MCO Updates

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FY 2004 Transmittals

PT#

Date

Provider Type #

Topic

PT1-04 07/23/03 Medical Day Care # 47 FY 2004 Rates
PT2-04 07/28/03 Hospital # 182 Administrative Day Rates
PT3-04 07/31/03 Waiver for Older Adults # 7 Limited Participation
PT4-04 07/31/03 Waiver for Older Adults # 8 Bed Reservations in Assisted Living Facilities and Charging Miscellaneous Fees
PT5-04 08/07/03 Home Health # 37 Preauthorization
PT6-04 10/08/03 Managed Care Organization Transmittal # 44 Denial/Appeal Letter Template
PT7-04 10/08/03 Pharmacy Transmittal # 171 Co-payment Change for Maryland Pharmacy Assistance Participants
PT8-04 10/08/03 Emergency Services Transporters Transmittal # 1 New Billing Code for Emergency Services Transportation
PT9-04 10/08/03 Clinic Transmittal # 59 Procedure Code Change for Billing Purposes
PT10-04 10/03/03 Oxygen Transmittal # 25 Amendments to Oxygen and Respiratory Equipment
PT11-04 10/08/03 Transport Transmittal # 4 Co-payments for Non-Emergency Transportation
PT12-04 10/09/03 Nursing Home Transmittal # 182 Amendments to Nursing Facility Regulations
PT13-04 10/09/03 Rare & Expensive Case Management Program Transmittal # 3 Proposed Changes to Regulations 10.09.69
PT-14-04 10/14/03 Managed Care Organization Transmittal # 46 Proposed Amendments to Health Choice Regulations
PT15-04 10/31/03 Medical Day Care Transmittal # 48 Adoption of Amendments to COMAR 10.09.07 MDC Services
PT16-04 11/26/03 Managed Care Organization Transmittal # 47 Adoption of Amendments to HealthChoice Regulations
PT17-04 12/09/03 Managed Care Organization Transmittal # 48 Department Review in Orthodontic Appeals
PT18-04 12/16/03 Hospital Transmittal # 183 Fee-for-Service Hospital Day Limits
PT19-04 01/08/04 Nursing Home Transmittal # 183 Revised Interim Rates Effective Jan 1, 2004 and HIPAA Billing Compliance
PT20-04 01/30/04 Healthy Start program Transmittal # 5 Healthy Start Procedure Code Changes
PT21-04 01/29/04 Pharmacy Transmittal # 172 Changes to Estimated Acquisition Cost of Drugs
PT22-04 02/17/04 REM Case Mgmt # 4 Adoption of Regulation Changes - COMAR 10.09.69
PT23-04 02/17/04 DMS/DME # 55 Equipment and Supplies for Institutional Recipients Pending Discharge to Home
PT24-04 03/1/04 Pharmacy # 173 Billing of Hemophilia Clotting Factors
PT25-04 03/3/04 MCO # 50 Emergency and Proposed Amendments to Regulation .19 under COMAR 10.09.65
PT26-04 03/3/04 MCO # 51 Adoption of Amendments to HealthChoice Regulations
PT27-04 04/6/04 Waiver Older Adults # 9 Proposed Regulations COMAR 10.09.54
PT28-04 04/16/04 MCO # 52 Billing MA Recipients for Missed Appointments
PT29-04 04/21/04 MCO # 53 Proposed Amendments to Health Choice Regulations
PT30-04 04/23/04 Ambulatory Surgery Care # 2 Addition of Procedure Codes used by Free-Standing Ambulatory Surgical Centers
PT31-04 04/26/04 Pharmacy # 174 Coverage for OTC Antihistamines and Step Therapy for Phosphate Binders
PT32-04 04/23/04 Dental # 37 Dental Procedure Codes and Fee Schedule
PT33-04 05/05/04 Personal Care # 40 Proposed Amendments on Personal Care Services
PT34-04 05/20/04 Supply and Equipment # 56 Coverage of Prosthesis and Repairs of Purchased Equipment for Institutionalized Recipients
PT35-04 05/24/04 Pharmacy # 175 Changes to Pharmacy Dispensing fee and Co-payment for Prescriptions
PT36-04 05/24/04 MCO # 54 Mental Health Formulary Managed Care Carve-Out
PT37-04 06/10/04 Medical Day Care # 49 Fiscal Year 2005 Per Diem Rates
PT38-04 06/18/04 Nursing Home # 186 Fiscal Year 2005 Interim Rates
PT39-04 06/14/04 Managed Care # 55 (and others) LTC Medical Eligibility Review form (DHMH 3871 B, 6/04)
PT40-04 06/14/04 Nursing Home # 188 Amendments to NF Regulations - Working Capital Fund
PT42-04 06/23/04 Autism Waiver # 186 Fiscal Year 2005 Program Rate Increases
PT43-04 06/23/04 Older Adults Waiver # 11 Fiscal Year 2005 Program Rate Increases
PT44-04 06/23/04 Living at Home # 7 Fiscal Year 2005 Program Rate Increases
PT45-04 06/24/04 Hospital # 187 Fee-For-Service Hospital Day Limits
PT46-04 06/30/04 General Provider # 60 Assessing Providers Cost of Recovering Overpayments
PT47-04 06/30/04 Hospital # 188 Administrative Day Rates