MCO Updates

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FY 2009 Transmittals

PT#

Date

Provider Transmittal No.

Topic

PT 01-09

07/01/08

Medical Care Transmittal No. 64

Fiscal Year 2009 Per Diem Rate

PT 02-09

07/01/08

Personal Care Services Transmittal No. 43

Fiscal Year 2009 Medical Assistance Personal Care Services Program Reimbursement Rates

PT 03-09

07/01/08

Waiver for Older Adults Transmittal No.26

Fiscal Year 2009 Program Rate Increases - REVISED

PT 04-09

07/23/08

Medical Day Care Transmittal No. 65; Waiver for Older Adults Transmittal No.27; Living at Home Waiver Transmittal No. 16

Medical Eligibility Review Process - Reimbursement Level

PT 05-09 08/11/08 Hospital Transmittal No. 201 Medicaid Rates for Administrative Days
PT 06-09 08/18/08 Dialysis Transmittal No. 1 Reporting the National Drug Code (NDC)/Quantity Effective September 1, 2008
PT 07-09 08/18/08 General Provider Transmittal No. 67 Reporting National Drug Code (NDC) Quantity when billing for drugs effective September 1, 2008
PT 08-09 08/20/08 General Provider Transmittal No. 68 Required Features on Tamper-resistant Prescriptions Effective October 1, 2008
PT 09-09 08/27/08 Home Health Transmittal No. 52 Preauthorization
PT 10-09 09/24/08 Pharmacy Transmittal No. 187 Maryland Medicaid May Cover up a 3-day Emergency Supple of Atypical Antipsychotics
PT 11-09 09/29/08 Medical Day Care Transmittal No. 66 Medical Day Care Services Waiver - Policy on Transfers of Participants Between Participating Providers
PT 12-09 09/30/08 General Provider Transmittal No. 69 Continuity of Mental Health Medication During Hospital to Community Transition for Maryland Medicaid and HealthChoice Patients
PT 13-09 09/30/08 Waiver for Children with Autism Spectrum Disorder Transmittal No. 11 Revision to Billing for Intensive Individual Support Services (IISS)
PT 14-09 10/27/08 General Provider Transmittal No. 70 Clarification of Clotting Factors Prior-Authorization Requirements
PT 15-09 10/27/08 Waiver for Older Adults Transmittal No. 28 Adjustment to Fiscal 2009 Year Program Rates
PT 16-09 10/27/08 Living at Home Waiver Program Transmittal No. 17 Adjustment to Fiscal Year 2009 Program Rates
PT 17-09 11/05/08 Medical Day Care Transmittal No. 67 Fiscal Year 2009 Per Diem Rate
PT 18-09 11/05/08 Personal Care Services No. 44 Fiscal Year 2009 Medical Assistance Personal Care Services Program Reimbursement Rates
PT 19-09 11/20/08 Medical Day Care Transmittal No. 68; Community Pathways Waiver Transmittal No. 01; New Directions Waiver Transmittal No. 1 Medical Day Care Services in the Community Pathways and New Directions Waivers
PT 20-09 11/25/08 Nursing Home Transmittal No. 215 Revised Fiscal Year 2009 Interim Rates, Effective November 1, 2008
PT 21-09 11/25/08 Model Waiver for Disabled Children Transmittal No. 29 Physician Reimbursement for Plan of Care Meetings
PT 22-09 01/2/09 MCO Transmittal No. 71 Amendments to HealthChoice and PAC Regulations
PT 23-09 12/15/08 Pharmacy Program Transmittal No. 188 Prescriber NPI Mandated on Pharmacy Claims
PT 24-09 01/24/08 EPSDT Private Duty Nursing Transmittal No. 14; Model Waiver Transmittal No. 30; Home Health Transmittal No. 53 New Rates Effective November 1, 2008
PT 25-09 01/21/09 General Provider Transmittal No. 71 Time Limit for Submitting Claims
PT 26-09 01/14/09 General Provider Transmittal No. 72 Amendments to HealthChoice and PAC Regulations
PT 27-09 01/26/09 Home Health Transmittal No. 54 Revised Home Health Fee Schedule
PT 28-09 01/27/09 Nursing Home Transmittal No. 216 Coverage of Bariatric Bed-A and Bariatric Bed-B; Modification to Coverage Requirements for Negative Pressure Wound Therapy
PT 29-09 02/03/09 EPSDT No. 31; Pharmacy No. 189 Oral Nutritional Supplements and Supplemental Vitamins EPSDT and REM Coverage Limitations
PT 30-09 02/09/09 General Provider No. 72 Cessation of Weekly Paper Remittance Advice (RAs) Payment Reports
PT 31-09 02/18/09 Managed Care Organization Transmittal No. 73 Amendments to HealthChoice and PAC Regulations
PT 32-09 03/16/09 Hospital Transmittal No. 202; Living at Home Waiver Transmittal No.18; MCO Transmittal No. 74; Medical Day Care Transmittal No. 69; Nursing Home Transmittal No. 217; Waiver for Older Adults Transmittal No. 29 Revised DHMH 3871B
PT 33-09 02/19/09 Dental Transmittal No. 43 Preauthorization of Dental Services
PT 34-09 03/26/09 Managed Care Organization Transmittal No. 75 Proposed Amendments to HealthChoice and PAC Regulations
PT 35-09 04/01/09 Nursing Home Transmittal No. 218 Reimbursement for Power Wheelchairs and Power Wheelchair Repairs
PT 36-09 4/17/09 Transmittal #: General Provider Transmittal No. 73 Providers' Responsibility to Screen for Excluded Parties
PT 37-09 4/17/09 General Provider Transmittal No. 74 Providers' Recordkeeping Requirements
PT 38-09 4/14/09 EPSDT: Private Duty Nursing Services Transmittal No. 15 Proposed Amendments to COMAR 10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Private Duty Nursing
PT 39-09 4/14/09 Model Waiver Program Transmittal No. 31 Proposed Amendments to COMAR 10.09.27 Home Care for Disabled Children Under a Model Waiver
PT 40-09 4/14/09 Medical Supply and Equipment Transmittal No. 63 State identification tags for purchased equipment
PT 41-09 5/13/09 Medical Supply and Equipment Transmittal No. 64 COMAR 10.19.12 Disposable Medical Supplies and Durable Medical Equipment
PT 42-09 5/25/09 Maryland Pharmacy Program Transmittal No. 190 Maryland Medicaid Mental Health Formulary Managed Care Carve Out
PT 43-09 6/4/09 Dental Transmittal No. 44 Change in reimbursement for dental services
PT 44-09 6/19/09 Substance Abuse Provider Transmittal No. 2 Improvements in Substance Abuse Treatment System
PT 45-09 6/30/09 Autism Waiver Transmittal No. 12; EPSDT: Private Duty Nursing Services Transmittal No. 16; Living at Home Waiver Transmittal No. 19; Medical Day Care Transmittal No. 70; Model Waiver for Disabled Children Transmittal No. 32; Personal Care Services Transmittal No. 45; Waiver for Older Adults Transmittal No. 30 Change to Fiscal Year 2010 Program Rates Increases
PT 46-09 7/1/09 Provider Transmittal Number: Nursing Home Transmittal No. 219 Nursing Home Pay-For-Performance Scores
PT 47-09 7/1/09 SProvider Transmittal No. 220 Fiscal year 2010 Interim Rates