|4/2/2020 12:29 PM|
Corona Virus Updates - Revised 03/31/2020
WV MEDICAID MAX SCRIPT DAYS LIMITS CHANGED TO NINETY (90) DAYS FOR NON-CONTROLLED MAINTENANCE MEDICATIONS
Attention WV Medicaid Pharmacy Providers,
In response to the COVID-19 novel coronavirus outbreak, until further notice WV Medicaid has changed the Pharmacy POS Max Script Days limitations policy to allow up to a ninety (90) day supply of Non-Controlled maintenance medications to be dispensed with each fill.
This change does not apply to Non-Controlled NDC?s that currently have a specific Max Script Days limit in place (e.g. 14 days for many short-term oral antibiotics). Those specific Max Rx Days limits will remain in place.
Additionally, this change does not apply to any Controlled Substance NDC's with a DEA Schedule of II, III, IV, or V.
WV MEDICAID COVID RESPONSE: NON-INSURED PATIENTS
In response to the ongoing COVID-19 emergency, WV Medicaid has been authorized to provide Pharmacy POS coverage of a limited number of medications to NON-INSURED patients who are experiencing symptoms associated with a possible COVID-19 infection. The following medications are available under this temporary emergency benefit: *Albuterol 90 mcg inhaler *Guaifenesin *Dextromethorphan *Guaifenesin-dextromethorphan *Acetaminophen
Prescriptions written for these medications may be covered for non-insured patients by using the Medicaid ID number 24000000099.
Prescribers please include on the prescription: "Dx: For symptoms related to a possible COVID-19 infection"
NOTE: In order to cover non-insured patients using the single ID number (24000000099), all automated drug utilization review (DUR) and clinical safety edits have been turned off in our system for any claims using that single ID number. All responsibility for the safety and clinical appropriateness of these medications lies with the prescriber and the filling pharmacist. E-prescribing functionality is still available; however, the patient history will not be accurate for the Medicaid ID listed above.
UPDATE: WV MEDICAID COVERAGE OF PLAQUENIL (HYDROXYCHLOROQUINE) AND CHLOROQUINE
As of 03/27/2020, WV Medicaid has extended the Pharmacy POS coverage of Plaquenil (hydroxychloroquine) and chloroquine to allow for USE WITH A DOCUMENTED POSITIVE TEST RESULT FOR COVID-19, both for WV MEDICAID MEMBERS and NON-INSURED PATIENTS. (Use Medicaid ID number 24000000099 for non-insured patients. DUR and clinical safety edits are turned off for claims for using this single non-insured ID number).
WV Medicaid Members with established history of use of these drugs (60 days of therapy in the past 90 days) will not require Prior Authorization, but all other claims for them will require a review by the WV Medicaid Rational Drug Therapy Program (RDTP), phone number 1-800-847-3859. On-label use requires documentation of diagnosis. Off-label use for COVID-19 requires documentation of a positive test result.
Thank you for all that you are doing during this time. We will let you know of any other changes that may be needed for this situation.
|2/5/2020 1:02 PM|
2020 Spring Provider Workshop ?
Please join us at the 2020 Spring Provider Workshops so you and your staff will be aware of upcoming developments which may impact your practice/organization. The West Virginia Bureau for Medical Services (BMS), the West Virginia Children's Health Insurance Program (WVCHIP), and DXC Technology will be conducting eight workshops throughout the state from March 30 through April 9, 2020. The agenda items will impact a wide variety of providers and topics. Please take a moment to register for the workshop of your choice. Please register using the link below or email one of our Provider Field Representatives at WVProviderFieldRepresentative@molinahealthcare.com
Registration Link: https://www.surveymonkey.com/r/2020SpringProviderWorkshops
|1/27/2020 1:05 PM|
?Effective March 1, 2020 - WV Medicaid will transition how we provide health care for foster children, children adopted from foster care, children in kinship care and children diagnosed with serious emotional disorder (SED).
In order for the below MHP Provider Letter link to work, you must be signed in first. Once logged in, click the link to see the full letter from BMS explaining the details of this upcoming change.
MHP Provider Letter
|7/29/2019 9:31 AM|
WV Health PAS-OnLine Upgrade may require a Browser Update
The WV Health PAS-OnLine web portal will be upgraded this evening Monday, July
29, 2019 after 7:00 PM ET. Your web browser may need to be upgraded to remain compatible with
the Health PAS-OnLine web portal. After the upgrade, only the following browsers will be able to access the web portal. If you have an older browser, you may upgrade by accessing one of the links below:
If you have questions concerning the web portal upgrade or browser requirements, please contact the EDI Helpdesk at (888) 483-0793.
|7/18/2019 12:17 PM|
|6/27/2019 11:22 AM|
?New look for Electronic Health Record
Effective July 1, 2019 the Electronic Health Record functionality known as Care Evolution will no longer be available. The Electronic Health Record tool will utilize a new clinical profile functionality. Clinical Profile provides authorized healthcare providers access to a member's claims and clinical data grouped by relative types (office visits, service history, diagnosis, hospital, transportation, etc.). A new WV Medicaid TPA ? Electronic Health Record User Guide is available to provide assistance with navigating the new Electronic Health Record clinical profile functionality.
|6/20/2019 5:47 PM|
?The Service Coverage Limitations feature of the Member Eligibility Verification tool is INCORRECTLY returning a value of 'SERVICE NOT COVERED' for ALL service codes regardless if the service is covered or not. Please refrain from validating a member's eligibility for a particular procedure code or service code via the web portal until further notice. A new notification will be posted once the feature is displaying correctly. Contact our Customer Support Representatives at 888-483-0793 to verify a member's service coverage limitations. Note, all other eligibility information such as the member's Enrollments, Other Insurance, Copay, etc. is displaying correctly. We apologize for any inconvenience.
|6/6/2019 2:44 PM|
?The Health PAS-OnLine web portal will receive enhancements during the scheduled maintenance window on Saturday June 8, 2019. The new feature available is the 'View Enrolled Providers' option located under the Account Maintenance tab. This feature allows trading partners to view enrollment information for providers and facilities associated to their trading partner account. Click the document below to view more information on this new feature and other enhancements.
Health PAS-OnLine Enhancements.pdf
Contact the EDI Helpdesk by phone: 888-483-0793 or email: email@example.com for assistance with the enhancements.
|5/24/2019 10:23 AM|
Receiver ID/Sender ID Changes
DXC has updated the Receiver ID format for EDI inbound files and the Sender ID format for EDI outbound files.The previous format WV_MMIS_4MOLINA is now WV_MMIS_4_DXCMS. EDI inbound files received with WV_MMIS_4MOLINA will continue to be accepted and processed. ALL outbound acknowledgment and response files (TA1, 999, 824, 271, etc.) will be transmitted with the new Sender ID WV_MMIS_4_DXCMS in the file name and body of the file.
Updated Companion Guides with additional information and examples have been posted on the Health PAS-OnLine web portal under Reference Material. For assistance concerning this change please contact the DXC EDI Helpdesk at 888-483-0793 or email firstname.lastname@example.org.
|5/6/2019 1:32 PM|
?ATTENTION Long Term Care (LTC) Providers, Nursing Home Hospice Providers and their Billing Agencies - UPDATE
New contract rates for LTC claims have been loaded to the claims processing system. Claims pended for rates have been adjudicated.
|4/29/2019 10:43 AM|
Paper Claim Billing - UPDATED
Effective April 15, 2019, the West Virginia Medicaid and WVCHIP claims processing system will only accept original CMS-1500 and UB 04 claim forms when billing a paper claim. This policy does not impact paper Dental ADA Forms, paper Pharmacy Universal Claim Forms or electronic claim submissions. ?CMS-1500 and UB 04 claims must be in the red ink format, copies will be returned to the provider.
|3/11/2019 3:33 PM|
EFT and Paper Check Notification
The WV Bureau for Medical Services is implementing an Electronic Fund Transfer (EFT) Initiative. This effort is to decrease the administrative burden of generating paper checks. If you currently receive reimbursement by paper check please set up EFT via the State Auditor's Website immediately. New EFT forms are available on the State Auditor's Website (www.wvsao.gov).
Providers who's EFTs have been returned for incorrect account information will be placed on PAYHOLD. The PAYHOLD will remain in effect until corrected EFT information is submitted.
|1/7/2019 5:16 PM|
?DXC Technology's West Virginia Medicaid Call Center is constantly striving to provide the best customer service experience for our provider community. We would appreciate your feedback on your experience with our call center. Please complete our Customer Satisfaction Survey by clicking the available hyperlink. Thank you!
|1/4/2019 1:56 PM|
FQHC Correspondence Notice
If you are a Federally Qualified Healthcare Center and you received a correspondence dated January 2, 2019 related to reimbursement rates, please disregard, as the information is incorrect. A new, corrected correspondence will be sent in the coming days. We apologize for any inconvenience.
|12/28/2018 12:28 PM|
PAPER CHECK/EFT CHANGES
As you are aware, the State Auditor has released multiple letters to vendors encouraging them to change their payment method from check to EFT or Purchasing card. The goal of this effort is to process payments more efficiently. If you are a vendor that currently receives checks, we want to again encourage you to make the change to EFT. By making the change, you will receive payments much safer, faster and should be provided with much quicker access to your funds. Please follow the instructions on the Auditor's web site in order to do so.
The link to the Auditor's site is https://www.wvsao.gov/ElectronicPayments/Default. The web site includes information to assist vendors with this change. The form to change is listed under vendor forms. Select the form applicable to Medicaid WVCHIP Providers (Medicaid WVCHIP Direct Deposit Setup).
Effective January 2019 paper checks will be printed/distributed one day a week so it is imperative that you make this change in order to prevent delays in future payments.
Please contact the Auditor's Office if you have any issues with completion of the form.
|11/26/2018 11:21 AM|
?Notice to all Providers: The 1099s for Tax Year 2018 will be released before January 31, 2019. Please verify your legal name and mailing address are correct by December 31, 2018. This information may be viewed and updated on the Business Info tab of the Provider Enrollment Application accessed via the Health PAS-OnLine web portal. If you have any questions or need assistance contact the Provider Enrollment department at (888) 483-0793, option 4.
|11/26/2018 11:20 AM|
The October 2018 nursing facility rates have been revised for facilities that had a SAV updated between 1/1/18 and 5/31/18. Please watch for the revised rate letter. If you have any questions, please contact Jeanne Snow at 304-558-8334 email@example.com or Sherry Jarvis at 304-558-0446 firstname.lastname@example.org.?
|11/26/2018 11:15 AM|
DXC Technology completed the acquisition of Molina Medicaid Solutions effective Oct. 1, 2018.
For Molina Medicaid Solutions, this transaction represents an exciting opportunity to grow under new ownership. DXC Technology will work closely with Molina Medicaid Solutions to ensure daily operations will not be impacted due to this transaction. Please continue business as usual as this transition is expected to be seamless to the provider and member community.
Soon you will begin to see changes to the Health PAS-OnLine web portal as we begin updating the company name and logo. Web portal accounts will not be affected. You will NOT need to register for a new account. Financial cycles, deadlines, claim billing processes, call center phone numbers and mailing addresses will remain the same. Contact email addresses will be updated in the future and will be communicated to the provider community once completed.
For more information, please see the press release.
|11/26/2018 11:14 AM|
Providers Must Enroll to Prescribe for Medicaid
On and after October 17, 2018, West
Virginia Medicaid will begin to deny all claims for prescriptions written by any
prescriber not enrolled with West Virginia Medicaid.
Open the follow document for additional information:
Unenrolled Prescriber Newsletter.pdf
To prevent interruptions in Medicaid
members? access to needed prescription medications, prescribers must make sure
they are enrolled with West Virginia Medicaid.
For questions, please contact DXC Technology Provider
Enrollment at 888-483-0793 or the DXC Technology Pharmacy Help Desk at 888-483-0801.
|9/27/2018 3:25 PM|
2018 Fall Provider Workshop Presentations Available
The 2018 Fall Provider Workshop presentations are now available under Reference Material > WV Provider Workshops or click the following hyper link to quickly access the presentations.
2018 Fall Workshop Presentations
We encourage everyone to review the information to be aware of upcoming developments and changes that may impact your practice/organization.
|9/26/2018 3:44 PM|
Web Portal Connection Issues
Users who receive the error 'This page can't be displayed' when logging onto the web portal need to contact their Internet Service Provider (ISP) or IT department to request the following DNS mapping be added: 126.96.36.199 adfsi3.molinahealthcare.com
As a temporary workaround to resolve the issue until ?your ISP or IT department is able to resolve the issue, the IP address can be updated on your computer's local host folder. For more information on this process click the following hyperlink: Update Local Host.
|7/31/2018 1:50 PM|
?Opioid Prescription Changes
Beginning Wednesday, July 18, 2018, West Virginia Medicaid will no longer pay for prescriptions (including refills) for pain medication that contain opioids, if the person prescribing your medicine is not enrolled with West Virginia Medicaid. WV Medicaid will not override the denial at the pharmacy, and no exceptions will be made.
This is a Federal rule and the Medicaid pharmacy program must follow it.
Prescribers not enrolled in the West Virginia Medicaid program may contact the WV Medicaid Enrollment Department at 888-483-0793 for information on how to become an enrolled provider.
you are in a Managed Care Organization (MCO) plan and your current prescriber is not willing to enroll with West Virginia Medicaid and/or you need help finding an enrolled provider, please contact your MCO's Help Desk and ask them to help you find an enrolled healthcare provider. The numbers to call are listed below:
- Aetna: 888-348-2922
- Family Health Plan: 855-412-8001
- The Health Plan: 888-613-8385
- Unicare: 800-782-0095
If you are not in a managed care plan (known as Fee for Service), you can call the Molina Customer Help Desk at 888-483-0797 and ask them to help you locate an enrolled healthcare provider.
|7/17/2018 1:02 PM|
LTC Coverage Code Changes
Effective July 1, 2018, members eligible for Long Term Care services will have a different eligibility coverage code. Moving forward, LTC claims will be DENIED if the member is not eligible for LTC Coverage. Please verify the member's LTC eligibility on the WVMMIS portal for the date of services that you will be submitting LTC claims, prior to rendering services
Click the following hyperlink 'LTC Coverage Example' to view an example of how the LTC coverage will appear on the WVMMIS portal.
If you need assistance with eligibility verification, please contact Molina Customer Service at 1-888-483-0793. If there are questions regarding the member's eligibility, please contact the member's caseworker at the county office. DHHR Client Services may also be reached at 1-800-642-8589.
|5/6/2018 9:52 PM|
?New Web Portal Features and Enhancements
New features and enhancements have been added to the Health PAS-OnLine web portal. New features include managing Provider and Billing Agent affiliations. Enhancements have been made to the Provider Directory and Manage Users areas. For more information on the changes click the following hyperlink: Health PAS-OnLine Updates
If you experience issues with web portal functionality, it may be necessary to delete browsing history, cookies and temporary internet files to allow your computer to access these new changes. Click the following hyperlink for information on how to "Delete Browsing History".
If you need assistance with these new features please contact the EDI Helpdesk by calling 888-483-0793, select option 1 to enter an NPI, then select option 6 to speak with the EDI Helpdesk or send an email to email@example.com.
|3/19/2018 10:18 AM|
Reminder: Effective April 1, 2017, providers billing WV Medicaid for 340B outpatient drugs should submit modifier UD with the HCPCS drug code to identify drugs purchased at 340B prices. Medicaid is required to exempt these drug claims from drug rebate invoicing. Submission of the modifier UD will be used to identify administration of 340B drugs at the claim level.