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PA Bulletin, Doc. No. 01-1430a

[31 Pa.B. 4248]

[Continued from previous Web Page]

PACE Provider Bulletins: 1995

*  January 1, 1995--Drug Utilization Review Program: Addition of new criteria for antidepressants, antipsychotics and benzodiazepines.

*  February 17, 1995--Antidepressants, Antipsychotics and Benezodiazepines: Reminder to Pharmacy to carefully review both the reject codes and accompanying messages.

*  February 24, 1995--Toradol: Reimbursement restrictions.

*  February 24, 1995--Minitran: 30-day supply limit.

*  March 1995--PACE Drug Utilization Review Criteria.

*  March 3, 1995--Medicare Update: Extended coverage for prescription drugs used in immunosuppressive therapy to three years following hospital discharge for an organ transplant.

*  March 3, 1995--Maximum Initial Dose for selected antipsychotic, antidepressant or benezodiazepine agents.

*  March 27, 1995--Non-Sedating Antihistamines and Oral Antifungals Coadministration is Contraindicated. PACE will reject claims for Seldane, Seldane-D, Hismanal, Claritin, Claritin-D, Diflucan, Nizoral and Sporanox.

*  March 1995--Third Party Billing Reminder: PACE is payer of last resort, pharmacy must bill other third parties first.

*  May 5, 1995--Brand Patent Expirations/Generic Substitutions.

*  July 1995--CellCept Billing Instructions.

*  July 1, 1995--Claims Submissions: 90-day limit to file claims for reimbursement.

*  August 1, 1995--Injectable Chemotherapeutics: Effective 9/1/95 PACE Reimbursement for list of injectable chemotherapeutics limited to 20% of AWP.

*  August 18, 1995--Non-Participating Manufacturer List.

*  August 18, 1995--Drug Utilization Review Program: New maximum dose criteria added to the PACE ProDur Program effective 8/28/95--Nefazodone (Serzone) 600 mg/day; Fluvoxamine (Luvox) 50 mg/day (initial) and 300 mg/day (maximum); Lansoprazole (Prevacid) 30 mg/day.

*  September 1, 1995--Common Package Size Reimbursement Listing.

*  September 1, 1995--Epoetin Alfa (EPO) Injections: Effective 9/11/95 PACE reimbursing only 20% of AWP for Epogen and Procrit.

*  September 6, 1995--Early Refill Edit: Additional classes added to the Early Refill Edit.

*  September 22, 1995--Drug Utilization Review Program: Effective 9/25/95 duplicate therapy edit applied to the following class of drugs: Proton Pump Inhibitors--Prilosec and Prevacid.

*  October 1995--PACE POCAS Telecommunications Number: New direct number available to pharmacy providers for Primary Claim Submission: 950-5545.

PACE Provider Bulletins: 1994

*  February 8, 1994--Reimbursement Criteria for Temazepam (effective 3/1/94).

*  May 23, 1995--Glyburide: Mandatory Substitution of Micronase and Diabeta.

*  May 1994--Prograf Billing Instructions

*  May 1995--Ophthalmics: Days Supply Provisions

*  May 1994--Betaseron Billing Instructions

*  July 1, 1994--Ophthalmics: Noted billing discrepancies regarding pharmacies reporting of the days supply.

*  July 23, 1994--Narrow Therapeutic Index Exemption Listing (Revised)

*  August 1994--Incorrect Physician License Numbers: Notice to Pharmacy Providers of Procedures to Disallow Claims Submitted with Wrong Prescriber I.D.

*  August 19, 1994--Physician/Medical Assistants: PACE Reimbursement of Prescriptions Written by Physician Assistants.

*  September 23, 1994--PACE will no longer reimburse for more than 13 gm of Serevent per prescription.

*  September 26, 1994--Febatol--No PACE Reimbursement after 12/26/94.

*  September 30, 1994--Manufacturers' Rebate Update

*  October 3, 1994--DAW/Product Selection Code (Revised)

*  October 21, 1994--Oral Contraceptives: Effective 10/30/94 PACE no longer reimburses except through the Medical Exception process.

*  October 21, 1994--New Maximum Dose Criteria Added to the PACE ProDUR Program: Maximum daily dose and duplicate therapy criteria for NSAIDs (Trilisate; Disalcid; and Cataflam) and maximum daily dose criteria for miscellaneous anti-ulcer preparations (Propulsid and Reglan).

*  November 18, 1994--Oral Chemotherapeutics: Effective 12/15/94 PACE reimburses only 20% of AWP for Cyclophosphamide 25 mg/oral; Cytoxan 50 mg/oral; Etoposide/Vepesid 50 mg/oral; and Melphalan/Alkeran 2 mg/oral.

*  December 2, 1994--30-Day Supply Requirement: Humulin and Solganal.

PACE Provider Bulletins: 1993

*  January 1, 1993--PACE Legislative Changes Effective 1/1/93
Dispense as Written (DAW) Codes
Mandatory Generic Substitution when an ''A'' rated generic therapeutically equivalent drug is available.
Pricing Information
Consultation Fee Discontinued

*  February 28, 1993--Deadline for PACE Provider Reenrollment and Conversion to 3.2 NCPDP Telecommunications Standard for PACE. Telecommunications Standard for Claims Submission.

*  March 1, 1993--Standard Error Codes

*  March 1, 1993--Early Refill Edit

*  March 1, 1993--Halcion Error Code Revisions

*  March 1, 1993--Processing Requirements: Conversion to NCPDP Version 3.2

*  March 19, 1993--POCAS System Maintenance on 4/10/93 and 4/11/93.

*  May 14, 1993--Delay in Provider Reimbursement

*  May 21, 1993--Change in the ProDUR screening criteria for H2 Receptor Antagonists effective 6/1/93.

*  June 28, 1993--Implementation of PACE ProDUR Changes:
Maximum daily dose for NSAIDs
Maximum daily dose for Omeprazole, Sucralfate and Misoprostrol.
Maximum daily dosage allowed for Famotidine (Pepcid) changed from 80 mg/day to 40 mg/day.

*  June 28, 1993--Claims Processing Procedures When POCAS Is Not Available.

*  July 1, 1993--Non-Participating Manufacturers List

*  July 23, 1993--30-Day Supply Requirements

*  July 23, 1993--Narrow Therapeutic Index Exemption Listing (Revised)

*  September 28, 1993--Manufacturers Rebate Update (Non-Participating Manufacturer List, effective 10/5/93 was attached.)

PACE Provider Bulletins: 1992

*  April 1992--Provider Training Seminars (5/11/92 through 7/2/92)

*  May 29, 1992--Manufacturers' Rebate News: Center Laboratories

*  June 19, 1992--Manufacturers' Rebate News: Roxane Laboratories, Inc.
   --Astra Pharmaceutical Products
   --IPR Pharmaceutical
   --Immunex Corporation

*  August 16, 1992--PACE Rescue Plan:Implementation of ProDUR; NCPDP Version 3.2 and related Program Changes

*  September 1992--Dixon-Shane recoupments/pharmacy credits.

*  November 9, 1992--PACE Pharmacy Provider Manual

*  December 23, 1992--Narrow Therapeutic Index Exemption Listing

*  December 1992--Generic Substitution on Oral Prescriptions (Included Poster and Informational Flyers).

PACE Provider Bulletins: 1991

*  June 21, 1991--Co-Pay Change ($4 to $6 effective 7/1/91)

*  August 14, 1992--General Program Issues:
   --Claims Payment
   --Cardholder Eligibility Changes (Income Eligibility Changed to $13,000 for Single and $16,200 for Married Couples)
   --Nursing Home Providers
   --Cosmetic Drugs (Effective 10/1/91 claims for Rogaine and Retin-A no longer paid)
   --Paper Claims (Only claims for Compound Drugs or claims whose Quantity is in Excess of 9999 accepted as paper claims)
   --Persantine and Dipyridamole (These two drugs must have an indication on the prescription that it is being used as an adjunct to Coumadin anticoagulants for the prevention of postoperative thromboembolic complications of cardiac valve replacement in order to be allowed payment by (PACE).
   --Audit Issues (Telephone Prescriptions and Brand Medically Necessary Requirements).

*  August 21, 1991--Final Instructions Concerning the PACE On-line Claims Adjudication System (POCAS).

*  September 27, 1991--Billing Instructions
   --Cosmetic Drugs
   --Exception Claim Processing
   --POCAS, post payment review
   --Nursing Home Claims

Division of Program & Regulatory Coordination

Contact: Robert Hussar, Division Chief (717)-783-6207

Current Aging Program Directives

   Provided below is a comprehensive list of current Aging Program Directives and LAMP/OPTIONS Bulletins. Directives, which do not appear on the list, are no longer in effect. Current directives are as follows:

Program Area 01--''AAA Administration''
--88-01-07 Personnel Action Plan for Private Non-Profit Area Agencies on Aging (AAA)
--91-01-01 Certification and Disclosure Regarding Lobbying
--91-01-05 Area Agency on Aging Involvement in Corporate Eldercare Activities
--92-01-01 Single Audit Act Audit Requirements
--92-01-06 Minimum Standards for Governing Boards of Private Non-Profit Area Agencies on Aging
--93-01-04 Providing AAA Funded Services to Domiciliary Care and Personal Care Home Residents
--94-01-02 Indirect Cost Policy for Department of Aging Contracts
--94-01-04 Department of Aging Heat Emergency Plan
--95-01-05 Emergency Cooling Project
--95-01-09 Assessments of Persons With ''An Other Related Condition'' Who Are Exceptional Admissions
--97-01-02 Accounting Manual For AAA Programs
--97-01-03 Interim Revision of the OPTIONS Assessment Reporting Forms OPT01 and OPT 01X
--98-01-02 Area Agency on Aging Program Income Policies
--00-01-01 FY 2000-2004 Four-Year Plan Requirements
--00-01-04 PDA Waiver Paid Claims Reconciliation
--00-01-06 PDA Contract Procurement Requirements for Area Agencies on Aging
--00-01-07 OPTIONS Procedures Manual
--01-01-01 FY 2000-2001 Block Grant Amendments
--01-01-02 AAA Utilization of Federal Funds in Provision of Caregiver Services
--01-01-03 AAA Program Requirements, Planning Allocations, and Aging Services Block Grant Format
--01-01-04 FY 2001-2002 Program and Financial Reporting Requirements

Program Area 02--''Home Delivered Meals''

See Program Area 03.

Program Area 03--''Congregate Meals''

--Policies and Standards for the Department of Aging Funded Nutrition Service Programs

Program Area 04--''Socialization/Recreation/Education/Health Promotion''

--96-04-01 Senior Community Center And Satellite Center Policies and Standards

--98-04-01 PrimeTime Health Program

Program Area 05--''Employment Services''

--95-05-02 Title V Senior Community Service Employment Program: Final Rule

--96-05-02 Title V S.C.S.E.P.: Eligibility and Assessment Forms

Program Area 06--''Volunteer Services''

--85-06-01 Volunteer Services

Program Area 07--''Passenger Transportation Services''

--85-07-01 Policies for Transportation Services

Program Area 11--''Information and Referral''

--85-11-01 Policies and Procedures for the Provision of I & R Services by AAAs

Program Area 22--''Assessments''

--See APD #95-05-09 and Book I of APD #00-01-07.

Program Area 23--''Care Management''

--See APD #00-01-07.

Program Area 24--''Protective Services Intake/Investigation''

--89-24-01 Protective Services for Older Adults Regulations

--89-24-02 Required Standard Forms for Protective Services

--92-24-01 Change in Report of Need Form (Supplements APD #89-24-02)

--93-24-01 Protective Services Investigations

--93-24-02 Protective Services Investigations (supplements APD #93-18-01)

--97-24-01 Protective Services Report of Need and Investigation Summary and Assessment Form

--00-24-01 Perpetrator Designation and Notification in P.S. Cases

Program Area 13--''Personal Care''

--See APD #00-01-07.

Program Area 12--''Home Health''

--See APD #00-01-07.

Program Area 19--''Home Support''

--See APD #00-01-07.

Program Area 20--''Adult Day Care''

--See 6 Pa. Code Chapter 11, Sections 11.1 to 11.292.

Program Area 25--''Domiciliary Care''

--85-25-02 Statewide Expansion of Domiciliary Care Program

--90-25-01 Domiciliary Care Services for Adults--Final Rule making

--93-25-01 Keys Amendment Implementation as It Relates to the Domiciliary Care Program

--00-25-01 Domiciliary Care Consumer Payment To Providers

Program Area 09--''Legal Assistance''

--85-09-01 AAA Program of Legal Services to the Elderly

Program Area 10--''Ombudsman''

--98-10-01 Long-Term Care Ombudsman Program

Program Area 14--''Personal Assistance Service''

--See APD #00-01-07.

Program Area 18--''Medical Equipment, Supplies and Adaptive Devices''

--See APD #00-01-07.

Program Area 29--''Other''

--85-29-01 Changes in PSA Boundaries

--85-29-02 Generic Policies and Procedures for the Request and Consideration of Waivers of PDA Policies

--85-29-04 PDA Fair Hearings and Appeals Regulations

--85-29-06 Interdepartmental Cooperative Agreement between the PDA and DPW, Office of Mental Health

--86-29-01 PACE Regulations

--91-29-05 Department of Aging Energy Emergency Plan

--92-29-03 Final Regulations--Family Caregiver Support Program (replaces Sections I-V of APD 92-22-02)

--92-29-07 Advance Notice to Health Care Facilities Prior to Termination of Utility Service

--94-29-04 Emergency Operations Plan for the Department of Aging (rescinds APD #92-22-04)

--96-29-01 Statement of PDA Intent Re: Allocation To New Area Agencies

--97-29-01 Retention of AAA Records

--97-29-02 Emergency Operations Plan for the Department of Aging.

--98-29-01 List of Current Aging Program Directives (APDs) and Options Level II bulletins

--00-29-01 Department of Aging Energy Emergency Response Plan


--90-05 Protocol Requirements for Serving Medicaid Nursing Home Applicants and Medical Assistance Recipients with Acquired Immune Deficiency Syndrome (AIDS) or Symptomatic Immune Deficiency Virus (HIV)

--90-07 Transmit DPW/OMA Memo (8/30/90)

--90-08 Policy Change in Referral Procedures for Individuals with Mental Retardation/Other Related Condition Diagnosis

--95-01 Medical Assistance (MA) Estate Recovery Program (supplements OPTIONS-Level II Bulletin #93-01)



Bureau of Animal Health and Diagnostic Services

*  Scrapie Containment and Eradication Strategy

Contact: Phillip Debok (717-783-8300)

*  Chronic Wasting Disease Containment and Eradication Strategy

Contact: Phillip Debok (717-783-8300)

Bureau of Plant Industry

*  Fertilizer, Soil Conditioner and Plant Growth Substance Enforcement Action Penalty Matrix

Contact: John Breitsman (717-787-4843)

*  Pesticide Enforcement Action Penalty Matrix

Contact: Joseph Uram (717-787-4843)

Pennsylvania State Conservation Commission

*  Pennsylvania's Nutrient Management Plan Implementation Grants Program Application Form and Guidelines

Contact: Karl Brown (717-787-8821)


Bureau of Animal Health and Diagnostic Services

*  Pennsylvania Animal Diagnostic Laboratory System User Guide

Contact: Dr. Helen Acland (717-787-8808)

Bureau of Food Distribution

*  Farmers Market Nutrition Program--Farmer/Vendor Procedure Manual

*  Woman, Infants and Children (''WIC'') Clinic Procedure Manual

*  Self Declaration of Need: Income Poverty Guidelines for TEFAP

Contact: Edward Wadlinger (717-787-2940)

Bureau of Food Safety and Laboratory Services

*  rBST Labeling Information

*  Application to Install or Remodel a Milking System

*  Supplement to a Farm Refrigerated Bulk Milk Storage Tank and/or a Precooler Installation Application

Contact: James C. Dell (717-787-4316)

*  Model Food Service Self-Inspection Checklist

*  Ice Manufacturing Plants Consumer Confidence Program Guidelines

*  Listeria Handbook for Retail Food Establishments

*  Procedures for Vacuum Packaging Foods in Reduced Oxygen Packages

*  Retail Food Establishment Consumer Confidence Program Self-Inspection Checklist

Contact: Lenchen Radle (717-787-4315)

Pennsylvania Harness Racing Commission

*  Guidelines for Medications in Racehorses

Contact: Anton J. Leppler (717-787-5196)

*  Licensing Procedures and Standards for Applicants

Contact: Anton J. Leppler (717-787-5196)

Pennsylvania Horse Racing Commission

*  Guidelines for Medications in Racehorses

Contact: Benjamin H. Nolt, Jr. (717-787-1942)

Bureau of Plant Industry

*  Instructions for Licensing under the Pennsylvania Commercial Feed Law

*  Instructions for Licensing under the Pennsylvania Fertilizer, Soil Conditioner and Plant Growth Substance Law

*  Directions for Reviewing Specialty Fertilizer Registration in Pennsylvania

*  Instructions for Licensing under the Pennsylvania Agricultural Liming Materials Act

Contact: John Breitsman (717-787-4843)

*  Directions for Registering Pesticides in Pennsylvania

*  Experimental Pesticide Use Permits

*  Grower Record Keeping Guidelines for Pesticide Applications made under an Emergency Exemption

*  Directions for Soil Conditioner and Plant Growth Substance Registration in Pennsylvania

Contact: John Lake (717-787-4843)

*  IPM for Pennsylvania Schools: A How-To Manual

Contact: Lee B. Bentz (717-772-5204)

Bureau of Ride and Measurement Standards

*  Amusement Ride Operators' and Attendants' Manual

Contact: Charles Bruckner (717-787-6772)

Pennsylvania State Conservation Commission

*  Best Management Practices Manual for Pennsylvania Livestock and Poultry Operations

Contact: Karl Brown (717-787-8821)

*  Pennsylvania's Nutrient Management Act Technical Manual

Contact: Karl Brown (717-787-8821)


Bureau of Farmland Protection

*  Checklist for Review of an Agricultural Conservation Easement Purchase Recommendation

*  Checklist for Evaluation of a County Agricultural Conservation Easement Purchase Program

Contact: Raymond Pickering (717-783-3167)

Bureau of Food Safety and Laboratory Services

*  Summary of Enforcement Requirements for Violations of Bacterial Count, Somatic Cell Count and Antibiotic Residue Tests for Individual Milk Producer Samples

*  Clarification of Enforcement Policy for a Producer Utilizing Two Bulk Milk Tanks

Contact: James C. Dell (717-787-4316)

*  Tolerances for Egg Quality, below which a Warning Letter shall be issued to a store

*  Tolerances for Egg Quality, below which Seizure of Eggs will be made at a store

*  Tolerances for Egg Quality, below which Prosecution will be initiated against a store

*  Tolerances for Egg Quality, below which Seizure of Eggs will be made at a plant

Contact: Kim F. Miller (717-787-3294)

*  Guidelines for Inspection of Food Concessions at Fairs

*  Inspection Guidelines for Farmers Markets and Stands

Contact: Lenchen Radle (717-787-4315)

Bureau of Market Development

*  Agricultural Fair Program State Premium Guideline Book

Contact: Ron Miller (717-787-5342)

Bureau of Plant Industry

*  Turfgrass Seed Certification Interagency and Interstate Certification

Contact: Joe Garvey (717-787-5609)

*  Plant Pest Act Enforcement Action Penalty Matrix

Contact: Walt Blosser (717-772-5205)

Pennsylvania Harness Racing Commission

*  Procedures with respect to Unlicensed Owners

Contact: Anton J. Leppler (717-787-5196)


Bureau of Food Safety and Laboratory Services

*  Industry Responsibilities with respect to Broken Seals

Contact: James C. Dell (717-787-4316)

*  Temperature Requirements for Safe Handling of Hot and Cold Foods

*  Guidelines for Self-Service Bulk Food Displays

*  Guidelines for Maple Syrup Operations

Contact: Lenchen Radle (717-787-4315)

Bureau of Plant Industry

*  Pennsylvania Pesticide Hypersensitivity Registry Fact Sheet

Contact: John C.R. Tacelosky (717-787-4843)


   Nonregulatory public documents of the Department of Banking are divided into three indexed categories listed below: Letters from Secretaries of Banking to Regulated Entities; Guidance Available Regarding Compliance with Depository Institution Statutes and Regulations; and, Guidance Available Regarding Compliance with Licensee Statutes and Regulations. The contact person for all Department of Banking documents is David H. Bleicken (717) 787-1471.

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