[40 Pa.B. 4465]
[Saturday, August 7, 2010]
[Continued from previous Web Page]
PUBLIC WELFARE
(Editor's Note: Statements of Policy are in upper and lower case. Notices of Rule Change are in all capitals. Notices of Rule Change adopted more than 180 days before deposit are starred (*).)
Office of Income Maintenance—Contact: Edward J. Zogby (717) 787-4081
POLICY STATEMENTS:
Year Code
CitationSubject 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 Reconsideration03/15/84 275-84-10 1993 *CH. 166 PROVIDING SUPPORTIVE
SERVICES TO PARTICIPANTS
IN THE COMMUNITY WORK
EXPERIENCE PROGRAM08/21/93 166-93-01 1995 *CH. 257 MA ESTATE RECOVERY—
CHAPTER 178—MEDICAL
ASSISTANCE RESOURCES;
CHAPTER 257—REIMBURSEMENT06/01/95 257-95-01 1996 CH. 125 ACT 1995-20 PROVISIONS
RELATING TO PERSONS SENTENCED
OR CHARGED FOR A FELONY OR
MISDEMEANOR04/05/96 125-96-01 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
• Homeless Assistance Program—Instructions and Requirements (Note: Revised/Reissued Annually)
• BETP Master Guidelines
• Summary of Pennsylvania's State Food Stamp Employment and Training Program
• TANF Work Verification Plan
• LIHEAP HandbookOffice of Medical Assistance—Contact: Leesa Allen (717) 772-6341
POLICY STATEMENTS:
Year Code
CitationSubject Date Issued Bulletin Number 1981 Ch. 1251 Clarification of M.A.
Bulletin # 22-80-0108/19/81 22-81-01 Ch. 1121 Info. Concerning Claims
Submitted as Compounded
Prescriptions06/30/82 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. 1245,
1163Ambulance Transportation 04/22/85 11-85-08 Ch. 1163 Psych. Inpatient Adm of
Patients with D/A and
Psychiatric Diagnoses05/31/85 13-85-04 Ch. 1153 Requirements for Treatment
Plans and Doc. of Treatment10/31/85 29-85-02
33-85-02Ch. 1149 Clarification of Treatment
Plan Requirements for
Orthodontists02/11/86 03-86-1 Ch. 1163 Offset of Investment Income 02/21/86 11-86-04 Ch. 1151 12-86-02
13-86-011986 Ch. 1101.75
(a)(5)Policy Clarification 07/23/86 19-86-06 Ch. 1101 Policy Clarification Re:
Provider's Signature09/19/86 99-86-06 Ch. 1101 Professional License No. 10/13/86 11-86-12
12-86-05Ch. 1101 Preclusion of Convicted
Persons, Not Providers, from
Participation or Involvement
in the MA Program10/24/86 99-86-09 Ch. 1123 Durable Medical Equipment
Warranties10/28/86 05-86-02
19-86-07Ch. 1101 Records Maintenance and
Avail. Requirements11/05/86 23-86-02 1987 Ch. 1101 Physicians' Response. Home
Health Services01/12/87 01-87-01 Ch. 1223 Single County Authorities 12-87-01
13-87-01Ch. 1149 Palliative Emerg. Treat. 04/24/87 03-87-02
27-87-01Ch. 1223 Nonrecompensable Services
Drug Screens07/29/87 11-87-05
12-87-04
16-87-01
28-87-02Ch. 1101/
Ch. 1123Coverage for Motorized
Wheelchairs07/30/87 05-87-02
01-87-08
19-87-06Ch. 1123 Policy Relating to Apnea Monitors 09/02/87 01-87-15
05-87-04
19-87-09Ch. 1150 Spec. Enroll. Req. to Bill
Tech. Comp. of Ped. Pneumograms10/07/87 05-87-05
19-87-101988 Ch. 1101 Policy Clarification Regarding
Physician License07/01/88 1101-88-01 1989 Ch. 1101 Policy Reminder Regarding
Practitioner License Requirements09/09/89 1101-89-02 1990 Ch. 1150 Payment Policy for Consultations 04/27/90 1150-90-01 1991 *CH. 1101
CH. 1121
CH. 1123
CH. 1241EPSDT—OBRA '89 08/02/91 1101-91-01
1121-91-02
1123-91-01
1241-91-011992 *CH. 1141
*CH. 1153CLOZAPINE SUPPORT SERVICES 01/31/92 1141-92-01
1153-92-01Ch. 1241 Revised EPSDT Immunization
Guidelines12/11/92 1241-92-01 1993 *CH. 1165 PAYMENT FOR MENTAL
HEALTH SERVICES PROVIDED
IN A RESIDENTIAL TREATMENT
FACILITY FOR ELIGIBLE
INDIVIDUALS UNDER
21 YEARS OF AGE01/01/93 1165-93-07 *CH. 1121 CHANGES IN THE MEDICAL
ASSISTANCE PHARMACEUTICAL
BENEFITS07/09/93 1121-93-01 *CH. 1149 DENTAL SERVICES FOR ADULTS 07/09/93 1149-93-01 *CH. 1101 BASIC HEALTH CARE FOR
ADULT GENERAL ASSISTANCE
RECIPIENTS (FELIX ET. AL. V.
CASEY ET. AL.)
STIPULATION OF SETTLEMENT07/21/93 1101-93-03 *CH. 1101 UPDATE TO EXCEPTIONS
PROCESS AND CRITERIA UNDER
THE GENERAL ASSISTANCE
BASIC HEALTH CARE PACKAGE07/21/93 1101-93-04 Ch. 1241 Centers for Disease Control
Blood Lead Testing09/03/93 1241-93-01 Ch. 1101 Business Arrangements Between
Nursing Facilities and Pharmacy
Providers10/08/93 1101-93-05 1994 Ch. 1241 Update to Blood Lead Testing
Guidelines04/08/94 1241-94-01 *CH. 1239 M.A. CASE MANAGEMENT
SERVICES FOR RECIPIENTS
UNDER THE AGE OF 2105/17/94 1239-94-01 *CH. 1121 PHARMACEUTICAL SERVICES
DRUG COVERAGE FOR MEDICALLY
NEEDY IN NURSING FACILITIES06/24/94 1121-94-01 *CH. 1121 PHARMACEUTICAL SERVICES
PRIOR AUTHORIZATION
REQUIREMENT MULTISOURCE
BRAND NAME DRUGS08/26/94 1121-94-02 *CH. 1121
CH. 1126
CH. 1129
CH. 1141
CH. 1163
CH. 1221
CH. 1225
CH. 1242TREATMENT OF INFERTILITY—
DISCONTINUED COVERAGE FOR
DRUGS AND RELATED SERVICES08/30/94 1121-94-03
1126-94-01
1129-94-01
1141-94-01
1163-94-01
1221-94-01
1225-94-01
1242-94-01*CH. 1101 GENERAL ASSISTANCE
RESTRUCTURE AS A RESULT
OF ACT 4909/02/94 1101-94-01 1995 CH. 1153 ACCESSING OUTPATIENT
WRAPAROUND MENTAL
HEALTH SERVICES09/08/95 1153-95-01 CH. 1157 MENTAL HEALTH SERVICES
PROVIDED IN NON-JCAHO09/08/95 1157-95-01 CH. 1165 UPDATE-JCAHO-ACCREDITED
RTF SERVICES09/08/95 1165-95-01 *CH. 1153 PRIOR AUTHORIZATION OF
PARTIAL HOSPITALIZATION12/30/94 1153-94-01 CH. 1163 PAYMENT POLICY FOR
ABORTION SERVICES12/15/95 1163-95-02 1997 Ch. 1141 Revision to Physician Assistant and
Nurse Midwife Supervision
Requirement07/30/97 1141-97-01 1998 Ch. 1163 Revision of Utilization Guidelines
for Inpatient Hospital Drug and
Alcohol Services Under the
Medical Assistance Program05/18/98 1163-98-01 Ch. 1101
Ch. 1141
Ch. 1150
Ch. 1221Regulation Changes Regarding
''Emergency Medical Condition''07/01/98 1101-98-01
1141-98-01
1150-98-01
1121-98-01Ch. 1141
Ch. 1153Clozapine Support Services 12/29/98 33-98-08
29-98-08
01-98-191999 Ch. 1187 Capital Component Payments for
Post-Moratorium Beds04/17/99 1187-99-01 Ch. 1101 ''Payment in Full'' 09/17/99 99-99-06 2001 Ch. 1101 Clarification of Coverage for
Motorized Wheelchairs and
Other Durable Medical Equipment02/16/01 01-01-02
05-01-01
17-01-01
19-01-02
49-01-02
50-01-01
1101-01-01
1123-01-01Ch. 1241 Revision to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program7/1/01 01-01-10
10-01-03
11-01-05
17-01-04 26-01-03 49-01-07— Breast and Cervical Cancer
Prevention and Treatment Program12/26/01 99-01-12 2002 Ch. 1223 Drug and Alcohol Clinics with
Provisional Licenses10/26/02 28-02-02 Ch. 1241 Revision to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program1/22/02 01-02-01
10-02-01
11-02-01
17-02-01
26-02-01
49-02-01— Breast and Cervical Cancer
Prevention and Treatment Program5/3/02 99-02-06 Ch. 1241 Addition of Procedure Code 90732
to Medical Assistance Fee Schedule
for Administration of Pneumococcal
Vaccine11/18/02 01-02-13
10-02-04
11-02-06
17-02-07
26-02-04
49-02-062003 Ch. 1241 2003 Recommended Childhood
Immunization Schedule3/31/03 01-03-04
10-03-01
11-03-01
17-03-01
26-03-01
49-03-02Ch. 1241 Coverage of Pediarix and Addition
of Procedure Code 90723 to
Medical Assistance Fee Schedule for
Administration of Pediarix Vaccine5/15/03 01-03-06
10-03-02
11-03-02
17-03-03
26-03-02
49-03-03Ch. 1241 Elimination of the Pennsylvania
Children's Check-up (EPSDT)
Form (MA-517)9/5/03 01-03-08 10-03-03
11-03-05
17-03-04
26-03-03
49-03-05Ch. 1223 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
Treatment10/1/03 28-03-02 Ch. 1101 Liability for Cost Sharing for
Recipients Enrolled in Medical
Assistance through Fee for Service
or Managed Care and a Private
Third Party Insurer9/1/03 99-03-12 — Continuity of Care for Recipients
Transferring Between and Among
Fee for Service and Managed Care
Organizations9/1/03 99-03-13 2004 Ch. 1223 Methadone Take-Home Services 2/1/04 28-04-01 2005 Ch. 1121 Pen and Ink Change—Medical Assistance
Handbook, Prior Authorization of
Pharmaceutical Services, Preferred
Drug List12/30/05 02-05-06 Ch. 1121 Preferred Drug List—Phase 3 12/1/05 30-05-06 Ch. 1121 Scope of Coverage of Pharmacy
Services for Dual Eligibles in the
Medical Assistance (MA) Program11/17/05 99-05-21 Ch. 1121 Preferred Drug List—Phase 2 11/8/05 02-05-03 Ch. 1241 Revisions to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Periodicity Schedule10/25/05 01-05-04 Ch. 1121 Preferred Drug List—Phase 1 10/7/05 02-05-01 Ch. 1121 Prior Authorization of Drugs That
Exceed Established Quantity Limits—
Phase 2 Enforcement9/16/05 99-05-17 Ch. 1101 Copayment Changes for Brand Name
and Generic Prescription Drugs8/26/05 24-05-05 Ch. 1121 Prior Authorization of Drugs That
Exceed Established Quantity Limits—
Phase 1 Enforcement8/10/05 99-05-14 Ch. 1153 Psychological/Psychiatric/Clinical
Re-Evaluations and Re-Authorization
For Behavioral Health Rehabilitation
(BHR) Services for Children and
Adolescents with Behavioral Health
Needs Compounded by Developmental
Disorders6/24/05 07-05-01 2005 Recommended Childhood and
Adolescents Immunization Schedule5/26/05 33-05-01 2006 Implementation of the CMS-1500 Health
Insurance Claim Form (Version 08/05)12/18/06 99-06-16 Ch. 1101 Change to copayment requirements
for recipients eligible under the
Breast and Cervical Cancer Prevention
and Treatment coverage group and
Titles IV-B and IV-E Foster Care and
Adoption Assistance12/10/06 99-06-12 Ch. 1101 Clarification of Exclusions from
Copayment Requirements12/10/06 99-06-13 Ch. 1153 Mobile Mental Health Treatment 11/30/06 08-06-18 Ch. 1153 Clarification of Payment Policy for
Abortion Services11/28/06 99-06-15 Ch. 1245 Reimbursement for Non-Emergency
Transportation Services11/17/06 03-06-15 Ch. 1245 Implementation of ACCESS Plus
Referral Requirements10/20/06 99-06-11 Ch. 1101 Revised HealthCare Benefits Packages
Provider Reference Chart (MA 446)10/6/06 99-06-10 Ch. 1163 Medical Assistance Payment for Services
of Teaching Physicians in Hospitals,
Clinics and Emergency Rooms9/16/06 1141-06-01 Ch. 1153 Revision to Minimum Staff
Qualifications of Therapeutic Staff
Support (TSS) Workers8/24/06 08-06-15 Ch. 1153 Federal Medicaid Citizenship and
Identity Eligibility Requirements7/24/06 99-06-07 Ch. 1121 Preferred Drug List—Quarterly Update 4/24/06 02-06-07 Ch. 1241 2006 Recommended Childhood and
Adolescent Immunization Schedule4/16/06 01-06-03 Ch. 1150 Prudent Payment of Claims 4/3/06 99-06-04 Ch. 1121 Federal Clarification—Elimination of
Medicaid Coverage of Drugs for
Treatment of Erectile Dysfunction3/7/06 03-06-03 Ch. 1150 Disenrollment of Dual Eligibles from
Physical Health Managed Care1/27/06 99-06-01 Ch. 1121 Prior Authorization of Drugs that
Exceed Est. Quantity Limits—Phase
3 Enforcement and Additional Drugs
With Quantity Limits01/27/06 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
32-06-02Ch. 1121 Preferred Drug List—Phase 4 1/25/06 02-06-02 Ch. 1163 Place of Service Review Procedures 1/3/06 14-06-01 2007 Ch. 1249 Rescission of the Statement of Policy
Clarifying the Conditions Under Which
Medical Assistance Recipients May Be
Considered Homebound1249-07-04 Ch. 1150 The Addition of Isentress (raltegravir) to
the Special Pharmaceutical Benefits
Program12/21/07 09-07-16
21-07-04
24-07-16
31-07-22Ch. 1150 Medical Assistance Program Fee
Schedule: Addition of Telehealth
Technology Code and Informational
Modifier for Consultations Performed
Using Telecommunication Technology11/30/07 09-07-15 Ch. 1123 MA Program Outpatient Fee Schedule
Revisions for Speech Generating Devices11/29/07 24-07-11
25-07-05
31-07-18Ch. 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
27-07-09Ch. 1101 Childhood Nutrition and Weight
Management Services for Recipients
Under 21 Years of Age11/1/07 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
27-07-07Ch. 1121 Delay in Implementation of the Tamper-
Resistant Pad Requirements10/29/07 99-07-18 Ch. 1121 Special Pharmaceutical Benefits
Program (SPBP) Income Ceiling for
HIV Applicants10/15/07 09-07-10
21-07-03
24-07-10
31-07-14Ch. 1121 Tamper Resistant Prescription Pads 9/28/07 99-07-16 Ch. 1123 2007 Power Mobility Device HCPCS
Updates; Prior Authorization
Requirements9/19/07 99-07-15 Ch. 1163 Medicare Inpatient Pricing Logic
Modification8/17/07 01-07-08 Ch. 1123 Provider Specialty 220 Hearing Aid
Dispenser Requirement and Updated
Medical Assistance Program Fee
Schedule for Hearing Aid Supplies8/3/07 01-07-07
24-07-09
31-07-12
20-07-03
25-07-04Ch. 1221 Preferred Drug List—May 2007
Technical Correction7/31/07 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
27-07-06Ch. 1149 Discontinuance of the Prior Authorization
Requirement for Dental Procedure Codes
D7140 and D72107/11/07 27-07-04 Ch. 1121 Preferred Drug List—Updates to Prior
Authorization of Pharmaceutical Services
Handbook Pages7/27/07 02-07-03
11-07-04
30-07-03
14-07-03
31-07-10
08-07-11
24-07-07
32-07-04
09-07-08
27-07-05Ch. 1123 Special Pharmaceutical Benefits
Program (SPBP) Income Ceiling Increase
for HIV Applicants7/1/07 09-07-05
21-07-02
24-07-04
31-07-07Ch. 1101 The Elimination of Paper Vouchers 6/14/07 99-07-10 Ch. 1123 Requirements for Coverage of Enteral
Nutritional Supplements and Issuance of
Enteral Nutritional Supplements MA
Program Outpatient Fee Schedule6/1/07 08-07-10
09-07-07
24-07-06
25-07-03
31-07-09Ch. 1121 Preferred Drug List—July 2007
Quarterly Update6/1/07 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
32-07-03Ch. 1101 Co-pay/Deductibles on Exceptional
Durable Medical Equipment (DME)6/1/07 03-07-04 Ch. 1249 Rescind MA Program Statement of
Policy Regarding the Clarification of
Conditions Under Which MA
Recipients May be Considered
Homebound7/10/07 1249-07-01 Ch. 1150 Medical Assistance Program Fee
Schedule Revision; Change to
Conversion Factor for Anesthesia
Services5/10/07 31-07-05 Ch. 1121 Preferred Drug List—Quarterly Update 5/1/07 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
32-07-02Ch. 1101 Clarification Regarding the Definition
of Medically Necessary—Statement of
Policy4/21/07 99-07-04 Ch. 1241 2007 Recommended Childhood and
Adolescent Immunization Schedules3/23/07 01-07-05 Ch. 1123 Provider Specialty 220 (Hearing Aid
Dispenser) Requirement3/1/07 01-07-03 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)1/31/07 OMHSAS-06-07 Ch. 1150 Policy Reinforcement Regarding Billing
For Tobacco Cessation Counseling Services1/4/07 99-07-02 2008 Ch. 1121 Preferred Drug List—Fall 2007 Update
Part 2 Technical Correction1/11/08 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
32-07-08Ch. 1149 Implementation of ADA Claim Form—
Version 2006 and Elimination of Dental
Prior Authorization Forms1/11/08 17-08-01 Ch. 1163 Preventable Serious Adverse Events 1/14/08 01-07-11 Ch. 1101 Implementation of SelectPlan for
Women2/1/08 01-08-02 Ch. 1241 Clarification of Childhood Nutrition and
Weight Management Services for
Recipients Under 21 Years of Age2/15/08 99-08-01 Ch. 1241 The Addition of Selzentry (maraviroc)
and Intelence (etavirine) to the Special
Pharmaceutical Benefits Program2/29/08 09-08-03
24-08-04
21-08-01
31-08-04Ch. 1121 Medical Necessity Guidelines for Lyrica
for Fibromyalgia3/5/08 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
32-08-01Ch. 1121 Tamper Resistant Prescription Pads 3/21/08 99-08-03 Ch. 1101 SelectPlan for Women Program—
Addition of Covered Services4/23/08 01-08-05 Ch. 1150 Prudent Payment of Claims—Updated 4/25/08 99-08-05 Ch. 1121 Preferred Drug List—Spring 2008
Update6/2/08 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
32-08-03Ch. 1149 ADA Claim Form—Version 2006 and
Discontinuance of P. O. Box 81866/16/08 17-08-02 Ch. 1150
Ch. 1141
Ch. 1147Medical Assistance Program Fee
Increase for Select Ophthalmological
Examinations07/22/08 18-08-04
31-08-12Ch. 1150
Ch. 1249Medical Assistance (MA) Program Fee
Increases for Select Home Health
Agency Services7/22/08 05-08-02 Ch. 1150
Ch. 1141
Ch. 1147Medical Assistance Program Fee
Increases for Select Office Visits and
Consultations for Vision Services7/22/08 18-08-03 Ch. 1150
Ch. 1249Medical Assistance Program Fee
Increases for Select Private Duty/
Shift Nursing Services to MA
Recipients Under 21 Years of Age7/22/08 05-08-03
16-08-01Ch. 1150
Ch. 1149Medical Assistance Program Fee
Increases for Select Dental Services7/22/08 27-08-06 Ch. 1150 Medical Assistance Program Fee
Increases for Select Office Visits
and Consultations7/22/08 09-08-09
31-08-11
33-08-05Ch. 1150
Ch. 1243Medical Assistance Program Fee
Schedule Changes for Select
Laboratory Procedure Codes7/22/08 08-08-09
09-08-10
28-08-04
31-08-13
33-08-06Ch. 1150
Ch. 1141Medical Assistance Program Outpatient
Fee Schedule Increase for a Select
Colonoscopy Procedure7/22/08 01-08-07 Ch. 1150 Fee Increases for Select Healthy
Beginnings Plus Services7/25/08 05-08-04
08-08-13
31-08-17
33-08-08
47-08-11Ch. 1150
Ch. 1241Screening for Developmental Delays
and Autism Spectrum Disorders7/25/08 99-08-10 Ch. 1145 Recipient Access to Chiropractic
Services8/4/08 99-08-11 Ch. 1150 Prior Authorization of Advanced
Radiologic Imaging Services8/5/08 99-08-08 Ch. 1150
Ch. 1225Medical Assistance Program Family
Planning Clinic Select Fee Increases
and Updates8/29/08 08-08-08 Ch. 1101
Ch. 1150
Ch. 1221SelectPlan for Women Updated
Covered Services Chart9/5/08 01-08-09
08-08-17
09-08-17
24-08-12
28-08-06
31-08-21
33-08-09Ch. 1163 Payment Policy for Hospital
Readmissions9/12/08 01-08-10 Ch. 1241 Updates for Early Periodic Screening,
Diagnosis and Treatment Program9/18/08 99-08-13 Ch. 1150
Ch. 1121Reminder of Implementation of Tamper
Resistant Prescription Pad Requirements9/24/08 99-08-14 Ch. 1101
Ch. 1150Implementation of Claim Check 10/2/08 99-08-17 Ch. 1150
Ch. 1147Addition of Procedure Code 67820 to
Optometrist Medical Assistance Program
Outpatient Fee Schedule11/14/08 18-08-07 Ch. 1150 Preventable Serious Adverse Events 11/26/08 01-08-11 Ch. 1150
Ch. 1147Addition of Procedure Codes to the
Medical Assistance Program Fee
Schedule for Office Visits for Optometrists12/29/08 18-09-01 2009 Ch. 1150
Ch. 1123
Ch. 1147Removal of Prior Authorization Requirement for Eyeglass Lenses 2/9/09 18-09-02
24-09-01
25-09-01 31-09-01Ch. 1101
Ch. 1150
Ch. 1241Pentacel® (DTaP-IPV/Hib), Kinrix®
(DTaP-IPV) and Rotarix® (Rotavirus)
Vaccines2/9/09 01-09-01
08-09-01
09-09-01
31-09-02
33-09-01Ch. 1101
Ch. 1150
Ch. 12412009 Recommended Childhood and
Adolescent Immunization Schedules2/20/09 01-09-04
08-09-04
09-09-04
31-09-05
33-09-02Ch. 1150 Medical Assistance Program Fee
Schedule Procedure Code End-dating
of Keratomileusis3/27/09 99-09-04 Ch. 1149 Implementation of the Pediatric Dental
Periodicity Schedule4/24/09 27-09-02 Ch. 1121 Spring 2009 Preferred Drug List (PDL)
Pharmacy Update6/5/09 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
32-09-03Ch. 1150 Revisions to Medical Assistance
Program Fee Schedule Rates for Select
Services6/15/09 99-09-05 Ch. 1150 2008 HCPCS Updates and Other
Procedure Code and Procedure Code/
Modifier Combination Changes7/6/09 99-09-06 Ch. 1105
Ch. 1150Revised Medical Assessment Form
(PA 635)8/10/09 31-09-38
19-09-01
09-09-34Ch. 1101 Changes to Procedure Codes for the 8/13/09 01-09-38 Ch. 1150 Administration Fees for Kinrix®
(DTaP-IPV) and Rotarix® (Rotavirus
Vaccines08-09-39
09-09-40
31-09-41
33-09-03Ch. 1101
Ch. 1150
Ch. 1141
Ch. 1221SelectPlan for Women Program
Forumulary9-1-09 01-09-39
08-09-40
09-09-41
24-09-38
28-09-04
31-09-42
33-09-04Ch. 1101
Ch. 1150
Ch. 1141
Ch. 1221SelectPlan for Women Program—
Addition of Covered Services9-8-09 01-09-40
08-09-41
09-09-42
24-09-39
28-09-05
31-09-43
33-09-05Ch. 1150
Ch. 1241Structured Screening for Developmental
Delays and Autism Spectrum Disorders9-8-09 99-09-07 Ch. 1150 Billing for the Administration of the
Influenza A (H1N1) 2009 Monovalent
Vaccine10-9-09 99-09-10 Ch. 1101
Ch. 1141
Ch. 1142
Ch. 1143
Ch. 1144
Ch. 1145
Ch. 1147
Ch. 1149Revision of the PROMISe® Individual
Practitioner Enrollment Application and
Implementation of Credentialing for Certain
Providers Types10-16-09 99-09-08 Ch. 1121 Fall 2009 Preferred Drug List (PDL) and
Quantity Limits Update—Pharmacy
Services11-2-09 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
32-09-35Ch. 1141
Ch. 1145Recipient Access to Chiropractic
Services11-30-09 99-09-11 Ch. 1101
Ch. 1150
Ch. 1241Hiberix®, Haemophilus Influenzae
Type b (Hib) Vaccine12-31-09 01-09-62 08-09-61
09-09-62
31-09-64
33-09-072010 Ch. 1187 Nursing Facility Participation Review
Process and Guidelines—Statement of
Policy04/3/2010 Ch. 1150 Health Care Benefit Package 12
Updated Employability Assessment
Procedure Code List2-5-10 01-10-02
08-10-03
09-10-03
18-10-01
28-10-01
29-10-01
31-10-03Ch. 1150 Medical Assistance Program Fee
Schedule Revisions2-19-10 99-10-01 Ch. 1101
Ch. 1150
Ch. 12412010 Recommended Childhood and
Adolescent Immunization Schedules3-15-10 01-10-06
08-10-07
09-10-07
31-10-09
33-10-01Ch. 1141
Ch. 1144Application of Topical Fluoride
Varnish by Physicians and CRNPs3-15-10 Ch. 1121 Spring 2010 Preferred Drug List (PDL)
Quantity Limits Update—Pharmacy
Services5-3-10 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
32-10-06Ch. 1150
Ch. 1121Updated Recommendations for
Gardasil® Quadrivalent Human
Papillomavirus (HPV) Vaccine5-3-10 01-10-14
08-10-15
09-10-16
31-10-17
33-10-02Ch. 1101
Ch. 1150Announcing the Federally Mandated
Change to Electronic Healthcare
Transactions for Healthcare and
Pharmacy Transactions6-8-10 99-10-07 Ch. 1101
Ch. 1150
Ch. 1241Revisions to the Early and Periodic
Screening, Diagnosis and Treatment
(EPSDT) Program Periodicity Schedule6-14-10 99-10-06 Ch. 1150 2009 HCPCS Updates and Other
Procedure Code and Procedure Code/
Modifier Combination Changes6-14-10 99-10-05
GUIDANCE MANUALS:
• Provider Handbook 01—Physician (update effective
07/18/08)
• Provider Handbook 03—Dentist
• Provider Handbook 04—Podiatrist
• Provider Handbook 05—Medical Supplier
• Provider Handbook 06/08—Short Procedure Unit/Ambulatory Surgical Center
• Provider Handbook 07—Chiropractor
• Provider Handbook 09—Birth Centers
• Provider Handbook 10-I—Independent Medical/Surgical Clinic
• Provider Handbook 11-I—Inpatient Hospital (Encompasses provider types General Hospital, Rehabilitation Hospital, Private Mental Hospital, State Mental Hospital and Extended Acute Psychiatric Care)
• Provider Handbook 11-O—Outpatient Hospital (Encompasses provider types General Hospital, and Rehabilitation Hospital)
• Provider Handbook 15—Optometrist
• Provider Handbook 16—Independent Laboratory
• Provider Handbook 18—Ambulance Company
• Provider Handbook 19—Pharmacy
• Provider Handbook 20—Portable X-Ray Provider
• Provider Handbook 21—Renal Dialysis Center
• Provider Handbook 22—Funeral Director
• Provider Handbook 23—Home Health Agency
• Provider Handbook 26—Rural Health Clinic (update 12/24/08)
• Provider Handbook 28—Drug and Alcohol Clinic
• Provider Handbook 29—Outpatient Psychiatric Clinic
• Provider Handbook 30—Family Planning Clinic
• Provider Handbook 31—Midwives
• Provider Handbook 33—Psychiatric Partial Hospitalization Facility
• Provider Handbook 36-L—Nursing Facility Services only applies to County Nursing Facilities and Private Nursing Facilities. Nursing facility case mix regulations implemented in 1996 (Pa. Code Chapter 1187) do not encompass provider types State Mental Retardation Center, Private ICF/MR, or State Restoration Center (update effective 04/09)
• Provider Handbook 37—Hospice
• Provider Handbook 41—Psychologist
• Provider Handbook 42—Comprehensive Outpatient Rehabilitation Facility
• Provider Handbook 43—Physical Therapist
• Provider Handbook 44—Certified RN Anesthetist
• Provider Handbook 49—Certified RN Practitioner
• Provider Handbook 50—Early Periodic Screening, Diagnosis and Treatment (EPSDT) Provider (update effective 12/24/08)
• Provider Handbook 54—Nutritionist
• Provider Handbook 55—PA Department of Aging (PDA) Waiver
• Provider Handbook 59—COMMCARE Waiver (update effective 09/22/08)
• Medical Assistance Transportation Program—Instructions and Requirements (Note: Revised/Reissued Annually)Office of Long-Term Living—Contact: Robert McNamara (717) 705-3705
GUIDANCE MANUALS:
Bureau of Home and Community Based Services
• Attendant Care Program Requirements
• Attendant Care Medicaid Waiver #0277
• Attendant Care Program Policy and Program Directives and Clarifications
• Community Services Program for Persons with Physical Disabilities (CSPPPD) Program Requirements
• OBRA Medicaid Waiver #0235
• Independence Medicaid Waiver #0319
• COMMCARE Waiver #0386
• Community Services Program for Persons with Physical Disabilities Policy and Program Directives and ClarificationsOffice of Children, Youth & Families—Contact: Cathy Utz (717) 705-2912
POLICY STATEMENTS:
Year Code
CitationSubject Date Issued Bulletin Number 1980 Ch. 3140 Funding of Basic Ed.
Components of Private Day
Treatment Center Programs10/29/80 99-80-22 1981 — OCYF Licensing Procedures:
Clarification of Provider's Right
to Appeal DPW Issuance of a
Provisional Certification of Compliance10/29/81 99-81-38 1982 Ch. 3130 Notice of Right to Appeal for
Spanish-Speaking Clients12/30/82 3130-82-01 1983 Ch. 3130 Clarification of the
Definition of ''Accept for Service''02/04/83 3130-83-03 Ch. 3700 Waiver for Foster Family Homes
by Foster Family Care Agencies02/04/83 3700-83-01 Ch. 3130 Clarification of County C & Y
Agency Requirements with
Respect to Fee Setting02/04/83 3130-83-04 Ch. 3130 Clarif. on Caseworker-to-
Family Case Load Ratio and Case
Management Functions02/04/83 3130-83-07 Ch. 3140 Clarif. of Adoption Asst.
to Relatives in Adoption Cases05/02/83 3140-83-07 Ch. 3140 Chapter 3140.22
Reimbursement Regulations
Alternative Programs
3140.22(e)02/04/83 3140-83-02 Ch. 3140 Chapter 3140.22
Reimbursement Regulations
Community Residential Service
3140.22(d)(3)02/04/83 3140-83-03 Ch. 3140 3130.64(b)(2), 3130.67(9),
3140.131(7), 3700.35(b)(1)
Reimbursement to Parents for the
Cost of Child Visits08/15/83 3130-83-11
3140-83-13
3700-83-031984 Ch. 3140 Reimbursement Rates for
Placements in VisionQuest
Wilderness and Wagon Train Programs01/12/84 3140-84-01 Ch. 3001 Transmittal of Interdpt. Memo.
on Nonimmunized Students
Excluded from Attending School07/08/84 99-84-13 Ch. 3490 Release of Child Abuse Info.
to the Media08/15/84 99-84-20 Ch. 3140 VisionQuest Policy 09/07/84 3140-84-05 1985 Ch. 3001.5 Unannounced Visits to Licensed
and Approved Facilities/Agencies08/20/85 99-85-18 Ch. 3130 Interstate Compact on Juveniles 09/30/85 99-85-27 Ch. 3490 Providing Copies of Child
Abuse Reports to Subjects11/20/85 99-85-28 1986 Ch. 3490 Law Enforcement Officials as
Perpetrators of Suspected
Child Abuse07/15/86 3490-86-04 Ch. 3490 Policy Clarifications Regarding
Child Protective Services Law
and Regulations as Related to Act 3304/01/86 3490-86-02 Ch. 3490 Policy Clarifications Regarding
Child Protective Services Law
and Regulations as Related to
Act 33—Part II06/16/86 3490-86-05 Ch. 3490 Policy Clarifications Regarding
Child Protective Services Law
and Regulations as Related to
Act 33—Part III11/01/86 3490-86-08 1987 Ch. 3490 Implementation of Child Protective
Service Policies Relating to Alleged
Medical Neglect of Disabled Infants05/01/87 3490-87-01 Ch. 3490 Sharing Child Abuse Info
Among DPW Offices09/01/87 3490-87-03 Ch. 3490 Policy Clarification of the Child
Protective Services Law and
Regulations06/01/87 3490-87-02 Ch. 3140 Personal Incident Costs 10/01/87 3140-87-05 Ch. 3140 OCYF Financial Participation
in Costs of County Human
Service Departments08/31/87 3140-87-02 1988 — Special Medical Assistance—Healthy
Beginnings—for Pregnant Women
and Qualified Children11/02/88 99-88-08 Ch. 3490 Screening Student Interns 05/88 3490-88-01 1989 Ch. 3350 Adoption Record Disclosure 07/01/89 3350-89-01 1991 Ch. 3130 Regulatory Interpretation Guidelines
for Revisions to Chapter 313009/20/91 3130-91-03 1992 Ch. 3140 Title XX Invoicing Procedures for
the Youth Development Centers
and Youth Forestry Camps
(YDCs/YFCs)09/25/92 99-92-02 1994 — Site Visits and Access to Records
by PA Protection and Advocacy, Inc.08/22/94 00-94-19 1995 Ch. 3490 Amendments to the Child Protective
Services Law that Become Effective
July 1, 199509/05 3490-95-02 1996 Ch. 3490 Certification and Training for
Children and Youth Workers06/20/96 3490-96-03 00 Update of Policies and Procedures
for Juveniles in Detention04/30/96 00-96-03 00 Maximization of the OCYF's
Grant Funds07/01/96 00-96-04 00 Surveying and Evaluating Child
Welfare Agencies Implementation
and Compliance with MEPA08/15/06 00-96-06 1997 Ch. 3140 Availability of Federal Financial
Participation For Profit
Residential Child Care Facilities01/17/97 3140-97-02 — Access to Pennsylvania State
Police Records10/01/97 00-97-09 — Priority Placement Request
Procedures for the Interstate Compact
on the Placement of Children12/01/97 00-97-12 1998 Ch. 3140 MEPA 1994—Small Business 02/07/98 3140-98-03 — 1997 Association of Juvenile Compact
Administrators Rules and Regulations
Amended Travel Permit06/01/98 00-98-06 1999 Ch. 3140 Adoption Assistance Questions
and Answers03/17/99 3140-99-01 Ch. 3490 Drug Convictions Prohibiting Hiring
and Approving Foster/Adoptive
Parent Applications02/03/99 3490-99-01 Ch. 3490 Implementation of Revisions to the
Child Protective Services Law as
Amended by Act 127 of 199810/01/99 3490-99-02 2000 Ch. 3140 Invoicing Procedures—Child
Welfare TANF04/15/00 3140-00-03 Ch. 3140 AFCARS Planning, Budgeting and
Invoicing Procedures08/15/00 3140-00-02 Ch. 3490 Child Death Review and Report
Protocols10/10/00 3490-00-01 Ch. 3800 Child Residential and Day Treatment
Facilities Licensing Measurement
Instrument Revisions05/30/00 3800-00-01 2001 Ch. 3130 The Second Revised Interim
Guidelines for the Adoption and
and Safe Families Act of 199701/02/01 3130-01-01 Ch. 3140 Revised Policies and Procedures:
Title IV-E Placement Maintenance
Eligibility and Reimbursability, Title
IV-E Adoption Assistance Eligibility
and Title XX Medicaid Eligibility04/09/01 3140-01-01 Ch. 3490 Revised Certification and Training
Requirements for Children and
Youth Supervisors09/25/01 3490-01-02 2003 — Kinship Care Policy 06/30/03 00-03-03 — Megan's Law 04/13/03 00-03-02 Ch. 3140 Interstate Compact on Adoption
and Medical Assistance01/01/04 3140-03-02 Ch. 3350 Statewide Adoption Network
Policies and Procedures01/01/03 3350-03-01 Ch. 3490 A.Y. v. DPW/Allegheny County 03/10/03 3490-03-01 Ch. 3490 Federal Criminal History
Clearances for PA Residents04/25/03 3490-03-02 Ch. 3130
Ch. 3140Permanent Legal Custodian Policy 08/20/03 3130-03-01
3140-03-072004 — Annual Bulletin Update 7/01/04 00-04-01 — MH/MR Services for Children Placed
Out-of-County In Pre-Adoptive or
Foster Homes7/19/04 00-04-02 Ch. 3140 Child Welfare TANF Services
Policies and Procedures5/17/04 3140-04-06 Ch. 3140 Approval/Licensing of Foster
Family Homes4/1/04 3140-04-02 Ch. 3140
Ch. 3490Child Placements with Emergency
Caregivers7/01/04 3140-04-05/
3490-04-01Ch. 3700 Medical Foster Care Services for
Children Served by County Children
and Youth Agencies7/1/04 Special Transmittal 2005 Ch. 3490 Implementation of Act 160 of 2004
Amending the Child Protective Services
Law9/1/05 3490-05-01 2006 — Federal Financial Participation Rate
Change for Title IV-E Placement
Maintenance and Adoption Assistance
Costs10/18/06 00-06-05 Ch. 3140 Random Moment Time Study Policy
and Procedures—Juvenile Probation
Offices7/28/06 3140-06-03 Ch. 3140 Random Moment Time Study Policy
and Procedures—County Children and
Youth Agencies6/30/06 3140-06-04 Ch. 3140 Federal Title IV-E and Medicaid
Administrative Invoicing Procedures9/12/06 3140-06-05 Ch. 3140 Act 148 Invoicing Procedures for
County Child Welfare Services10/11/06 3140-06-06 Ch. 3140 Random Moment Time Study
Requirements Family Service Plan
Documentation10/11/06 Special Transmittal Ch. 3800 Strategies and Practices to Eliminate
Unnecessary Use of Restraint1/30/06 Special Transmittal Ch. 3490 Safety Assessment and Planning Process 3/15/06 3490-06-01 2007 — FFP Rate Change for Title IV-E
Placement Maintenance and Adoption
Assistance Costs4/16/07 00-07-01 Ch. 3490 Protocol to Address Domestic Violence
in Families with Child Welfare
Involvement8/3/07 Special Transmittal 2008 Ch. 3350 Expanded Ground for Involuntary
Termination of Parental Rights4/3/08 Special Transmittal Ch. 3490 Frequency and Tracking of Caseworker
Visits to Children in Federally Defined
Foster Care5/1/08 3490-08-05 Ch. 3140 Title IV-E Foster Case Maintenance
and Adoption Assistance Program
Costs Allowable for Federal Financial
Participation (FFP)5/12/08 3140-08-01 Ch. 3350
Ch. 3490
Ch. 3700Implementation of Safe and Timely
Placement of Foster Children Act
(P. L. 109-239)5/12/08 99-08-01 Ch. 3490 Implementation of Act 126 of 2006
Amending the Child Protective Services
Law3/24/08 3490-08-02 Ch. 3490 Developmental Evaluation and Early
Intervention Referral Policy3/21/08 3490-08-01 Ch. 3490 Implementation of Act 179 of 2008
And Act 72 of 2007 Amending the
Child Protective Services Law6/27/08 3490-08-03 Ch. 3130
Ch. 3140Educational Stability and Continuity
For Children in Substitute Care10/1/08 3130-08-01 Ch. 3490 Implementation of New Reporting
Requirements As Required by Act 146
of 2006 and Act 179 of 200610/1/08 3490-08-04 Ch. 3700 Implementation of Act 68 of 2005
(The Resource Family and Adoption
Process Act), Act 73 of 2005 (The
Resource Family Care Act), and Act
78 of 200710/1/08 3700-08-01 Ch. 3130
Ch. 3350
Ch. 3700Impact of Act 109 on Agency Operations 12/29/08 Special Transmittal 2009 Act 76 of 2007 1/7/09 Special Transmittal Ch. 3130
Ch. 3140
Ch. 3700Fostering Connections to Success and
Increasing Adoptions Act of 20082/24/09 Special Transmittal Ch. 3130 Implementation of the Indian Child
Welfare Act of 19783/9/09 3130-09-01 Ch. 3170 Out of Home Placement Services—
Contract Documentation4/7/09 3170-09-01 YDC/YFC Interim Per Diem Rates 5/14/09 00-09-01 Ch. 3130
Ch. 3140
Ch. 3170Fiscal Year 2010-11 Children, Youth
and Families Needs-Based Plan and
Fiscal Year 2009-10 Implementation
Plan Instructions5-21-09 3140-09-02 Ch. 3170 Out of Home Placement Services—
Contract Documentation08/25/09 3170-09-02 Ch. 3700
Ch. 3800Disaster Planning 10-09-09 Letter from Deputy Secretary Ch. 3800 Strategies and Practices to Eliminate
the Use of Unnecessary Restraints12/19/09 3800-09-01 Ch. 3800 Prone Restraints in Children's
Facilities12/19/09 3800-09-02 Ch. 3140 Implementation of Child Care Funding
Policy Beginning State Fiscal Year (SFY)
2010-201107/01/09 3140-09-03 Ch. 3130
Ch. 3140Fostering Connections to Success and
Ch. 3140 Increasing Adoptions Act of 2008—
Adoption Program Requirements12/30/09 Special Transmittal 2010 Ch. 3130 Shared Case Responsibility and
Procedures05/03/10 3130/10/01
[Continued on next Web Page]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
