QI-2523- Practice Guidelines on Developmentally Appropriate Mental Health Assessment and Diagnosis for Med-QUEST Members Through Five Years Old (Attachments)
QI-2522 - Medicaid Fee-For-Service and Quest Integration Hospice Rates Effective October 1, 2025 - September 30, 2026
QI-2521- Hospital Quality P4P Guidance for Measurement Year 2025 (Replaces QI-2512)
QI-2516 - Implementation of Managed Care Encounter Reconciliation (MCER) Mainframe Process
QI-2515 - Medicaid Fee-For-Service Rates for All Nursing Facilities Effective July 1, 2025
QI-2514 - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective July 1, 2025 - December 31, 2025
QI-2513 - Adverse Event Report (AER) Form and Instructions
QI-2512- Hospital Quality Pay for Performance Guidance for Measurement Year 2025
QI-2511 - Managed Care Organization (MCO) Pay for Performance Guidance for Measurement Year 2025 Regarding Measure Weighting and LTSS Benchmark
QI-2508 - Implementation of Encounter Edits P406 & P375
QI-2507A- Payment Suspension To Provider - Samuel Mahelona Memorial Hospital (Attachment)
QI-2507 - Payment Suspension To Provider - Samuel Mahelona Memorial Hospital (Attachment)
QI-2505 - Plan Staff Services Reporting (Replaces QI-2323A)
QI-2503- Med-QUEST Guidance on Medicaid Coverage of Routine Patient Costs Furnished in Connection with Participation in Qualifying Clinical Trials (Replaces QI-2209) & Attachment A
QI-2502 - My Choice My Way - Long Term Services and Support (LTSS) Choice Form
QI-2501A - Fee for Service Rates for HCBS eff 1.1.2025
QI-2501 - Fee For Service Rates For Home and Community-Based Services (HCBS) Effective January 1, 2025
QI Memos - 2024
QI-2431- Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD) Guidelines for Applied Behavioral Analysis (ABA) - (Replaces QI-2301)
QI - 2430A- Community Palliative Care Benefit Implementation (Update to QI-2430)
QI-2430 - Community Palliative Care Benefit Implementation
QI-2429 - Requirement for all Providers to Register with HOKU, Including Referring, Ordering, Prescribing and Attending (ROPA) Providers
QI-2428 - Medicaid Fee-For-Service FHQH & RHC PPS Rates Effective January 1, 2025 - December 31, 2025
QI-2427 - Medicaid Fee-For-Service Rates for All Nursing and Hospice Facilities Effective January 1, 2025 - June 30, 2025
QI-2426- Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective January 1, 2025 - June 30, 2025
QI-2425A - Payment Suspension to Provider - Hale Makua - Kahului - (Replace QI-2425)
QI-2425 - Payment Suspension to Provider - Hale Makua - Kahului (Attachment)
QI-2421 - Managed File Transfer (MFT) 12 Character Minimum Password Effective January 1, 2025
QI-2420 - Medicaid Fee-For-Service and Quest Integration Hospice Rates Effective October 1, 2024 - September 30, 2025
QI-2419A - QUEST Integration (QI) Rolling Plan Change and Transition Of Care (TOC) Files (Addendum)
QI-2419 - Quest Intergration (QI) Rolling Plan Change and Transition of Care (TOC)
QI-2416 - Revisions to the Health and Functional Assessment (HFA)
QI-2415 - Health Plan Submission (HPS) File Changes Effective July 1, 2025
QI-2414 - Exception to HRS Chapter 388 – Self Direct Provider
QI-2413 - Medicaid Fee-For-Service Rates for All Nursing and Hospice Facilities Effective July 1, 2024
QI-2412 - Managed Care Organization Pay for Performance Guidance for Measurement Year 2024 regarding Measure Weighting and Long Term Services and Support Benchmark
QI-2411B - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective July 1, 2024 - December 31, 2024 (Replaces QI-2411A)
QI-2411A - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective July 1, 2024 - December 31, 2024 (Addendum to QI-2411)
QI-2411 - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective July 1, 2024 - December 31, 2024
QI-2410 - Zero Pay Encounter Submissions Related to Coordination of Benefits (COB) Claims
QI-2409 - Shareinfo - New Instructions To The Health Plans
QI-2318 - Temporary Payments to Wahiawa General Hospital for Waitlist-Only Stays
QI-2317C - Covid-19 Pandemic Aciton Plan for QI Health Plans - Part VIII (Update to QI-2317B)
QI-2317B- Covid-19 Pandemic Action Plan for QI Health Plans - Part VIII (Update to QI-2317A)
QI-2317A- Covid-19 Pandemic Action Plan for QI Health Plans - Part VIII (Update to QI-2317)
QI-2317- Covid-19 Pandemic Action Plan for QI Health Plans - Part VIII
QI-2316- Select Quest Integration (QI) and Community Care Services (CCS) Reports and Key Performance Indicators in Production Effective April 29, 2023; Process for Production Announcement and Oversight
QI-2315 - Requirement for all Providers to Register with Hoku
QI-2314D Community Integration Services (CIS+) Implementation Updated Guidelines: Medical Respite - October 2025 (Update to QI-2314C)
QI-2314C - Community Integration Services (CIS) Implementation Updated Guidelines: CIS Data and Reporting (Update to QI-2314B) (Appendix H - CIS Process Flow)
QI-2314- Community Integration Services (CIS) Implementation Updating Guidelines: Roles and Responsibilities, Forms, Billing and Payment
QI-2313 - Medicaid Fee-For-Service (FFS) Hospice Nursing Facilities Rates Effective January 1, 2023 - June 30, 2023
QI-2312 - Medicaid Fee-For-Service (FFS) Dental Program Dental Formulary
QI-2310- Home and Community-Based Services Settings Final Rule Guidance for Implementation and Provider Compliance Monitoring
QI-2309- Special COVID-19 Pandemic Payment for HCPCS Level II Code M0201
QI-2308- Home and Community Based Services Settings Final Rule Provider Implementation and Ongoing Compliance Monitoring
QI-2307- Managed Care Organization (MCO) Pay for Performance Guidance for Measurement Year 2023 Regarding Measure Weighting and LTSS Benchmark
QI-2306 - (Replaced by QI-2338) - Real-Time Audio-Only Interaction Policy After the Federal Public Health Emergency Related to the Covid-19 Pandemic Expires
QI-2305C - Electronic Visit Verification (EVV) Manual Editing and Entry of Visits (Update to QI-2305B)
QI-2305B - Electronic Visit Verification (EVV) Manual Editing and Entry of Visits (Update to QI-2305A)
QI-2305A - Electronic Visit Verification (EVV) Manual Editing and Entry of Visits (Update to QI-2305)
QI-2305 - Electronic Visit Verification (EVV) Manual Editing and Entry of Visits (Replaces QI-2223)
QI-2304 - Requirement for QI-2121 Providers with Extensions to Register by Extended Deadline
QI-2303- Medicaid Fee-For-Service Rates for Emergency Air Ambulace Services Effective January 1, 2023
QI-2302 - Payment Suspension to Provider - Bryant LaPorte, DDS
QI-2301- Coverage of Intensive Behavioral Therayp (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
QI Memos - 2022
QI-2229- Community Care Foster Family Home (CCFFH) and Expanded Adult Residential Care Home (EARCH) Rates for Home and Community Based Services (HCBS) Effective January 1, 2023
QI-2228 - Adult Dental Benefits Effective January 1, 2023
QI-2227 - Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
QI-2226A - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2023 through December 31, 2023 (Addendum to QI-2226)
QI-2226- Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2023 through December 31, 2023
QI-2225- Medicaid Fee-For-Service Rates Effective January 1, 2023
QI-2224- Self Direct (SD) Rates for Home and Community Based Services (HCBS) Effective October 1, 2022
QI-2223- (Replaced by QI-2305) - Electronic Visit Verification (EVV) Manual Editing and Entry of Visits
QI-2222- DHS 1139 Medicaid Provider Enrollment Form and Home and Community-Based Services Settings Final Rule
QI-2221- Managed Care Organization (MCO) Pay for Performance Guidance for Measurement Year 2023 and Measurement Year 2026
QI-2220A- (Replaces QI-2220) - Managed Care Organization Pay for Performance Guidance for Measurement Years 2021 and 2022
QI-2220 - (Replaced by QI-2220A) - Managed Care Organization Pay for Performance Guidance for Measurement Years 2021 and 2022
QI-2219 - Quest Integration (QI) Transition of Care (TOC FILES)
QI-2218 - Payment Suspension to Provider - Michael Izumi, DDS
QI-2217 - RESCINDED Payment Suspension to Provider - Jennifer Grace Shaw, LMHC (Replaces QI-1606)
QI-2216- Health Functional Assessment (HFA) Cohort Approach Pilot
QI-2215 - Medicaid Fee-For-Service and Quest Integration Hospice Rates Effective October 1, 2022 through
September 30, 2023
QI-2214- Change in Reprocessing Pended EVV Encounters
QI-2213 - (Replaces QI-1715) - Clarification of reporting requirements for medications provided by 340B contract pharmacies to QUEST Integration (QI) and Community Care Services (CCS) Members
QI-2210 - Medicaid Fee-For-Serviice Rates - Effective July 1, 2022
QI-2209 - Medicaid Fee-For-Service Hospice Nursing Facilitiies Rates - Effective July 1, 2022 - December 31, 2022
QI-2208- Med-QUEST Guidance on Medicaid Coverage of Routine Patient Costs Furnished in Connection with Participation in Qualifying Clinical Trials (Replaces QI-2150)
QI-2207A - Auto Assignment Algorithm for QI Members eff 1.1.27-12.31.27-signed (Addendum to QI-2207)
QI-2207- Auto Assigment Algorithm for Quest Integration (QI) Members - Effective July 1, 2022 - December 31, 2026
QI-2206- APR DRG Billing Guidance (Update to QI-2116A)
QI-2205 - Requirements for Health Plans to Submit NDC Code and NCPDP Units on Encounters
QI-2204A- COVID-19 Home Test Kits (NON-PCR) (Replaces QI-2204)
QI-2204- (Replaced by QI-2204A) - COVID-19 Home Test Kits (NON-PCR)
QI-2203- Requirement for Health Plans to Submit the CN1 Segment on Encounters (Replaces QI-2124)
QI-2202- Emergency Transportation to Alternative Destinations
QI-2201 - Medicaid Fee-For-Service Hospice Nursing Facilities Rates - Effective January 1, 2022 - June 30, 2022
QI Memos - 2021
QI-2167 - Community Care Foster Family Home (CCFFC) and Expanded Adult Residential Care Home (EARCH) Rates for Home and Community Based Services (HCBS) Effective January 1, 2022
QI-2166 - Medicaid Fee-For-Service Rates - Effective January 1, 2022 - June 30, 2022
QI-2165 - Medicaid Fee-For-Service FQHC & RHC PPS Rates - Effective January 1, 2022 - December 31, 2022
QI-2163- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Data Requirements for Health Plans
QI-2162- QUEST Integration (QI) Transition of Care (TOC) Files
QI-2150 - (Replaced by QI-2208) - MED-QUEST Guidance Regarding the Coverage of Routine Costs Associated with Qualifying Clinical Trials (Replaces QI-1934)
QI-2149 - QUEST Integration Coverage for Our Care, Our Choice Act (End of Life Care Option) (Replaces QI-1927)
QI-2148 - Support ACT MED-QUEST Division Minimum Standards Effective October 1, 2019 (Replaces QI-1926)
QI-2147 - Guidelines and Procedures for Transportation, Meals, and Lodging Associated with Approved Inter-Island and Out-of-State Medical Services (Replaces QI-1921)
QI-2146 - Primary Care Physicians (PCP) Managed Care Enhanced Reimbursement (Replaces QI-1918)
QI-2145 - Revised Grievances and Appeals Templates (Replaces QI-1909) (Attachments)
QI-2144- Coordination of Services Between QUEST Integration and the 1915(c) Home and Community Based-Services Waiver for a Member Under the Age of Twenty-One (21) with Intellectual and/or Developmental Disabilities (Replaces QI-1821)
QI-2137- Pregnancy Intention Screening and Contraceptive Coverage (Replaces QI-1613)
QI-2136 - Universal Precautions for QUEST Integration Members Receiving At-Risk and Home and Community Based Services (HCBS) (Replaces QI-1507)
QI-2135- Revised Instuctions to CMS-416 Report (Replaces QI-1426)
QI-2134 - Home and Community Based Services Policy Guidance for Environmental Accessiblity Adaptations/Home Modifications, Moving Assistance and Specialized Medical Equipment and Supplies (Replaces QI-1420)
QI-2133 - Member Expedited Appeal Procedures (Replaces QI-1416A)
QI-2132- At Risk for Institutional Level of Care Criteria (Replaces QI-1406)
QI-2131 - Supervision Requirements for Behavioral Health Providers in FQHCs and RHCs (Replaces ADM-1201)
QI-2130 - Elective Caesarean Section - Not Covered (Replaces BEN-1101)
QI-2129 - Medicaid Fee-For-Service and Quest Integration Hospice Rates effective October 1, 2021 - September 30, 2022
QI-2128 - Updated Guidelines for Health Coordination Assessments and Health Action Plans for Members Living in a Community Care Foster Family Homes (CCFFH), Expanded Adult Residential Care Homes (EARCH) and Assisted living Facilities (ALF)
QI-2127- Auto Assignment Algorithm for QUEST Integration (QI) Members effective January 1, 2022 - December 31, 2022
QI-2126A-COVID-19 Monoclonal Antibody Treatment - FQHC/RHC Reimbursement for Administration
QI-2126- COVID-19 Monoclonal Antibody Treatment - FQHC/RHC Reimbursement for Administration
QI-2125- Home Care Agency Providers of Home and Community Based Services 1915(c) Intellectual and Developmental Disabilities (I/DD) Waver Providers
QI-2125- Home Care Agency Providers of Home and Community Based Services 1915(c) Intellectual and Developmental Disabilities (I/DD) Waver Providers (ATTACHMENT)
QI-2124- (Replaced by QI-2203) - Requirement for Health Plans to Submit the CN1 Segment on Encounters
QI-2123- Covid-19 Pandemic Action Plan for QI Health Plans - Part VII
QI-2121- Requirement for Providers to Register with Hoku
QI-2120 - Continued Coverage of Audio-Only Visits Through Federal Public Health Emergency (PHE)
QI-2119 - Medicaid Provider Enrollment for Personal Care Service Agencies and Home Health Care Agencies under the 21st Century Cures Act
QI-2118 - Provider Master Registry (PMR) File and Provider Type
QI-2117- Mandatory Pickup/Dropoff Locations for Non-Emergency Transportation (ATTACHMENT)
QI-2117- Mandatory Pickup/Dropoff Locations for Non-Emergency Transportation
QI-2116A - (Updated by QI-2206) - Implementation of all Patients Refined Diagnosis Related Groups (APR DRG)
QI-2116 - Implementation of all Patients Refined Diagnosis Related Groups (APR DRG)
QI-2115- Auto Assignment Algorithm for Quest Integration (QI) Members effective July 1, 2021 - December 31 2021
QI-2113B - Medicald Fee-For-Service Rates effective July 1, 2021 (Addendum to QI-2113A)
QI-2113A - Medicaid Fee-For-Service Rates effective July 1, 2021 (Addendum to QI-2113)
QI-2113- Medicaid Fee-For-Service Rates effective July 1, 2021
QI-2112- Medicaid Fee-For-Service Hospice Nursing Facilities Rates effective July 1, 2021 - December 31, 2021
QI-2111- Community Integration Services (CIS) Rapid Cycle Assessments (RCAs)
QI-2109 - Hospice for Members Receiving Home and Community Based Services (HCBS)
QI-2108A - Payment Suspension to Providers (Hawaii Dental Clinic) (Addendum to QI-2108)
QI-2108 - Payment Suspension to Providers (Hawaii Dental Clinic)
QI-2107A - Covid-19 Pandemic Action Plan for QI Health Plans - Part VI (Addendum to QI-2107)
QI-2107 - Covid-19 Pandemic Action Plan for QI Health Plans - Part VI
QI-2106 - Medicaid Rural Health Clinic Prospective Payment System Dental Rates for Kahuku Medical Center - Effective October 12, 2020 through December 31, 2021
QI-2105 - Community Integration Services (CIS) Implementation Guidelines: Overview, Member Eligibility, Service Delivery, Coordination & Reimbursement
QI-2104A - CCFFH and EARCH Rates for HCBS (Addendum to QI-2104)
QI-2104- Community Care Foster Family Home and Expanded Adult Residential Care Home Rates for Home and Community Based Services Effective January 1, 2021
QI-2103 - Medicaid Eligibility for Freely Associated States Under the Compact of Free Association (COFA) Citizens
QI-2102 - Civil Rights Awareness Training Requirements
QI Memos - 2020
QI-2042 - Medicaid Fee-For-Service Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC) Prospective Payment System (PPS) Rates - Effective January 1, 2021 through December 31, 2021
QI-2041 - Medicaid Fee-For-Service Rates - Effective January 1, 2021 (Addendum to QI-2022)
QI-2040 - Medicaid Fee-For-Service Hospice Nursing Facility Rates for Hospice Hilo dba Hawaii Care Choices and St. Francis Hospice - Effective January 1, 2021
QI-2039- Dental Services Requiring General Anesthesia Performed in a Hospital Setting
QI-2038 - Orally Administered Drugs to Terminate a Pregnancy During the Public Health Emergency
QI-2037A - COVID-19 Pandemic Action Plan for QI Health Plans - Part V (Addendum)
QI-2037 - COVID-19 Pandemic Action Plan for QI Health Plans - Part V
QI-2036- Telehealth Guidance During the Public Health Emergency related to EPSDT Visits
QI-2035 - Suspension to Provider (Paul A. Kaiwi Jr.)
QI-2033- COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured
QI-2032 - Medicaid Fee-For-Service Hospice Rates - Effective Octobr 1, 2020 through September 30, 2021
QI-2031 - QUEST Integration (QI) Transition of Care (TOC) Files
QI-2020 - Coverage of Services for Autism Spectrum Disorder via Telehealth
QI-2019 - Updated DHS 1145 - Hysterectomy Acknowledgement Form and Rescinding 1146 - Sterilization - Consent Form Change
QI-2018 - Quality Portion of Auto-Assigment Algorithm for QUEST Integration (QI) Members
QI-2016- COVID-19 Pandemic Action Plan for QI Health Plans and Providers - Part IV
QI-2015 - COVID-19 Pandemic Action Plan for QI Health Plans - Part III
QI-2014 - COVID-19 Pandemic Action Plan for QI Health Plans - Part II
QI-2013 - Telehealth Guidance for Public Health Emergency - Telephonic Services and Services Billable by Qualified Non-Physician Health Care Professionals
QI-2012A- (Replaced by QI-2024) - Subacute Definitions (Addendum)
QI-2012 - (Replaced by QI-2024) - Subacute Definitions
QI-2011A - Clarification of Items and Services Carved Out from the Long Term Care PPS Rates (Addendum)
QI-2011 - Clarification of Items and Services Carved Out from the Long Term Care PPS Rates
QI-2010 - Telehealth Guidance During Public Health Emergency Related to COVID-19
QI-2009 - COVID-19 Pandemic Action Plan for QI Health Plans
QI-2008 - Federally Qualified Health Center Telehealth Guidance During Public Health Emergency Period in Response to COVID-19
QI-2007 - (Replaced by QI-2338) - Tele-Health Payment Guidance for Federally Qualified Health Centers (FQHC)
QI-2006B- New Provider Enrollment System - HOKU System Update (Addendum)
QI-2006A - New Provider Enrollment System - HOKU System Update (Addendum)
QI-2006 - New Provider Enrollment System - HOKU System Update
QI-2004 - Revised QUEST Integration Coverage for Our Care, Our Choice Act (End of Life Care Option)
QI-2003 - Community Integration Services (CIS) Data Requirements
QI-2002 - Payment Suspension to Provider (Philip Suh, MD) - Effective January 17, 2020
QI Memos – 2019
QI-1934 - (Replaced by QI-2150) - Med-QUEST Guidance Regarding the Coverage of Routine Costs Associated with Qualifying Clinical Trials
QI-1933 - Medicaid Fee-for-Service Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC) Prospective Payment Rates (PPS) - Effective January 1, 2020 through December 31, 2020
QI-1932A - Medicaid Fee-for-Service REVISED Hospice Nursing Facility Rate for Hospice Hilo - Effective January 1, 2020
QI-1932 - Medicaid Fee-for-Service Hospice Nursing Facility Rate for Hospice Hilo - Effective January 1, 2020
QI-1931 - Medicaid Fee-for-Service Hospice Nursing Facility Rate for St. Francis - Effective January 1, 2020
QI-1930A - Medicaid Fee-for-Service REVISED Hospice Rates - Effective January 1, 2020 through June 30, 2020
QI-1930 - Medicaid Fee-for-Service Hospice Rates - Effective January 1, 2020 through June 30, 2020
QI-1929 - Electronic Visit Verification (EVV) Service Codes and Modifiers
QI-1928 - QUEST Integration (QI) Transition of Care (TOC) Files
QI-1927- (Replaced by QI-2149) - QUEST Integraton Coverage for Our Care, Our Choice Act (End of Life Care Option)
QI-1926- (Replaced by QI-2148) - Support Act Med-QUEST Division Minimum Standards Effective October 1, 2019
QI-1925 - Medicaid Rural Health Clinic Prospective Payment System Rates for North Hawaii Clinics
QI-1924 - Provider Enrollment of Home and Community-Based Services (HCBS) Providers and Home Health Agencies
QI-1923 - Payment Suspension to Provider (Haumea Home Health Agency LLC) restored Effective September 10, 2019
QI-1922A- Medicaid Fee-for-Service Hospice Rates to include Malama Ola Health Services
QI-1922 - Medicaid Fee-for-Service Hospice Rates - Effective October 1, 2019 through September 30, 2020
QI-1921 - (Replaced by QI-2147) - Guidelines and Procedures for Transportation, Meals, and Lodging Associated with Approved Inter-Island and Out-of-State Medical Services [Replaces QI-1712, dated 07/21/17]
QI-1920 - Quality Portion of Auto Assignment Algorithm for QUEST Integration (QI) Members [Supersedes QI-1811]
QI-1919 - Payment Suspension to Provider (Evergreen Adult Day Care) restored Effective July 18, 2019
QI-1918 - (Replaced by QI-2146) - Primary Care Physicians (PCP) Managed Care Enhanced Reimbursement
QI-1917 - Out-of-State and Default Provider Type Clarifications
QI-1915A - Medicaid Fee-for-Service REVISED Hospice Nursing Facility Rates for Hospice Hilo - Effective July 1, 2019
QI-1915 - Medicaid Fee-for-Service Hospice Nursing Facility Rates for Hospice Hilo - Effective July 1, 2019
QI-1914A - Medicaid Fee-for-Service REVISED Hospice Nursing Facility Rate for St. Francis - Effective July 1, 2019
QI-1914 - Medicaid Fee-for-Service Hospice Nursing Facility Rate for St. Francis - Effective July 1, 2019
QI-1912 - Payment Suspension to Provider (Evergreen Adult Day Care) Effective June 7, 2019
QI-1911B - Medicaid Fee-for-Service REVISED Rates Effective July 1, 2019
QI-1911A - Medicaid Fee-for-Service REVISED Rates Effective July 1, 2019
QI-1911 - Medicaid Fee-for-Service Rates Effective July 1, 2019
QI-1908 - Update for Billing codes for Intensive Behavior Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
QI-1906 - Medicaid Fee-for-Service Hospice Nursing Facility Rate for Hospice Hilo - Effective January 1, 2019
QI-1905 - Medicaid Fee-for-Service Hospice Nursing Facility Rate for St. Francis - Effective January 1, 2019
QI-1902- Service Plan for Members Receiving Long Term Services and Supports (LTSS)
QI Memos – 2018
QI-1829 - Direct Acting Antiviral (DAA) Medications for Treatment of chronic Hepatitis C Infection
QI-1827 - Medicaid Rural Health Clinic (RHC) Prospective Payment System (PPS) Rates for Kaiser Foundation Health Clinics
QI-1826A - Annual Reporting and Monitoring Activities Period: January 1, 2019 - December 31, 2019 (Addendum)
QI-1826 - Annual Reporting and Monitoring Activities Period: January 1, 2019 - December 31, 2019
QI-1821 - (Replaced by QI-2144) - Coordination of Services Between QUEST Integration and the 1915(c) Home and Community Based-Services Waiver for a Member Under the Age of Twenty-One (21) with Intellectual and/or Developmental Disabilities
QI-1820 - Medicaid Fee-For-Services (FFS) Nursing Facility Rates Effective January 2, 2019 through June 30, 2019
QI 1813 - Hawaii Medicaid Quest Integration (QI) Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
QI 1812A - (Replaced by QI-2143) - Payment Suspension to Provider (PAC MED) supersedes
QI 1812 - Payment Suspension to Provider (PAC MED) Effective July 23, 2108
QI 1811- [Supercedes QI-1701] Quality Portion of Auto-Assignment Algorithm for QUEST Integration (QI) Members
QI 1810 - Medicaid Fee-For-Services (FFS) Hospice Nursing Facility Rate for St. Francis (Provider No. 251954) Effective July 1, 2018
QI 1802 - (EPASRR) Additional February Face-to-Face Trainings for O'ahu
QI 1801 - Community Care Foster Family Home (CCFFH) and Expanded Adult Residential Care Home (EARCH) Rates Home and Community Based Services Effective January 1, 2018.
QI 1729 - Medicaid Fee-For-Service Hospice Nursing Facility Rate for St. Francis (Provider NO. 251954) - Effective January 1, 2018
QI 1728 - Medicaid Fee-For-Service Long Term Care Acuity Rates for New Nursing Facility - Kalakaua Gardens
QI 1727- Electronic Preadmission Screening/Resident Review (ePASRR) Soliciting Public and Private Stakeholders Suggestion(s)
QI 1725A- Medicaid Fee-For-Service Hospice Nursing Facility Care Rates Effective January 1, 2018 through June 30, 2018
QI 1724 - QUEST Integration (QI) Transition of Care (TOC) Files
QI 1721 - Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
QI 1719 - Medicaid Fee-For-Service Hospice Rates Effective October 1, 2017 through September 30, 2018
QI 1718 - Community Care Foster Family Home (CCFFH) and Expanded Adult Residential Care Home (EARCH) Rates Home and Community Based Services Effective January 1, 2017
QI 1716 - Guidelines for Home and Community Based Services
QI 1715- (Replaced by QI-2213) - Reporting Requirements for 340B Medications Provided by Contract Pharmacies and Non-340B Medications Provided by 340B Covered Entities to QUEST Integration (QI) and Community Care Services (CCS) Members
Download Attachments for QI 1715: A - B - C - Cover Entity Mailing List - DRAMS Extract Flat File
QI 1714 - (Replaced by QI-2141) - Transition of Care - Clarification of Financial Responsibility Roles
Download Attachment for QI 1714
QI 1713 - Ownership Personnel Submissions & Changes to the Health Plan Add (HPA), HealthPlan Submission (HPS) and Provider Master Registry (PMR) Files
QI 1712 - Guidelines and Procedures for Transportation, Meals, and Lodging Associated with Approved Inter-Island and Out-of-State Medical Services
QI 1711 - Payment Suspension to Providers - Effective June 5, 2017
QI 1710 - Medicaid Fee-For-Service Rates Effective July 1, 2017
QI 1709 - Assisted Living Facility Rates Home and Community Based Services Effective January 1, 2017
QI 1708 - Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children under 21 Years of Age with Autism Spectrum Disorder (ASD)
QI 1605– Mass Adjustments for Quest Integration (QI) 2015 Revised Rates
QI-1606 - (Replaced by QI-2217) - Payment Suspension to Provider - Jennifer Grace Shaw, LMHC
QI 1607 – Medicaid Fee-For-Service Rates Effective July 1, 2016
QI 1609 – Dental TPA Contract to Hawaii Dental Service (HDS) Effective July 1, 2016
QI 1610 – Fee-For-Service Hospice Nursing Facility Care Rates Effective July 1, 2016 through December 31, 2016
QI 1610A– Medicaid Hospice Nursing Facility Care Rates Effective July 1, 2016 through December 31, 2016
QI 1611– Hawaii Medicaid Quest Integration (QI) Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
QI 1612– Medicaid Benefits for Prenatal Screening, Brief Intervention, and Referral to Treatment (SBIRT) Pilot Project
QI 1613– (Replaqced by QI-2137) One Key Question and Contraceptive Coverage
QI 1614 – Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
QI 1615 – Medicaid Benefits for the Prevention of Zika Virus Transmission
QI 1616– Quest Integration (QI) Transition of Care (TOC) Files
Download the Attachments for QI 1616
QI 1617 – Medicaid Fee-For-Service Hospice Rates Effective October 1, 2016 through September 30, 2017
QI 1618– Medicaid Fee-For-Service Hospice Rates Effective October 1, 2016 through September 30, 2017
QI 1620– (Replaced by QI-2138) QI Health Plan and DOHEIP Collaboration
QI 1622– Medicaid Fee-For-Service Nursing Facility and Hospital Waitlisted Rates Effective January 1, 2017 through June 30, 2017
QI 1623 – Medicaid Fee-For-Service FQHC PPS Rates Effective January 1, 2017 through December 31, 2017
QI 1623A – Medicaid Fee-For-Service FQHC PPS Rates Effective January 1, 2017 through December 31, 2017
QI Memos – 2015
QI 1501– Medicaid Fee-For-Service Hospice Rates for Nursing Facilities Effective January 1, 2015 through June 30, 2015
QI 1524– Medicaid Fee-For-Service Hospice Rates for Nursing Facility - Effective January 1, 2016
QI 1524A – Medicaid Fee-For-Service Hospice Rates for Nursing Facility Care - Effective January 1, 2016 through June 30, 2016
QI 1525 – Update to Pay-For-Performance (P4P) Incentives Performance Measures
QI 1526– Medicaid Fee-For-Service FQHC PPS Rates Effective January 1, 2016 through December 31, 2016
QI 1527– 2016 Performance Improvement Projects for QUEST Integration
FFS Memos -2025
FFS 25-09- Practice Guidelines on Developmentally Appropriate Mental Health Assessment and Diagnosis for Med-QUEST Members Through Five Years Old (Attachments)
FFS 25-08- Hospital Quality P4P Guidance for Measurement Year 2025 (Replaces FFS-25-06)
FFS 25-06- Hospital Quality Pay for Performance Guidance for Measurement Year 2025
FFS 25-03A - Payment Suspension To Provider - Samuel Mahelona Memorial Hospital (Attachment)
FFS 25-03 - Payment Suspension To Provider - Samuel Mahelona Memorial Hospital (Attachment)
FFS 25-02- Med-QUEST Guidance on Medicaid Coverage of Routine Patient Costs Furnished in Connetion with Participation in Qualifying Clinical Trials & Attachment A
FFS Memos - 2024
FFS 2413 - Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD) Guidelines for Applied Behavioral Analysis (ABA) - (Replaces FFS-2301)
FFS 2412A - Community Pallative Care Benefit Implementation (Update to FFS 2412)
FFS 2412 - Community Palliative Care Benefit Implementation
FFS 2410 - Updated Guidelines for Submittal and Payment of Induced Abortion Claims (Replaces FFS 2104)
FFS 2409 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2025 - December 31, 2025
FFS 2408A - Payment Suspension to Provider - Hale Makua - Kahului (Replaces FFS 2408)
FFS 2307- Temporary Payments to Wahiawa General Hospital for Waitlist-Only Stays
FFS 2306 - Requirement for All Providers to Register with Hoku
FFS 2305 - Medicad Fee-For-Service (FFS) Dental Program Dental Formulary
FFS 2304 - (Replaced by FFS 2322) - Real-Time Audio-Only Interaction Policy After the Federal Public Health Emergency Related to the Covid-19 Pandemic Expires
FFS 2302- Medicaid Fee-For-Service Rates for Emergency Air Ambulance Services Effective January 1, 2023
FFS 2301- Coverage of Intensive Behaviorial Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
FFS Memos - 2022
FFS 2210- Denture Claim Submission Effective January 1, 2023
FFS 2209- Adult Dental Benefits Effective January 1, 2023
FFS 2208- Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
FFS 2207- Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2023 through December 31, 2023
FFS 2206 - Payment Suspension to Provider - Michael Izumi, DDS
FFS 2203A - COVID-19 Home Test Kits (NON-PCR) (Replaces FFS 22-03)
FFS 2203 - (Replaced by FFS 22-03A) - COVID-19 Home Test Kits (NON-PCR)
FFS 2202- Emergency Transportation to Alternative Destinations
FFS 2201 - Update on Orally Administered Drugs to Terminate a Pregnancy
FFS Memos - 2021
FFS 2120- 2022 Updates to the Medicaid Dental Fee Schedule
FFS 2119 - QI Health Plan and DOHEIP Collaboration (Replaces CTR-1603)
FFS 2118 - Coordination of Services Between Quest Integration and the 1915(c) Home and Community Based-Services Waiver for a Member Under the Age of Twenty-One (21) with Intellectual and/or Developmental Disabilities (Replaces CTR-1803)
FFS 2117- Transition of Care - Clarification of Financial Responsibility Roles (Replaces FFS 1706, CTR-1702) (Attachment QI-2141)
FFS 2109 - Continued Coverage of Audio-Only Visits Through Federal Public Health Emergency (PHE)
FFS 2108 - Provider Master Registry (PMR) File and Provider Type
FFS 2107- Mandatory Pickup/Dropoff Locations for Non-Emergency Transportation (ATTACHMENT)
FFS 2107- Mandatory Pickup/Dropoff Locations for Non-Emergency Transportation
FFS 2106A- (Updated by FFS 22-04) - Implementation of all Patients Refined Diagnosis Related Groups (APR DRG)
FFS 2106 - Implementation of all Patients Refined Diagnosis Related Groups (APR DRG)
FFS 2105- Orally Administered Drugs to Terminate a Pregnancy During the Public Health Emergency (PHE)
FFS 2104- Updated Guidelines for Submittal and Payment of Induced/Intentional Termination of Pregnancy (ITOP) Services; FFS 2104 Attachment A
FFS 2103 - Medicaid Rural Health Clinic Prospective Payment System Dental Rates for Kahuku Medical Center - Effective October 12, 2020 through December 31, 2021
FFS 2102 - Medicaid Eligibility for Freely Associated States Under the Compact of Free Association (COFA) Citizens
FFS 2101 - Civil Rights Awareness Training Requirements
FFS Memos - 2020
FFS 2017- Dental Services Requiring General Anesthesia Performed in a Hospital Setting
FFS 2016 - Medicaid Fee-For-Service Federally Qualified Health Center (FQHC) & Rural Health Center (RHC) Prospective Payment System (PPS) Rates - Effective January 1, 2021 through December 31, 2021
FFS 2014- COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured
FFS 2012 - Required Quantity Prescribed Field in Point of Sale Claim Submission for Schedule II Drugs
FFS 2011 - Universal Precautions for QUEST Integration Members Receiving At-Risk and Home and Community Based Services (Addendum to FFS-M15-05)
FFS 2010 - Opioid Medications Morphine Milligram Equivalents (MME) for Chronic Pain Treatment, International Classification of Diseases, Tenth Revision (ICD-10) on Opioid Prescriptions, Opioid Prior Authorization (PA) Criteria, Initial Concurrent Opioid and Benzodiazepines Days Suppy, Electronic Prescription Accountability Requirement, and Opioid Therapy Informed Concent Process
FFS 2009 - Coverage of Services for Autism Spectrum Disorder via Telehealth
FFS 2008 - Teledentistry and Telephonic Guidance During Public Health Emergency Period in Response to COVID-19
FFS 2006 - Telehealth Guidance for Public Health Emergency - Telephonic Services and Services Billable by Qualified Non-Physician Health Care Professionals
FFS 2005 - Telehealth Guidance During Public Health Emergency Related to COVID-19
FFS 2004- Federally Qualified health Center Telehealth Guidance During Public Health Emergency Period in Response to COVID-19
FFS 2003 - (Replaced by FFS-2322) - Tele-Health Payment Guidance for Federally Qualified Health Centers (FQHC)
FFS 2001- 2020 Changes and Additions to the Medicaid CDT Code Listing
FFS Memos - 2019
FFS 1905 - Medicaid Fee-for-Service Program Pharmacy Reimbursement Changes
FFS 1904 - 2019 Changes and Additions to the Medicaid CDT Code Listing
FFS 1903 - Update for Billing Codes for Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
FFS 1810 - Direct Acting Antiviral (DAA) Medications for Treatment of chronic Hepatitis C Infection
FFS 1809A- Correction to Interim Caries Arresting Medicament Application D1354
FFS 1809 - Topical Application of Fluoride - D1206 and D1208 Interim Caries Arresting Medicament Application - D1354
FFS 1807 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2019 Through December 31, 2019
FFS 1806- National Drug Rebate Agreement Participation
FFS 1805 - Hawaii Medicaid Quest Integration (QI) Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
FFS 1803 - Review of Medical Claims for Individuals Eligible Under Emergency Medical Assistance
FFS 1711 - Electronic Preadmission Screening/Resident Review (ePASRR) Soliciting Public and Private Stakeholders Suggestion(s)
FFS 1710– Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
FFS 1708A – Enhanced Reimbursement to Eligible Primary Care Physicians and Obstetricians for Managed Care
FFS 1708– Enhanced Reimbursement to Eligible Primary Care Physicians and Obstetricians for Managed Care
FFS 1707– Hawaii Medicaid Quest Integration (QI) Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
FFS 1706 – Transition of Care - Clarification of Financial Responsibility Roles (Replaced by FFS 2117)
FFS 1705– Medicaid Fee-For-Service FQHC PPS Rates Effective January 1, 2017 through December 31, 2017
FFS 1703– Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
FFS 1702– Medicaid Fee-For-Service (FFS) Dental Program Dental Formulary (Replaced by FFS 2116)
FFS 1701A– Tele-Health Law (Act 226, SLH 2016) Implementation (Replaced by FFS 2115)
FFS 1701– Tele-Health Law (Act 226, SLH 2016) Implementation
FFS Memos-2016
FFS 1607– Affordable Care Act (ACA) 1557 Requirements and Compliance
FFS 1605– Medicaid Benefits for the Prevention of Zika Virus Transmission
FFS 1604– Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection
FFS 1603– Hawaii Medicaid Quest Integration (QI) Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
FFS 1601– 2016 Dental TPA Contract to Hawaii Dental Service (HDS) Effective July 1, 2016
FFS Memos – 2015
FFS 1514– Medicaid Hospice Rates - Effective October 1, 2015 Through December 31, 2015 and January 1, 2016 Through September 30, 2016
FFS 1513 – Revised DHS 1178 Form for Preadmission Screening Resident Review (PASRR)
FFS 1510– Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
FFS 1509 – Allowable Bill Types for Intermediate Care Facility (ICF) and Sub-Acute Services
FFS 1508 – Hawaii Medicaid Quest Integration Guideline for Prophylaxis of Respiratory Syncytial Virus (RSV) Infections in High Risk Infants and Children
CCS-2307- Change to Status of Error Code D330 Primary DX CD Must be with Transportation or Interpretive Procedure Code
CCS-2305 - Covid-19 Pandemic Action Plan for CCS Health Plan Part II
CCS-2304 - Select Quest Integration (QI) and Community Care Services (CCS) Reports and Key Performance Indicators in Production Effective April 29, 2023; Process for Production Announcement and Oversight
CCS-2303D - Community Integration Services (CIS+) Implementation Updated Guidelines: Medical Respite - October 2025 (Update to CCS-2303C)
CCS-2303C - Community Integration Services (CIS) Implementation Updated Guidelines: CIS Data and Reporting (Update to CCS-2303B) (Appendix H - CIS Process Flow)
CCS-2303A - Community Integration Services (CIS) Implementation Updated Guidelines: CIS Assessment and CIS Action Plan
CCS-2303 - Community Integration Services (CIS) Implementation Updated Guidelines: Roles and Responsibilities, Forms, Billing and Payment (Appendix B) (Appendix C)
CCS-2302- (Replaced by CCS-2311) - Real-Time Audio-Only Interaction Policy After the Federal Public Health Emergency Related to the Covid-19 Pandemic Expires
CCS Memos - 2022
CCS-2205- APR DRG Billing Guidance (Update to CCS-2106A)
CCS-2204- Requirements for Health Plans to Submit NDC Code and NCPDP Units on Encounters
CCS-2202- Requirement for Health Plans to Submit the CN1 Segment on Encounters (Replaces CCS-2110)
CCS-2201- Emergency Transportation to Alternative Destinations
CCS Memos - 2021
CCS-2112- Revised Grievances and Appeals Templates (Replaces CCS-1901)
CCS-2111 - Transition of Care - Clarification of Financial Responsiblity Roles (Replaces CCS-1702)
CCS 1801 - Annual Reporting and Monitoring Activities Period: January 1, 2018 - December 31, 2018
CCS 1802- Medicaid Managed Care Organization Drug Utilization Review Annual Report
CCS 1803 - Revised Templates for Denial of Payment, Denial of Service Authorization and Denial of Service
CCS 1804 - Annual Reporting and Monitoring Activities Period: January 1, 2019 - December 31, 2019
CCS Memos – 2017
CCS 1702 – (Replaced by CCS-2111) - Transition of Care - Clarification of Financial Responsibility Role
CCS 1703– Reporting Requirements for 340B Medications Provided by Contract Pharmacies and Non-340B Medications Provided by 340B Covered Entities to QUEST Integration (QI) and Community Care Services (CCS) Members
CCS Memos – 2016
CCS 1601 – Annual Reporting and Monitoring Activities Period: January 1, 2016 - December 31, 2016
CTR 2103 - Payment Suspension to Providers (Hawaii Dental Clinic)
CTR 2102 - Medicaid Rural Health Clinic Prospective Payment System Dental Rates for Kahuku Medical Center - Effective October 12, 2020 through December 31, 2021.
CTR 2101 - Civil Rights Awareness Training Requirements
CTR Memos - 2020
CTR 2005 - Medicaid Fee-For-Service Federally Qualified Health Center (FQHC) & Rural Health Clinic (RHC) Prospective Payment System (PPS) Rates - Effective January 1, 2021 through December 31, 2021
CTR 2004- Dental Services Requiring General Anesthesia Performed in a Hospital Setting
CTR 2003- Telehealth Guidance During the Public Health Emergency Related to EPSDT Visits
CTR 2002- Revised Dental Claim Procedure - Listing of Procedures Performed
CTR 1806 - Topical Application of Fluoride - D1206 and D1208 Interim Caries Arresting Medicament Application - D1354
CTR 1805 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2019 Through December 31, 2019
CTR 1804 - 2018 Distribution of Going Home Plus Rebalancing Funds for Community Integration Services Coordinator (CISC) Positions
CTR 1803 - Coordination of Services Between QUEST Integration and the 1915(c) Home and Community Based-Services Waiver for a Member Under the Age of Twenty-One (21) with Intellectual and/or Developmental Disabilities (Replaced by FFS 2118)
CTR 1802- National Drug Rebate Agreement Participation
CTR Memos – 2017
CTR 1703 – Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2018 - December 31, 2018
