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MCO Updates

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    ​FY 2017 Transmittals

     

    PT #Use SHIFT+ENTER to open the menu (new window).
      
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    PT 01-177/5/2016Managed Care Organizations No. 112Reporting Provider Cotnract Terminations
    PT 02-178/3/2016Hospital No. 242Fiscal Year 2017 Medicaid Rates for Administrative Days
    PT 03-178/11/2016Hospital No. 243Update in Procedure for Submitting Claims Reviews
    PT 04-178/12/2016Medical Supply and Equipment No. 69, Oxygen No. 30Future Submissions of Certain DME Preauthorization Requests
    PT 05-178/29/2016Nursing Home No. 259Certification of Need for NF Services
    PT 06-1710/3/2016Medical Supply and Equipment Transmittal No. 70Coverage of Continuous Glucose Monitoring Systems
    PT 07-1710/3/2016Hospice Transmittal No. 12Hospice Payment Rates for Federal Fiscal Year 2017
    PT 08-1710/5/2016General Provider Transmittal No. 83Medicaid Program Updates for Fall 2016
    PT 10-1710/11/2016FQHCDocumenting Behavioral Health Services Billed in FQHC Settings
    PT 09-1710/12/2016Nursing Home No. 2602016 Nursing Home Pay-for-Performance Scores
    PT 11-1711/3/2016Hospital No. 244Distinguishing Between 1184 Newborn Hospital Report of Newborn Process and Hospital Presumptive Eligibility for Newborns
    PT 13-1712/1/2016Home Health No. 7Calendar Year 2017 Home Health Fee Schedule
    PT 14-1712/8/2016Vision Services No. 1Reimbursement for Additional Vision Care Services
    PT 15-1712/8/2016Hospital No. 245; MCO No. 113; Nursing Home No. 261Roles and Responsibilities of Nursing Facilities, Specialty Pediatric Hospitals and Chronic Hospitals when Admitting HealthChoice MCO Members
    PT 16-1712/19/2016Beacon Health Options No. 8; Hospital No. 246; MCO No. 11424 Hour Maximum for Outpatient Observation Stays
    PT 17-1712/20/2016Beacon Health Options No. 9; MCO No. 115; Laboratory No. 67; Opioid Treatment Provider No. 5; Substance Use Disorder No. 19Community-based Medical Laboratory Billing for Substance Use Disorder Screening/Testing for Calendar Year 2017
    PT 18-171/5/2017Beacon Health Options No. 10; Laboratory No.68; Opioid Treatment Providers No. 6Medicaid Billing for Drug Testing and Screening
    PT 19-171/19/2017Federally Qualified health Center No. 10Enrolling Individual/Rendering Maryland Medicaid Providers
    PT 20-172/10/2017Beacon Health Options No. 11; Laboratory No. 69; Substance Use Disorder No.20
    PT 21-172/10/2017Abortion Clinics No.2, Physicians No. 141Coding and Reimbursement Changes for Abortion Procedures
    PT 22-172/10/2017Abortion Clinics No.3Correction--Coding and Reimbursement Changes for Abortion Procedures
    PT 23-173/6/2017Nursing Home No. 262Process for Continued Stay Reviews
    PT 24-173/6/2017Nursing Home No. 263MDS Validation Reviews
    PT 25-173/27/2017Substance Use Disorder No 21Combination of Services, OMT Restrictions
    PT 27-173/30/2017MCO No. 117Directing Acting Antiviral (DAA) Coverage
    PT 28-174/13/2017Hospital No. 248Process for Submitting Retroactive Eligibility Cases to Telligen
    PT 29-175/9/2017Home and Community-Based Options Waiver No. 8; Community First Choice No. 5; Community Personal Assistance Services No. 2Criminal Background Checks and Monthly Claims Submission
    PT 26-173/28/2017Substance Use Disorder No. 22Combination of Services Limitations Level 1, Level 2.1, Level 2.5
    PT 30-175/11/2017Hospital No. 249Billing for Fee-for-Service Observation Stays
    PT 31-175/23/2017MCO No. 118Directing Acting Antiviral (DAA) Coverage Correction
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