FFS Memos-2017 FFS Memos-2016 FFS Memos-2015 FFS Memos-2014 ACS Memos-2013 ACS Memos-2012 ACS Memos-2011 ACS Memos-2010 ACS Memos-2009
ACS Memos-2008 ACS Memos-2007 ACS Memos-2006 ACS Memos-Miscellaneous
Provider Pharmacy Memos

The following memos are available for download. You will need Adobe Acrobat Reader to view these files.

ADM Memos

ADM Memos-2014

• ADM-1406 Electronic Health Record Survey
• ADM-1405 Bill Type 89X

ADM Memos-2013

• ADM-1319 Allowable Bill Types for Long Term Care Facility Services
• ADM-1317 Coverage of Topical Fluoride Varnish Application
• ADM-1312 Implementation of the Hawaii Medicaid EHR Incentive Program

ADM Memos-2012

• ADM-1221 Implementation of Payment of Services Reimbursement Increases for Primary Care Physicians (PCP) for Calendar Years (CY) 2013 and 2014
• ADM-1215 Transition of Dental Claims Contract to Hawaii Dental Services (HDS) Effective January 16, 2013
• Hawaii Medicaid Dental Transition Calendar

ADM Memos-2010

• ADM-1007 Clarification on Consultation Codes

Xerox State Healthcare Memos (ACS)

FFS Memos-2017

• FFS M17-02 Medicaid Fee-For-Service (FFS) Dental Program Dental Formulary
• FFS M17-01 Tele-Health Law (Act 226, SLH 2016) Implementation

FFS Memos-2016

• FFS M16-07 Affordable Care Act (ACA) 1557 Requirements and Compliance
• FFS M16-05 Medicaid Benefits for the Prevention of Zika Virus Transmission
• FFS M16-04 Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
• FFS M16-03 Hawaii Medicaid Quest Integration (QI) Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
• FFS M16-01 2016 Dental TPA Contract to Hawaii Dental Service (HDS) Effective July 1, 2016

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FFS Memos-2015

• FFS M15-14 Medicaid Hospice Rates - Effective October 1, 2015 Through December 31, 2015 and January 1, 2016 Through September 30, 2016
• FFS M15-13 Revised DHS 1178 Form for Preadmission Screening Resident Review (PASRR)
• FFS M15-13 Attachment Part A, B, C
• FFS M15-12 Revised Guidelines for Submittal and Payment of Induced/Intentional Termination of Pregnancy (ITOP) Claims
• FFS M15-11 lCD-10 Conversion Guidelines
• FFS M15-10 Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
• FFS M15-09 Allowable Bill Types for Intermediate Care Facility (ICF) and Sub-Acute Services
• FFS M15-08 Hawaii Medicaid Quest Integration Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
• FFS M15-07 Preadmission Screening Resident Review (PASRR)
• FFS M15-06 Transition of Care for State-Funded Medical Assistance Program Beneficiaries
• FFS M15-05 Universal Precautions for Quest Integration Members Receiving At-Risk and Home and Community Based Services
• FFS M15-04 Transition of State of Hawaii Organ and Tissue Transplant (SHOTT) Program Contractor
• FFS M15-02A Cost of Living Adjustment (COLA)/Federal Poverty Level (FPL) - UPDATED
• FFS M15-01 Allowable Bill Types for Long Term Care Facility Services

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FFS Memos-2014

• FFS M14-17 QUEST Integration Implementation
• FFS M14-16 Transition of Care - Clarification on Financial Responsibility Roles
• FFS M14-15A Enhanced Reimbursement to Eligible Primary Care Physicians for Certain Primary Care Services
• FFS M14-15 Six-Month Extension of Enhanced Reimbursement to Eligible Primary Care Physicians for Certain Primary Care Services
• FFS M14-13 Screening Employees and Contractors for Individuals and Entities Excluded from Participation in Federal Healthcare Programs
• FFS M14-10 Benefits to Medicaid Beneficiaries
• FFS M14-05 ICD-10 Conversion Guidelines for FFS Providers
• FFS M14-04 Bill Type 89X
• FFS M14-03 Provider Applications for Federally Qualified Health Centers (FQHCs) & Rural Health Centers (RHCs) Providers

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ACS Memos-2013

• FFS M13-11 Coverage of Topical Fluoride Varnish Application
• ACS M13-09 Implementation of the Hawaii Medicaid EHR Incentive Program
• ACS M13-08 Recovery Audit Contractor (RAC) Services
• ACS M13-07 Medical Record Documentation Requirements
• ACS M13-06 Discontinuation of Automated Prior Authorization (PA) Process for FFS Prescriptions
• ACS M13-05 Med-QUEST Division and Medicare�s PECOS Requirements
• ACS M13-04 Medicaid Fee-For-Service Program Pharmacy Reimbursement Changes
• ACS M13-03 Reporting Requirement of Non-340B Medications to Comply with the Affordable Care Act (ACA) Medicaid Medication Rebate Program
• ACS M13-02 Changes to Psychotherapy Codes for Fee-For-Services (FFS) Reimbursement Effective January 1, 2013
• ACS M13-01 Transition of Community Care Services (CCS) Program Contractor

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ACS Memos-2012

• ACS M12-12B Reminder on Self-Attestation of Primary Care Physicians for Receipt of Reimbursement Increases For Primary Care Services for CY 2013 and CY 2014
• ACS M12-12A Information on Self-Attestation of Primary Care Physicians for Receipt of Reimbursement Increases For Primary Care Services for CY 2013 and CY 2014
• ACS M12-12 Implementation of Payment of Services Reimbursement Increases for Primary Care Physicians (PCP) for Calendar Years (CY) 2013 and 2014
• ACS M12-11 Provider Reimbursement for EPSDT Services in Third-Party Liability (TPL) Claims
• ACS M12-10 Transition of Dental Claims Contract to Hawaii Dental Services (HDS) Effective January 16, 2013
• Hawaii Medicaid Dental Transition Calendar
• ACS M12-09 Guidelines for Submittal and Payment of Intentional Termination of Pregnancy (ITOP) Claims
• ACS M12-08B Criminal History Record and Registry Check Process Update
• ACS M12-08A Criminal History Record and Registry Check Process Update
• ACS M12-08 Criminal History Record and Registry Check Process
• ACS M12-06 Annuity Documentation for Medicaid Long-Term Care Services (LTCS) Coverage
• ACS M12-04 Medicaid Processing of 340B Medications
• ACS M12-02 Federally Qualified Health Centers and School-Based Dental Services
• ACS M12-01 Supervision Requirements for Behavioral Health Providers in FQHCs and RHCs

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ACS Memos-2011

• ACS M11-12 Elective Caesarean Section � Not Covered
• ACS M11-11 Payment Error Rate Measurement (PERM) Provider Education Calls by Centers for Medicare and Medicaid Services (CMS)
• ACS M11-10 Interpretive Rules on Level of Care Evaluation Forms (1147s)
• ACS M11-08 New Process for Requesting Reimbursement of Nurse Aide Training Competency Evaluation Program Testing Fees
• ACS M11-06 Non-Emergency Transportation Policy revisions
• ACS M11-05 Provider Exclusion/Reinstatement List on MQD Website
• ACS M11-04 Behavioral Health Providers Billing for Medicaid Rehabilitation Option Services
• ACS M11-03 Reimbursement to FQHCs for Retinal Imaging and Interpretation
• ACS M11-02 Changes in Oxygen Reimbursement
• ACS M11-01 EPOGEN Overpayments

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ACS Memos-2010

• ACS M10-18 Hospice Care for Children Related to Affordable Care Act (ACA)
• ACS M10-16 Clarification on Billing Hearing Aid Related Services for Early Intervention (0 to 3) Client
• ACS M10-09B Guidance of Health Plan Reimbursement to Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs)
• ACS M10-09A Guidance of Health Plan Reimbursement to Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs)
• ACS M10-09 Guidance of Health Plan Reimbursement to FQHCs and RHCs
• ACS M10-05 Exclusion from all Federal Health Care Programs
• ACS M10-03 Medicaid Payment for Long-Term Care Services
• ACS M10-02 Clarification on Epogen Reimbursement and Composite/Epogen Rates

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ACS Memos-2009

• ACS M09-29 Standards Regardign the Reputable and Responsible Character of H&CBS Providers
• ACS M09-28 Audits by Medicaid Integrity Contractors (MICs)
• ACS M09-26 Clarification on the 1147 Functional Points Instruction
• ACS M09-25 Clarification to Oxygen Rental Criteria in the Medicaid Provider Manual
• ACS M09-24 Coordination of Benefits for QExA clients
• ACS M09-18 Acute Care Hospital Costs for DOH/CAMHD Clients
• ACS M09-16 Non-Emergency Transportation Policy Adherence
• ACS M09-15 Medicaid Fee Schedule Changes
• ACS M09-14 Drugs Prescribed by Dentists for QUEST or QUEST Expanded Access (QExA) Recipients
• ACS M09-13 Change in Prior Authorization Requirements for Nicotine Replacement Therapy
• ACS M09-11 Level of Care Evaluations (1147) Deferrals
• ACS M09-10 Coordination of Benefits (COB) and Cross-over Claims
• ACS M09-09 Prior Authorization Denials
• ACS M09-08 Clarification and Changes in Policies and Prior Authorization Requirements for Hearing Aid Related Services
• ACS M09-07 Final Nursing Facility Level of Care Determination Forms (1147) for QExA Implementation
• ACS M09-06 Proper Billing for Non-Emergency Transportation Services
• ACS M09-01 Changes in Completing the Medicaid Census Report

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ACS Memos-2008

• ACS M08-23 Fee-For-Service (FFS) Program Only
  1. Quest Expanded Access (QExA) Program for FFS Recipients - Effective February 1, 2009
  2. Behavior Health Management Change - Efffective January 1, 1009
• ACS M08-22 Incident Reports
• ACS M08-20 Community Review of 1147 Forms for QUEST Expanded Access (QExA) Implementation
• ACS M08-19 Fee-For-Service (FFS) Program Only
  1. Quest Expanded Access (QExA) Program for FFS Recipeints - Effective February 1, 2009
  2. Medicaid Drug Federal Upper Limits (FUL) Updates - Effective November 6, 2008 and November 28, 2008
• ACS M08-18 Exclusion from all Federal Health Care Programs
• ACS M08-16 Medicaid (G) Codes for Screening and Brief Intervention for Alcohol and Substance Abuse HCPCS Codes G0396 & G0397
• ACS M08-12 Pharmacy Claims for Drugs Prescribed by Dentists for QUEST Recipients are Processed by Medicaid Fee-For-Service (FFS)
• ACS M08-10 Fee Schedule - Neighbor Island
• ACS M08-09 VOID

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ACS Memos-2007

• ACS M07-23 Changes to Medicare Payment Methodologies
• ACS M07-22 Addiitonal Changes in Prior Authorization Requirements and Clarifications
• ACS M07-22 Attachment A - DME/Supplies Not Requiring Prior Authorization
• ACS M07-17 Clarification and Changes in Prior Authorization Requirements for Vision Services
• ACS M07-17 Attachment (CERTIFICATION OF VISION SERVICES AND SUPPLIES)
• ACS M07-13 Tamper-Resistant Paper Prescriptions are Required for Medicaid Reimbursement Effective October 1, 2007
• ACS M07-13A and Attachment Tamper-Resistant Prescription paper and/or Pads (TRPP) TO USE EFFECTIVE October 1, 2007 and FAQ's
• ACS M07-13B REVISION: Tamper-Resistant Prescription paper (TRPP) TO USE, EFFECTIVE: April 1, 2008
• ACS M07-13C Tamper Resistant Prescription Pad Clarification of Population Covered and Recommended Features for Hawaii Medicaid
• ACS M07-13D Prescribers Required To Use Tamper Resistant Prescription Pads (TRPP) April 1, 2008 For Written Prescriptions; Pharmacists Contact Prescribers If TRPP Not Used
• ACS M07-13E Tamper Resistant Prescription Pad (TRPP) Clarification of Recommended Features for Hawaii Medicaid Effective October 1, 2008
• ACS M07-06 State Approved Feeding Assistants Training Program (FATP)
• ACS M07-03 Clarification of Enternal Supplies used for Medicaid Eligibles

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ACS Memos-2006

• ACS M06-18 Clarification and Changes in Prior Authorization Requirements
• ACS M06-17 Revised DHS Form 208
• ACS M06-13 Specialty Care for QUEST Members under Age 21 Who Reside on a Neighbor Island
• ACS M06-11 Medicare Denial Code PR49
• ACS M06-10 2005-0414-06 TPL Coverage Type on Web
• ACS M06-08 2005-0414-03 TPL Information on 271
• ACS M06-07 Billing for Pre-Natal Services and Deliveries
• ACS M06-03 Formal 1147 Denial Process

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