MCO Updates

SEARCH COMAR

FY 2011 Transmittals

PT#

Date

Provider Transmittal No.

Topic

PT 01-12 08/08/2011 Nursing Home Transmittal No. 234 DHMH 257 - Revised Form and Process

PT 01-11

07/14/10

General Provider No. 79

Part B Coinsurance Payments

PT 02-11

07/14/10

Nursing Home No. 228

Fiscal Year 2011 Interim Rates

PT 03-11 08/16/10 Nursing Home Transmittal No. 229 2010 Nursing Home Pay-for-Performance Scores
PT 04-11 08/16/10 Home Health Transmittal No. 55 Preauthorization
PT 05-11 09/01/10 Personal Care Services Transmittal No. 47 Fee Schedule for FY 2011
PT 06-11 09/14/10 MCO Transmittal No. 80 Payment to FQHC for unforeseen Illnesses
PT 07-11 09/14/10 Personal Care Services No. 48 Denial/Termination of Personal Care Services
PT 08-11 09/14/10 EPSDT No. 32 Procedure Change-Modifier Required for Initial Medical Exam of Child in State-Supervised Care
PT 09-11 09/29/10 Nursing Home Transmittal No. 230 Local Contact Agency for MDS Section Q Referrals
PT 10-11 09/29/10 Nursing Home Transmittal No. 231 Nursing Facility Reimbursement Handbook
PT 11-11 10/21/10 Hospital Transmittal No. 209 Fiscal Year 2011 Medicaid Rates for Administrative Days
PT 12-11 10/21/10 Managed Care Organizations Transmittal No. 81 MCO Medicaid Fraud Reporting
PT 13-11 12/07/10 Program for All-Inclusive Care for Elderly (PACE) Transmittal No. 2 Administrative and Reporting Requirements and Formats--Maryland Medical Assistance PACE Program
PT 14-11 01/19/11 Various New Utilization Control Agent
PT 15-11 01/20/11 Hospital #211 Acute Care Utilization Review Process
PT 16-11 01/24/11 Audiology #4 Audiology Provider Manual and Fee Schedule
PT 17-11 03/16/11 Managed Care Organizations CORRECTION To Managed Care Organizations Transmittal No. 81 “MCO Medicaid Fraud Reporting”
PT 18-11 03/25/11 Managed Care Organization No. 83 Hospice No. 9 Coverage of Hospice and Treatment Services for Children
PT 19-11 04/14/11 Managed Care Organization No. 84 Hospital No. 212 Observation for Primary Adult Care Recipients
PT 20-11 04/19/11 Pharmacy No. 194 Mandatory Pharmacy cost of Dispensing Analysis (PCDA)
PT 21-11 06/14/11 Physician # 134 July 1, 2011 Provider Fee Schedule Change
PT 22-11 06/14/11 Medical Day Care # 77 Revised Fiscal Year Per Diem Rate, Effective July 1, 2011
PT 23-11 06/14/11 Waiver for Children with Autism Spectrum Disorder #15 Adjustment for Fiscal Year 2012 program Rates
PT 24-11 06/14/11 Waiver for Older Adults #36 Adjustment for Fiscal Year 2012 Program Rates
PT 25-11 07/01/11 Nursing Home # 233 Administrative Days in Nursing Facilities
PT 26-11 06/14/11 Model Waiver # 37 and EPSDT: PDN # 18 Adjustment for Fiscal Year 2012 Program Rates
PT 27-11 06/14/11 Living At Home # 25 Fiscal Year 2012 Program Rates
PT 28-11 06/24/11 Pharmacy # 195 and MCO #85 Changes to Pharmacy Dispensing Fee
PT 29-11 06/30/11 MCO # 86 Change in Reimbursement to District of Columbia Hospitals Effective July 1, 2011