03-07-01

Ch. 1221 Correction to Title XIX Medical Assistance Program Family Planning Clinic Fee Schedule 02/06/07 08-07-01

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

— Revised Medical Assessment Form (PA 635) 01/12/07 01-07-01
19-07-01
09-07-01

Ch. 1150 Policy Reinforcement Regarding Billing For Tobacco Cessation Counseling Services 01/04/07 99-07-02

— False Act Claims Provisions of Deficit Reduction Act of 2005 Employee Education About False Claims Recovery 01/02/07 99-07-01

2008 Ch. 1121 Preferred Drug List—Fall 2007 Update Part 2 Technical Correction 01/11/08 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
19-08-01
20-08-01
21-08-01
27-08-01

Ch. 1163 Preventable Serious Adverse Events 01/14/08 01-07-11

Ch. 1121 Legend Attachment to Medical Assistance Bulletin 01-07-12, et al 01/31/08 01-08-01
05-08-01
18-08-01
20-08-01
24-08-01
25-08-01
31-08-01

Ch. 1101 Implementation of Select Plan for Women 02/01/08 01-08-02
08-08-02
09-08-02
24-08-03
28-08-01
31-08-03
33-08-01

Ch. 1241 Clarification of Childhood Nutrition and Weight Management Services for Recipients Under 21 Years of Age 02/15/08 99-08-01

Ch. 1241 The Addition of Selzentry (maraviroc) and Intelence (etavirine) to the Special Pharmaceutical Benefits Program 02/29/08 09-08-03
24-08-04
21-08-01
31-08-04

Ch. 1121 Medical Necessity Guidelines for Lyrica for Fibromyalgia 03/05/08 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
32-08-01

Ch. 1141 Medical Assistance Program Outpatient Fee Schedule Changes for Select Chemotherapy Administration Procedure Codes 03/14/08 01-08-03
08-08-03
31-08-05

Ch. 1101
1150 MA Program Fee Schedule Changes—2007 HCPCS Updates; Addition of Procedure Codes and Modifiers; Prior Authorization 03/14/08 99-08-04

Ch. 1141
1126 Medical Assistance Program Outpatient Fee Schedule Changes for Select Office Visit Procedure Codes 03/14/08 31-08-06
09-08-04
33-08-02

Ch. 1121 Tamper Resistant Prescription Pads 03/21/08 99-08-03

Ch. 1241 2008 Recommended Childhood and Adolescent Immunization Schedules 03/21/08 01-08-04
08-08-04
09-08-05
31-08-07
33-08-07

Ch. 1101 Select Plan for Women Program—Addition of Covered Services 04/23/08 01-08-05
08-08-06
09-08-07
24-08-06
28-08-03
31-08-09
33-08-04

Ch. 1150 Prudent Payment of Claims—Updated 04/25/08 99-08-05

Ch. 1121 Preferred Drug List—Spring 2008 Update 06/02/08 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
32-08-03

— Revised Error Reconciliation Recommendations for the National Provider Index (NPI) 06/05/08 99-08-07

Ch. 1149 ADA Claim Form—Version 2006 and Discontinuance of P.O. Box 8186 06/16/08 17-08-02

Ch. 1123 Nursing Facility Documentation Requirements for Moveable Equipment That is Rented or Leased 07/07/08 03-08-04

Ch. 1101 Fee-For-Service Coverage for Recipients in Health Care Benefits Package 12 07/16/08 99-08-09

Ch. 1121 Prior Authorization of Early Refills of Prescriptions 07/18/08 02-08-04
11-08-04
30-08-08
03-08-08
08-08-11
09-08-12
14-08-04
24-08-08
27-08-07
31-08-15
32-08-04

Ch. 1150
Ch. 1141
Ch. 1147 Medical Assistance Program Fee
Increase for Select Ophthalmological
Examinations 07/22/08 18-08-04
31-08-12

Ch. 1150
Ch. 1249 Medical Assistance (MA) Program Fee
Increases for Select Home Health Agency Services 07/22/08 05-08-02

Ch. 1150
Ch. 1141
Ch. 1147 Medical Assistance Program Fee
Increases for Select Office Visits and
Consultations for Vision Services 07/22/08 18-08-03

Ch. 1150
Ch. 1249 Medical 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
16-08-01

Ch. 1150
Ch. 1149 Medical Assistance Program Fee
Increases for Select Dental Services 07/22/08 27-08-06

Ch. 1150 Medical Assistance Program Fee
Increases for Select Office Visits and Consultations 07/22/08 09-08-09
31-08-11
33-08-05

Ch. 1150
Ch. 1243 Medical Assistance Program Fee
Schedule Changes for Select Laboratory Procedure Codes 07/22/08 08-08-09
09-08-10
28-08-04
31-08-13
33-08-06

Ch. 1150
Ch. 1141 Medical Assistance Program Outpatient
Fee Schedule Increase for a Select Colonoscopy Procedure 07/22/08 01-08-07

Ch. 1150 Fee Increases for Select Healthy Beginnings Plus Services 07/25/08 05-08-04
08-08-13
31-08-17
33-08-08
47-08-11

Ch. 1150
Ch. 1241 Screening for Developmental Delays
and Autism Spectrum Disorders 07/25/08 99-08-10

Ch. 1145 Recipient Access to Chiropractic Services 08/04/08 99-08-11

Ch. 1150 Prior Authorization of Advanced Radiologic Imaging Services 08/05/08 99-08-08

Ch. 1121 Prior Authorization of Tysabri 08/25/08 02-08-07
11-08-07
30-08-07
03-08-07
14-08-06
31-08-20
08-08-16
24-08-11
32-08-08
09-08-16

Ch. 1121 Prior Authorization of Letaris, Methadone, and Myobloc 08/25/08 02-08-05
11-08-05
30-08-05
03-08-05
14-08-05
31-08-18
08-08-14
24-08-09
32-08-06
09-08-14
27-08-08

Ch. 1121 Prior Authorization of Atypical Antipsychotics, Cough and Cold Medications, and Stimulants and Related Agents 08/25/08 02-08-06
11-08-06
30-08-06
03-08-06
14-08-06
31-08-19
08-08-15
24-08-10
32-08-07
09-08-15
27-08-09

Ch. 1150
Ch. 1225 Medical Assistance Program Family
Planning Clinic Select Fee Increases and Updates 08/29/08 08-08-08

Ch. 1101
Ch. 1150
Ch. 1221 Select Plan for Women Updated
Covered Services Chart 09/05/08 01-08-09
08-08-17
09-08-17
24-08-12
28-08-06
31-08-21
33-08-09

Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Proteins 09/10/08 02-08-08
11-08-08
30-08-08
03-08-09
14-08-08
31-08-22
08-08-18
24-08-13
32-08-10
09-08-18
27-08-11

Ch. 1163 Payment Policy for Hospital Readmissions 09/12/08 01-08-10

Ch. 1241 Updates for Early Periodic Screening, Diagnosis and Treatment Program 09/18/08 99-08-13

Ch. 1150
Ch. 1121 Reminder of Implementation of Tamper
Resistant Prescription Pad Requirements 09/24/08 99-08-14

Ch. 1121 Synagis—Updated Guidelines to Determine Medical Necessity 10/10/08 02-08-10
11-08-10
30-08-10
03-08-11
14-08-10
31-08-24
08-08-20
24-08-15
32-08-12
09-08-20
27-08-13

Ch. 1121 Cytokine and CAM Antagonists—Updated Guidelines to Determine Medical Necessity 10/10/08 02-08-09
11-08-09
30-08-09
03-08-10
14-08-09
31-08-23
08-08-19
24-08-14
32-08-11
09-08-19
27-08-12

Ch. 1141
1163 Increase to Maximum Medical Assistance Payment to Practitioners for Services Provided During a Period of Hospitalization 10/20/08 09-08-16

Ch. 1101
1150 Implementation of Claim Check 10/20/08 99-08-17

— Specialty Pharmacy Drug Program 10/20/08 99-09-01

Ch. 1121 Non-Payment of Anti-dementia Drugs for Children Less Than 18 Years of Age 10/20/08 99-08-15

Ch. 1121 Preferred Drug List 2008 Update 10/31/08 02-08-11
03-08-12
08-08-21
09-08-21
11-08-11
14-08-11
24-08-16
27-08-14
30-08-11
31-08-25
32-08-13

Ch. 1101
Ch. 1150 Implementation of Claim Check 10/02/08 99-08-17

Ch. 1121 Grandfathering of Prescriptions for Non-Preferred Atypical Antipsychotics for Children Under Six (6) Years of Age 11/07/08 02-08-12
11-08-12
30-08-12
03-08-13
14-08-12
31-08-26
08-08-22
24-08-17
32-08-14
09-08-22
27-08-15

Ch. 1150
Ch. 1147 Addition of Procedure Code 67820 to
Optometrist Medical Assistance Program Outpatient Fee Schedule 11/14/08 18-08-07

Ch. 1150 Preventable Serious Adverse Events 11/26/08 01-08-11

— Special Pharmaceutical Benefits Program (SPBP)—Updated Eligibility Criteria for SP1 Card Holders 12/05/08 08-08-23
09-08-23
24-08-18
01-08-04
31-08-27

Ch. 1150
Ch. 1147 Addition of Procedure Codes to the
Medical Assistance Program Fee Schedule for Office Visits for Optometrists 12/29/08 18-09-01

2009 Ch. 1150
Ch. 1123
Ch. 1147 Removal of Prior Authorization
Requirement for Eyeglass Lenses 02/09/09 18-09-02
24-09-01
25-09-01
31-09-01

Ch. 1101
Ch. 1150
Ch. 1241 Pentacel® (DTaP-IPV/Hib), Kinrix®
(DTaP-IPV) and Rotarix® (Rotavirus)
Vaccines 02/09/09 01-09-01
08-09-01
09-09-01
31-09-02
33-09-01

— Special Pharmaceutical Benefits Program (SPBP)—2009 Federal Poverty Guidelines for SP1 Card Holders 02/13/09 01-09-03
24-09-03
08-09-03
28-09-02
09-09-03
31-09-04
21-09-02

Ch. 1101
Ch. 1150
Ch. 1241 2009 Recommended Childhood and
Adolescent Immunization Schedules 02/20/09 01-09-04
08-09-04
09-09-04
31-09-05
33-09-02

— Clarifying Medical Assistance (MA) Policy related to Medicare Cost Sharing under Part D for Dual Eligible Recipients in the MA Program 03/10/09 99-09-02

— Clarification of Procedures for Responding to Requests for Copies of Medical Assistance (MA) Recipients' Bills 03/20/09 99-09-03

Ch. 1121 Prior Authorization of Hypoglycemics, Incretin Mimetics—
Enhancers 03/20/09 02-09-01
11-09-01
30-09-01
03-09-01
14-09-01
31-09-06
08-09-05
24-09-04
32-09-01
09-09-05
27-09-01

Ch. 1150 Medical Assistance Program Fee Schedule Procedure Code End-dating of Keratomileusis 03/27/09 99-09-04

Ch. 1149 Implementation of the Pediatric Dental Periodicity Schedule 04/24/09 27-09-02

Ch. 1121 Medical Necessity Guidelines for Cymbalta for Treatment of Fibromyalgia 05/22/09 01-09-05
02-09-02
03-09-02
08-09-06
09-09-06
11-09-02
14-09-02
24-09-05
27-09-03
30-09-02
31-09-07
32-09-02

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update 06/05/09 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
32-09-03

Ch. 1150 Revisions to Medical Assistance Program Fee Schedule Rates for Select Services 06/15/09 99-09-05

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Cytokine and CAM Antagonists Updated Handbook Pages 06/19/09 01-09-09
02-09-06
03-09-06
08-09-10
09-09-10
11-09-06
14-09-06
24-09-09
27-09-07
30-09-06
31-09-11
332-09-06

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Hypoglycemics, Insulins Updated Handbook Pages 06/19/09 01-09-07
02-09-04
03-09-04
08-09-08
09-09-08
11-09-04
14-09-04
24-09-07
27-09-05
30-09-04
31-09-09
32-09-04

Ch. 1121 Automated Prior Authorization of Pharmacy Services—Stimulants and Related Agents Updated Handbook Pages 06/29/09 01-09-11
08-09-12
14-09-08
30-09-08
02-09-08
09-09-12
24-09-11
31-09-13
03-09-08
11-09-08
27-09-08
32-09-08

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Antibiotics, GI Updated Handbook Pages 06/29/09 01-09-26
02-09-23
03-09-23
08-09-27
09-09-27
11-09-23
14-09-23
24-09-26
27-09-23
30-09-23
31-09-28
32-09-23

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Bronchodilators, Beta Agonist Updated Handbook Pages 06/29/09 01-09-25
02-09-22
03-09-22
08-09-26
09-09-26
11-09-22
14-09-22
24-09-25
27-09-22
30-09-22
31-09-27
32-09-22

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Inhaled Glucocorticoids Updated Handbook Pages 06/29/09 01-09-17
02-09-14
03-09-14
08-09-18
09-09-18
11-09-14
14-09-14
24-09-17
27-09-14
30-09-14
31-09-19
32-09-14

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Sedative Hypnotics Updated Handbook Pages 06/29/09 01-09-12
08-09-13
14-09-09
30-09-09
02-09-09
09-09-13
24-09-12
31-09-14
03-09-09
11-09-09
27-09-09
32-09-09

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Oral Antifungals Updated Handbook Pages 06/29/09 01-09-16
02-09-13
03-09-13
08-09-17
09-09-17
11-09-13
14-09-13
24-09-16
27-09-13
30-09-13
31-09-18
32-09-13

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Minimally Sedating Antihistamines Updated Handbook Pages 06/29/09 01-09-23
02-09-20
03-09-20
08-09-24
09-09-24
11-09-20
14-09-20
24-09-23
27-09-20
30-09-20
31-09-25
32-09-20

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Pulmonary Arterial Hypertension (PAH) Agents Handbook Pages 06/29/09 01-09-13
08-09-14
14-09-10
30-09-10
02-09-10
09-09-14
24-09-13
31-09-15
03-09-10
11-09-10
27-09-10
32-09-10

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Ophthalmic Immunomodulators Updated Handbook Pages 06/29/09 01-09-14
08-09-15
14-09-11
30-09-11
02-09-11
09-09-15
24-09-14
31-09-16
03-09-11
11-09-11
27-09-11
32-09-11

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Antidepressants, SSRIs Updated Handbook Pages 06/29/09 01-09-22
02-09-19
03-09-19
08-09-23
09-09-23
11-09-19
14-09-19
24-09-22
27-09-19
30-09-19
31-09-24
32-09-19

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) 06/29/09 01-09-24
02-09-21
03-09-21
08-09-25
09-09-25
11-09-21
14-09-21
24-09-24
27-09-21
30-09-21
31-09-26
32-09-21

Ch. 1121 Pharmacy Update—Oral Fluoroquinolones Updated Handbook Pages 06/29/09 01-09-20
02-09-17
03-09-17
08-09-21
09-09-21
11-09-17
14-09-17
24-09-20
27-09-17
30-09-17
31-09-22
32-09-17

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Intranasal Rhinitis Agents Updated Handbook Pages 06/29/09 01-09-18
02-09-15
03-09-15
08-09-19
09-09-19
11-09-15
14-09-15
24-09-18
27-09-15
30-09-15
31-09-20
32-09-15

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Growth Hormones Updated Handbook Pages 06/29/09 01-09-19
02-09-16
03-09-16
08-09-20
09-09-20
11-09-16
14-09-16
24-09-19
27-09-16
30-09-16
31-09-21
32-09-16

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Bronchodilators, Anticholinergic Updated Handbook Pages 06/29/09 01-09-21
02-09-18
03-09-18
08-09-22
09-09-22
11-09-18
14-09-18
24-09-21
27-09-18
30-09-18
31-09-23
32-09-18

Ch. 1121 Spring 2009 Preferred Drug List (PDL) Pharmacy Update—
Acne Agents, Oral Updated Handbook Pages 06/29/09 01-09-10
08-09-11
14-09-07
30-09-07
02-09-07
09-09-11
24-09-10
31-09-12
03-09-07
11-09-07
27-09-08
32-09-07

Ch. 1121 Automated Prior Authorization of Pharmacy Services—
Lipotropics, Statins Updated Handbook Pages 06/29/09 01-09-15
02-09-12
03-09-12
08-09-16
09-09-16
11-09-12
14-09-12
24-09-15
27-09-12
30-09-12
31-09-17
32-09-12

Ch. 1150 2008 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes 07/06/09 99-09-06

Ch. 1121 Prior Authorization of Benzodiazepines—Pharmacy Services 07/27/09 01-09-31
02-09-28
03-09-28
08-09-32
09-09-32
11-09-28
14-09-28
24-09-31
27-09-29
30-09-28
31-09-33
32-09-28

Ch. 1121 Prior Authorization of Buprenorphine Agents (Suboxone and Subutex)—Pharmacy Services 07/27/09 01-09-30
02-09-27
03-09-27
08-09-31
09-09-31
11-09-27
14-09-27
24-09-30
27-09-28
30-09-27
31-09-32
32-09-27

Ch. 1121 Prior Authorization of Topical Acne Agents—Pharmacy Services 07/27/09 01-09-28
02-09-25
03-09-25
08-09-29
09-09-29
11-09-25
14-09-25
24-09-28
27-09-26
30-09-29
31-09-30
32-09-25

Ch. 1121 State Maximum Allowable Cost (MAC) List (Including the Federal Upper Limit)—Pharmacy Services 07/27/09 01-09-32
02-09-29
03-09-29
08-09-33
09-09-33
11-09-29
14-09-29
24-09-32
27-09-30
30-09-29
31-09-34
32-09-29

Ch. 1121 Prior Authorization of Cough and Cold Medications for Children Under Six (6) years of Age—Pharmacy Services 07/27/09 01-09-27
02-09-24
03-09-24
08-09-28
09-09-28
11-09-24
14-09-24
24-09-27
27-09-25
30-09-04
31-09-29
32-09-24

— Special Pharmaceutical Benefits Program (SPBP)—Addition of CD4 Tests to the List of Outpatient Laboratory Services for SP1 Card Holders 08/03/09 01-09-33
08-09-34
09-09-35
21-09-03
24-09-33
28-09-03
31-09-36

Ch. 1105. 1150 Revised Medical Assessment Form
(PA 635) 08/10/09 31-09-38
19-09-01
09-09-34

Ch. 1121 Prior Authorization of Skeletal Muscle Relaxants—
Pharmacy Services 08/10/09 01-09-35
09-09-37
27-09-32
02-09-31
11-09-31
30-09-31
03-09-31
14-09-31
31-09-38
08-09-36
24-09-35
32-09-31

Ch. 1121 Prior Authorization of Narcotic Analgesics—Pharmacy Services 08/10/09 01-09-34
09-09-36
27-09-31
02-09-30
11-09-30
30-09-30
03-09-30
14-09-30
31-09-37
08-09-35
24-09-34
32-09-30

Ch. 1101
Ch. 1150 Changes to Procedure Codes for the Administration Fees for Kinrix® (DTaP-IPV) and Rotarix® (Rotavirus Vaccines 08/13/09 01-09-38
08-09-39
09-09-40
31-09-41
33-09-03

Ch. 1101
1150. 1141
1221 Select Plan for Women Program
Formulary 09/01/09 01-09-39
08-09-40
09-09-41
24-09-38
28-09-04
31-09-42
33-09-04

Ch. 1121 SUBJECT Prior Authorization of Atypical Antipsychotics—
Pharmacy Services 09/01/09 01-09-36
09-09-38
27-09-33
02-09-32
11-09-32
30-09-32
03-09-32
14-09-32
31-09-39
08-09-37
24-09-36
32-09-32

Ch. 1101. 1150
1141
1221 Select Plan for Women Program—Addition of Covered Services 09/08/09 01-09-40
08-09-41
09-09-42
24-09-39
28-09-05
31-09-43
33-09-05

Ch. 1150
1241
Structured Screening for Developmental Delays and Autism Spectrum Disorders
09/08/09
99-09-07

Ch. 1121 Prior Authorization of Neulasta—Pharmacy Services 09/17/09 01-09-29
02-09-26
03-09-26
08-09-30
09-09-30
11-09-26
14-09-26
24-09-29
27-09-27
30-09-26
31-09-31
32-09-26

Ch. 1121 Prior Authorization of Conventional (Typical) Antipsychotics—
Pharmacy Services 09/21/09 01-09-37
09-09-39
27-09-34
02-09-33
11-09-33
30-09-33
03-09-33
14-09-33
31-09-40
08-09-38
24-09-37
32-09-33

Ch. 1121 Available Resources: 2009 Novel Influenza Virus A (H1N1) 09/24/09 01-09-41
08-09-42
09-09-43
31-09-44
33-09-06

Ch. 1141 Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services 10/05/09 99-09-09

Ch. 1150 Billing for the Administration of the Influenza A (H1N1) 2009 Monovalent Vaccine 10/09/09 99-09-10

Ch. 1101 1141
1142
1143
1144
1145. 1147
1149 Revision of the PROMISe® Individual
Practitioner Enrollment Application and Implementation of Credentialing for Certain
Providers Types 10/16/09 99-09-08

Ch. 1121 Prior Authorization of Proton Pump Inhibitors (PPIs)—
Pharmacy Services 10/20/09 01-09-42
08-09-43
14-09-34
30-09-34
02-09-34
09-09-44
24-09-40
31-09-45
03-09-34
11-09-34
27-09-35
32-09-34

Ch. 1121 Fall 2009 Preferred Drug List (PDL) and Quantity Limits Update—
Pharmacy Services 11/02/09 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
32-09-35

Ch. 1141 1145 Recipient Access to Chiropractic Services 11/30/09 99-09-11

Ch. 1121 Steroids, Topical Low Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-51
09-09-53
27-09-44
02-09-43
11-09-43
30-09-43
03-09-43
14-09-43
31-09-54
08-09-52
24-09-49
32-09-43

Ch. 1121 Ophthalmic Antibiotics Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-58
09-09-59
27-09-50
02-09-49
11-09-49
30-09-49
03-09-49
14-09-49
31-09-60
08-09-58
24-09-55
32-09-49

Ch. 1121 Steroids, Topical High Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-54
09-09-55
27-09-46
02-09-45
11-09-45
30-09-45
03-09-45
14-09-45
31-09-56
08-09-54
24-09-51
32-09-45

Ch. 1121 Platelet Aggregation Inhibitors Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-47
09-09-49
27-09-40
02-09-39
11-09-39
30-09-39
03-09-39
14-09-39
31-09-50
08-09-48
24-09-45
32-09-39

Ch. 1121 Pharmacy Services Fall 2009 Preferred Drug List (PDL) Pharmacy Update—Bronchodilators, Beta Agonists Updated Handbook Pages 11/02/09 01-09-48
09-09-50
27-09-41
02-09-40
11-09-40
30-09-40
03-09-40
14-09-40
31-09-51
08-09-49
24-09-46
32-09-40

Ch. 1121 Antivirals, Topical Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-57
09-09-58
27-09-49
02-09-48
11-09-48
30-09-48
03-09-48
14-09-48
31-09-59
08-09-57
24-09-54
32-09-48

Ch. 1121 Ophthalmic Anti-Inflammatories New Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-49
09-09-51
27-09-42
02-09-41
11-09-41
30-09-41
03-09-41
14-09-41
31-09-52
08-09-50
24-09-47
32-09-41

Ch. 1121 Pancreatic Enzymes Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-50
09-09-52
27-09-43
02-09-42
11-09-42
30-09-42
03-09-42
14-09-42
31-09-53
08-09-51
24-09-48
32-09-42

Ch. 1121 Steroids, Topical Very High Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-55
09-09-56
27-09-47
02-09-46
11-09-46
30-09-46
03-09-46
14-09-46
31-09-57
08-09-55
24-09-52
32-09-46

Ch. 1121 Fall 2009 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services 11/02/09 01-09-44
09-09-46
27-09-37
02-09-36
11-09-36
30-09-36
03-09-36
14-09-36
31-09-47
08-09-45
24-09-42
32-09-36

Ch. 1121 Steroids, Topical Medium Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-52
09-09-54
27-09-45
02-09-44
11-09-44
30-09-44
03-09-44
14-09-44
31-09-55
08-09-53
24-09-50
32-09-44

Ch. 1121 Antidepressants, Other Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-45
09-09-47
27-09-38
02-09-47
11-09-37
30-09-37
03-09-47
14-09-37
31-09-48
08-09-46
24-09-43
32-09-37

Ch. 1121 Antifungals, Oral Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-46
09-09-48
27-09-39
02-09-38
11-09-38
30-09-38
03-09-38
14-09-38
31-09-49
08-09-47
24-09-44
32-09-38

Ch. 1121 Bone Resorption Suppression and Related Agents Updated Handbook Pages Pharmacy Services Fall 2009 Preferred Drug List (PDL) Update 11/02/09 01-09-56
09-09-57
27-09-48
02-09-47
11-09-47
30-09-47
03-09-47
14-09-47
31-09-58
08-09-56
24-09-53
32-09-47

Ch. 1143 Correction to Medical Assistance Bulletin 14-06-04 for Podiatrists 11/30/09 14-09-50

Ch. 1121 Prior Authorization and Quantity Limits of Botulinum Toxins Pharmacy Services 12/11/09 01-09-61
09-09-62
27-09-53
02-09-52
11-09-52
30-09-52
03-09-52
14-09-52
31-09-63
08-09-61
24-09-58
32-09-52

Ch. 1121 Preferred Drug List (PDL) New Drugs to Market Handbook Pages Pharmacy Services 12/11/09 01-09-60
09-09-61
27-09-52
02-09-51
11-09-51
30-09-51
03-09-51
14-09-51
31-09-62
08-09-60
24-09-57
32-09-51

— Prone Restraints in Children's Facilities 12/19/09 3800-09-02

— Strategies and Practices to Eliminate the Use of Unnecessary Restraints 12/19/09 3800-09-01

Ch. 1101 1150
1241 Hiberix®, Haemophilus Influenzae
Type b (Hib) Vaccine 12/31/09 01-09-62
08-09-61
09-09-62
31-09-64
33-09-07

2010 — Special Pharmaceutical Benefits Program (SPBP)-Implementation of the Revised HIV/AIDS Formulary for SP1 Cardholders 01/25/10 08-10-02
09-10-02
24-10-02
31-10-02

Ch. 1121 List of Drugs with Established Quantity Limits/Daily Dose Limits—Pharmacy Services 01/29/10 01-10-01
09-10-01
27-10-01
02-10-01
11-10-01
30-10-01
03-10-01
14-10-01
31-10-01
08-10-01
24-10-01
32-10-01

Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Proteins—
Pharmacy Services 01/29/10 01-10-03
09-10-04
27-10-02
02-10-01
11-10-01
30-10-01
03-10-01
14-10-01
31-10-01
08-10-01
24-10-01
32-10-01

Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services 02/05/10 01-10-05
09-10-06
27-10-04
02-10-04
11-10-04
30-10-04
03-10-04
14-10-04
31-10-07
08-10-06
24-10-05
32-10-04

Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 02/05/10 01-10-02
08-10-03
09-10-03
18-10-01
28-10-01
29-10-01
31-10-03

Ch. 1147 Medical Assistance Program Outpatient Fee Schedule Procedure Code Changes for Vision Services 02/15/10 18-10-02
31-10-05

Ch. 1150 Medical Assistance Program Fee Schedule Revisions 02/19/10 99-10-01

Ch. 1101
1150
1241 2010 Recommended Childhood and
Adolescent Immunization Schedules 03/15/10 01-10-06
08-10-07
09-10-07
31-10-09
33-10-01

Ch. 1141
1144
Application of Topical Fluoride
Varnish by Physicians and CRNPs
03/15/10

09-10-08
31-10-08

Ch. 1121 Prior Authorization of Neulasta—Pharmacy Services 04/01/10 01-10-07
09-10-09
27-10-05
02-10-05
11-10-05
30-10-05
03-10-05
14-10-05
31-10-10
08-10-08
24-10-06
32-10-05

Ch. 1121 Oral Buprenorphine Agents Updated Handbook Pages—
Pharmacy Services 04/03/10 01-10-04
09-10-05
27-10-03
02-10-03
11-10-03
30-10-03
03-10-03
14-10-03
31-10-06
08-10-05
24-10-04
32-10-03

— Implementation of New Physical Health Managed Care Organizations in the HealthChoices Southeast and Lehigh/Capital Zones 04/23/10 99-10-02

Ch. 1121 Analgesics, Narcotic Long Acting Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/01/10 01-10-15
09-10-17
27-10-12
02-10-12
11-10-12
30-10-12
03-10-13
14-10-12
31-10-18
08-10-16
24-10-13
32-10-12

Ch. 1121 Fibromyalgia Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-10
09-10-12
27-10-08
02-10-08
11-10-08
30-10-08
03-10-08
14-10-08
31-10-13
08-10-11
24-10-09
32-10-08

Ch. 1121 Spring 2010 Preferred Drug List (PDL) Quantity Limits Update—Pharmacy Services 05/03/10 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
32-10-06

Ch. 1121 Oral Immunosuppressive Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-12
09-10-14
27-10-10
02-10-10
11-10-10
30-10-10
03-10-10
14-10-10
31-10-15
08-10-13
24-10-11
32-10-10

— Limitation on Allowable Other Medical Expenses Related to Nursing Facility Services 05/03/10 03-10-02

Ch. 1121 Multiple Sclerosis Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-13
09-10-15
27-10-11
02-10-11
11-10-11
30-10-11
03-10-11
14-10-11
31-10-16
08-10-14
24-10-12
32-10-11

Ch. 1121 Hepatitis C Agents Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-11
09-10-13
27-10-09
02-10-09
11-10-09
30-10-09
03-10-09
14-10-09
31-10-14
08-10-12
24-10-10
32-10-09

Ch. 1121 Antidepressants, Other Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/03/10 01-10-09
09-10-11
27-10-07
02-10-07
11-10-07
30-10-07
03-10-07
14-10-07
31-10-12
08-10-10
24-10-08
32-10-07

Ch. 1121 Oral Anticonvulsants Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-18
09-10-20
27-10-15
02-10-15
11-10-15
30-10-15
03-10-16
14-10-15
31-10-21
08-10-19
24-10-16
32-10-15

Ch. 1121 Angiotensin Modulator Combinations Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-17
09-10-19
27-10-14
02-10-14
11-10-14
30-10-14
03-10-15
14-10-14
31-10-20
08-10-18
24-10-15
32-10-14

Ch. 1121 Pulmonary Arterial hypertension Agents, Oral and Inhaled Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-16
09-10-18
27-10-13
02-10-13
11-10-13
30-10-13
03-10-14
14-10-13
31-10-19
08-10-17
24-10-14
32-10-13

Ch. 1121 Analgesics, Narcotic Short Acting Handbook Pages Pharmacy Services Spring 2010 Preferred Drug List (PDL) Update 05/21/10 01-10-19
09-10-21
27-10-16
02-10-16
11-10-16
30-10-16
03-10-17
14-10-16
31-10-22
08-10-20
24-10-17
32-10-16

Ch. 1101
1150 Announcing the Federally Mandated
Change to Electronic Healthcare Transactions for Healthcare and Pharmacy Transactions 06/08/10 99-10-07

Ch. 1101
1150
1241 Revisions to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program Periodicity Schedule 06/14/10 99-10-06

Ch. 1150 2009 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes 06/14/10 99-10-05

Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 07/09/10 01-10-20
08-10-21
09-10-22
18-10-03
28-10-02
29-10-02
31-10-23

Ch. 41 Change of Protocol for Certain Provider Appeals 07/09/10 99-10-08

Ch. 1101
1102
1121
1123
1149
1151
1163
1181
1187
1230
1243 Policy Clarification Regarding Written Prescriptions—Statement of Policy 07/17/10 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
1243-10-01

Ch. 1121 Prior Authorization of Spiriva (Bronchodilators, Anticholinergic)—Pharmacy Services 07/29/10 01-10-21
09-10-23
27-10-17
02-10-17
11-10-17
30-10-17
03-10-18
14-10-17
31-10-25
08-10-22
24-10-18
32-10-17

Ch. 1101 Select Plan for Women—Update to Covered Services 07/30/10 01-10-22
08-10-24
09-10-21
24-10-19
28-10-03
31-10-26
33-10-03

Ch. 1225 Changes to the Provision of Hemoglobin Laboratory Services by Family Planning Clinics 07/30/10 08-10-23

Ch. 1121 Electronic Prescribing for Providers That Have ePrescribing Software 08/04/10 03-10-19
09-10-25
14-10-18
18-10-04
24-10-20
27-10-18
31-10-24
33-10-04

Ch. 1121 Prior Authorization of Analgesics, Narcotic Long Acting—Pharmacy Services 08/27/10 01-10-26
09-10-28
27-10-21
02-10-20
11-10-20
30-10-20
03-10-22
14-10-21
31-10-29
08-10-27
24-10-23
32-10-20

Ch. 1121 Prior Authorization of Analgesics, Narcotic Short Acting—Pharmacy Services 08/27/10 01-10-25
09-10-27
27-10-20
02-10-19
11-10-19
30-10-19
03-10-21
14-10-20
31-10-28
08-10-26
24-10-22
32-10-19

Ch. 1121 Updated List of Drugs with Established Quantity Limits/Daily Dose Limits—Pharmacy Services 08/27/10 01-10-23
09-10-26
27-10-19
02-10-18
11-10-18
30-10-18
03-10-20
14-10-19
31-10-27
08-10-25
24-10-21
32-10-18

Ch. 1101
1150
1241 Updates to the Medical Assistance Program Fee Schedule for the Administration of the Vaccines Prevnar 13®, Cervarix®, Twinrix®, Recombivax HB®, and Menveo® 08/30/10 01-10-27
08-10-28
09-10-29
31-10-30
33-10-05

Ch. 1150 Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services 08/30/10 99/10/09

Ch. 1121
Retrospective Drug Use Review—Pharmacy Services
09/01/10
99-10-10

Ch. 1121 Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services 09/27/10 99-10-11

Ch. 1145 Recipient Access to Chiropractic Services 10/08/10 99-10-12

Ch. 1121 Antipsychotics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-33
09-10-35
27-10-25
02-10-24
11-10-24
30-10-24
03-10-26
14-10-25
31-10-36
08-10-34
24-10-27
32-10-24

Ch. 1121 Analgesics/Anesthetics, Topical Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-29
09-10-31
27-10-21
02-10-20
11-10-20
30-10-20
03-10-22
14-10-21
31-10-32
08-10-30
24-10-23
32-10-20

Ch. 1121 Intranasal Rhinitis Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-41
09-10-43
27-10-33
02-10-32
11-10-32
30-10-32
03-10-34
14-10-33
31-10-44
08-10-42
24-10-35
32-10-32

Ch. 1121 Oral Fluoroquinolones Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-39
09-10-41
27-10-31
02-10-30
11-10-30
30-10-30
03-10-32
14-10-31
31-10-42
08-10-40
24-10-33
32-10-30

Ch. 1121 Fall 2010 Preferred Drug List (PDL) and Quantity Limits Update—Pharmacy Services 11/05/10 01-10-28
09-10-30
27-10-20
02-10-19
11-10-19
30-10-19
03-10-21
14-10-20
31-10-31
08-10-29
24-10-22
32-10-19

Ch. 1121 Inhaled Glucocorticoids Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-40
09-10-42
27-10-32
02-10-31
11-10-31
30-10-31
03-10-33
14-10-32
31-10-43
08-10-41
24-10-34
32-10-31

Ch. 1121 Antihyperuricemics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-31
09-10-33
27-10-23
02-10-22
11-10-22
30-10-22
03-10-24
14-10-23
31-10-34
08-10-32
24-10-25
32-10-22

Ch. 1121 Bronchodilators, Beta Agonists Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-37
09-10-39
27-10-29
02-10-28
11-10-28
30-10-28
03-10-30
14-10-29
31-10-40
08-10-38
24-10-31
32-10-28

Ch. 1121 Antivirals, Oral Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-34
09-10-36
27-10-26
02-10-25
11-10-25
30-10-25
03-10-27
14-10-26
31-10-37
08-10-35
24-10-28
32-10-25

Ch. 1121 Macrolides/Ketolides Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10/42
09-10-44
27-10-34
02-10-33
11-10-33
30-10-33
03-10-35
14-10-34
31-10-45
08-10-43
24-10-36
32-10-33

Ch. 1121 Antibiotics, Inhaled Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-30
09-10-32
27-10-22
02-10-21
11-10-21
30-10-21
03-10-23
14-10-22
31-10-33
08-10-31
24-10-24
32-10-21

Ch. 1121 Bone Resorption Suppression and Related Agents Handbook Pages—Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-30
09-10-32
27-10-22
02-10-21
11-10-21
30-10-21
03-10-23
14-10-22
31-10-33
08-10-31
24-10-24
32-10-21

Ch. 1121 Bile Salts Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-35
09-10-37
27-10-27
02-10-26
11-10-26
30-10-26
03-10-28
14-10-27
31-10-38
08-10-36
24-10-29
32-10-26

Ch. 1121 Antiparasitics, Topical Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-32
09-10-34
27-10-24
02-10-23
11-10-23
30-10-23
03-10-25
14-10-24
31-10-35
08-10-33
24-10-26
32-10-23

Ch. 1121 Cytokine and CAM Antagonists Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/05/10 01-10-38
09-10-40
27-10-30
02-10-29
11-10-29
30-10-29
03-10-31
14-10-30
31-10-41
08-10-39
24-10-32
32-10-29

Ch. 1121 Alzheimer's Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-49
09-10-51
27-10-41
02-10-40
11-10-40
30-10-40
03-10-42
14-10-41
31-10-52
08-10-50
24-10-43
32-10-40

Ch. 1121 Ophthalmic Antibiotics Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-44
09-10-46
02-10-35
11-10-35
30-10-35
03-10-37
14-10-36
31-10-47
08-10-45
24-10-38
32-10-35

Ch. 1121 Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Handbook Pages—Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-43
09-10-45
27-10-35
02-10-34
11-10-34
30-10-34
03-10-36
14-10-35
31-10-46
08-10-44
24-10-37
32-10-34

Ch. 1101
1121 Requirement for Prescribing Provider
National Provider Identifier (NPI) Number on Outpatient Pharmacy Claims—Pharmacy Services 11/12/10 99-10-13

Ch. 1121 Cephalosporins Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-48
09-10-50
27-10-40
02-10-39
11-10-39
30-10-39
03-10-41
14-10-40
31-10-51
08-10-49
24-10-42
32-10-39

Ch. 1121 Stimulants and Related Agents Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-47
09-10-49
27-10-39
02-10-38
11-10-38
30-10-38
03-10-40
14-10-39
31-10-50
08-10-48
24-10-41
32-10-38

Ch.1121 Platelet Aggregation Inhibitors Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-46
09-10-48
27-10-38
02-10-37
11-10-37
30-10-37
03-10-39
14-10-38
31-10-49
08-10-47
24-10-40
32-10-37

Ch. 1121 Ophthalmic Anti-Inflammatories Handbook Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 11/12/10 01-10-45
09-10-47
27-10-37
02-10-36
11-10-36
30-10-36
03-10-38
14-10-37
31-10-48
08-10-46
24-10-39
32-10-36

Ch. 1129 Dental Encounter payment for Dental Services Rendered by Rural Health Clinics and Federally Qualified Health Centers 11/15/10 08-10-50

Ch. 1245
1187 Payment for Non-Emergency Transportation Services 11/24/10 03-10-43
26-10-01

Ch. 1121 Incretin Mimetic/Enhancer Hypoglycemics Pages Pharmacy Services Fall 2010 Preferred Drug List (PDL) Update 12/01/10 01-10-50
09-10-51
27-10-42
02-10-41
11-10-42
30-10-41
03-10-44
14-10-42
31-10-53
08-10-51
24-10-44
32-10-41

Ch. 1101 Missed Appointments 12/01/10 99-10-14

Ch. 1101
1150
1241 Medical Assistance Program Coverage of the 2010-2011 Influenza Vaccines 12/01/10 99-10-16

Ch. 1121 Oral Buprenorphine Agents Updated Handbook Pages—Pharmacy Services 12/13/10 01-10-51
09-10-52
27-10-42
02-10-42
11-10-42
30-10-42
03-10-45
14-10-43
31-10-54
08-10-52
24-10-45
32-10-42

Ch. 1121 Hypoglycemics, TZDs Updated Handbook Pages Pharmacy Services 12/20/10 01-10-52
09-10-53
27-10-43
02-10-43
11-10-43
30-10-43
03-10-46
14-10-44
31-10-55
08-10-53
24-10-46
32-10-43

Ch. 1121 Prior Authorization of Topamax/Topiramate Oral Anticonvulsants Updated Handbook Pages Pharmacy Services 12/24/10 01-10-53
09-10-54
27-10-44
02-10-44
11-10-44
30-10-44
03-10-47
14-10-45
31-10-56
08-10-54
24-10-47
32-10-44

Ch. 1121 Prior Authorization of Methadone in Analgesics, Narcotic Long Acting Updated Handbook Pages Pharmacy Services 12/24/10 01-10-54
09-10-55
27-10-45
02-10-45
11-10-45
30-10-45
03-10-48
14-10-46
31-10-57
08-10-55
24-10-48
32-10-45

— Complex Case Planning 12/28/10 00-10-02

2011 Ch. 1150 2010 HCPCS Updates and Other Procedure Code and Procedure Code/Modifier Combination Changes 01/03/11 99-11-01

Ch. 1123 Change in Billing of Repairs and Replacements for Durable Medical Equipment 01/14/11 24-11-01

Ch. 1101
1150 Medical Assistance Electronic Health Records (EHR) Incentive Program for Eligible Professionals 01/25/11 08-11-02
09-11-01
27-11-01
31-11-01
33-11-01

Ch. 1101
1150 Medical Assistance Electronic Health Records (EHR) Incentive Program for Eligible Hospitals 01/28/11 01-11-01

Ch. 1225 Rescind MA Program Fee Increase for Oral Contraceptives Dispensed by Family Planning Clinics 02/09/11 08-11-03

Ch. 1241 2011 Recommended Childhood and Adolescent Immunization Schedules 03/18/11 01-11-04
08-11-06
09-11-05
31-11-05
33-11-04

Ch. 1101
1150 MA Program Outpatient Fee Schedule Decrease for Select Incontinence Products 04/05/11 24-11-02
25-11-02

— Electronic Prescribing Internet-based Application for Enrolled Medicaid Prescribers 04/08/11 03-11-01
09-11-02
14-11-01
18-11-01
24-11-03
27-11-02
31-11-02
33-11-03

Ch. 1150 Health Care Benefit Package 12 Updated Employability Assessment Procedure Code List 04/13/11 01-11-02
08-11-04
09-11-03
18-11-02
28-11-01
29-11-01
31-11-03

Ch. 1101 Select Plan for Women Program—Update to Covered Services 04/13/11 01-11-03
08-11-05
09-11-04
24-11-04
28-11-02
31-11-04
33-11-03

Ch. 1101
1150 Medical Assistance Electronic Health Record (EHR) Incentive Program Application Process for Eligible Professionals (EP) 05/13/11 08-11-07
09-11-06
27-11-03
31-11-06
33-11-05

Ch. 1101
1150 Medical Assistance Electronic Health (EHR) Incentive Program Application Process for Eligible Hospitals 05/13/11 01-11-05

Ch. 1121 Prior Authorization of Androgenic Agents—Pharmacy Services 05/26/11 01-11-06
09-11-07
27-11-04
02-11-01
11-11-01
30-11-01
03-11-02
14-11-02
31-11-07
08-11-08
24-11-05
32-11-01

Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 05/26/11 01-11-10
09-11-11
27-11-08
02-11-05
11-11-05
30-11-05
03-11-06
14-11-06
31-11-11
08-11-12
24-11-09
32-11-05

Ch. 1121 Prior Authorization of Antidepressants, SSRIs—Pharmacy Services 05/26/11 01-11-08
09-11-09
27-11-06
02-11-03
11-11-03
30-11-03
03-11-04
14-11-04
31-11-09
08-11-10
24-11-07
32-11-03

Ch. 1121 Prior Authorization of Atypical Antipsychotics—Pharmacy Services 05/26/11 01-11-09
09-11-10
27-11-07
02-11-04
11-11-04
30-11-04
03-11-05
14-11-05
31-11-10
08-11-11
24-11-08
32-11-04

Ch. 1121 Prior Authorization of Proton Pump Inhibitors (PPIs)—Pharmacy Services 05/26/11 01-11-07
09-11-08
27-11-05
02-11-02
11-11-02
30-11-02
03-11-03
14-11-03
31-11-09
08-11-09
24-11-06
32-11-02

Ch. 1150 Revisions to the Medical Assistance Program Fee Schedule Rates for Select Services 05/30/11 99-11-02

Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services 06/08/11 01-11-17

Ch. 1121 Prior Authorization of Antihyperuricemics—Pharmacy Services 06/08/11 01-11-16
09-11-17
27-11-14
02-11-11
11-11-11
30-11-11
03-11-12
14-11-12
31-11-17
08-11-18
24-11-15
32-11-11

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 06/08/11 01-11-18
09-11-19
27-11-16
02-11-13
11-11-13
30-11-13
03-11-14
14-11-14
31-11-19
08-11-20
24-11-17
32-11-13

Ch. 1121 Prior Authorization of Cymbalta Handbook Pages—Pharmacy Services 06/08/11 01-11-18
09-11-19
27-11-16
02-11-13
11-11-13
30-11-13
03-11-14
14-11-14
31-11-19
08-11-20
24-11-17
32-11-13

Ch. 1121 Prior Authorization of Tysabri—Pharmacy Services 06/08/11 01-11-13
09-11-14
27-11-11
02-11-08
11-11-08
30-11-08
03-11-09
14-11-09
31-11-14
08-11-15
24-11-12
32-11-08

Ch. 1121 Prior Authorization of Xolair—Pharmacy Services 06/08/11 01-11-15
09-11-16
27-11-13
02-11-10
11-11-10
30-11-10
03-11-11
14-11-11
31-11-16
08-11-17
24-11-14
32-11-10

Ch. 1121 Compounded Hydroxyprogesterone Caproate (17-P)—Pharmacy Services 06/08/11 01-11-19
09-11-20
27-11-17
02-11-14
11-11-14
30-11-14
03-11-15
14-11-15
31-11-20
08-11-21
24-11-18
32-11-14

Ch. 1121 Prior Authorization of Duplicate Therapy—Pharmacy Services 06/08/11 01-11-20
09-11-21
27-11-18
02-11-15

Ch. 1121 Prior Authorization of Makena—Pharmacy Services 06/21/11 01-11-11
09-11-12
27-11-09
02-11-06
11-11-06
30-11-06
03-11-07
14-11-07
31-11-12
08-11-13
24-11-10
32-11-06

Ch. 1121 Prior Authorization of Nuedexta—Pharmacy Services 06/21/11 01-11-12
09-11-13
27-11-10
02-11-07
11-11-07
30-11-07
03-11-08
14-11-08
31-11-12
08-11-14
24-11-11
32-11-07

Ch. 1121 Anticoagulants Handbook Pages—Pharmacy Services 07/14/11 01-11-40
09-11-41
27-11-38
02-11-35
11-11-35
30-11-35
03-11-36
14-11-36
31-11-41
08-11-42
24-11-11
32-11-35

Ch. 1121 Angiotensin Modulators Handbook Pages—Pharmacy Services 07/14/11 01-11-39
09-11-40
27-11-37
02-11-34
11-11-34
30-11-34
03-11-35
14-11-35
31-11-40
08-11-41
24-11-38
32-11-34

Ch. 1121 Opiate Dependence Treatments (Formerly Oral Buprenorphine Agents) Handbook Pages—Pharmacy Services 07/14/11 01-11-34
09-11-35
27-11-32
02-11-29
11-11-29
30-11-29
03-11-30
14-11-30
31-11-35
08-11-36
24-11-33
32-11-29

Ch. 1121 Bladder Relaxant Preparations Handbook Pages—Pharmacy Services 07/14/11 01-11-14
09-11-25
27-11-22
02-11-19
11-11-19
30-11-19
03-11-20
14-11-20
31-11-25
08-11-26
24-11-23
32-11-19

Ch. 1121 Platelet Aggregation Inhibitors Handbook Pages—Pharmacy Services 07/14/11 01-11-38
09-11-39
27-11-36
02-11-33
11-11-33
30-11-33
03-11-34
14-11-34
31-11-39
08-11-40
24-11-37
32-11-33

Ch. 1121 Cephalosporins and Related Agents Handbook Pages—Pharmacy Services 07/14/11 01-11-26
09-11-27
27-11-24
02-11-21
11-11-21
30-11-21
03-11-22
14-11-22
31-11-27
08-11-28
24-11-25
32-11-21

Ch. 1121 Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) Handbook Pages—Pharmacy Services 07/14/11 01-11-29
09-11-30
27-11-27
02-11-24
11-11-24
30-11-24
03-11-25
14-11-25
31-11-30
08-11-31
24-11-28
32-11-24

Ch. 1121 Pulmonary Arterial Hypertension Agents, Oral and Inhaled Handbook Pages—Pharmacy Services 07/14/11 01-11-30
09-11-31
27-11-28
02-11-25
11-11-25
30-11-25
03-11-26
14-11-26
31-11-31
08-11-32
24-11-29
32-11-25

Ch. 1121 Prior Authorization of Growth Hormones—Pharmacy Services 07/14/11 01-11-42
09-11-43
27-11-40
02-11-37
11-11-37
30-11-37
03-11-38
14-11-38
31-11-43
08-11-44
24-11-41
32-11-25

Ch. 1121 Bone Resorption Suppression and Related Agents Handbook Pages—Pharmacy Services 07/14/11 01-11-32
09-11-33
27-11-30
02-11-27
11-11-27
30-11-27
03-11-28
14-11-28
31-11-33
08-11-34
24-11-31
32-11-27

Ch. 1121 Multiple Sclerosis Agents Handbook Pages—Pharmacy Services 07/14/11 01-11-41
09-11-42
27-11-39
02-11-36
11-11-36
30-11-36
03-11-37
14-11-37
31-11-42
08-11-43
24-11-40
32-11-36

Ch. 1121 Preferred Drug List (PDL) Update August 2011—Pharmacy Services 07/14/11 01-11-37
09-11-38
27-11-35
02-11-32
11-11-32
30-11-32
03-11-33
14-11-33
31-11-38
08-11-39
24-11-36
32-11-32

Ch. 1121 Preferred Drug List (PDL) Update August 2011—Pharmacy Services 07/14/11 01-11-35
09-11-36
27-11-33
02-11-30
11-11-30
30-11-30
03-11-31
14-11-31
31-11-36
08-11-37
24-11-34
32-11-32

Ch. 1121 Phosphate Binders Handbook Pages—Pharmacy Services 07/14/11 01-11-35
09-11-36
27-11-33
02-11-30
11-11-30
30-11-30
03-11-31
14-11-31
31-11-36
08-11-37
24-11-36
32-11-30

Ch. 1121 Analgesics, Narcotics Short Acting Handbook Pages—Pharmacy Services 07/14/11 01-11-23
09-11-24
27-11-21
02-11-18
11-11-18
30-11-18
03-11-19
14-11-19
31-11-24
08-11-25
24-11-22
32-11-18

Ch. 1121 Angiotensin Modulator Combinations Handbook Pages—Pharmacy Services 07/14/11 01-11-31
09-11-32
27-11-29
02-11-26
11-11-26
30-11-26
03-11-27
14-11-27
31-11-32
08-11-33
24-11-30
32-11-26

Ch. 1121 HIV/AIDS Medications Handbook Pages—Pharmacy Services 07/14/11 01-11-22
09-11-23
27-11-20
02-11-17
11-11-17
30-11-17
03-11-18
14-11-18
31-11-23
08-11-24
24-11-21
32-11-17

Ch. 1121 Antifungals, Topical Handbook Pages—Pharmacy Services 07/14/11 01-11-25
09-11-26
27-11-23
02-11-20
11-11-20
30-11-20
03-11-21
14-11-21
31-11-26
08-11-27
24-11-24
32-11-17

Ch. 1121 Incretin Memetic/Enhancer Hypoglycemics Handbook Pages—Pharmacy Services 07/14/11 01-11-33
09-11-34
27-11-31
02-11-28
11-11-28
30-11-28
03-11-29
14-11-29
31-11-34
08-11-35
24-11-32
32-11-28

Ch. 1121 Oral Contraceptives Handbook Pages—Pharmacy Services 07/14/11 01-11-28
09-11-29
27-11-26
02-11-23
11-11-23
30-11-23
03-11-24
14-11-24
31-11-29
08-11-30
24-11-27
32-11-23

Ch. 1121 Prenatal Vitamins Handbook Pages—Pharmacy Services 07/14/11 01-11-36
09-11-37
27-11-34
02-11-31
11-11-31
30-11-31
03-11-32
14-11-32
31-11-87
08-11-38
24-11-35
32-11-31

Ch. 1121 Colony Stimulating Factors Handbook Pages—Pharmacy Services 07/14/11 01-11-27
09-11-28
27-11-25
02-11-22
11-11-22
30-11-22
03-11-23
14-11-23
31-11-28
08-11-29
24-11-26
32-11-22

Ch. 1121 Antiemetics (Promethazine)—Pharmacy Services 07/19/11 01-11-21
09-11-22
27-11-19
02-11-16
11-11-16
30-11-16
03-11-17
14-11-17
31-11-22
08-11-23
24-11-20
32-11-16

Ch. 1121 Correction to Preferred Drug List (PDL) Update August 2011—Pharmacy Services 08/08/11 01-11-45
02-11-39
03-11-40
08-11-46
09-11-45
11-11-39
14-11-40
24-11-46
27-11-42
30-11-39
31-11-44
32-11-39
33-11-07

Ch. 1121 Procedures to Submit Requests for Prior Authorization of Selected Medications by Facsimile (Fax)—Pharmacy Services 08/08/11 01-11-46
02-11-40
11-11-40
30-11-40
09-11-46
27-11-43
03-11-41
14-11-41
31-11-45
08-11-47
24-11-47
32-11-40
33-11-08

Ch. 1150 2011 HCPCS Updates and Other Procedure Code Changes 08/08/11 00-11-04

Ch. 1101 Provider Screening of Employees and Contractors for Exclusion from Participation in Federal Health Care Programs and the Effect of Exclusion on Participation 08/15/11 99-11-05

Ch. 1121 Prior Authorization of Synagis—Pharmacy Services 08/15/11 01-11-47
09-11-47
27-11-44
02-11-41
11-11-41
30-11-41
03-11-42
14-11-42
31-11-46
08-11-48
24-11-48
32-11-41
33-11-09

Ch. 1121 Early Refills—Pharmacy Services 08/15/11 01-11-47
09-11-47
27-11-44
02-11-41
11-11-41
30-11-41
03-11-42
14-11-42
31-11-46
08-11-48
24-11-48
32-11-41
03-11-09

— Specialty Pharmacy Drug Program
—Updated List of Covered Drugs
—Pharmacy Services 09/09/11 99-11-60

Ch. 1149 Medical Assistance Dental Benefit Changes 09/26/11 27-11-47
08-11-51

Ch. 1163 Revised Payment Policy for Hospital Readmissions 10/03/11 01-11-44

— Discontinued Mailing of Medical Assistance Bulletins 09/26/11 99-11-08

Ch. 1150 Prudent Payment of Claims 09/30/11 99-11-07

Ch. 1163 Revised Payment Policy for Hospital Readmission 09/30/11 01-11-44

Ch. 1121 Prior Authorization of Stimulants and Related Agents—Pharmacy Services 10/17/11 01-11-48
09-11-48
27-11-45
02-11-42
11-11-42
30-11-42
03-11-43
14-11-43
31-11-47
08-11-49
24-11-49
32-11-42
33-11-10

Ch. 1121 Prior Authorization of Xyrem—Pharmacy Services 10/17/11 01-11-49
09-11-49
27-11-46
02-11-43
11-11-43
30-11-43
03-11-44
14-11-44
31-11-48
08-11-50
24-11-50
32-11-43
33-11-11

— 5010/D.0 Instructions to be Ready for Electronic Transaction Upgrades 10/27/11 99-11-09

Ch. 1121 Prior Authorization of Benzodiazepines—Pharmacy Services 10/28/11 01-11-50

Ch. 1121 Prior Authorization of Skeletal Muscle Relaxants—Pharmacy Services 10/28/11 01-11-50
09-11-50
27-11-48
02-11-44
11-11-44
30-11-44
03-11-45
14-11-45
31-11-49
08-11-52
24-11-51
32-11-44
33-11-12

Ch. 1121 Prior Authorization of Early Refills Exemptions and Automated Approvals—Pharmacy Services 11/02/11 01-11-53
09-11-53
27-11-51
02-11-47
11-11-48
30-11-47
03-11-48
14-11-48
31-11-52
08-11-55
24-11-54
32-11-47
33-11-15

Ch. 1150 Announcing the Federally Mandated Implementation of the National Correct Coding Initiative (NCCI) in the Pennsylvania Department of Public Welfare's Medical Assistance Program 11/10/11 99-11-10

Ch. 1150 ClaimCheck® Claims Criteria—Update 11/23/11 99-11-11

Ch. 1101
1150 Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Professionals (EP) 12/02/11 08-11-56
09-11-54
27-11-52
31-11-53
33-11-16

Ch. 1101
1150 Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Hospitals (EH) 12/02/11 01-11-54

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 12/03/11 01-11-57
09-11-57
27-11-55
33-11-19
02-11-50
11-11-51
30-11-50
03-11-51
14-11-51
31-11-56
08-11-59
24-11-57
32-11-50

Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Agents—Pharmacy Services 12/03/11 01-11-56
09-11-56
27-11-54
33-11-18
02-11-49
11-11-50
30-11-49
03-11-50
14-11-50
31-11-55
08-11-58
24-11-56
32-11-49

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 12/09/11 01-11-52
09-11-52
27-11-50
02-11-46
11-11-46
30-11-46
03-11-47
14-11-47
31-11-51
08-11-54
24-11-53
32-11-46
33-11-14

Ch. 1121 Prior Authorization of Hepatitis C Agents—Pharmacy Services 12/10/11 01-11-55
09-11-55
27-11-53
33-11-17
02-11-48
11-11-49
30-11-48
03-11-49
14-11-49
31-11-54
08-11-57
24-11-55
32-11-48

Ch. 1121 Medical Assistance Pharmacy Benefit Package Change 12/30/11 99-11-58
14-11-52
18-11-03
24-11-58
27-11-56
31-11-57
33-11-20

2012 Ch. 1121 Prior Authorization of Antidepressants, Other—Pharmacy Services 01/26/12 01-12-02
09-12-02
27-12-02
33-12-02
02-12-02
11-12-02
30-12-02
03-12-02
14-12-02
31-12-02
08-12-02
24-12-02
32-12-02

Ch. 1121 Prior Authorization of Antihypertensives, Sympatholytic—Pharmacy Services 01/26/12 01-12-04
08-12-04
14-12-04
30-12-04
33-12-04
02-12-04
09-12-04
24-12-04
31-12-04
03-12-04
11-12-04
27-12-04
32-12-04

Ch. 1121 Prior Authorization of Antihistamines, Minimally Sedating—Pharmacy Services 01/26/12 01-12-03
09-12-03
27-12-03
33-12-03
02-12-03
11-12-03
30-12-03
03-12-03
14-12-03
31-12-03
08-12-03
24-12-03
32-12-03

Ch. 1121 Preferred Drug List (PDL) Update February 2012—Pharmacy Services 01/26/12 01-12-01
09-12-01
27-12-01
33-12-01
02-12-01
11-12-01
30-12-01
03-12-01
14-12-01
31-12-01
08-12-01
24-12-01
32-12-01

Ch. 1121 Prior Authorization of Cymbalta—Pharmacy Services 01/26/12 01-12-06
09-12-06
27-12-06
33-12-06
02-12-06
11-12-06
30-12-06
03-12-06
14-12-06
31-12-06
08-12-06
24-12-06
32-12-06

Ch. 1121 Prior Authorization of Bronchodilators, Beta Agonists—Pharmacy Services 01/26/12 01-12-05
09-12-05
27-12-05
33-12-05
02-12-05
11-12-05
30-12-05
03-12-05
14-12-05
31-12-05
08-12-05
24-12-05
32-12-05

Ch. 1121 Prior Authorization of Emollients—Pharmacy Services 01/30/12 01-12-08
09-12-08
27-12-08
33-12-08
02-12-08
11-12-08
30-12-08
03-12-08
14-12-08
31-12-08
08-12-08
24-12-08
32-12-08

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 01/30/12 01-12-07
09-12-07
27-12-07
33-12-07
02-12-07
11-12-07
30-12-07
03-12-07
14-12-07
31-12-07
08-12-07
24-12-07
32-12-07

Ch. 1121 Prior Authorization of Intranasal Rhinitis Agents—Pharmacy Services 02/01/12 01-12-11
09-12-11
27-12-11
33-12-11
02-12-11
11-12-11
30-12-11
03-12-11
14-12-11
31-12-11
08-12-11
24-12-11
32-12-11

Ch. 1121 Prior Authorization of Enzyme Replacements, Gauchers Disease—Pharmacy Services 02/01/12 01-12-09
08-12-09
14-12-09
30-12-09
33-12-09
02-12-09
09-12-09
24-12-09
31-12-09
03-12-09
11-12-09
27-12-09
32-12-09

Ch. 1121 Prior Authorization of Immunomodulators, Atopic Dermatitis—Pharmacy Services 02/01/12 01-12-10
08-12-10
14-12-10
30-12-10
33-12-10
02-12-10
09-12-10
24-12-10
31-12-10
03-12-10
11-12-10
27-12-10
32-12-10

Ch. 1121 Prior Authorization of Iron, Parenteral—Pharmacy Services 02/01/12 01-12-12
08-12-12
14-12-12
30-12-12
33-12-12
02-12-12
09-12-12
24-12-12
31-12-12
03-12-12
11-12-12
27-12-12
32-12-12

Ch. 1121 Prior Authorization of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)—Pharmacy Services 02/03/12 01-12-15
09-12-15
27-12-15
33-12-15
02-12-15
11-12-15
30-12-15
03-12-15
14-12-15
31-12-15
08-12-15
24-12-15
32-12-15

Ch. 1121 Prior Authorization of Myalgia and Neuropathy Agents—Pharmacy Services 02/03/12 01-12-14
08-12-14
14-12-14
30-12-14
33-12-14
02-12-14
09-12-14
24-12-14
31-12-14
03-12-14
11-12-14
27-12-14
32-12-14

Ch. 1121 Prior Authorization of Sedative Hypnotics—Pharmacy Services 02/06/12 01-12-19
09-12-19
27-12-19
33-12-19
02-12-19
11-12-19
30-12-19
03-12-19
14-12-19
31-12-19
08-12-19
24-12-19
32-12-19

Ch. 1121 Prior Authorization of Botulinum Toxins—Pharmacy Services 02/06/12 01-12-13
09-12-13
27-12-13
33-12-13
02-12-13
11-12-13
30-12-13
03-12-13
14-12-13
31-12-13
08-12-13
24-12-13
32-12-13

Ch. 1121 Prior Authorization of Stimulants and Related Agents—Pharmacy Services 02/06/12 01-12-21
09-12-21
27-12-21
33-12-21
02-12-21
11-12-21
30-12-21
03-12-21
14-12-21
31-12-21
08-12-21
24-12-21
32-12-21

Ch. 1121 Prior Authorization of Otic Anti-Infectives and Anesthetics—Pharmacy Services 02/13/12 01-12-18
08-12-18
14-12-18
30-12-18
33-12-18
02-12-18
09-12-18
24-12-18
31-12-18
03-12-18
11-12-18
27-12-18
32-12-18

Ch. 1121 Prior Authorization of Ophthalmic Antibiotic-Steroid Combinations—Pharmacy Services 02/13/12 01-12-17
08-12-17
14-12-17
30-12-17
33-12-17
02-12-17
09-12-17
24-12-17
31-12-17
03-12-17
11-12-17
27-12-17
02-12-17

Ch. 1121 Prior Authorization of Smoking Cessation Products—Pharmacy Services 02/14/12 01-12-20
09-12-20
27-12-20
03-12-20
02-12-20
11-12-20
30-12-20
03-12-20
14-12-20
31-12-20
08-12-20
24-12-20
32-12-20

Ch. 1128 Processing of Medicare Renal Dialysis Services Crossover Claims for Procedure Code 90999 02/21/12 30-12-22

Ch. 1101
1150 Correction to Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2 for Eligible Professionals (EP) 03/08/12 08-12-22
09-12-24
27-12-22
31-12-22
33-12-22

Ch. 1121 Prior Authorization of Myalgia and Neuropathy Agents—Pharmacy Services 03/18/12 01-12-22
09-12-23
27-12-23
33-12-23
02-12-22
11-12-22
30-12-23
03-12-22
14-12-22
31-12-23
08-12-23
24-12-22
32-12-22

Ch. 1121 Prior Authorization of Antibiotics, Topical—Pharmacy Services 03/18/12 01-12-24
09-12-25
27-12-24
33-12-25
02-12-23
11-12-23
30-12-24
03-12-23
14-12-23
31-12-25
08-12-25
24-12-23
32-12-23

Ch. 1123 Removal of NU Pricing Modifier from Procedure Codes for Oxygen Contents 03/20/12 24-12-24
25-12-01

Ch. 1121 Prior Authorization of Oncology Agents, Oral—Pharmacy Services 04/02/12 01-12-16
09-12-16
27-12-16
33-12-16
02-12-16
11-12-16
30-12-16
03-12-16
14-12-16
31-12-16
08-12-16
24-12-16
32-12-16

— Provider Electronic Solutions (PES) Software v3.59 replaces v3.58 04/06/12 99-12-01

Ch. 1101
Ch. 1150
Ch. 1241 Updates to the Medical Assistance Program Fee Schedule for the Administration of Prevnar 13® Vaccine 04/06/12 01-12-25
08-12-26
09-12-26
31-12-26
33-12-26

Ch. 1101 Updates to Medical Assistance Copayment Policy 04/16/12 99-12-03

Ch. 1121 Changes to the Drug Cost Component of Payment for Brand Name and Generic Drugs—Pharmacy Services 05/01/12 01-12-28
09-12-29
27-12-26
33-12-28
02-12-25
11-12-25
30-12-26
03-12-25
14-12-25
31-12-29
08-12-28
24-12-26
32-12-25

Ch. 1121 Changes to the Dispensing Fee Component of Payment for Brand Name and Generic Drugs—Pharmacy Services 05/01/12 01-12-27
09-12-28
27-12-25
33-12-27
02-12-24
11-12-24
30-12-25
03-12-24
14-12-24
31-12-24
08-12-27
24-12-25
32-12-24

Ch. 1149 Revision of Online Training Module for the Application of Topical Fluoride Varnish 05/01/12 09-12-27
31-12-27

Ch. 1163 Newborn Payment Policy for Acute Care General Hospitals 05/04/12 01-12-26

— Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services 05/11/12 99-12-04

— Electronic Forms 05/11/12 99-12-02

Ch. 1121 Prior Authorization of Makena—Pharmacy Services 05/11/12 01-12-29
02-12-26
03-12-26
08-12-29
09-12-30
11-12-26
14-12-26
24-12-27
27-12-27
30-12-27
31-12-30
32-12-26
33-12-29

Ch. 1150 Consultations Performed Using Telemedicine 05/23/12 09-12-31
31-12-31
33-12-30

Ch. 1229 HealthChoices Physical Health Managed Care Expansion 05/25/12 99-12-05

— Provider Preventable Conditions 06/15/12 01-12-30
03-12-27
09-12-32
18-12-01
31-12-32
33-12-31
02-12-27
08-12-30
14-12-27
27-12-28
32-12-27
47-12-01

— FQHC Change in Scope of Service 06/20/12 08-12-31

Ch. 1150 2012 HCPCS Updates and Other Procedure Code Changes 06/25/12 99-12-06

Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancers Hypoglycemics—Pharmacy Services 07/11/12 01-12-32
09-12-34
27-12-30
33-12-33
02-12-29
11-12-28
30-12-29
03-12-29
14-12-29
31-12-34
08-12-33
24-12-29
32-12-29

Ch. 1121 Preferred Drug List (PDL) Update August 2012—Pharmacy Services 07/12/12 01-12-33
09-12-35
27-12-31
33-12-34
02-12-30
11-12-29
30-12-37
03-12-30
14-12-30
31-12-35
08-12-34
24-12-30
32-12-30

Ch. 1121 Prior Authorization of Opiate Dependence Treatments—Pharmacy Services 07/13/12 01-12-36
08-12-36
14-12-31
30-12-31
33-12-35
02-12-31
09-12-37
24-12-32
31-12-37
03-12-31
11-12-30
27-12-33
32-12-31

Ch. 1121 Prior Authorization of Platelet Aggregation Inhibitors—Pharmacy Services 08/03/12 01-12-45
09-12-43
27-12-39
33-12-41
02-12-37
11-12-36
30-12-37
03-12-37
14-12-37
31-12-43
08-12-42
24-12-38
32-12-37

Ch. 1121 Prior Authorization of Pituitary Suppressive Agents, LHRH—Pharmacy Services 08/03/12 01-12-44
09-12-42
27-12-38
33-12-40
02-12-36
11-12-35
30-12-36
03-12-36
14-12-36
31-12-42
08-12-41
24-12-37
32-12-36

Ch. 1121 Prior Authorization of Benign Prostatic Hyperplasia (BPH) Treatments—Pharmacy Services 08/03/12 01-12-41
09-12-40
27-12-36
33-12-38
02-12-34
11-12-33
30-12-34
03-12-34
14-12-34
31-12-40
08-12-39
24-12-35
32-12-34

Ch. 1121 Prior Authorization of Erythropoiesis Stimulating Proteins—Pharmacy Services 08/03/12 01-12-42
09-12-41
27-12-37
33-12-39
02-12-35
11-12-34
30-12-35
03-12-35
14-12-35
31-12-41
08-12-40
24-12-36
32-12-35

Ch. 1121 Prior Authorization of Antibiotics, GI—Pharmacy Services 08/03/12 01-12-39
09-12-38
27-12-34
33-12-36
02-12-32
11-12-31
30-12-32
03-12-32
14-12-32
31-12-38
08-12-37
24-12-33
32-12-32

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 08/03/12 01-12-40
09-12-39
27-12-35
33-12-37
02-12-33
11-12-32
30-12-33
03-12-33
14-12-33
31-12-39
08-12-38
24-12-34
32-12-33

Ch. 1121 Prior Authorization of Lipotropics, Statins—Pharmacy Services 08/03/12 01-12-46
09-12-44
27-12-40
33-12-42
02-12-38
11-12-37
30-12-38
03-12-38
14-12-37
31-12-44
08-12-43
24-12-39
32-12-38

Ch. 1121 Prior Authorization of Growth Factors—Pharmacy Services 08/07/12 01-12-31
08-12-32
14-12-28
30-12-28
33-12-32
02-12-28
09-12-33
24-12-28
31-12-33
03-12-28
11-12-27
27-12-29
32-12-28

Ch. 1229 HealthChoices Physical Health Managed Care New West Zone Expansion 08/08/12 99-12-08

Ch. 1101
Ch. 1150 Medical Assistance Program Fee Schedule Revisions 08/31/12 99-12-10

Ch. 1150 Information Regarding Peritoneal Dialysis Treatment 09/13/12 01-12-50
30-12-43
31-12-49

Ch. 1101
Ch. 1150 Medical Assistance Program Fee Schedule Changes for Renal Dialysis Services 09/13/12 30-12-39
13-12-45

Ch. 1121 Prior Authorization of Hepatitis C Agents—Pharmacy Services 09/13/12 01-12-49
09-12-47
27-12-43
33-12-45
02-12-41
11-12-40
30-12-42
03-12-41
14-12-41
31-12-48
08-12-46
24-12-42
32-12-41

Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—Pharmacy Services 09/13/12 01-12-48
09-12-46
27-12-42
33-12-44
02-12-40
11-12-39
30-12-41
03-12-40
14-12-40
31-12-47
08-12-45
24-12-41
32-12-40

Ch. 1121 Prior Authorization of Bronchodilators, Anticholinergic—Pharmacy Services 09/13/12 01-12-47
09-12-45
27-12-41
33-12-43
02-12-39
11-12-38
30-12-40
03-12-39
14-12-39
31-12-46
08-12-44
24-12-40
32-12-39

Ch. 1150 New Procedure Codes for Tobacco Cessation Counseling Services 10/03/12 99-12-09

Ch. 1101 Delaying Alternative Cost Sharing for Families of Children with Disabilities with Incomes Over 200

10/15/12 99-12-15

Ch. 1121 Prior Authorization of Botulinum Toxins—Pharmacy Services 10/22/12 01-12-53
09-12-50
27-12-46
33-12-48
02-12-44
11-12-43
30-12-46
03-12-44
14-12-44
31-12-52
08-12-49
24-12-45
32-12-44

Ch. 1121 Prior Authorization of Angiotensin Modulator Combinations—Pharmacy Services 10/22/012 01-12-52
02-12-43
03-12-43
08-12-48
09-12-49
11-12-42
14-12-43
24-12-44
27-12-45
30-12-45
31-12-51
32-12-43
33-12-47

Ch. 1150 Federally Mandated Implementation: Updates to National Correct Coding Initiative (NCCI) 10/26/12 99-12-12

Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 10/30/12 01-12-54
08-12-50
14-12-45
30-12-47
33-12-49
02-12-45
09-12-51
24-12-46
31-12-53
03-12-45
11-12-44
27-12-47
32-12-45

Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—Pharmacy Services 10/30/12 01-12-56
08-12-52
14-12-47
30-12-49
33-12-51
02-12-47
09-12-53
24-12-48
31-12-55
03-12-47
11-12-46
27-12-49
32-12-47

Ch. 1121 Prior Authorization of Tysabri—Pharmacy Services 10/30/12 01-12-57
08-12-53
14-12-48
30-12-50
33-12-52
02-12-48
09-12-54
24-12-49
31-12-56
03-12-48
11-12-47
27-12-50
32-12-48

Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services 10/30/12 01-12-55
08-12-51
14-12-46
30-12-48
33-12-50
02-12-46
09-12-52
24-12-47
31-12-54
03-12-46
11-12-45
27-12-48
32-12-46

Ch.1123 Prior Authorization Requirements for the Rental of Medical Appliances and Durable Medical Equipment 12/10/12 24-12-55
25-12-02

Ch. 1101
Ch. 1150 Medical Assistance Program Fee Schedule Revisions 12/10/12 99-12-13

Ch. 1101
Ch. 1150
Ch. 1149 Addition to the Medical Assistance Program Fee Schedule for Administration of Flu Vaccine for Intradermal Use: Fluzone Intradermal^® 12/13/12 01-12-64
08-12-59
09-12-60
31-12-62
33-12-58

Ch. 1150 NPI Requirements on All Claim Submission Media 12/19/12 99-12-14

Ch. 1121 Anticoagulants—New Quantity Limit for Low Molecular Weight Heparins and Arixtra (Fondaparinux)—Pharmacy Services 12/21/12 01-12-63
09-12-59
27-12-55
33-12-57
02-12-53
11-12-52
30-12-55
03-12-53
14-12-53
31-12-61
08-12-58
24-12-54
32-12-53

Ch. 1121 Prior Authorization of Kalydeco—Pharmacy 12/21/12 01-12-60
09-12-56
27-12-52
33-12-54
02-12-50
11-12-49
30-12-52
03-12-50
14-12-50
31-12-58
08-12-55
24-12-51
32-12-50

Ch. 1121 Prior Authorization of Hypoglycemics, TZDs—Pharmacy Services 12/21/12 01-12-61
09-12-57
27-12-53
33-12-55
02-12-51
11-12-50
30-12-53
03-12-51
14-12-51
31-12-59
08-12-56
24-12-52
32-12-51

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 12/21/12 01-12-62
09-12-58
27-12-54
33-12-56
02-12-52
11-12-51
30-12-54
03-12-52
14-12-52
31-12-60
08-12-57
24-12-53
32-12-52

Ch. 1121 Prior Authorization of Korlym—Pharmacy Services 12/21/12 01-12-59
09-12-55
27-12-51
33-12-53
02-12-49
11-12-48
30-12-51
03-12-49
14-12-49
31-12-57
08-12-54
24-12-50
32-12-49

Ch. 1150 Clinical Laboratory Improvement Amendments Requirements 12/28/12 01-12-67
08-12-62
09-12-63
28-12-01
31-13-65
33-13-61

2013 Ch. 1121 Prior Authorization of Antipsoriatics Topical—Pharmacy Services 01/07/13 01-13-01
09-13-01
27-13-01
33-13-01
02-13-01
11-13-01
30-13-01
03-13-01
14-13-01
31-13-01
08-13-01
24-13-01
32-13-01

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 01/07/13 01-13-02
09-13-02
27-13-02
33-13-02
02-13-02
11-13-02
30-13-02
03-13-02
14-13-02
31-13-02
08-13-02
24-13-02
32-13-02

Ch. 1121 Prior Authorization of Diabetic Strips—Pharmacy Services 01/07/13 01-13-03
09-13-03
27-13-03
33-13-03
02-13-03
11-13-03
30-13-03
03-13-03
14-13-03
31-13-03
08-13-03
24-13-03
32-13-03

Ch. 1121 Prior Authorization of Glucocorticoids Oral—Pharmacy Services 01/07/13 01-13-04
09-13-04
27-13-04
33-13-04
02-13-04
11-13-04
30-13-04
03-13-04
14-13-04
31-13-04
08-13-04
24-13-04
32-13-04

Ch. 1121 Prior Authorization of Leukotriene Modifiers—Pharmacy Services 01/07/13 01-13-05
09-13-05
27-13-05
33-13-05
02-13-05
11-13-05
30-13-05
03-13-05
14-13-05
31-13-05
08-13-05
24-13-05
32-13-05

Ch. 1121 Prior Authorization of Neuropathic Pain Agents (Formerly Myalgia and Neuropathy Agents)—Pharmacy Services 01/07/13 01-13-06
09-13-06
27-13-06
33-13-06
02-13-06
11-13-06
30-13-06
03-13-06
14-13-06
31-13-06
08-13-06
24-13-06
32-13-06

Ch. 1121 Prior Authorization of Oncology Agents Breast Cancer—Pharmacy Services 01/07/13 01-13-07
08-13-07
14-13-07
32-13-07
02-13-07
09-13-07
24-13-07
30-13-07
03-13-07
11-13-07
27-13-07
31-13-07
33-13-07

Ch. 1121 Prior Authorization of Smoking Cessation Products—Pharmacy Services 01/07/13 01-13-08
09-13-08
27-13-08
33-13-08
02-13-08
11-13-08
30-13-08
03-13-08
14-13-08
31-13-08
08-13-08
24-13-08
32-13-08

Ch. 1121 Prior Authorization of Diabetic Meters—Pharmacy Services 01/07/13 01-13-09
09-13-09
27-13-09
33-13-09
02-13-09
11-13-09
30-13-09
03-13-09
14-13-09
31-13-09
08-13-09
24-13-09
32-13-09

Ch. 1229 HealthChoices Physical Health Managed Care New East Zone Expansion 01/18/13 99-13-02

Ch. 1121 Preferred Drug List (PDL) Update January 15, 2013—Pharmacy Services 01/22/13 01-13-11
09-13-11
27-13-11
33-13-11
02-13-10
11-13-10
30-13-10
03-13-10
14-13-10
31-13-12
08-13-11
24-13-11
32-13-10

Ch. 1150 Medical Assistance Program Fee Increase for Select Primary Care Services and Physician Attestation Form 01/22/13 31-13-11

Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—
Pharmacy Services 01/25/13 01-13-12
08-13-12
14-13-11
30-13-11
33-13-12
02-13-11
09-13-12
24-13-12
31-13-13
03-13-11
11-13-11
27-13-12
32-13-11

Ch. 1150 Medical Assistance Program Fee Increase for Select Primary Care Services and Physician Attestation Form 01/22/13 31-13-11

Ch. 1101 Ch. 1150 Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2013 for Eligible Professionals (EP) 02/01/13 08-13-10
09-13-10
27-13-10
31-13-10
33-13-10

Ch. 1101 Ch. 1150 Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2013 for Eligible Hospitals (EH) 02/01/13 01-13-10

Ch. 1101 Updated Procedures for Submitting the Deficit Reduction Act of 2005 Attestation Form 02/14/13 99-13-04

Ch. 1229 Continued Existence of the Fee-For-Service Delivery System in HealthChoices Zones and Enrollment of Breast and Cervical Cancer Prevention and Treatment (BCCPT) Recipients in HealthChoices 02/22/13 99-13-05

Ch. 1121 Prior Authorization of Analgesics Narcotic Short Acting—
Pharmacy Services 03/29/13 01-13-16
08-13-16
14-13-15
30-13-15
33-13-17
02-13-15
09-13-17
24-13-16
31-13-18
03-13-15
11-13-15
27-13-16
32-13-15

Ch. 1121 Prior Authorization of Bladder Relaxant Preparations—
Pharmacy Services 03/29/13 01-13-14
09-13-15
27-13-14
33-13-15
02-13-13
11-13-13
30-13-13
03-13-13
14-13-13
31-13-16
08-13-14
24-13-14
32-13-13

Ch. 1121 Prior Authorization of Bronchodilators Beta Agonists Short Acting Agents—Pharmacy Services 03/29/13 01-13-17
08-13-17
14-13-16
30-13-16
33-13-18
02-13-16
09-13-18
24-13-17
31-13-19
03-13-16
11-13-16
27-13-17
32-13-16

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 03/29/13 01-13-13
08-13-13
14-13-12
30-13-12
33-13-14
02-13-12
09-13-14
24-13-13
31-13-15
03-13-12
11-13-12
27-13-13
32-13-12

Ch. 1121 Prior Authorization of Chronic Obstructive Pulmonary Disease (COPD) Agents—Pharmacy Services 03/29/13 01-13-15
09-13-16
27-13-15
33-13-16
02-13-14
11-13-14
30-13-14
03-13-14
14-13-14
31-13-17
08-13-15
24-13-15
32-13-14

Ch. 1101
Ch. 1150 Medical Assistance Program Fee Schedule Revisions for Procedure Code K0606 04/01/13 24-13-10
25-13-01

Ch. 1101
Ch. 1150 Medical Assistance Program Fee Schedule Revisions 04/15/13 99-13-03

Ch. 1121 Medical Assistance Pharmacy Benefit Package Update 04/22/13 99-13-20
14-13-17
18-13-01
24-13-18
17-13-18
31-13-21
33-13-20

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 5/3/13 01-13-19
09-13-21
27-13-19
33-13-21
02-13-17
11-13-17
30-13-17
03-13-17
14-13-18
31-13-22
08-13-19
24-13-19
32-13-17

Ch. 1101 Revised Physician Attestation Form for Primary Care Services 05/03/13 31-13-32

Ch. 1121 Prior Authorization of Pulmonary Arterial Hypertension (PAH) Agents Oral and Inhaled—Pharmacy Services 05/03/13 01-13-23
09-13-25
27-13-23
33-13-25
02-13-21
11-13-21
30-13-21
03-13-21
14-13-22
31-13-26
08-13-23
24-13-23
32-13-21

Ch. 1121 Prior Authorization of Lyrica (pregabalin) Neuropathic Pain Agents and Oral Anticonvulsants—Pharmacy Services 05/03/13 01-13-25
09-13-27
27-13-25
33-13-27
02-13-23
11-13-23
30-13-23
03-13-23
14-13-24
31-13-28
08-13-25
24-13-25
32-13-23

Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—
Pharmacy Services 05/03/13 01-13-20
09-13-22
27-13-20
33-13-22
02-13-18
11-13-18
30-13-18
03-13-18
14-13-19
31-13-23
08-13-20
24-13-20
32-13-18

Ch. 1121 Prior Authorization of Botulinum Toxins
(Type A and Type B)—Pharmacy Services 05/03/13 01-13-21
09-13-23
27-13-21
33-13-23
02-13-19
11-13-19
30-13-19
03-13-19
14-13-20
31-13-24
08-13-21
24-13-21
32-13-19

Ch. 1121 Prior Authorization of Benzodiazepines; Analgesics Narcotic Long Acting; and Analgesics Narcotic Short Acting—Pharmacy Services 05/03/13 01-13-26
09-13-28
27-13-26
33-13-28
02-13-24
11-13-24
30-13-24
03-13-24
14-13-25
31-13-29
08-13-26
24-13-26
32-13-24

Ch. 1121 Medicare Part D Coverage of Barbiturates and Benzodiazepines—Pharmacy Services 05/03/13 01-13-28
08-13-28
14-13-27
30-13-26
33-13-30
02-13-26
09-13-30
24-13-28
31-13-31
03-13-26
11-13-26
27-13-28
32-13-26

Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—
Pharmacy Services 05/03/13 01-13-27
09-13-29
27-13-27
33-13-29
02-13-25
11-13-25
30-13-25
03-13-25
14-13-26
31-13-30
08-13-27
24-13-27
32-13-25

Ch. 1121 340B Drug Pricing Program Provider Requirements and Billing Instructions—Pharmacy Services 05/16/13 99-13-08

Ch. 1101 Application of InvestiClaimTM Analytics to Select Claims 05/17/13 99-13-09

Ch. 1150 Implementation of the Medical Assistance Program's Physician Fee Increases for Select Primary Care Services 05/23/13 31-13-34

Ch. 1150 Addition to the Medical Assistance Program Fee Schedule for Administration of Flu Vaccine Derived from Cell Cultures: Flucelvax 05/25/13 01-13-18
08-13-18
09-13-19
31-13-20
33-13-19

Ch. 1121 Prior Authorization of Androgenic Agents—Pharmacy Services 05/31/13 01-13-22
02-13-20
03-13-20
08-13-22
09-13-24
11-13-20
14-13-21
24-13-22
27-13-22
30-13-20
31-13-25
32-13-20
33-13-24

Ch. 1121 Prior Authorization of H.P. Acthar Gel—Pharmacy Services 05/31/13 01-13-24
02-13-22
03-13-22
08-13-24
09-13-26
11-13-22
14-13-23
24-13-24
27-13-24
30-13-22
31-13-27
32-13-22
33-13-26

Ch. 1150 2013 HCPCS Updates and Other Procedure Code Changes 06/24/13 99-13-07

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 07/02/13 01-13-38
02-13-34
03-13-34
08-13-36
09-13-38
11-13-34
14-13-35
24-13-36
27-13-36
30-13-34
31-13-42
32-13-34
33-13-38

Ch. 1121 Prior Authorization of Antiparasitics Topical—Pharmacy Services 07/02/13 01-13-37
02-13-33
03-13-33
08-13-35
09-13-37
11-13-33
14-13-34
24-13-35
27-13-35
30-13-33
31-13-41
32-13-33
33-13-37

Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—
Pharmacy Services 07/02/13 01-13-39
02-13-35
03-13-35
08-13-37
09-13-39
11-13-35
14-13-36
24-13-37
27-13-37
30-13-35
31-13-43
32-13-35
33-13-39

Ch. 1150 Hospital Payment Arrangements 1 and 2 for Emergency Room Services 07/02/13 01-13-29
31-13-33

Ch. 1121 Prior Authorization of Vasodilators Coronary—Pharmacy Services 07/02/13 01-13-36
02-13-32
03-13-32
08-13-34
09-13-36
11-13-32
14-13-33
24-13-34
27-13-34
30-13-32
31-13-40
32-13-32
33-13-36

Ch. 1121 Prior Authorization of Incretin Mimetic/Enhancer Hypoglycemics—Pharmacy Services 07/02/13 01-13-34
02-13-30
03-13-30
08-13-32
09-13-34
11-13-30
14-13-31
24-13-32
27-13-32
30-13-30
31-13-38
32-13-30
33-13-34

Ch. 1121 Prior Authorization of H. Pylori Treatments—Pharmacy Services 07/02/13 01-13-32
02-13-28
03-13-28
08-13-30
09-13-32
11-13-28
14-13-29
24-13-30
27-13-30
30-13-28
31-13-36
32-13-28
33-13-32

Ch. 1121 Preferred Drug List (PDL) Update July 24, 2013—
Pharmacy Services 07/07/13 01-13-31
09-13-31
27-13-29
33-13-31
02-13-27
11-13-27
30-13-27
03-13-27
14-13-28
31-13-35
08-13-29
24-13-29
32-13-27

Ch. 1121 Prior Authorization of Colony Stimulating Factors—
Pharmacy Services 07/13/13 01-13-33
09-13-33
27-13-31
33-13-33
02-13-29
11-13-29
30-13-29
03-13-29
14-13-30
31-13-37
08-13-31
24-13-31
32-13-29

Ch. 1121 Prior Authorization of Irritable Bowel Syndrome Agents—
Pharmacy Services 07/13/13 01-13-35
09-13-35
27-13-33
33-13-35
02-13-31
11-13-31
30-13-31
03-13-31
14-13-32
31-13-39
08-13-33
24-13-33
32-13-31

Ch. 1121 Prior Authorization of Acne Agents Oral—Doxycycline—
Pharmacy Services 07/22/13 01-13-40
08-13-38
14-13-37
30-13-36
33-13-40
02-13-36
09-13-40
24-13-38
31-13-44
03-13-36
11-13-36
27-13-38
32-13-36

Ch. 1127
Ch. 1150 Changes to the Payment Structure for Birth Center Services 08/29/13 09-13-13
31-13-14
33-13-13
47-13-01

Ch. 1101 Medical Assistance Electronic Health Record (EHR) Incentive Program Year 2014 for Eligible Hospitals (EH) 09/20/13 01-13-41

Ch. 1101 Implementation of ADA Claim Form—Version 2012 and Elimination of ADA Claim Form—Version 2006 09/20/13 17-13-01
19-13-01
20-13-01
27-13-39
31-13-45

Ch. 1101
Ch. 1149
Ch. 1129 Correction to the Procedures for Reporting of Other Provider Preventable Conditions (OPPCs) for Federally Qualified Health Centers Rural Health Clinics and Dentists 10/02/13 08-13-39
27-13-41

Ch. 1101 Application of InvestiClaimTM Analytics to Select Claims—Update 10/04/13 99-13-12

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 11/04/13 01-13-45
09-13-45
27-13-45
33-13-44
02-13-40
11-13-40
30-13-40
03-13-40
14-13-41
31-13-50
08-13-43
24-13-42
32-13-40

Ch. 1121 Prior Authorization of Angiotensin Modulators—Pharmacy Services 11/04/13 01-13-44
09-13-44
27-13-44
33-13-43
02-13-39
11-13-39
30-13-39
03-13-39
14-13-40
31-13-49
08-13-42
24-13-41
32-13-39

Ch. 1121 Prior Authorization of Benign Prostatic Hyperplasia (BPH) Treatment—Pharmacy Services 11/04/13 01-13-46
09-13-46
27-13-46
33-13-45
02-13-41
11-13-41
30-13-41
03-13-41
14-13-42
31-13-51
08-13-44
24-13-43
32-13-41

Ch. 1121 Prior Authorization of HIV/AIDS Medications—Pharmacy Services 11/04/13 01-13-47
09-13-47
27-13-47
33-13-46
02-13-42
11-13-42
30-13-42
03-13-42
14-13-43
31-13-52
08-13-45
24-13-44
32-13-42

Ch. 1121 Prior Authorization of Alzheimer's Agents—Pharmacy Services 11/04/13 01-13-42
09-13-42
27-13-42
33-13-41
02-13-37
11-13-37
30-13-37
03-13-37
14-13-38
31-13-47
08-13-40
24-13-39
32-13-37

Ch. 1121 Prior Authorization of Leukotriene Modifiers—Pharmacy Services 11/04/13 01-13-48
09-13-48
27-13-48
33-13-47
02-13-43
11-13-43
30-13-43
03-13-43
14-13-44
31-13-53
08-13-46
24-13-45
32-13-43

Ch. 1121 Prior Authorization of Angiotensin Modulator Combinations—Pharmacy Services 11/04/13 01-13-43
09-13-43
27-13-43
33-13-42
02-13-38
11-13-38
30-13-38
03-13-38
14-13-39
31-13-48
08-13-41
24-13-40
32-13-38

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 11/22/13 01-13-52
09-13-50
27-13-49
33-13-49
02-13-44
11-13-44
30-13-44
03-13-44
14-13-45
31-13-57
08-13-49
24-13-46
32-13-44

Ch. 1121 Prior Authorization of Analgesics
Narcotic Long Acting Analgesics Narcotic Short Acting
and Cough and Cold Medications—Pharmacy Services 11/22/13 01-13-55
09-13-53
27-13-52
33-13-52
02-13-47
11-13-47
30-13-47
03-13-47
14-13-48
31-13-60
08-13-52
24-13-49
32-13-47

Ch. 1121 Prior Authorization of Vecamyl (mecamylamine)—
Pharmacy Services 11/22/13 01-13-54
09-13-52
27-13-51
33-13-51
02-13-46
11-13-46
30-13-46
03-13-46
14-13-47
31-13-59
08-13-51
24-13-48
32-13-46

Ch. 1121 Prior Authorization of Lipotropics Other—Pharmacy Services 11/22/13 01-13-53
09-13-51
27-13-50
33-13-50
02-13-45
11-13-45
30-13-45
03-13-45
14-13-46
31-13-58
08-13-50
24-13-47
32-13-45

Ch. 1101 CAQH CORE Federal Mandate: Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) 11/22/13 99-13-14

Ch. 1101 Presumptive Eligibility as Determined by Hospitals 12/06/13 01-13-56

Ch. 1121 Preferred Drug List (PDL) Update January 22, 2014—
Pharmacy Services 12/18/13 01-13-57
02-13-48
03-13-48
08-13-53
09-13-54
11-13-48
14-13-49
24-13-50
27-13-53
30-13-48
31-13-61
32-13-48
33-13-53

Ch. 1150 Medical Assistance Program Fee Schedule Revisions 12/27/13 99-13-13

2014 Ch. 1150 Additions to the Medical Assistance Program Fee Schedule for Administration of Quadrivalent Flu Vaccine 08-14-02 01/07/14 01-14-03
09-14-01
31-14-02
33-14-01

Ch. 1101 Changes to MA 112 Newborn Eligibility Form 01/10/14 01-14-02
47-14-01

Ch. 1101 Implementation of the CMS-1500 Health Insurance Claim Form (version 02-12) 01/10/14 99-14-03

Ch. 1121 Prior Authorization of Antipsychotics—Pharmacy Services 01/20/14 01-14-05
09-14-03
27-14-02
33-14-03
02-14-02
11-14-02
30-14-02
03-14-02
14-14-02
31-14-04
08-14-04
24-14-02
32-14-02

Ch. 1121 Prior Authorization of Antipsoriatics Oral—Pharmacy Services 01/20/14 01-14-04
08-14-03
14-14-01
30-14-01
33-14-02
02-14-01
09-14-02
24-14-01
31-14-03
03-14-01
11-14-01
27-14-01
32-14-01

Ch. 1121 Prior Authorization of Anxiolytics—Pharmacy Services 02/03/14 01-14-06
02-14-03
03-14-03
08-14-05
09-14-04
11-14-03
14-14-03
24-14-03
27-14-03
30-14-03
31-14-05
32-14-03
33-14-04

Ch. 1121 Prior Authorization of Histamine II Receptor Blockers—
Pharmacy Services 02/03/14 01-14-08
09-14-06
27-14-05
33-14-06
02-14-05
11-14-05
30-14-05
03-14-05
14-14-05
31-14-07
08-14-07
24-14-05
32-14-05

Ch. 1121 Prior Authorization of Oncology Agents Oral—Pharmacy Services 02/03/14 01-14-11
09-14-09
27-14-08
33-14-09
02-14-08
11-14-08
30-14-08
03-14-08
14-14-08
31-14-10
08-14-10
24-14-08
32-14-08

Ch. 1121 Prior Authorization of Epinephrine Self-Injected—
Pharmacy Services 02/03/14 01-14-07
09-14-05
27-14-04
33-14-05
02-14-04
11-14-04
30-14-04
03-14-04
14-14-04
31-14-06
08-14-06
24-14-04
32-14-04

Ch. 1121 Prior Authorization of Immunomodulators Topical—
Pharmacy Services 02/03/14 01-14-09
09-14-07
27-14-06
33-14-07
02-14-06
11-14-06
30-14-06
03-14-06
14-14-06
31-14-08
08-14-08
24-14-06
32-14-06

Ch. 1121 Prior Authorization of Iron Oral—Pharmacy Services 02/03/14 01-14-10
09-14-08
27-14-07
33-14-08
02-14-07
11-14-07
30-14-07
03-14-07
14-14-07
31-14-09
08-14-09
24-14-07
32-14-07

Ch. 1121 Prior Authorization of Progestational Agents—Pharmacy Services 02/03/14 01-14-12
09-14-10
27-14-09
33-14-10
02-14-09
11-14-09
30-14-09
03-14-09
14-14-09
31-14-11
08-14-11
24-14-09
32-14-09

Ch. 1150 Sample Review of Physicians Receiving Increased Fees for Select Primary Care Services 02/18/14 31-14-12

Ch. 1121 Specialty Pharmacy Drug Program—Updated List of Covered Drugs—Pharmacy Services 02/18/14 99-14-05

Ch. 1101 Provider Credentialing by the Pennsylvania Medical Assistance Program 02/27/14 99-14-02

Ch. 1101 Re-enrollment/Revalidation of Medical Assistance (MA) Providers 03/07/14 99-14-06

Ch. 1149 2014 Recommended Childhood and Adolescent Immunization Schedules 04/01/14 99-14-07

Ch. 1121 Prior Authorization of Prescriptions That Exceed Established Quantity Limits/Daily Dose Limits—Pharmacy Services 04/25/14 01-14-18
09-14-13
27-14-11
33-14-12
02-14-11
11-14-11
30-14-11
03-14-14
14-14-11
31-14-16
08-14-14
24-14-11
32-14-11

Ch. 1121 Prior Authorization of Kalydeco. (ivacaftor)—Pharmacy Services 04/25/14 01-14-17
02-14-10
03-14-13
08-14-13
09-14-12
11-14-10
14-14-10
24-14-10
27-14-10
30-14-10
31-14-15
32-14-10
33-14-11

Ch. 1243 Addition to the Medical Assistance Program Fee Schedule—
Oncotype DX 05/06/14 01-14-16
08-14-12
09-14-11
28-14-01
31-14-14

Ch. 1121 Prior Authorization of Analgesics Narcotic Long Acting—
Pharmacy Services 05/30/14 01-14-24
09-14-19
27-14-17
33-14-18
02-14-16
11-14-16
30-14-16
03-14-19
14-14-16
31-14-22
08-14-20
24-14-16
32-14-16

Ch. 1121 Prior Authorization of Immune Globulins—Pharmacy Services 05/30/14 01-14-25
09-14-20
27-14-18
33-14-19
02-14-17
11-14-17
30-14-17
03-14-20
14-14-17
31-14-23
08-14-21
24-14-17
32-14-17

Ch. 1121 Prior Authorization of Hepatitis C Agents—Pharmacy Services 05/30/14 01-14-22
09-14-17
27-14-15
33-14-16
02-14-14
11-14-14
30-14-14
03-14-17
14-14-14
31-14-20
08-14-18
24-14-14
32-14-14

Ch. 1121 Prior Authorization of Opiate Dependence Treatments—
Pharmacy Services 05/30/14 01-14-21
09-14-16
27-14-14
33-14-15
02-14-13
11-14-13
30-14-13
03-14-16
14-14-13
31-14-19
08-14-17
24-14-13
32-14-13

Ch. 1121 Prior Authorization of Botulinum Toxins
(Type A and Type B)—Pharmacy Services 05/30/14 01-14-23
09-14-18
27-14-16
33-14-17
02-14-15
11-14-15
30-14-15
03-14-18
14-14-15
31-14-21
08-14-19
24-14-15
32-14-15

Ch. 1121 Prior Authorization of Alzheimer's Agents—Pharmacy Services 05/30/14 01-14-20
09-14-15
27-14-13
33-14-14
02-14-12
11-14-12
30-14-12
03-14-15
14-14-12
31-14-18
08-14-16
24-14-12
32-14-12

Ch. 1101 2014 HCPCS Updates and Other Procedure Code Changes 06/13/14 99-14-04

Ch. 1121 Preferred Drug List (PDL) Updated July 22, 2014—
Pharmacy Services 07/07/14 01-14-26
09-14-21
27-14-19
33-14-20
02-14-18
11-14-18
30-14-18
03-14-21
14-14-18
31-14-24
08-14-22
24-14-18
32-14-18

Ch. 1141
1150 ACA Primary Care Services 2014 Fee Schedule 07/07/14 31-14-13

Ch. 1121 Prior Authorization of Hypoglycemic, Alpha-Glucosidase Inhibitors—Pharmacy Services 07/25/14 01-14-33
09-14-28
27-14-26
33-14-27
02-14-25
11-14-25
30-14-25
03-14-28
14-14-25
31-14-31
08-14-29
24-14-25
32-14-25

Ch. 1121 Prior Authorization of Hypoglycemics, Metformins—
Pharmacy Services 07/25/14 01-14-34
02-14-26
03-14-29
08-14-30
09-14-29
11-14-26
14-14-26
24-14-26
27-14-27
30-14-26
31-14-32
32-14-26
33-14-28

Ch. 1121 Prior Authorization of Hypoglycemics, Sulfonylureas—
Pharmacy Services 07/25/14 01-14-35
02-14-27
03-14-30
08-14-31
09-14-30
11-14-27
14-14-27
24-14-27
27-14-28
30-14-27
31-14-33
32-14-27
33-14-29

Ch. 1121 Prior Authorization of Multiple Sclerosis Agents—
Pharmacy Services 07/25/14 01-14-36
02-14-28
03-14-31
08-14-32
09-14-31
11-14-28
14-14-28
24-14-28
27-14-29
30-14-28
31-14-34
32-14-28
33-14-30

Ch. 1121 Prior Authorization of Antiparasitics, Topical—Pharmacy Services 07/25/14 01-14-31
09-14-26
27-14-24
33-14-25
02-14-23
11-14-23
30-14-23
03-14-26
14-14-23
31-14-29
08-14-27
24-14-23
32-14-23

Ch. 1121 Prior Authorization of Antimigraine Agents, Other—
Pharmacy Services 07/25/14 01-14-29
09-14-24
27-14-22
33-14-23
02-14-21
11-14-21
30-14-21
03-14-24
14-14-21
31-14-27
08-14-25
24-14-21
32-14-21

Ch. 1121 Prior Authorization of Anticoagulants—Pharmacy Services 07/25/14 01-14-28
02-14-20
03-14-23
08-14-24
09-14-23
11-14-20
14-14-20
24-14-20
27-14-21
30-14-20
31-14-26
32-14-20
33-14-22

Ch. 1121 Prior Authorization of Hypoglycemics, SGLT2 Inhibitors—
Pharmacy Services 07/25/14 01-14-38
02-14-30
03-14-33
08-14-34
09-14-33
11-14-30
14-14-30
24-14-30
27-14-31
30-14-30
31-14-36
32-14-30
33-14-32

Ch. 1121 Prior Authorization of Nitrofuran Derivatives—Pharmacy Services 07/25/14 01-14-37
02-14-29
03-14-32
08-14-33
09-14-32
11-14-29
14-14-29
24-14-29
27-14-30
30-14-29
31-14-35
32-14-29
33-14-31

Ch. 1121 Prior Authorization of Hereditary Angioedema (HAE) Agents—Pharmacy Services 07/25/14 01-14-32
09-14-27
27-14-25
33-14-26
02-14-24
11-14-24
30-14-24
03-14-27
14-14-24
31-14-30
08-14-28
24-14-24
32-14-24

Ch. 1121 Prior Authorization of Thyroid Hormones—Pharmacy Services 07/25/14 01-14-39
02-14-31
03-14-34
08-14-35
09-14-34
11-14-31
14-14-31
24-14-31
27-14-32
30-14-31
31-14-37
32-14-31
33-14-33

Ch. 1121 Prior Authorization of Acne Agents, Oral—Pharmacy Services 08/05/14 01-14-27
09-14-22
27-14-20
33-14-21
02-14-19
11-14-19
30-14-19
03-14-22
14-14-19
31-14-25
08-14-23
24-14-19
32-14-19

Ch. 1121 Prior Authorization of Ulcerative Colitis Agents—
Pharmacy Services 08/05/14 01-14-40
09-14-35
27-14-33
33-14-34
02-14-32
11-14-32
30-14-32
03-14-35
14-14-32
31-14-38
08-14-36
24-14-32
32-14-32

Ch. 1121 Prior Authorization of Antimigraine Agents, Triptans—
Pharmacy Services 08/05/14 01-14-30
09-14-25
27-14-23
33-14-24
02-14-22
11-14-22
30-14-22
03-14-25
14-14-22
31-14-28
08-14-26
24-14-22
32-14-22

Ch. 1121 Prior Authorization of Tysabri—Pharmacy Services 08/11/14 01-14-41
09-14-36
27-14-34
33-14-35
02-14-33
11-14-33
30-14-33
03-14-36
14-14-33
31-14-39
08-14-37
24-14-33
32-14-33

Ch. 1101 Implementation of National Correct Coding Initiative Related Modifiers 09/12/14 99-14-08

Ch. 1149
1150 New Procedure Code for Dental Services 09/27/14 27-14-12

Ch. 1101
1150 Presumptive Eligibility for Pregnant Women 10/24/14 01-14-19
08-14-15
09-14-14
31-14-17
33-14-13
47-14-02

Ch. 1101 Implementation of Healthy Pennsylvania 11/04/14 99-14-09

Ch. 1101
1141
1150
1221 Advanced Radiologic Imaging Services 11/21/14 01-14-42

Ch. 1123 Revisions to Prior Authorization Requirements for Apnea Monitors 12/09/14 24-14-34
25-14-01

Ch. 1101 Healthy PA Benefit Plans 12/12/14 99-14-10

Ch. 1141
1150 Medical Assistance Fees for Primary Care Services 12/20/14 31-14-40

Ch. 1121 Prior Authorization of Hepatitis C Agents—Pharmacy Services 12/29/14 01-14-53
02-14-43
03-14-46
08-14-47
09-14-46
11-14-43
14-14-43
24-14-44
27-14-44
30-14-43
31-14-50
32-14-43
33-14-45

Ch. 1121 Prior Authorization of Anti-Allergens, Oral—Pharmacy Services 12/29/14 01-14-47
09-14-40
27-14-38
33-14-39
02-14-37
11-14-37
30-14-37
03-14-40
14-14-37
31-14-44
08-14-41
24-14-38
32-14-37

Ch. 1121 Prior Authorization of Rilutek (riluzole)—Pharmacy Services 12/29/14 01-14-51
02-14-41
03-14-44
08-14-45
09-14-44
11-14-41
14-14-41
24-14-42
27-14-42
30-14-41
31-14-48
32-14-41
33-14-43

Ch. 1121 Prior Authorization of Compounded Prescriptions—
Pharmacy Services 12/29/14 01-14-44
02-14-34
03-14-37
08-14-38
09-14-37
11-14-34
14-14-34
24-14-35
27-14-35
30-14-34
31-14-41
32-14-34
33-14-36

Ch. 1121 Prior Authorization of Cytokine and CAM Antagonists—
Pharmacy Services 12/29/14 01-14-52
02-14-42
03-14-45
08-14-46
09-14-45
11-14-42
14-14-42
24-14-43
27-14-43
30-14-42
31-14-49
32-14-42
33-14-44

Ch. 1121 Prior Authorization of Soliris (eculizumab)—Pharmacy Services 12/29/14 01-14-48
09-14-41
27-14-39
33-14-40
02-14-38
11-14-38
30-14-38
03-14-41
14-14-38
31-14-45
08-14-42
24-14-39
32-14-38

(Editor's Note: This document continues with the Governor's Office's Catalog of Nonregulatory Documents in Part IV at 51 Pa.B. 4697 (August 7, 2021).)

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Year	Subject	Date Issued	Bulletin Number
	Interim Technical Guidance for Claim and Service Documentation	07-25-18	00-18-04
	Fee Schedule Rates and Methodology for Waiver Services TSM and Base-Funded Program Services	09-13-18	00-18-05
	Variance Form and Process: Requesting a Variance	09-17-18	00-18-06
2019	OVR Referrals for ODP Employment Related Services	02-14-19	00-19-01
	OVR Referrals During a Period When OVR's Order of Selection is Closed	7-1-19	00-19-02
	Prioritization of Urgency of Need for Services (PUNS) Manual	7-23-19	00-19-03
	Individual Eligibility for the Consolidated, P/FDS and Community Living Waivers	11-26-19	00-19-04
2020	Regulatory Compliance Guide for Community Homes for Individuals with an Intellectual Disability or Autism	2-3-20	00-20-01
	Individual Support Plans for Individuals Receiving Targeted Support Management, Base-Funded Services, Consolidated, Community Living or P/FDS Waiver Services, or Who Reside in an ICF/ID	2-7-20	00-20-02
	Electronic Visit Verification (EVV) for Personal Care Services (PCS)	9-10-20	00-20-03
	Participant-Directed Services: Agency with Choice Financial Management Services Model	12-16-20	00-20-04
2021	Guidance for Human Rights Teams and Human Rights Committees	2-5-21	00-21-01
	Incident Management	3-1-21	00-21-02

•	Everyday Lives, Values in Action
•	Office of Developmental Programs Quality Assessment and Improvement Process
•	Pennsylvania's Guide to Participant-Directed Services
•	Individual Support Plan (ISP) Manual for Individuals Receiving Targeted Services Management, Base Funded Services, Consolidated Waiver Services, Community Living, P/FDS Services or Who Resides in an ICF/ID
•	Office of Developmental Programs Supports Coordinator Orientation
•	Independent Monitoring for Quality (IM4Q) Manual
•	Enterprise Incident Management System (EIM) Manual
•	Certified Investigator Manual
•	PUNS Manual
•	Supports Intensity Scale^TM (SIS^TM) and PA Plus User's Manual
•	Gold Book
•	AAW Provider Manual—Bureau of Supports for Autism and Special Populations (BSASP)
•	AAW Provider Information Table
•	Practice Guidelines—BSASP
•	Supports Coordinator Manual—BSASP
•	Behavioral Specialist Manual—BSASP
•	Participant Handbook—BSASP
•	Goal Attainment Scaling (GAS) Manual—BSASP
•	Reference Manual on Community HealthChoices (CHC)
•	ACAP Participant Handbook—BSASP/Keystone Autism Services
•	ACAP Provider Manual—BSASP/Keystone Autism Services
•	Best Instructional Practices Manual—BSASP
•	Periodic Risk Evaluation (PRE) Manual—BSASP

•	PROMISe Billing Quick Reference Error Status Codes Informational Packet (# 014-09)
•	Prudent Pay of Claims Policy Enforcement Informational Packet (# 075-11)
•	Use of SNAP for Individuals Residing in GLAs Informational Packet (# 015-12)
•	Emergency Respite Procedure Informational Packet (# 066-12)
•	Residential Vacancy Management Procedure Informational Packet (# 098-12)
•	Request for Waiver of Provision of Chapter 51 Informational Packet (# 002-13)
•	Incident Management Clarification of Responsibilities for the Supports Coordination Organizations (# 072-13)
•	Amendments to 55 Pa. Code Chapter 6000, Statements of Policy, Subchapter Q as a result of Adult Protective Services (# 031-15)

•	Viewing Service Utilization in HCSIS for AEs Informational Memo (# 005-09)
•	Electronic Funds Transfer Option Informational Memo (# 006-09)
•	Remittance Advice Quicktip # 7 Informational Memo (# 015-09)
•	Individual Purchases and Item Storage Informational Memo (# 049-10)
•	Incident Management Reporting Informational Memo (# 115-11)
•	How to Request a Reissue or Copy of Cashed Check Informational Memo (# 138-11)
•	Uniform Construction Code Clarification for Licensed Providers Informational Memo (# 180-11)
•	DRN Review Informational Memo (# 019-12)
•	Admissions to State Operated ICFs/ID Informational Memo (# 045-12).
•	Reporting Unauthorized Restrictive Interventions Informational Memo (# 080-12)
•	Clarification to ODP Communication # 098-12 Residential Vacancy Management Informational Memo (# 103-12).
•	Implementation Instructions on QM Plans Informational Memo (# 107-12)
•	Incident Investigation Determination Informational Memo (# 110-12)
•	NPI Number Required on All Claim Types Informational Memo (# 001-13)
•	Secondary Transition Website Informational Memo (# 059-13)
•	Communication Assistance Compliance Standards for Individuals who are Deaf (# 018-15)
•	Incident Report Finalization (# 025-15)
•	Helpful Resources from the PA Department of Transportation (# 034-15)
•	Implementation Instructions for Providers, including SCOs on Quality Management Plans (# 038-15)
•	Enforcement Actions against Noncompliant ODP Intellectual Disability Waiver Providers (# 062-15)

•	Providing Services to Persons with Autism/Pervasive Developmental Disorder
•	Therapeutic Services & the AAW-7/8/12
•	AAW Annual Review Plan Process Timelines—8/20/12
•	Additional info about Monthly Progress Notes for SCs—10/03/2012
•	AAW Quarterly Summary Reports: Which months to include?—1/18/2013
•	New PROMISe Applications—2/20/2013
•	AAW Service Utilization Calculator for SCs—4/19/2013
•	Excluded Parties List System database migrated to System for Award Management—4/23/2013
•	Fiscal Year End Activities—5/30/2013
•	Cost Report Instructions for the Consolidated and P/FDS Waiver Programs
•	ACT 62 Letter for Families September 2016
•	ACT 62 General Information for Families infographic
•	What Is ACT 62? Infographic
•	Differences Between Private Insurance & Medical Assistance infographic
•	Autism Insurance Act Fact Sheet
•	Autism Insurance Act FAQs
•	Filing Health Insurance Appeals, a brochure by the Pennsylvania Insurance Department
•	How to Appeal
•	Appeal: Sample Letter to Request an Internal Review
•	Appeal: Sample Letter to Request an External Review
•	Act 62 Statute
•	Act 62 Letter and Guidelines for Colleges and Universities: How Colleges and Universities Can Help Students Graduate with the Qualifications Needed for a Behavior Specialist License Electronic Visit Verification (EVV)—''What SCs and AEs Need to Know'' webinar July 27, 2020, Questions and Answers Critical Information for ODP CPS, Residential, and ICF Providers: Pharmacy Partnership (COVID-19 vaccination) Everyday Lives 2020: Recommendations, Strategies & Performance Measures BEST PRACTICE STANDARDS IN BEHAVIORAL SUPPORT

2013	Service Utilization Calculator for Supports Coordinators	4/22/2013	BAW13-08
	AAW Samples of Monthly Progress Notes & Quarterly Summary Report	4/23/2013	BAW13-09
	ADULT AUTISM WAIVER (AAW) PROVIDER NEED-TO-KNOW (NTK)—SCs	4/30/2013	BAW13-12
	Provider Qualification Verification (PQV) Process	6/4/2013	BAW13-15
	AAW Provider Billing and Claims Resolution Issues	6/10/2013	BAW13-16
	55 Pa. Code Chapter 51 Room and Board Contract is available to Residential Habilitation Providers	6/21/2013	BAW13-17
	Adding Behavioral Specialist Services (BSS) to an Individualized Service Plan (ISP)—For SC providers	6/21/2013	BAW13-19
	Adding Behavioral Specialist Services (BSS) to an Individualized Service Plan (ISP)—For BSS providers	6/26/2013	BAW13-20

	Update & Clarification Regarding AAW Assessments	9/13/2013	BAW13-24
2014	Assistive Technology (AT) Resource Reminder	2/28/2014	BAW-14-06
	Coordination of Supports Coordination (SC), Behavioral Specialist (BS), and Community Inclusion (CI) Services	6/23/2014	BAW14-16
	Adult Protective Services (APS) Reporting Requirements	7/2/2014	BAW14-18
2015
	Adult Protective Services (APS) Act and SC Agency Responsibilities	5/22/2015	BAW15-09
	Behavioral Specialist Providers' Functional Behavioral Assessment Review	9/11/2015	BAW15-18
	BSP-CIP Review Checklist	11/20/2015	BAW15-22
	Quarterly Summary Report Guidance	12/7/2015	BAW15-25
	NEW Adult Autism Waiver (AAW) MA 51 Process	12/11/2015	BAW15-26
	AAW Provider Certified Investigator Requirements	12/21/2015	BAW15-27
2016	Changes to the Adult Autism Waiver (AAW) Annual Review Plan (ARP) Process	3/14/2016	BAW16-07
	Functional Behavioral Assessment (FBA) Documentation Requirements	3/17/2016	BAW16-10
	Updated AAW Supports Coordination (SC) Manual is now available	3/22/2016	BAW16-11
	Updated Adult Autism Waiver Provider Manual is now available	4/1/2016	BAW16-12
	Obsolete BAS Administrative Notices	4/1/2016	BAW16-13
	SSD Intent to Enroll Form	4/21/2016	BAW16-14
	New Insurance Requirements	5/16/2016	BAW16-15
	Proposed rates for expanded services added to the Adult Autism Waiver	5/23/2016	BAW16-17
	Informing AAW Participants of Renewal Changes	6/8/2016	BAW16-21
	Admin Notice HCSIS Changes	6/14/2016	BAW16-23
	Admin Notice: New ISP Signature Page	6/24/2016	BAW16-26
	SC Individual Monitoring Form Template and Guidance	6/24/2016	BAW16-28
	Changes to ISP resulting from AAW Renewal	6/24/2016	BAW16-29
	Changes to Initial Individual Support Plan (ISP) and Annual Review Plan (ARP) Checklists	6/24/2016	BAW16-30
	Request for an Exception to Established Service Limits	7/1/2016	BAW16-31
	Admin Notice: Developing a Vocational Profile	7/26/2016	BAW16-34
	New and Revised Resources for Developing a Skill Building Plan (SBP)	8/3/2016	BAW16-35
	Adding the SSD/Systematic Skill Building (SSB) service to an ISP & Progress Reporting for SCs	8/10/2016	BAW16-36
	Adding the SSD/Systematic Skill Building (SSB) service to an ISP & Progress Reporting for SSB Providers	8/10/2016	BAW16-37
	Clarifications regarding Adult Autism Waiver (AAW) Employment Services	8/12/2016	BAW16-39
	AAW Renewal FAQs Available	8/24/2016	BAW16-43
	New Training Platform Launch Date—Reminder to Access Training Certificates	9/9/2016	BAW16-44
	Revised Definition of Crisis Event	9/14/2016	BAW16-45
	New Best Instructional Practices Manual	9/14/2016	BAW16-46
	MyODP Launch and Reminder	9/29/2016	BAW16-48
	Submitting and Entering the Vocational Profile into HCSIS	10/5/2016	BAW16-49
	SC Individual Monitoring and new Employment Info Detail Report	11/10/2016	BAW16-50
2017	Admin Notice: PRE Training	1/4/2017	BAW17-01
	G.A.S. Communication to All Providers	1/19/2017	BAW17-03
	Admin Notice: Employment Training and Voc Profile	2/27/2017	BAW17-06
	PRE Reminder	2/28/2017	BAW17-07
	Info Memo: Waiver Amendment Public Comment Period	3/6/2017	BAW17-09
	Admin Notice: Room and Board Contracts	3/13/2017	BAW17-12
	Admin Notice: Res Hab Request Form and Guidance	3/20/2017	BAW17-13
	Admin Notice: SIB-R Summary Report Process Change	3/21/2017	BAW17-14
	Admin Notice: GAS Training Available	3/22/2017	BAW17-15
	Informational Memo: Pathways to Employment	4/14/2017	BAW17-17
	Admin Notice: PRE Next Steps	5/1/2017	BAW17-18
	Informational Memo: AAW Amendment Submitted to CMS	6/2/2017	BAW17-21
	Admin Notice: New Service Utilization Review Signature Form	6/20/2017	BAW17-22
	Info Memo: Capacity Increase Amendment Approval	6/30/2017	BAW17-24
	Goal Attainment Scaling (GAS): Next Steps and Reminders	7/12/2017	BAW17-25
	Updated Employment Services	8/16/2017	BAW17-29
	Ensuring DSPs Meet AAW Qualifications	8/28/2017	BAW17-30
	PRE: Updated Resources and Upcoming Training	9/27/2017	BAW17-32
	ISP and ARP Checklists	10/27/2017	BAW17-33
2018	AAW Progress Report Changes—Webinars Scheduled	1/29/2018	BAW18-04
	AAW Service Utilization Review FAQs	2/13/2018	BAW18-05
	QSR—Roles and Responsibilities	2/23/2018	BAW18-08
	QSR—SC Guidance	2/23/2018	BAW18-09
	Entering SIB-r into Question Pro	4/30/2018	BAW18-13
	QSR FAQs for AAW Providers	6/14/2018	BAW18-15
	Required Monthly Contact Guidance and Timeframe	8/9/2018	BAW18-19
	REISSUE AND CLARIFICATION: Definition of Billable Units	8/9/2018	BAW18-20
	Revised QSR SC Process	8/17/2018	BAW18-21
	IT Employment Positions through Autism2Work	12/17/2018	BAW18-25
	AAW Supports & Services Directory (December 2018)	12/5/18	BAW18-26
	Adult Autism Waiver Amendment Update	12/19/2018	BAW18-27

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

•	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
•	Disaster Supplemental Nutrition Assistance Program Plan
•	Supplemental Nutrition Assistance Program Ed (SNAP ED) State Plan
•	Supplemental Nutrition Assistance Program (SNAP) Outreach State Plan
•	County Assistance Office Employee and Visitors Access Policy
•	Homeless Assistance Program—Instructions and Requirements
•	Pennsylvania's State SNAP Employment and Training Program State Plan
•	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 Instructions
•	CAOAA Procedures Manual
•	Pennsylvania WorkWear (PAWW) Manual
•	Education Leading to Employment and Career Training (ELECT) DHS Manual
•	Refugee State Plan
•	SNAP Employment, Advancement and Retention Network (EARN) Program and Policy Procedures Manual
•	SNAP E&T Procedures Manual

Year	Code Citation	Subject	Date Issued	Bulletin Number
1998	—	Respite Care Nursing Facility Admissions	04/17/98	35-98-06 36-98-06
	—	Medicare Cost-Sharing Payment for Nursing Facility Residents	07/31/98	35-98-10 36-98-10
1999	Ch. 1187	Capital Component Payments for Post-Moratorium Beds	06/28/99	1187-99-01 35-99-05 36-99-05
2008		Nursing Facility Documentation Requirements for Movable Equipment that is Rented or Leased	07/07/08	03-08-04
2009		Provider Rates for Services Funded through the OBRA, Independence and COMMCARE Waivers	06/25/09	05-09-02 17-09-02 36-09-02 41-09-02 43-09-02 55-09-02 59-09-02
2010		Office of Long-Term Living Home and Community Based Program Policy Clarification Update (Omnibus Bulletin)	11/23/10	05-10-08 51-10-08 55-10-08 59-10-08
		Nursing Home Transition Outreach Form	10/08/10	05-10-05 51-10-05 52-10-05 55-10-05 59-10-05
		Standards and Reimbursement Rates for the Enhanced Older Adult Daily Living Center Program for Medicaid Aging Waiver Participants	04/20/10	03-10-02 41-10-02 55-10-02
	Ch. 2600	Evacuation of Hospice Residents During Fire Drills—Statement of Policy	03/13/2010	40 Pa.B. 1411
2011		Accessibility Adaptations and Assistive Technology	10/11/11	05-11-07 51-11-07 52-11-07 54-11-07 55-11-07 59-11-07
		Community Integration Changes provided in the MA Home and Community—Based Waiver Program	09/29/11	05-11-05 51-11-05 52-11-05 55-11-05 59-11-05
		Program Fraud & Financial Abuse in Office of Long Term Living MA Home and Community Based Services (HCBS) Programs	08/08/11	05-11-04 51-11-04 52-11-04 54-11-04 55-11-04 59-11-04
		Recession of OLTL Bulletin 05-10-07, 51-10-07, 52-10-07, 5-10-075, 59-10-07	06/30/11	05-11-03 51-11-03 52-11-03 55-11-03 59-11-03
2012	CH. 1187	Nursing Facility Participation Review Process and Guidelines—statement of policy	06/30/12	42 Pa.B. 3748
	CH 52 CH 52	OLTL Service Coordination Rate in Effect OLTL Rate for Enrollment	07/14/12 06/30/12	42 Pa.B.4545 42 Pa.B. 381
	CH 52	OLTL Fee Schedule Rates established	06/09/12	42 Pa.B. 3343
2013	CH 52	Rescission of Office of Long-Term Living HCBS Directives, Bulletins and Other Policy Documents	12/04/13	05-13-11 51-13-11 55-13-11 59-13-11
	CH 52	Statewide Waiting List Guidelines for Office of Long-Term Living Medicaid Waivers and the Act 150 Program	11/05/13	05-13-08 51-13-08 55-13-08 59-13-08
	CH 52	Clarification of type, scope, amount, duration and frequency of services	05/16/13	05-13-05 08-13-05 11-13-05 17-13-05 19-13-05 25-13-05 26-13-05 41-13-05 51-13-05 54-13-05 55-13-05 59-13-05
	CH 52	Providing for Absence Policies in the Enhanced Adult Daily Living Centers	03/22/13	03-13-03 41-13-03 55-13-03
	CH 52	Billing Instructions-Home and Community Based Waiver Provider's Billing of Procedure Codes Based on Authorized Service Plans through PROMISe^TM	02/07/13	05-13-02 51-13-02 54-13-02 55-13-02 59-13-02
	CH 52 CH 52	OLTL Enrollment Fee Increase OLTL Service Coordination Rate Increase	01/26/13 01/26/13	43 Pa.B. 589 43 Pa.B. 590
	CH 52	Maintaining Waiver Eligibility While in an Institution	01/24/13	05-13-01 51-13-01 52-13-01 55-13-01 59-13-01
	—	Preventable Serious Adverse Events in Nonpublic and County Nursing Facilities	09/13/14	03-14-08
2014	CH 52	Final Fee Schedule Rates for Personal Assistance Services (Agency) Final Fee Schedule Rates for Personal Assistance Services (Consumer) Final Fee Schedule Rates for Service Coordination Services Service Coordination After-Hours Coverage	09/13/14 09/13/14 09/13/14 06/19/14	44 Pa.B. 5935 44 Pa.B. 5935 44 Pa.B. 5935 51-14-07 55-14-07 59-14-07
		Financial Management Services Information	05/12/14	51-14-07 54-14-07 55-14-07 59-14-07
		Revised Target Resident (MI, ID, ORC) Reporting Form (MA 408)	02/12/14	03-14-12
	CH 52	Release of OLTL Home and Community-Based Services Provider Handbook	01/30/14	03-14-02 05-14-02 08-14-02 11-14-02 17-14-02 19-14-02 23-14-02 25-14-02 26-14-02 41-14-02 51-14-02 54-14-02 55-14-02 59-14-02
		OLTL Home and Community-Based Services Service Authorization Form	01/15/14	51-14-01 55-14-01 59-14-01
	CH 52	Critical Incident Management	04/16/15	05-15-02 51-15-02 54-15-02 55-15-02 59-15-02
2015	CH 52	Rescission of HCBS Directives, Bulletins and other Policy Documents	10/27/2015	54-15-03, 59-15-03
		Medical Assistance Fee Schedule; Addition of Maximum Overtime Rates for Personal Assistance Services (Consumer) and Respite (Consumer)	01/02/16	46 Pa.B. 106
2016		Medical Assistance Fee Schedule Revisions in the Aging, COMMCARE, Independence and OBRA Waivers	01/02/16	46 Pa.B. 107
		Overtime and Minimum Wage Requirements in Participant-Directed Models of Service	01/11/2016	54-16-01, 59-16-01
		Electronic Submission of Nursing Facilities' MA-11 Cost Reports, Supporting Documentation and Signed Certification Report	03/01/2016	03-16-02
		Provider Choice Protocol	03/08/2016	59-16-03
		Act 150 Program Guidelines	05/12/2016	54-16-04, 59-16-04
		Organized Health Care Delivery System	08/29/2016	59-16-11
		Guidance for Nursing Facilities—MDS Section Q	10/03/2016	03-16-10 59-16-10
		Individual Service Plan Development, Review, and Implementation Nursing Home Transition Program Changes Participant Reviews Home and Community-Based Settings Requirements	10/14/2016 10/28/2016 12/28/2016 12/28/2016	59-16-13 59-16-09 59-16-12 59-16-14
		Medical Assistance Fee Schedule; Final Rates for Additional Services Added to the COMMCARE and Independence Waivers	11/19/16	46 Pa.B. 7398
2018		Standardized Participant Information Packet	01/16/2018	59-18-01
		Revised Pennsylvania Preadmission Screening Resident Review (PASRR) Level I Identification Form (MA 376)	08/01/2018	01-18-03 03-18-03 07-18-03 59-18-03
		Revised Pennsylvania Preadmission Screening Resident Review (PASRR) Level II Evaluation Form (MA 376.2)	08/01/2018	01-18-04 03-18-04
		Electronic Submission of the Cost Report (MA-11) Form for Reporting Periods Ending 12/31/18 and Thereafter	09/04/2018	03-18-05
		Rescission of HCBS Directives, Bulletins and Other Policy Documents	09/17/2018	59-18-06
	Ch. 2800	Assisted Living Residence Per Bed Fee Adjustment	06/19/18	48 Pa.B 3493
2019		Hearings and Appeals	02/11/2019	59-19-03
		Implementation of the Functional Eligibility Determination Process	04/01/2019	IEB-19-04 IAE-19-04 07-19-04
	CH 52	Medical Assistance Fee Schedule Revisions in the OBRA Waiver	08/24/2019	49 Pa.B. 4913
	CH 52	Medical Assistance Fee Schedule Revisions to the Act 150 Program	11/30/2019	49 Pa.B. 7136
		Revised Target Resident (MH, ID/DD, ORC) Reporting Form	12/30/2019	03-19-05
2020		Employment and Employment Related Services	07/09/2020	17-20-02
		Revised Standardized Physician Certification Form (MA 570)	08/10/2020	59-20-03
		Electronic Visit Verification (EVV) for Personal Care Services (PCS)	09/10/2020	07-20-04, 54-20-04, 59-20-04, 00-20-03
2021		Act 150 Program Sliding Fee Scale for Calendar Year 2021	03/25/2021	54-21-01, 59-21-01

•	Interpretive Guidelines—interpretations of the 1187 Nursing Facility regulations used during audits of the MA-11 Cost Reports
•	Instructions for Financial and Statistical Report-Form MA-11
•	MA-11 Cost Report Submission System—End User Manual V.6.0
•	Nursing Facility Assessment End User Manual
•	Resident Data Reporting Manual
•	UB-04 Billing Guide for PROMISe^TM Nursing Facilities for County and Nonpublic Nursing
•	Facilities and State Restoration Centers—Nursing facility services only applies to county
•	Nursing facilities and nonpublic nursing facilities. Regulations related to payment for nursing facility services can be found under 55 Pa. Code Chapters 1187 and 1189 and does not include intermediate care facilities for persons with an intellectual disability, Federal or State-owned long-term care nursing facilities or Veteran's homes.
•	Data Book (Participation Review Workbook)

•	Regulatory Compliance Guide for 55 Pa. Code Chapter 2600 (relating to Personal Care Homes) Revised April 1, 2013 (Anticipated to be revised in June 2021)
•	Personal Care Home Regulatory Interpretations—Questions/Answers, DHS BHSL website publications: September, October, November, and December 2014; January, February, March, April, May, June, July, August, October, and December 2015; January, February, April, October, November, and December 2016; April and October 2017; July and November 2018; January 2019.
•	Regulatory Compliance Guide for 55 Pa. Code Chapter 2800 (relating to Assisted Living Residences) effective March 1, 2015 (Anticipated to be revised in June 2021)
•	Assisted Living Residence Regulatory Interpretations—Questions/Answers, DHS BHSL website publications: October, November, and December 2014; January, February, March, April, May, July, August, October, and December 2015; January, February, April, October, November, and December 2016; April and October 2017; July and November 2018; January, March, and March 2019. Policy for Administrative Fines in Personal Care Homes Sale or change of legal entity process for Personal Care Homes
•	Licensing References Manual for Personal Care Homes, Assisted Living, Child Residential, Intellectual Disabilities, and Mental Health Service Providers

•	Licensing Regulation Suspension: Personal Care Homes (2600) and Assisted Living Residences (2800)—March 30, 2020
•	Operational Recommendations for Long-Term Service and Support (LTSS) Providers—March 13, 2020
•	Guidance Suspending and Restricting License Requirements for Personal Care Homes and Assisted Living Residences—March 29, 2020
•	Temporary Changes to 811 Project Rental Assistance (PRA) Program—March 31, 2020
•	Electronic Visit Verification (EVV) Implementation Timeline Update—April 8, 2020
•	Temporary Medication Administration Training Alternative for Personal Care Homes and Assisted Living Residences and Certified Trainer Extension—April 10, 2020
•	Clarification Guidance for Pennsylvania Pre-Admission Screening Resident Review (PASRR)—April 14, 2020
•	How Do Economic Impact Payments Affect Office of Long-Term Living (OLTL) Participants?—April 17, 2020
•	Diabetes Training for Unlicensed Staff to Administer Insulin in Personal Care Homes and Assisted Living Residences—May 1, 2020
•	Direct Care Staff Orientation Training Program for Personal Care Homes and Assisted Living Residences—May 18, 2020
•	Guidance for Modifications to Nursing Facility Bed Increase Requests During the COVID-19 Pandemic—June 4, 2020
•	180-Day Claims Exception Requests Process During the COVID-19 Pandemic—June 4, 2020
•	Personal Care Home and Assisted Living Residence Administrator Continuing Education—June 15, 2020
•	CARES Act Funding for OLTL Home and Community-Based Services Providers—June 22, 2020
•	CARES Act Funding for OLTL Community HealthChoices Managed Care Organizations (CHC-MCOs) and Living Independence for the Elderly (LIFE) Organizations—June 22, 2020
•	CARES Act Funding for OLTL Nursing Facility Providers—June 22, 2020
•	CARES Act Funding for OLTL for Licensed Personal Care Home (PCH) and Licensed Assisted Living Residences (ALR) Providers—June 22, 2020
•	CARES Act Funding for OLTL Nursing Facility Providers—July 6, 2020
•	Universal Testing of Long-Term Care Facilities—Personal Care Homes (PCH), Assisted Living Residences (ALR), and Private Intermediate Care Facilities (ICF)—Updated: August 3, 2020
•	Vaccination Information for Office of Long-Term Living Home and Community-Based Providers—January 12, 2021
•	Guidance for Adult Daily Living Providers Delivering Telephonic or Remote Services During the COVID-19 Public Health Emergency—January 13, 2021
•	Guidance on COVID-19 for Personal Care Homes, Assisted Living Residences and Private Intermediate Care Facilities—Updated: April 5, 2021
•	Transition Plan to Phase Out Temporary Changes to the OBRA 1915(c) Waiver—Updated: March 25, 2021
•	Temporary Changes to the OBRA 1915(c) Waiver—Updated: March 25, 2021
•	Transition Plan to Phase Out Temporary Changes to the Community HealthChoices 1915(c) Waiver—Updated: March 25, 2021
•	Temporary Changes to the Community HealthChoices 1915(c) Waiver—Updated: March 25, 2021
•	Transition Plan to Phase Out Temporary Changes to the Act 150 1915(c) Waiver—Updated: March 25, 2021
•	Temporary Changes to the Act 150 Program—Updated: March 25, 2021

[51 Pa.B. 4433][Saturday, August 7, 2021]

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[51 Pa.B. 4433]
[Saturday, August 7, 2021]