QI Memos - 2022

• 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-2164 - Hawaii Medicaid EPSDT Update
  
• 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 - 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)
• 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-2143A - Payment Suspension Lifted - PAC MED
  
• QI-2143 - Payment Suspension to Provider - Effective July 23, 2018 (Replaces QI-1812A)
• QI-2142 - Health Plan Submission File Changes (Replaces QI-1806) 
• QI-2141 - Transition of Care - Clarification of Financial Responsiblity Roles (Replaces QI-1714)
• QI-2140 - Medicaid Fee-For-Service (FFS) Dental Progam Dental Formulary (Replaces QI-1705) 
• QI-2139 - Tele-Health Law (Act 226, SLH 2016) Implementation (Replaces QI-1702A)
• QI-2138 - QI Health Plan and DOHEIP Collaboration (Replaces QI-1620) (Attachment A) (Attachment B) 
• 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 - 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-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-2030 - Medicaid Fee-For-Service Hospice Nursing Facilities Rates - Effective July 1, 2020 
• QI-2029 - HOKU COVID-19 Waivers and Policy Reminders
• QI-2028 - Clarification on Applied Behavior Analysis (ABA) Services Through Telehealth
  
• QI-2027 - Required Quantity Prescribed Field in Point of Sale Claim Submission for Schedule II Drugs
  
• QI-2026 - Medicaid Rates for Legacy Hilo Rehabilitation and Nursing Center
• QI-2025 - Universal Precautions for QUEST Integration Members Receiving At-Risk and Home and Community Based                    Services (Addendum to FFS-M15-05)
• QI-2024 - Subacute Definitions (Replaces QI-2012, QI-2012A)
• QI-2023 - Medicaid Rates for Island Skilled Nursing and Rehabilitation
• QI-2022 - Medicaid Fee-For-Service Rates - Effective July 1, 2020
• QI-2021 - Guidance on SARS-COV-2 Antibody Testing
• 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 - 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-2005 - New State Medicaid ID Card Design
• 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-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-1825 - Suspended Provider
  
• QI-1824 - Medicaid Fee-for-Service FQHC & RHC PPS Rates Effective January 1, 2019 Through December 31, 2019
  
• QI-1823 - 2018 Distribution of Going Home Plus Rebalancing Funds for Community Integration Services Coordinator                      (CISC) Positions
• QI-1822 - Pilot Reporting and Notifications Related to the Provision of Applied Behavioral Analysis (ABA)
  
• 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-1819 - New Hawaii Medicaid Threshold Rate
  
• QI-1818 - QUEST Integration (QI) Transition of Care (TOC) Files
  
• QI 1817 - National Drug Rebate Agreement Participation
• QI-1816A - [Supersedes QI-1816] - Medicaid Fee-For-Service Hospice Rates Effective October 1, 2018 through                                 September 30, 2019
  
• QI-1816 - Medicaid Fee-For-Service Hospice Rates Effective October 1, 2018 through September 30, 2019
  
• QI 1815 - Medicaid Managed Care Organization Drug Utilization Review Annual Report
  
• QI 1814 - Electronic Visit Verification (EVV)
  
• 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 1809 - Medicaid Fee-For-Services (FFS) Rates Effective July 1, 2018
  
• QI 1808 - Enhanced Reimbursement to Eligible Primary Care Physicians and Obstetricians for Managed Care
  
• QI 1806 - (Replaced by QI-2142) - Health Plan Submission File Changes
  
• QI 1805 - Annual Reporting and Monitoring Activities Period: January 1, 2018 - December 31, 2018
  
• QI 1804 - Long Term Care Eligibility on 834 and DMO
  
• QI 1803 - Medicaid Certified Nursing Facility Census Reports (DHS 1137)
• 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 Memos – 2017

• QI 1732 - EPASRR (Electronic Pre-admission Screening Resident Review) Additional January Webinar Trainings
  
• QI 1731 - Medicaid Fee-For-Service FQHC & RHC PPS Rates. Effective January 1, 2018 through December 31, 2018
• QI 1730 - Electronic Preadmission Screening Resident Review (ePASRR) Trainings Sign-up, Start Up, and Go-Live
  
• 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 - 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 1707 - Grievance Acknowledgement Template Revision Download Attachments for QI 1707
• QI 1706A - QI and CCS Report Tool - Updated Version. Download Attachments for QI 1706A
  
• QI 1706 - QI and CCS Report Tool - Updated Version
• QI 1705 - (Replaced by QI-2140) - Medicaid Fee-For-Service (FFS) Dental Program Formulary
  
• QI 1704 - Medicaid Fee-For-Service Hospice Nursing Facility Care Rates Effective January 1, 2017 through                                     June 30, 2017
• QI 1703 - Annual Reporting and Monitoring Activities Period: January 1, 2017 - December 31, 2017. Download                                Attachments for QI 1703
• QI 1702A - (Replaced by QI-2139) - Tele-Health Law (Act 226, SLH 2016) Implementation Download Attachment                               for QI 1702A
• QI 1702 - Tele-Health Law (Act 226, SLH 2016) Implementation
• QI 1701 - Quality Portion of Auto-Assignment Algorithm for QUEST Integration (QI) Members