QI Memos - 2026

• QI-2623 - Gender Affirming Update Effective October 13, 2026
• QI-2622 - ITOP and Spontaneous Termination of Pregnancy
• QI-2621 - Community Care Services (CCS) Program to AlohaCare Effective November 1 2026
• QI-2620 - Third-Party Authorizations for Quest Integration (QI) Health Plan, Community Care Services (CCS) Health Plan, Medicaid Fee-for-Service (FFS) Provider and Hawaii Dental Services (HDS) Grievance and Appeals 
• QI-2619 - Medicaid Reentry Program Policy and Operational Guidance (Appendix B - Eligibility and Enrollment Responsibilities Summary) (Appendix C - Member Mailing Addresses and Correspondence) (Appendix D - Detailed Services Descriptions) (Appendix E - Reentry Program Rates, Billing Code and Other Guidance) (Appendix F - Resources and Key Contacts) (Appendix G - Carceral Facility Readiness Assessment) (Appendix I - Supplemental Guidance: Reentry Targeted Case Management Model) 
• QI-2617A - Nutrition Supports Implementation Guidelines: October 2026 Update (Appendix A - Nutrition Supports Request Form (10/2026)) (Appendix B - Nutrition Supports Person-Centered Service Plan (PCSP) (10/26)) (Appendix C - Nutrition Supports PCSP QI Health Plan Script (10/2026)) (Appendix D - Nutrition Supports PSCP Referral Provider Script (10/2026))
• QI-2615 - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective July 1, 2026 - December 31, 2026
• QI-2614 - Medicaid Fee-For-Service Rates Effective July 1, 2026
• QI-2613 - Fund Disbursement Guidelines: Section 1115 Demonstration Health+ Related Social Needs (HRSN) Infrastructure Investment (Appendix A - Minimum Community Capacity Grant Application Content; Appendix B - Community Capacity Grant Budget Template)
• QI-2612 - MEDICAID FEE-FOR-SERVICE FQHC & RHC PPS RATES For New Provider Waianae Coast Comprehensive Health Center The Comp at Tamura's Super Market Effective April 17, 2025 - December 31, 2026
• QI-2611 - Transportation Guidance: Section 1115 Demonstration Home and Community-Based Services (HCBS) Non-Medical Transportation (NMT) UPDATE
• QI-2610 - MEDICAID FEE-FOR-SERVICE FQHC & RHC PPS RATES For New Provider East Hawaii Health Clinic at Puna Kai Effective June 30, 2025 through December 31, 2026
• QI-2609 - Medicaid Fee-For-Service FQHC & RHC PPS For New Provider Waianae Elementary & Nanakuli Intermediate/High Schools Effective January 15, 2026 through December 31, 2025
• QI-2608 - Auto Assignment Algorithm for QI Members Effective March 1, 2026 to December 31, 2028  
• QI-2607 - 2026 Hospital Quality P4P
• QI-2606 - Medicaid Fee-For-Service FQHC & RHC PPS Rates for New Provider West Hawaii Community Health Center Effective August 26, 2025 - December 31, 2026
• QI-2605 - EVV Services Codes and Modifiers (Replaces QI-2125)
• QI-2604A - Fee-For-Service Rates for HCBS Effective January 1, 2026 (Update to QI-2604)
• QI-2604 - Fee-For-Service Rates for HCBS Effective January 1, 2026
• QI-2603 - Medicaid Fee-For Service FQHC & RHC PPS Rates For New Provider Waianae Coast Comprehensive Health Center Effective December 17, 2024 - December 31, 2026
• QI-2602 - Exception to HRS Chapter 388 - Self Direct Provider
• QI-2601A - Community Integration Services Plus (CIS+) Implementation Updated Guidelines:  Medical Respite Updates -   July 2026 (Appendix A - CIS+ Responsibilities) (Appendix B - CIS+ Referral Form) (Appendix C - CIS+ Member Consent Form) (Appendix D - CIS+ Assessment Form) (Appendix E - CIS+ Action Plan) (Appendix H - CIS+ Process Flow) (Appendix I - Medical Respite Authorization Form) (Appendix J - Medical Respite Person Centered Service Plan)  (Appendix K - Medical Respite Provider Attestation Form) (Appendix L - Medical Respite Provider Discharge Form) 
• QI-2601 - Community Integration Services Plus (CIS+) Implementation Update Guidelines:  Medical Respite - December 2025 (Appendix A - Responsibilities) (Appendix B - CIS+ Referral Form) (Appendix C - CIS+ Consent Form) (Appendix D - CIS+ Assessment) (Appendix E - CIS+ Action Plan) (Appendix H - CIS+ Process Flow) (Appendix I - Medical Respite Authorization Form) (Appendix J - Medical Respite Person Centered Service Plan)
• QI Memos - 2025
• QI-2534 - Responsibilities When Medicaid Members are Temporarily Outside The State or The Service Area
• QI-2533 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2026 - December 31, 2026
• QI-2532 - Medicaid Fee-For-Service Rates for All Nursing and Hospice Facilities Effective January 1, 2026
• QI-2530 - Hawaii State Hospital to Community Care Services Provisional Enrollment Transition for Medicaid                 Beneficiaries - Pilot Program 
• QI-2531 - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility  Rates Effective January 1, 2026 - June 30, 2026
• QI-2521A - Hospital Quality P4P Guidance for MY2025 (Replaces QI-2521)
• QI-2527 - Telehealth Implementation
• QI-2528 - Medicaid Fee-For-Service Nursing Facility Acuity Rate Effective July 29. 2025 - December 31, 2025
• QI-2526 - Civil Rights Awareness Training Requirements
• QI-2525A - KAU 'AI PONO:  Season of Eating Well Pilot Guidelines - December 2025 (Replaces QI -2525) 
• QI-2525 - KAU 'AI PONO:  Season of Eating Well Pilot Guidelines - November 2025  (Appendix B - Kau ‘Ai Pono Food Benefit Request Form – Member Facing) (Appendix C - Kau ‘Ai Pono Food Benefit Request Form – Scripted) (Appendix D - Kau ‘Ai Pono Proactive Authorization Referral Form) (Appendix E - Kau ‘Ai Pono FQHC Distribution Tracker Kau ‘Ai Pono & Invoice) (Appendix F - FQHC Offering Tracker)
• QI-2524A - Rescind Payment Suspension All Island Case Management Corporation
• QI-2524 - Payment Suspension to Provider - All Island Case Management Corporation 
• 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-2520 - Electronic Visit Verification (EVV) Vendor Issued Smartphone Devices 
• QI-2519 - Medical Loss Ratio (MLR) Requirements for Health Plan Subcontractors 
• QI-2518 - Medicaid Specific BIN-PCN with Group ID and Active Date on Member Cards
• QI-2517 - Coding Guidance for HRSN Screening
• QI-2516A - Implementation of Managed Care Encounter Reconciliation (MCER) Mainframe Process (Replaces QI-2516)
• 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-2422 - Grievance and Appeal Templates               
• 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 Integration (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-2408 - Dental Ground Transportation (Replaces QI - 2334)
• QI-2407B - Update Fee For Service Rates for Home and Community Based Services (HCBS) Effective January 1, 2024 (Update to QI-2407) 
• QI-2407A - Fee For Service Rates for Home and Community Based Services (HCBS) Effective January 1, 2024 (Update to QI-2407) 
• QI-2407 - Fee For Service Rates for Home and Community Based Services (HCBS) Effective January 1, 2024
• QI-2406 - Revisions to the Health Functional Assessment (HFA) and Health Action Plan (HAP)                                                          (HFA and HAP Forms)  (HFA and HAP Instructions)  ( Attachments Forms and Instructions) (PA and SN Tools                 and Instructions)
• QI-2405 - SFTP URL Change 
• QI-2404A - Civil Rights Awareness Training Requirements (Update to QI-2404)
• QI-2404 - Civil Rights Awareness Training Requirements
• QI-2403 - APR DRG Billing Guidance 
• QI-2402 - Med-QUEST Pharmacy Benefits Manager (PBM) File Availability 
• QI-2401 - Updated Calculator and Factor Tables For All Patient Redefined Diagnostic Related Group Effective January                    1, 2024

QI Memos - 2023

• QI-2344 - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective January 1, 2024 - June 30, 2024
• QI-2343 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2024 - December 31, 2024
• QI-2342 - Medicaid Fee-For-Service Rates for All Nursing and Hospice Facilities Effective January 1, 2024 - June 30,                 2024
• QI-2341 - Professional Fee Schedule Update to 100% Medicare
• QI-2340 - Reimbursement for the Administration Fee of Long-Acting Injectable Antipsychotics (LAIA) Administered in                         the Community Setting
• QI-2339 - Group Billing Providers Shall Not be the Rendering Provider
• QI-2338A - Telehealth Implementation (Addendum QI-2338)
• QI-2338 - Telehealth Implementation (Replaces QI-2306, QI-2139, QI-2007)
• QI-2337 - Quest Integration (QI) Transition of Care (TOC) Files during Modified Annual Plan Change Period
• QI-2336 - Medicaid Fee-For-Service and Quest Integration Hospice Rates Effective October 1, 2023 - September 30,                      2024
• QI-2335A - Hawaii Wildfires Public Health Emergency Action Plan (Update to QI-2335)
• QI-2335 - Hawaii Wildfires Public Health Emergency Action Plan 
• QI-2334 - Dental Ground Transportation (Replaced by QI-2408) 
• QI-2333 - Preadmission Screening and Resident Review (PASRR) For Individuals With Serious Mental Illness (SMI)
• QI-2332- Screening, Brief Intervention, and Referral to Treatment Services 
• QI-2331- Med-Quest Provider Application Fee Waiver for Institutional Providers 
• QI-2330 - Rescinded Payment Suspension to Provider - Hale Makua (Kahului) (Replaces QI-2322)
• QI-2329 - Payment Suspension to Provider  – Kuakini Geriatric Care, Inc 
• QI-2328 - New Dental Fee Schedule Effective JULY 15, 2023
• QI-2327A - Street Medicine (Update QI-2327)
• QI-2327 - Street Medicine
• QI-2326 - Medicaid Fee-For-Service Nursnig & Hospice Facility Rates Effective July 1, 2023
• QI-2325 - Medicaid Fee-For-Service Hospice Inpatient Nursing Facility Rates Effective July 1, 2023 - December 31,                        2023
• QI-2324 - Payment Suspension to Provider - Nuuanu Hale
• QI-2323A - Plan Staff Services Reporting (Addendum to QI-2323) 
• QI-2323 - Plan Staff Services Reporting 
• QI-2322 - (Replaced by QI-2330) - Payment Suspension to Provider - Hale Makua - Kahului
• QI-2321 - Change to Status of Error Code D330 Primary DX CD Must be with Transportation or Interpretive Procedure                    Code  
• QI-2320 - Payment Suspension to Provider - Liliha Healthcare Center 
• QI-2319 - APR DRG Billling Guidance 
• QI-2318 - Temporary Payments to Wahiawa General Hospital for Waitlist-Only Stays
• QI-2317C - Covid-19 Pandemic Action 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-2314B - Community Integration Services (CIS) Implementation Updated Guidelines:  CIS Data and Reporting                         (Appendix A - Responsibilities) (Appendix F - HPO Funding) (Appendix G - HCBS Member Rights)    
• QI-2314A - Community Integration Services (CIS) Implementation Updated Guidelines:  CIS Assessment and CIS                       Action Plan (Appendix B - CIS Referral fillable) (Appendix C - CIS Consent fillable)                                                      (Appendix D - CIS Assessment fillable) ( Appendix E - CIS Action Plan fillable) 
• 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 Ambulance Services Effective January 1, 2023 
• QI-2302 - Payment Suspension to Provider - Bryant LaPorte, DDS
• QI-2301 - Coverage of Intensive Behavioral Therapy (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-2211 -  APR DRG Billing Guidance 
• QI-2210 - Medicaid Fee-For-Service Rates - Effective July 1, 2022
• QI-2209 - Medicaid Fee-For-Service Hospice Nursing Facilities 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 Assignment 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-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 - (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-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) (Attachment AA Master Record)
• QI-2141 - Transition of Care - Clarification of Financial Responsibility Roles (Replaces QI-1714) (Attachment for QI-2141)
• QI-2140 - Medicaid Fee-For-Service (FFS) Dental Program Dental Formulary (Replaces QI-1705) 
• QI-2139 - (Replaced by QI-2338) - 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 Instructions to CMS-416 Report (Replaces QI-1426) 
• QI-2134 - Home and Community Based Services Policy Guidance for Environmental Accessibility 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-2114 - Subacute Definitions (Replaces QI-2024)
• QI-2113B - Medicaid 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 October 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-Assignment 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-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 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 Integration 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)                 (Attachment A - ABA Pilot Report) 
• 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 - [Supersedes 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 - (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 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

FFS Memos - 2026

• FFS 26-10 - Gender Affirming Update Effective October 13, 2026
• FFS 26-09 - ITOP and Spontaneous Termination of Pregnancy
• FS 26-08 - Third-Party Authorizations for Quest Integration (QI) Health Plan, Community Care Services (CCS) Health Plan, Medicaid Fee-for-Services (FFS) Provider and Health Dental Services (HDS) Grievance and Appeals
• FFS 26-06 - Medicaid Fee-For-Service FQHC & RHC PPS Rates For New Provider Waianae Coast Comprehensive The Comp Tamura's Super Market Effective April 17, 2025 - December 31, 2026 
• FFS 26-03 - 2026 Hospital Quality P4P
• FFS 26-02 - Medicaid Fee-For-Service FQHC & RHC PPS Rates For New Provider West Hawaii Community Health Center Effective August 26, 2025 - December 31, 2026
• FFS 26-01 - Medicaid Fee-For-Service FQHC & RHC PPS Rates For New Provider Waianae Coast Comprehensive Effective December 17, 2024 - December 31, 2026

FFS Memos -2025

• FFS 25-15 - Responsibilities When Medicaid Members are Temporarily Outside The State or The Service Area
• FFS 25-14 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2026 - December 31, 2026
• FFS 25-13 - Hawaii State Hospital to Community Care Services Provisional Enrollment Transition for Medicaid                     Beneficiaries - Pilot Program 
• FFS 25-08A - Hospital Quality P4P Guidance for MY2025 (Replaces FFS 25-08)
• FFS 25-12 - Telehealth Implementation
• FFS 25-11 - Civil Rights Awareness Training Requirements
• FFS 25-10A- Rescind Payment Suspension All Island Case Management Corporation
• FFS 25-10 Payment Suspension to Provider - All Island Case Management Corporation
• 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 25-07 - Coding Guidance for HRSN Screening
• 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 Palliative 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 2408 - Payment Suspension to Provider - Hale Makua - Kahului  (Attachment)  
• FFS 2406 - Requirement for all Providers to Register with HOKU, Including Referring, Ordering, Prescribing and Attending (ROPA) Providers
• FFS 2405 -  Dental Ground Transportation (Replaces FFS 2320) 
• FFS 2403 -  SFTP URL Change
• FFS 2402A - Civil Rights Awareness Training Requirements (Update FFS 2402)
• FFS 2402 - Civil Rights Awareness Training Requirements
• FFS 2401 -  APR DRG Billing Guidance 

FFS Memos - 2023

• FFS 2325 - Medicaid Fee-For-Service FQHC & RHC PPS Rates Effective January 1, 2024 - December 31, 2024
• FFS 2324 - Professional Fee Schedule Update to 100% Medicare
• FFS 2323 - Reimbursement for the Administration Fee of Long-Acting Injectable Antipsychotics (LAIA) Administered in                       the Community Setting
• FFS 2322A - Telehealth Implementation (Addendum)
• FFS 2322 - Telehealth Implementation (Replaces FFS 2304, FFS 2115, FFS 2003)
• FFS 2321B - Hawaii Wildfires Public Health Emergency Action Plan (Part 1) 
• FFS 2321A - Hawaii Wildfires Public Health Emergency Action Plan (Update to FFS 2321) 
• FFS 2321 - Hawaii Wildfires Public Health Emergency Action Plan 
• FFS 2320 - Dental Ground Transportation 
• FFS 2319 - Preadmission Screening and Resident Review (PASRR) For Individuals With Serious Mental Illness (SMI)
• FFS 2318 - Screening, Brief Intervention and Referral to Treatment Services  
• FFS 2317 - Med-Quest Provider Application Fee Waiver for Institutional Providers 
• FFS 2316 - Rescinded Payment Suspension to Proivder - Hale Makua (Kahului) (Replaces FFS 2311)
• FFS 2315 - Payment Suspension to Provider - Kuakini Geriatric Care, Inc
• FFS 2314 - New Dental Fee Schedule Effective JULY 15, 2023
• FFS 2313A - Street Medicine (Update FFS 2313)
• FFS 2313 - Street Medicine 
• FFS 2312 - Payment Suspension to Provider - Nuuanu Hale 
• FFS 2311 - (Replaced by FFS-2316) - Payment Suspension to Provider - Hale Makua - Kahului 
• FFS 2310 - Change to Status of Error Code D330 Primary DX CD Must be with Transportation or Interpretive Procedure                    Code
• FFS 2309 - Payment Suspension to Provider - Liliha Healthcare Center
• FFS 2308 - APR DRG Billing Guidance 
• 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 2204 - APR DRG Billing Guidance (Update to FFS 21-06A)
• 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 2116 - Medicaid Fee-For-Service (FFS) Dental Program Dental Formulary (Replaces FFS 1702)
• FFS 2115 - (Replaced by FFS-2322) - Tele-Health Law (Act 226, SLH 2016) Implementation (Replaces FFS-1701A)
• FFS 2114 - Universal Precautions for Quest Integration Members Receiving At-Risk and Home and Community Based                       Services (HCBS) (Replaces FFS-M15-05)
• FFS 2113 - Medicaid Fee-For-Service FQHC & RHC PPS Rates - Effective January 1, 2022 - December 31, 2022
• FFS 2111A - COVID-19 Monoclonal Antibody Treatment - FQHC/RHC Reimbursement for Administration
• FFS 2111 - COVID-19 Monoclonal Antibody Treatment - FQHC/RHC Reimbursement for Administration
• 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 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 - (Replaced by FFS-2322) - 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 (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 1701 – Printing Approval Form
• 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

CCS Memos - 2026

• CCS 2605 - Community Care Services (CCS) Program to AlohaCare Effective November 1 2026
• CCS-2604 -  Third-Party Authorizations for Quest Integration (QI) Health Plan, Community Care Services                       (CCS) Health Plan, Medicaid Fee-for-Services (FFS) Provider and Hawaii Dental Services (HDS)                      Grievance and Appeals
• CCS-2602 -  2026 Hospital Quality P4P
• CCS-2601A - Community Integration Services Plus (CIS+) Implementation Updated Guidelines:  Medical Respite -                           July 2026 (Updates CCS-2601)
• CCS-2601 - (Updated by CCS-2601A) Community Integration Services Plus (CIS+) Implementation Updated                     Guidelines:  Medical Respite - December 2025 (Replaces CCS-2303D)

CCS Memos - 2025

• CCS-2511 - Responsibilities When Medicaid Members are Temporarily Outside The State or Service Area
• CCS-2510 - Hawaii State Hospital to Community Care Services Provisional Enrollment Transition for Medicaid                     Beneficiaries - Pilot Program 
• CCS-2509 - Telehealth Implementation (Replaces CCS-2311A)
• CCS-2508 - Civil Rights Awareness Training Requirements (Replaces CCS-2403A)
• CCS-2507A - Hospital Quality P4P Guidance for MY2025 (Replaces CCS-2507)
• CCS-2507 - (Replaced by CCS-2507A)Hospital Quality P4P Guidance for Measurement Year 2025
• CCS-2506 - Coding Guidance for HRSN Screening
• CCS-2505 - Medical Loss Ratio (MLR) Requirements for Health Plan Subcontractors
• CCS-2504 - Medicaid Specific BIN-PCN with Group ID and Active Date on Member Cards
• CCS-2503A - Implementation of Managed Care Encounter Reconciliation (MCER) Mainframe Process (Replaces                                 CCS-2503)
• CCS-2503 - Implementation of Managed Care Encounter Reconciliation (MCER) Mainframe Process
• CCS-2502 - Implementation of Encounters Edits P406 & P375
• CCS-2501 - Plan Staff Services Reporting (Replaces CCS-2308A)

CCS Memos - 2024

• CCS-2410A - Community Pallative Care Benefit Implementation (Update to CCS-2410)
• CCS-2410 - (Replaced by CCS-2410A) Community Palliative Care Benefit Implementation
• CCS-2409 - Requirement for all Providers to Register with HOKU, Including Referring, Ordering, Prescribing and                     Attending (ROPA) Providers
• CCS-2408 - Grievance and Appeal Templates (Replaces CCS-2112)
• CCS-2407 - Managed File Transfer (MFT) 12 Character Minimum Password Effective January 1, 2025
• CCS-2406 - Zero Pay Encounter Submissions Related to Coordination Of Benefits (COB) Claims
• CCS-2405 - Shareinfo - New Instructions To The Health Plans
• CCS-2404 - SFTP URL Change
• CCS-2403A - Civil Rights Awareness Training Requirements (Update CCS-2403)
• CCS-2403 - (Replaced by CCS-2403A) Civil Rights Awareness Training Requirements  
• CCS-2402 – APR DRG Billing Guidance (Update to CCS-2306)
• CCS-2401 - Updated Calculator and Factor Table For All Patient Refined Diagnostic Related Groups Effective                     January 1, 2024

CCS Memos - 2023

• CCS-2314 - Professional Fee Schedule Update to 100% Medicare
• CCS-2313 - Reimbursement for the Administration Fee of Long-Acting Injectable Antipsychotics (LAIA) Administered                     in the Community Setting 
• CCS-2312 - Group Billing Providers Shall Not be the Rendering Provider
• CCS-2311A - Telehealth Implementation (Addendum)
• CCS-2311 - Telehealth Implementation (Replace CCS-2302)
• CCS-2310A - Street Medicine (Update CCS-2310)
• CCS-2310 - (Updated by CCS-2310A) Street Medicine 
• CCS-2309 - CCS Pay for Performance Guidance for Measurement Year July 2023 to June 2024  
• CCS-2308A - Plan Staff Services Reporting (Addendum to CCS-2308)
• CCS-2308 - Plan Staff Services Reporting 
• CCS-2307 - Change to Status of Error Code D330 Primary DX CD Must be with Transportation or Interpretive                                Procedure Code 
• CCS-2306 – (Replaced by CCS-2402)  APR DRG Billing Guidance  
• 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 - (Updated by CCS-2601) Community Integration Services (CIS+) Implementation Updated Guidelines:                          Medical Respite - October 2025 (Update to CCS-2303C) 
• CCS-2303C - (Updated by CCS-2303D) Community Integration Services (CIS) Implementation Updated                        Guidelines:  CIS Data and Reporting (Update to CCS-2303B) (Appendix H - CIS Process Flow)
• CCS-2303B - (Updated by CCS-2303C) Community Integration Services (CIS) Implementation Updated                        Guidelines:  CIS Data and Reporting (Appendix A - Responsibilities) (Appendix F - Funding)                        (Appendix G - HCBS Member Rights) (Update to CCS-2303A)
• CCS-2303A - (Updated by CCS-2303B) Community Integration Services (CIS) Implementation Updated                        Guidelines:  CIS Assessment and CIS Action Plan (Update to CCS-2303)
• CCS-2303 - (Updated by CCS-2303A) 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-2206 – (Replaces CCS-1703) – Clarification of reporting requirements for medications provided by 340B                     contract pharmacies to QUEST Integration (QI) and Community Care Servies (CCS) Members
• CCS-2205 - (Replaced by CCS-2402) APR DRG Billing Guidance (Update to CCS-2106A)
• CCS-2204 - Requirements for Health Plans to Submit NDC Code and NCPDP Units on Encounters (Supersedes                     ADM-1015, ADMX-1018)
• 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 Responsibility Roles (Replaces CCS-1702) 
•                    (Attachment QI-2141)
• CCS-2110 - (Replaced by CCS-2202) - Requirement for Health Plans to Submit the CN1 Segment on Encounters  
• CCS-2109 - Covid-19 Pandemic Action Plan for QI Health Plans - Part VII
• CCS-2108 - Provider Master Registry (PMR) File and Provider Type
• CCS-2107 - Mandatory Pickup/Dropoff Locations for Non-Emergency Transportation (ATTACHMENT)
• CCS-2107 - Mandatory Pickup/Dropoff Locations for Non-Emergency Transportation
• CCS-2106A - (Updated by CCS-2205) - Implementation of all Patients Refined Diagnosis Related Groups                                    (APR DRG)
• CCS-2106 - Implementation of all Patients Refined Diagnosis Related Groups (APR DRG)
• CCS-2105 - Community Integration Services (CIS) Rapid Cycle Assessments (RCAs)
• CCS-2103 - Community Integration Services (CIS) Data Requirements
• CCS-2104 – ICD-10 Conversion Guidelines 
• CCS 2102 - Community Integration Services (CIS) Implementation Guidelines: Overview, Member Eligibility, Service                     Delivery, Coordination & Reimbursement
• CCS 2101 - (Replaced by CCS-2403) 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 – (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
  

CCS Memos – 2015

• CCS 1501 – CCS Report Formats
• CCS 1502 – Annual Reporting and Monitoring Activities Period: July 1, 2015 - December 31, 2015 
  

CCS Memos – 2014

• CCS 1401 – Bill Type 89X
• CCS 1402 – DHS 1147 Approval for Individuals with Mental Illness
• CCS 1403 – Annual Reporting and Monitoring Activities Period: July 1, 2014 - June 30 2015

CTR Memos - 2021

• CTR 2103A - Payment Suspension to Providers (Hawaii Dental Clinic) (Addendum CTR 2103)
• 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 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 (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
  
• 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 (Replaced by FFS 2119)
• CTR 1602 – Monthly and Quarterly Dental Reports January to December
• CTR 1601 – FQHC Dental Rates as of January 1, 2016

CTR Memos – 2015

• CTR 1503 – Update on Federal Bureau of Investigation (FBI) Audit at Med-QUEST Division (MQD) in January 2015
• CTR 1502 – Transition of Care (TOC) Information
• CTR 1501 – Transition of State of Hawaii Organ and Tissue Transplant (SHOTT) Program Contractor