Provider Memos
View the current memos below:
The following files are available for download. You will need Adobe Acrobat Reader to view these files. For later memos, see Pharmacy Communications.
QI Memos - 2021
- 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 - Subacute Definitions (Addendum)
- QI-2012 - 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 - 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 - Effetive 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 - QUEST Integraton Coverage for Our Care, Our Choice Act (End of Life Care Option)
- QI-1926 - 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 - 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 - 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 - 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 - Medicaid Fee-For-Service Hospice Rates Effective October 1, 2018 through September 30, 2019 (supersedes)
- 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 - 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 - 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 – 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 – 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 – 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
QI Memos – 2016
- QI 1601 – Annual Reporting and Monitoring Activities Period: January 1, 2016 - December 31, 2016
Download the Attachments for QI 1601
- QI 1602 – Changes to the QUEST Integration (QI) Annual Plan Change (APC) Process
- QI 1603 – Medicaid Fee Schedule - Clarification
- QI 1604 – Payment Suspension to Provider
- QI 1605 – Mass Adjustments for Quest Integration (QI) 2015 Revised Rates
- 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 – 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 – 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 1502 – Self-Direction Forms
- QI 1503 – Kolea Downtime in Preparation for Wave 2
- QI 1504 – Coverage of Intensive Behavioral Therapy for Autistic Spectrum Disorder (ASD)
- QI 1506 – Transition of Care (TOC) Information
- QI 1507 – Universal Precautions for QUEST Integration Members Receiving At-Risk and Home and Community Based Services
- QI 1508 – Payment Suspension to Provider
- QI 1509 – Medicaid Inpatient Fee-For-Service Rates Effective July 1, 2015
- QI 1510 – Hepatitis C Medication Coverage Guidelines
- QI 1511 – Payment Suspension to Provider
- QI 1513 – Quest Integration (QI) Transition of Care (TOC) Files
- QI 1514 – Allowable Bill Types for Intermediate Care Facility (ICF) and Sub-Acute Services
- QI 1515 – Coverage of Intensive Behavioral Therapy (IBT) for Treatment of Children Under 21 Years of Age with Autism Spectrum Disorder (ASD)
- QI 1516 – ICD-10 Conversion Guidelines
- QI 1517 – Medicaid Fee-For-Service Hospice Rates for Nursing Facilities - Effective July 1, 2015 through December 31, 2015
- QI 1518 – Medicaid Hospice Rates - Effective October 1, 2015 through December 31, 2015 and January 1, 2016 through September 30, 2016
- QI 1520 – Medicaid Hospice Rates - Effective October 1, 2015 through December 31, 2015 and January 1, 2016 through September 30, 2016
- QI 1521 – Medicaid Fee-For-Service Nursing Facility and Hospital Waitlisted Rates Effective January 1, 2016 through June 30, 2016
- QI 1522 – Expansion of Claim Reference Number (CRN) in Encounter System
- QI 1523 – Drug Utilization Code Requirement
- 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 - 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 2014 - COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured
- FFS 2013 - Interim Caries Arresting Medicament Application - D1354 Adult Dental Emergency Coverage
- 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 - Tele-Health Payment Guidance for Federally Qualified Health Centers (FQHC)
- FFS 2002 - New State Medicaid ID Card Design
- 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 1901 - Reimbursement for Procedures Related to Fee-For-Service (FFS) Teledentistry Services
FFS Memos - 2018
- 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 1802 –Medicaid Certified Nursing Facility Census Reports (DHS 1137)
- FFS 1801 – (EPASRR) Additional February Face-to-Face Trainings for O'ahu
FFS Memos – 2017
- FFS 1714 – ePASRR (Electronic Pre-admission Screening Resident Review) Additional January Webinar Trainings
- FFS 1713 – Medicaid Fee-For-Service FQHC & RHC PPS Rates. Effective January 1, 2018 through December 31, 2018
- FFS 1712 – Electronic Preadmission Screening Resident Review (ePASRR) Trainings Sign-up, Start Up, and Go-Live
- 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
- 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
- FFS 1701 – Printing Approval Form
- FFS 1701A – Tele-Health Law (Act 226, SLH 2016) Implementation
- 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 1513 – Attachment Part A, B, C
- FFS 1512 – Revised Guidelines for Submittal and Payment of Induced/Intentional Termination of Pregnancy (ITOP) Claims
- FFS 1511 – lCD-10 Conversion Guidelines
- 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
- FFS 1507 – Preadmission Screening Resident Review (PASRR)
- FFS 1506 – Transition of Care for State-Funded Medical Assistance Program Beneficiaries
- FFS 1505 – Universal Precautions for Quest Integration Members Receiving At-Risk and Home and Community Based Services
- FFS 1504 – Transition of State of Hawaii Organ and Tissue Transplant (SHOTT) Program Contractor
- FFS 1503 – Coverage Of Intensive Behavioral Therapy For Autistic Spectrum Disorder (ASD)
- FFS 1502A – Cost of Living Adjustment (COLA)/Federal Poverty Level (FPL) - UPDATED
- FFS 1501 – Allowable Bill Types for Long Term Care Facility Services
CCS Memos - 2021
- CCS 2101 - Civil Rights Awareness Training Requirements
CCS Memos - 2020
- CCS 2001 - COVID-19 Pandemic Action Plan for CCS Health Plan
CCS Memos - 2019
- CCS 1901 - Revised Grievances and Appeals Templates
Download Attachments for CCS-1901
CCS Memos - 2018
- 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 – Transition of Care - Clarification of Financial Responsibility Roles
Download the Attachments for CCS 1702
- 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
Download the Attachments for CCS 1703
CCS Memos – 2016
- CCS 1601 – Annual Reporting and Monitoring Activities Period: January 1, 2016 - December 31, 2016
Download the Attachments for CCS 1601
CCS Memos – 2015
- CCS 1501 – CCS Report Formats
Download the Attachments for CCS 1501
- CCS 1502 – Annual Reporting and Monitoring Activities Period: July 1, 2015 - December 31, 2015
CCS Memos – 2014
CTR Memos - 2021
- CTR 2101 - Civil Rights Awareness Training Requirements
CTR Memos - 2020
- 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 2001 - New State Medicaid ID Card Design
CTR Memos - 2019
- CTR 1902 - 2019 Changes and Additions to the Medicaid CDT Code Listing
- CTR 1901 - Reimbursement for Procedures Related to Federally Qualified (FQHC) Teledentistry Services
CTR Memos - 2018
- CTR 1806A - Correction to Interim Caries Arresting Medicament Application D1354
- 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
- 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
- CTR 1702 – Transition of Care - Clarification of Financial Responsibility Roles
Download the Attachments for CTR 1702
- CTR 1701 – Medicaid Fee-For-Service FQHC PPS Rates Effective January 1, 2017 through December 31, 2017
CTR Memos – 2016
- CTR 1603 – QI Health Plan and DOHEIP Collaboration
- CTR 1602 – Monthly and Quarterly Dental Reports January to December
- CTR 1601 – FQHC Dental Rates as of January 1, 2016
CTR Memos – 2015