{"id":7060,"date":"2019-03-04T09:58:12","date_gmt":"2019-03-04T16:58:12","guid":{"rendered":"https:\/\/93fd47b736.nxcli.net\/corporate\/?page_id=7060"},"modified":"2024-10-09T11:16:24","modified_gmt":"2024-10-09T17:16:24","slug":"medicaid-portal-provider-news","status":"publish","type":"page","link":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/","title":{"rendered":"Medicaid Portal &#8211; Provider News"},"content":{"rendered":"<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-15169 size-medium alignleft\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png\" alt=\"\" width=\"750\" height=\"110\" srcset=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png 300w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-1024x151.png 1024w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-768x113.png 768w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-1536x226.png 1536w, https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-2048x302.png 2048w\" sizes=\"(max-width: 750px) 100vw, 750px\" \/><\/a><\/p>\n<div id=\"header_right\">\n<div id=\"portal_sign_in_button\"><a href=\"https:\/\/myqualitrac.com\" class=\"su-button su-button-style-flat\" style=\"color:#FFFFFF;background-color:#f16649;border-color:#c1523b;border-radius:0px\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color:#FFFFFF;padding:0px 38px;font-size:27px;line-height:54px;border-color:#f69480;border-radius:0px;text-shadow:none\"> Portal Sign In<\/span><\/a><\/div>\n<div id=\"portal_sign_registration\"><a style=\"font-size: small; margin-left: 75px;\" href=\"https:\/\/powerforms.docusign.net\/04dd8d07-86c3-408e-aeef-50a61354f2c1?env=na3&amp;acct=4957888b-75e8-44d9-849a-ce8f4db18623\" target=\"blank\" rel=\"noopener\"><strong>Portal Registration<\/strong><\/a><\/div>\n<div id=\"prior_auth\">\n<p>&nbsp;<\/p>\n<\/div>\n<\/div>\n<div class=\"clearcontent\">\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxathree card-1\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/03\/Home-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-document-library\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxazero card-1\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/03\/Document-Library-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-education-training\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxafour card-1\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/03\/Education-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-faqs\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxaone card-1\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2020\/03\/FAQsQuicknote-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-provider-news\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxatwo card-1 currentbox\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/03\/Providers-icon-1.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-contact-us\/\"><img loading=\"lazy\" decoding=\"async\" class=\"boxafive card-1\" src=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/03\/Contact-Us-icon.png\" alt=\"image\" width=\"150\" height=\"175\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"clearcontent\">\n<h1><strong>Provider News<\/strong><\/h1>\n<p>Stay on top of the latest provider news from Mountain-Pacific including: implementation updates, stakeholder meetings, policy changes and other issues related to services provided to Montana Medicaid members.<\/p>\n<ul>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/PriorAuthorizationRequirementsWhenaMemberHasThirdPartyLiability-508.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Requirements When a Member Has Third Party Liability &#8211; July 29, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/NewPersonalRepresentativeOptionintheQualitracPortal-508.pdf\" target=\"_blank\" rel=\"noopener\">New Personal Representative Option in the Qualitrac Portal &#8211; July 19, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/TemporarySuspensionofPriorAuthorizationandContinuedStayReviewRequirementsUpdate6.25.24-508.pdf\" target=\"_blank\" rel=\"noopener\">Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; June 28, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/05\/OrderingGeneticLabTestsfromAssurexHealth-508.pdf\" target=\"_blank\" rel=\"noopener\">Ordering Genetic Lab Tests from Assurex Health &#8211; May 10, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/PriorAuthorizationChangesforEyeglassesandContacts-508.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Changes to Eyeglasses and Contacts &#8211; April 23, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/NegativePressureWoundTherapyPumpsE2402DoNotRequirePriorAuthorization-508.pdf\" target=\"_blank\" rel=\"noopener\">Negative Pressure Wound Therapy Pumps (E2402) Do Not Require Prior Authorization &#8211; April 8, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/TemporarySuspensionofPriorAuthorizationandContinuedStayReviewRequirementsUPDATE-508.pdf\" target=\"_blank\" rel=\"noopener\">Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; April 2, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/ComplexCareAdd-OnStructure-508.pdf\" target=\"_blank\" rel=\"noopener\">Complex Care Add-On Structure &#8211; February 8, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Criteria-Update-for-Gait-Trainers-EPSDT-Only-January-26-2024.pdf\" target=\"_blank\" rel=\"noopener\">Criteria Update for Gait Trainers &#8211; EPSDT Only &#8211; January 26, 2024<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Prior-Authorization-Information-November-8-2023.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Information &#8211; November 8, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/10\/TemporarySuspensionofPriorAuthorizationsandContinuedStayReviews-508.pdf\" target=\"_blank\" rel=\"noopener\">Temporary Suspension of Prior Authorizations and Continued Stay Reviews &#8211; October 6, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/10\/ReminderDMEPriorAuthorizationRequirements-508.pdf\" target=\"_blank\" rel=\"noopener\">Reminder DME Prior Authorization Requirements &#8211; October 6, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/WheelchairandBariatricEquipmentCoverageforNursingFacilityResidents508.pdf\" target=\"_blank\" rel=\"noopener\">Wheelchair and Bariatric Equipment Coverage for Nursing Facility Residents &#8211; June 28, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/NewDentalPriorAuthorizationProcessThroughQualitracPortal.pdf\" target=\"_blank\" rel=\"noopener\">New Dental Prior Authorization Process Through Qualitrac Portal &#8211; June 16, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/NewHearingAidReviewandApprovalProcessThroughQualitracPortal1.pdf\" target=\"_blank\" rel=\"noopener\">New Hearing Aid Review and Approval Process Through Qualitrac Portal &#8211; June 2, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/MedicaidCoverageofAbortionServicesREVISED508.pdf\" target=\"_blank\" rel=\"noopener\">Medicaid Coverage of Abortion Services (Revised) &#8211; May 5, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/Non-AdjunctiveTherapeuticandAdjunctiveNon-TherapeuticContinuousGlucoseMonitorsCGMsPolicyRevision508.pdf\" target=\"_blank\" rel=\"noopener\">Non-Adjunctive (Therapeutic) and Adjunctive (Non-Therapeutic) Continuous Glucose Monitors &#8211; May 1, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/MedicaidCoverageofAbortionServices508.pdf\" target=\"_blank\" rel=\"noopener\">Medicaid Coverage of Abortion Services &#8211; May 1, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/ResumptionofFace-to-FaceRequirementsforSelectedProgramsREVISED.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Face-to-Face Requirements for Selected Programs (Revised) &#8211; April 10, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeResumptionofPriorAuthorizationRequirementsREVISED27.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Prior Authorization Requirements (Revised) &#8211; March 22, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeReinstatementofthePrimaryCareProviderReferralforPassport25.pdf\" target=\"_blank\" rel=\"noopener\">Reinstatement of the Primary Care Provider Referral for Passport &#8211; March 22, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeNon-CoveredServicesAgreementPolicyReturntoRequirements26.pdf\" target=\"_blank\" rel=\"noopener\">Non-Covered Services Agreement Policy Return to Requirements &#8211; March 22, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeCoverageandReimbursementPolicyforTelemedicineTelehealth26.pdf\" target=\"_blank\" rel=\"noopener\">Coverage and Reimbursement Policy for Telemedicine\/Telehealth Services &#8211; March 22, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/EndofPublicHealthEmergency03032023.pdf\" target=\"_blank\" rel=\"noopener\">End of Public Health Emergency &#8211; March 3, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/OmnipodCoverage01312023.pdf\" target=\"_blank\" rel=\"noopener\">Omnipod Coverage &#8211; January 31, 2023<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/ChangetoTherapeuticGroupHomeCSRRequirements01232023.pdf\" target=\"_blank\" rel=\"noopener\">Youth Therapeutic Group Home Continued Stay Review Requirements &#8211; January 23, 2023<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/ResumptionofPAandContinuedStayReviews05262022.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Prior Authorizations and Continued Stay Reviews (Behavioral Health) &#8211; May 27, 2022<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/PriorAuthorizationQualitracPortal05112022.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Qualitrac Portal Reissued &#8211; May 11, 2022<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/PhysicianAdministeredDrugPriorAuthorizationInformationREVISED05092022.pdf\" target=\"_blank\" rel=\"noopener\">Physician Administered Drug Prior Authorization Information (Revised) &#8211; May 9, 2022\u00a0<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2022PN\/ResumptionofPAsandCSRsforSUDClinicallyManagedHighIntensityResidentialTreatmentASAM3.504052022.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Prior Authorizations and Continued Stay Reviews for SUD Clinically Managed High-Intensity Residential Treatment (ASAM 3.5) &#8211; April 5, 2022<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/AppliedBehaviorAnalysisServicesStatePlanAmendmentApproved01272022.pdf\" target=\"_blank\" rel=\"noopener\">Applied Behavior Analysis Services State Plan Amendment Approved &#8211; January 27, 2022<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Montana-Healthcare-Programs-Notice.pdf\" target=\"_blank\" rel=\"noopener\">Non-Therapeutic CGM Devices &#8211; January 3, 2022<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/CFC-PAS-COVID-19-Reinstatement-of-MPQH-final_12.14.21.pdf\">CFC\/PAS COVID-19 Reinstatement of Mountain-Pacific Quality Health &#8211; December 14, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/portal-announcement_ambulance-appeals_10.6.21.pdf\">Ambulance Appeal Submissions via the Portal &#8211; October 7, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/PriorAuthorizationCriteriaforSynagis09232021V2.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Criteria for Synagis\u00ae &#8211; September 23, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Updated-Criteria-for-ENTYVIO.pdf\" target=\"_blank\" rel=\"noopener\">Updated Criteria for ENTYVIO (vedolizumab) &#8211; July 30, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/provnoticeetalChromosomalAneuploidyTesting07202021-1.pdf\" target=\"_blank\" rel=\"noopener\">Fetal Chromosomal Aneuploidy Testing &#8211; July 20, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/provnoticePArequiredforLemtrada07132021508.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Required for Lemtrada &#8211; July 13, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/provnoticeproccode58350chromotubation06112021.pdf\" target=\"_blank\" rel=\"noopener\">Procedure Code 58350, Chromotubation &#8211; June 11, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Provider-Notice-for-Process-to-Enter-PASRR-requests-through-Qualitrac-portal.pdf\" target=\"_blank\" rel=\"noopener\">Process to Enter PASRR Requests through the Qualitrac Portal &#8211; May 17, 2021<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/07\/Provider-Notice-May-5-2021-508.pdf\" target=\"_blank\" rel=\"noopener\">Date Spans for Prior Authorization Through the Qualitrac Portal &#8211; May 5, 2021<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2021PN\/provnoticeDMEPSDTPAthroughQualitrac03012021.pdf\" target=\"_blank\" rel=\"noopener\">Durable Medical Equipment (DME) and DME Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Prior Authorizations through the Qualitrac Portal &#8211; March 1, 2021<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2021PN\/provnoticePRTFdischargeplanningprocess02092021.pdf\" target=\"_blank\" rel=\"noopener\">Psychiatric Residential Treatment Facility Discharge Authorization Process &#8211; February 10, 2021<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/forms\/EPSDTCoversheetandForm12032020.pdf\" target=\"_blank\" rel=\"noopener\">EPSDT Prior Authorization Requests &#8211; December 4, 2020<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticediscardeddrugsbiologicalsanduseofjwmodifier10192020.pdf\" target=\"_blank\" rel=\"noopener\">Discarded Drugs and Biologicals and the Use of the JW Modifier &#8211; October 19, 2020<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticehmkchipdmeposclaimsadminchange09102020.pdf\" target=\"_blank\" rel=\"noopener\">HMK-CHIP DMEPOS Claims Administration Change &#8211; September 10, 2020<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticePAD_PArequests08072020.pdf\" target=\"_blank\" rel=\"noopener\">Physician Administered Drug (PAD) Prior Authorization (PA) Requests (Revised) &#8211; August 10, 2020<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticeexpandedbehavioralhealthservicesforadults07272020.pdf\" target=\"_blank\" rel=\"noopener\">Expanded Behavioral Health Services for Adults &#8211; July 27, 2020<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticeelimPAandCRforMRIoftheheadandctofthebrain04232020.pdf\" target=\"_blank\" rel=\"noopener\">Montana Healthcare Programs Notice: Elimination of Prior Authorization and Criteria Requirements for MRI of the Head and CT of the Brain &#8211; April 23, 2020<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticesuspensionofPAorContinuedStayReviewsandClinicreqforsomemedicaidprograms04222020.pdf\" target=\"_blank\" rel=\"noopener\">Provider Notice for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs &#8211; April 22, 2020<\/a>\n<ul>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/FAQforSuspensionofPriorAuthorizationsProviderNotice0506200.pdf\" target=\"_blank\" rel=\"noopener\">FAQs for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs<\/a><\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2020\/04\/2020-04-03-PRTF-Provider-Notice.pdf\" target=\"_blank\" rel=\"noopener\">Provider Notice for Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Requests &#8211; April 6, 2020<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2020\/01\/IOPProviderNotice_Eff02_01_2020_508.pdf\">Provider Notice for Prior Authorization and Continued Stay Requirements for SUD and Adult Mental Health &#8211; January 17, 2020<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/12\/Provider-Notice-Childrens-Mental-Health-Bureau.pdf\">Provider Notice for Children&#8217;s Mental Health Continued Stay Review Process &#8211; December 30, 2019<\/a><\/li>\n<li><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2019PN\/provnoticenewEPSDTreviewapprovalprocessqualitrac11222019.pdf\" target=\"_blank\" rel=\"noopener\">Provider Notice: New Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Review and Approval Process through Qualitrac Portal &#8211; November 22, 2019<\/a><\/li>\n<li><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/11\/Provider-notice-for-Behavioral-Health-Services.pdf\">Provider Notice for Medicaid Behavioral Health Services &#8211; November 14, 2019<\/a><\/li>\n<\/ul>\n<\/div>\n<h6><em>This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.<\/em><\/h6>\n","protected":false},"excerpt":{"rendered":"<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\"><\/a><\/p>\n<p><a href=\"https:\/\/myqualitrac.com\" class=\"su-button su-button-style-flat\" style=\"color:#FFFFFF;background-color:#f16649;border-color:#c1523b;border-radius:0px\" target=\"_blank\" rel=\"noopener noreferrer\"> Portal Sign In<\/a><br \/>\n<a style=\"font-size: small; margin-left: 75px;\" href=\"https:\/\/powerforms.docusign.net\/04dd8d07-86c3-408e-aeef-50a61354f2c1?env=na3&amp;acct=4957888b-75e8-44d9-849a-ce8f4db18623\" target=\"blank\" rel=\"noopener\">Portal Registration<\/a><\/p>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/\"><\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-document-library\/\"><\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-education-training\/\"><\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-faqs\/\"><\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-provider-news\/\"><\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/medicaid-portal-contact-us\/\"><\/a><br \/>\n&nbsp;<\/p>\n<p>Provider News<br \/>\nStay on top of the latest provider news from Mountain-Pacific including: implementation updates, stakeholder meetings, policy changes and other issues related to services provided to Montana Medicaid members.<\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/PriorAuthorizationRequirementsWhenaMemberHasThirdPartyLiability-508.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Requirements When a Member Has Third Party Liability &#8211; July 29, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/NewPersonalRepresentativeOptionintheQualitracPortal-508.pdf\" target=\"_blank\" rel=\"noopener\">New Personal Representative Option in the Qualitrac Portal &#8211; July 19, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/TemporarySuspensionofPriorAuthorizationandContinuedStayReviewRequirementsUpdate6.25.24-508.pdf\" target=\"_blank\" rel=\"noopener\">Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; June 28, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/05\/OrderingGeneticLabTestsfromAssurexHealth-508.pdf\" target=\"_blank\" rel=\"noopener\">Ordering Genetic Lab Tests from Assurex Health &#8211; May 10, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/PriorAuthorizationChangesforEyeglassesandContacts-508.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Changes to Eyeglasses and Contacts &#8211; April 23, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/NegativePressureWoundTherapyPumpsE2402DoNotRequirePriorAuthorization-508.pdf\" target=\"_blank\" rel=\"noopener\">Negative Pressure Wound Therapy Pumps (E2402) Do Not Require Prior Authorization &#8211; April 8, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/TemporarySuspensionofPriorAuthorizationandContinuedStayReviewRequirementsUPDATE-508.pdf\" target=\"_blank\" rel=\"noopener\">Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; April 2, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/ComplexCareAdd-OnStructure-508.pdf\" target=\"_blank\" rel=\"noopener\">Complex Care Add-On Structure &#8211; February 8, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Criteria-Update-for-Gait-Trainers-EPSDT-Only-January-26-2024.pdf\" target=\"_blank\" rel=\"noopener\">Criteria Update for Gait Trainers &#8211; EPSDT Only &#8211; January 26, 2024<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Prior-Authorization-Information-November-8-2023.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Information &#8211; November 8, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/10\/TemporarySuspensionofPriorAuthorizationsandContinuedStayReviews-508.pdf\" target=\"_blank\" rel=\"noopener\">Temporary Suspension of Prior Authorizations and Continued Stay Reviews &#8211; October 6, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/10\/ReminderDMEPriorAuthorizationRequirements-508.pdf\" target=\"_blank\" rel=\"noopener\">Reminder DME Prior Authorization Requirements &#8211; October 6, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/WheelchairandBariatricEquipmentCoverageforNursingFacilityResidents508.pdf\" target=\"_blank\" rel=\"noopener\">Wheelchair and Bariatric Equipment Coverage for Nursing Facility Residents &#8211; June 28, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/NewDentalPriorAuthorizationProcessThroughQualitracPortal.pdf\" target=\"_blank\" rel=\"noopener\">New Dental Prior Authorization Process Through Qualitrac Portal &#8211; June 16, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/NewHearingAidReviewandApprovalProcessThroughQualitracPortal1.pdf\" target=\"_blank\" rel=\"noopener\">New Hearing Aid Review and Approval Process Through Qualitrac Portal &#8211; June 2, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/MedicaidCoverageofAbortionServicesREVISED508.pdf\" target=\"_blank\" rel=\"noopener\">Medicaid Coverage of Abortion Services (Revised) &#8211; May 5, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/Non-AdjunctiveTherapeuticandAdjunctiveNon-TherapeuticContinuousGlucoseMonitorsCGMsPolicyRevision508.pdf\" target=\"_blank\" rel=\"noopener\">Non-Adjunctive (Therapeutic) and Adjunctive (Non-Therapeutic) Continuous Glucose Monitors &#8211; May 1, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/MedicaidCoverageofAbortionServices508.pdf\" target=\"_blank\" rel=\"noopener\">Medicaid Coverage of Abortion Services &#8211; May 1, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/ResumptionofFace-to-FaceRequirementsforSelectedProgramsREVISED.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Face-to-Face Requirements for Selected Programs (Revised) &#8211; April 10, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeResumptionofPriorAuthorizationRequirementsREVISED27.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Prior Authorization Requirements (Revised) &#8211; March 22, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeReinstatementofthePrimaryCareProviderReferralforPassport25.pdf\" target=\"_blank\" rel=\"noopener\">Reinstatement of the Primary Care Provider Referral for Passport &#8211; March 22, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeNon-CoveredServicesAgreementPolicyReturntoRequirements26.pdf\" target=\"_blank\" rel=\"noopener\">Non-Covered Services Agreement Policy Return to Requirements &#8211; March 22, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/provnoticeCoverageandReimbursementPolicyforTelemedicineTelehealth26.pdf\" target=\"_blank\" rel=\"noopener\">Coverage and Reimbursement Policy for Telemedicine\/Telehealth Services &#8211; March 22, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/EndofPublicHealthEmergency03032023.pdf\" target=\"_blank\" rel=\"noopener\">End of Public Health Emergency &#8211; March 3, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/OmnipodCoverage01312023.pdf\" target=\"_blank\" rel=\"noopener\">Omnipod Coverage &#8211; January 31, 2023<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2023\/ChangetoTherapeuticGroupHomeCSRRequirements01232023.pdf\" target=\"_blank\" rel=\"noopener\">Youth Therapeutic Group Home Continued Stay Review Requirements &#8211; January 23, 2023<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/ResumptionofPAandContinuedStayReviews05262022.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Prior Authorizations and Continued Stay Reviews (Behavioral Health) &#8211; May 27, 2022<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/PriorAuthorizationQualitracPortal05112022.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Qualitrac Portal Reissued &#8211; May 11, 2022<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/PhysicianAdministeredDrugPriorAuthorizationInformationREVISED05092022.pdf\" target=\"_blank\" rel=\"noopener\">Physician Administered Drug Prior Authorization Information (Revised) &#8211; May 9, 2022\u00a0<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2022PN\/ResumptionofPAsandCSRsforSUDClinicallyManagedHighIntensityResidentialTreatmentASAM3.504052022.pdf\" target=\"_blank\" rel=\"noopener\">Resumption of Prior Authorizations and Continued Stay Reviews for SUD Clinically Managed High-Intensity Residential Treatment (ASAM 3.5) &#8211; April 5, 2022<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/AppliedBehaviorAnalysisServicesStatePlanAmendmentApproved01272022.pdf\" target=\"_blank\" rel=\"noopener\">Applied Behavior Analysis Services State Plan Amendment Approved &#8211; January 27, 2022<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Montana-Healthcare-Programs-Notice.pdf\" target=\"_blank\" rel=\"noopener\">Non-Therapeutic CGM Devices &#8211; January 3, 2022<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/CFC-PAS-COVID-19-Reinstatement-of-MPQH-final_12.14.21.pdf\">CFC\/PAS COVID-19 Reinstatement of Mountain-Pacific Quality Health &#8211; December 14, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/portal-announcement_ambulance-appeals_10.6.21.pdf\">Ambulance Appeal Submissions via the Portal &#8211; October 7, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/PriorAuthorizationCriteriaforSynagis09232021V2.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Criteria for Synagis\u00ae &#8211; September 23, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Updated-Criteria-for-ENTYVIO.pdf\" target=\"_blank\" rel=\"noopener\">Updated Criteria for ENTYVIO (vedolizumab) &#8211; July 30, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/provnoticeetalChromosomalAneuploidyTesting07202021-1.pdf\" target=\"_blank\" rel=\"noopener\">Fetal Chromosomal Aneuploidy Testing &#8211; July 20, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/provnoticePArequiredforLemtrada07132021508.pdf\" target=\"_blank\" rel=\"noopener\">Prior Authorization Required for Lemtrada &#8211; July 13, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/provnoticeproccode58350chromotubation06112021.pdf\" target=\"_blank\" rel=\"noopener\">Procedure Code 58350, Chromotubation &#8211; June 11, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Provider-Notice-for-Process-to-Enter-PASRR-requests-through-Qualitrac-portal.pdf\" target=\"_blank\" rel=\"noopener\">Process to Enter PASRR Requests through the Qualitrac Portal &#8211; May 17, 2021<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/07\/Provider-Notice-May-5-2021-508.pdf\" target=\"_blank\" rel=\"noopener\">Date Spans for Prior Authorization Through the Qualitrac Portal &#8211; May 5, 2021<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2021PN\/provnoticeDMEPSDTPAthroughQualitrac03012021.pdf\" target=\"_blank\" rel=\"noopener\">Durable Medical Equipment (DME) and DME Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Prior Authorizations through the Qualitrac Portal &#8211; March 1, 2021<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2021PN\/provnoticePRTFdischargeplanningprocess02092021.pdf\" target=\"_blank\" rel=\"noopener\">Psychiatric Residential Treatment Facility Discharge Authorization Process &#8211; February 10, 2021<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/forms\/EPSDTCoversheetandForm12032020.pdf\" target=\"_blank\" rel=\"noopener\">EPSDT Prior Authorization Requests &#8211; December 4, 2020<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticediscardeddrugsbiologicalsanduseofjwmodifier10192020.pdf\" target=\"_blank\" rel=\"noopener\">Discarded Drugs and Biologicals and the Use of the JW Modifier &#8211; October 19, 2020<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticehmkchipdmeposclaimsadminchange09102020.pdf\" target=\"_blank\" rel=\"noopener\">HMK-CHIP DMEPOS Claims Administration Change &#8211; September 10, 2020<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticePAD_PArequests08072020.pdf\" target=\"_blank\" rel=\"noopener\">Physician Administered Drug (PAD) Prior Authorization (PA) Requests (Revised) &#8211; August 10, 2020<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticeexpandedbehavioralhealthservicesforadults07272020.pdf\" target=\"_blank\" rel=\"noopener\">Expanded Behavioral Health Services for Adults &#8211; July 27, 2020<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticeelimPAandCRforMRIoftheheadandctofthebrain04232020.pdf\" target=\"_blank\" rel=\"noopener\">Montana Healthcare Programs Notice: Elimination of Prior Authorization and Criteria Requirements for MRI of the Head and CT of the Brain &#8211; April 23, 2020<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/provnoticesuspensionofPAorContinuedStayReviewsandClinicreqforsomemedicaidprograms04222020.pdf\" target=\"_blank\" rel=\"noopener\">Provider Notice for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs &#8211; April 22, 2020<\/a><\/p>\n<p><a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2020PN\/FAQforSuspensionofPriorAuthorizationsProviderNotice0506200.pdf\" target=\"_blank\" rel=\"noopener\">FAQs for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs<\/a><\/p>\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2020\/04\/2020-04-03-PRTF-Provider-Notice.pdf\" target=\"_blank\" rel=\"noopener\">Provider Notice for Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Requests &#8211; April 6, 2020<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2020\/01\/IOPProviderNotice_Eff02_01_2020_508.pdf\">Provider Notice for Prior Authorization and Continued Stay Requirements for SUD and Adult Mental Health &#8211; January 17, 2020<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/12\/Provider-Notice-Childrens-Mental-Health-Bureau.pdf\">Provider Notice for Children&#8217;s Mental Health Continued Stay Review Process &#8211; December 30, 2019<\/a><br \/>\n<a href=\"https:\/\/medicaidprovider.mt.gov\/docs\/providernotices\/2019PN\/provnoticenewEPSDTreviewapprovalprocessqualitrac11222019.pdf\" target=\"_blank\" rel=\"noopener\">Provider Notice: New Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Review and Approval Process through Qualitrac Portal &#8211; November 22, 2019<\/a><br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2019\/11\/Provider-notice-for-Behavioral-Health-Services.pdf\">Provider Notice for Medicaid Behavioral Health Services &#8211; November 14, 2019<\/a><\/p>\n<p>This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.<\/p>\n","protected":false},"author":16,"featured_media":0,"parent":7056,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"class_list":{"0":"post-7060","1":"page","2":"type-page","3":"status-publish","5":"entry"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Medicaid Portal - Provider News - Mountain Pacific<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Medicaid Portal - Provider News - Mountain Pacific\" \/>\n<meta property=\"og:description\" content=\"Portal Sign In Portal Registration &nbsp;     &nbsp;  Provider News Stay on top of the latest provider news from Mountain-Pacific including: implementation updates, stakeholder meetings, policy changes and other issues related to services provided to Montana Medicaid members. Prior Authorization Requirements When a Member Has Third Party Liability &#8211; July 29, 2024 New Personal Representative Option in the Qualitrac Portal &#8211; July 19, 2024 Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; June 28, 2024 Ordering Genetic Lab Tests from Assurex Health &#8211; May 10, 2024 Prior Authorization Changes to Eyeglasses and Contacts &#8211; April 23, 2024 Negative Pressure Wound Therapy Pumps (E2402) Do Not Require Prior Authorization &#8211; April 8, 2024 Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; April 2, 2024 Complex Care Add-On Structure &#8211; February 8, 2024 Criteria Update for Gait Trainers &#8211; EPSDT Only &#8211; January 26, 2024 Prior Authorization Information &#8211; November 8, 2023 Temporary Suspension of Prior Authorizations and Continued Stay Reviews &#8211; October 6, 2023 Reminder DME Prior Authorization Requirements &#8211; October 6, 2023 Wheelchair and Bariatric Equipment Coverage for Nursing Facility Residents &#8211; June 28, 2023 New Dental Prior Authorization Process Through Qualitrac Portal &#8211; June 16, 2023 New Hearing Aid Review and Approval Process Through Qualitrac Portal &#8211; June 2, 2023 Medicaid Coverage of Abortion Services (Revised) &#8211; May 5, 2023 Non-Adjunctive (Therapeutic) and Adjunctive (Non-Therapeutic) Continuous Glucose Monitors &#8211; May 1, 2023 Medicaid Coverage of Abortion Services &#8211; May 1, 2023 Resumption of Face-to-Face Requirements for Selected Programs (Revised) &#8211; April 10, 2023 Resumption of Prior Authorization Requirements (Revised) &#8211; March 22, 2023 Reinstatement of the Primary Care Provider Referral for Passport &#8211; March 22, 2023 Non-Covered Services Agreement Policy Return to Requirements &#8211; March 22, 2023 Coverage and Reimbursement Policy for Telemedicine\/Telehealth Services &#8211; March 22, 2023 End of Public Health Emergency &#8211; March 3, 2023 Omnipod Coverage &#8211; January 31, 2023 Youth Therapeutic Group Home Continued Stay Review Requirements &#8211; January 23, 2023 Resumption of Prior Authorizations and Continued Stay Reviews (Behavioral Health) &#8211; May 27, 2022 Prior Authorization Qualitrac Portal Reissued &#8211; May 11, 2022 Physician Administered Drug Prior Authorization Information (Revised) &#8211; May 9, 2022\u00a0 Resumption of Prior Authorizations and Continued Stay Reviews for SUD Clinically Managed High-Intensity Residential Treatment (ASAM 3.5) &#8211; April 5, 2022 Applied Behavior Analysis Services State Plan Amendment Approved &#8211; January 27, 2022 Non-Therapeutic CGM Devices &#8211; January 3, 2022 CFC\/PAS COVID-19 Reinstatement of Mountain-Pacific Quality Health &#8211; December 14, 2021 Ambulance Appeal Submissions via the Portal &#8211; October 7, 2021 Prior Authorization Criteria for Synagis\u00ae &#8211; September 23, 2021 Updated Criteria for ENTYVIO (vedolizumab) &#8211; July 30, 2021 Fetal Chromosomal Aneuploidy Testing &#8211; July 20, 2021 Prior Authorization Required for Lemtrada &#8211; July 13, 2021 Procedure Code 58350, Chromotubation &#8211; June 11, 2021 Process to Enter PASRR Requests through the Qualitrac Portal &#8211; May 17, 2021 Date Spans for Prior Authorization Through the Qualitrac Portal &#8211; May 5, 2021 Durable Medical Equipment (DME) and DME Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Prior Authorizations through the Qualitrac Portal &#8211; March 1, 2021 Psychiatric Residential Treatment Facility Discharge Authorization Process &#8211; February 10, 2021 EPSDT Prior Authorization Requests &#8211; December 4, 2020 Discarded Drugs and Biologicals and the Use of the JW Modifier &#8211; October 19, 2020 HMK-CHIP DMEPOS Claims Administration Change &#8211; September 10, 2020 Physician Administered Drug (PAD) Prior Authorization (PA) Requests (Revised) &#8211; August 10, 2020 Expanded Behavioral Health Services for Adults &#8211; July 27, 2020 Montana Healthcare Programs Notice: Elimination of Prior Authorization and Criteria Requirements for MRI of the Head and CT of the Brain &#8211; April 23, 2020 Provider Notice for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs &#8211; April 22, 2020 FAQs for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs  Provider Notice for Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Requests &#8211; April 6, 2020 Provider Notice for Prior Authorization and Continued Stay Requirements for SUD and Adult Mental Health &#8211; January 17, 2020 Provider Notice for Children&#8217;s Mental Health Continued Stay Review Process &#8211; December 30, 2019 Provider Notice: New Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Review and Approval Process through Qualitrac Portal &#8211; November 22, 2019 Provider Notice for Medicaid Behavioral Health Services &#8211; November 14, 2019  This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/\" \/>\n<meta property=\"og:site_name\" content=\"Mountain Pacific\" \/>\n<meta property=\"article:modified_time\" content=\"2024-10-09T17:16:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/\",\"url\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/\",\"name\":\"Medicaid Portal - Provider News - Mountain Pacific\",\"isPartOf\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png\",\"datePublished\":\"2019-03-04T16:58:12+00:00\",\"dateModified\":\"2024-10-09T17:16:24+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#primaryimage\",\"url\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\",\"contentUrl\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png\",\"width\":2456,\"height\":362},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Medicaid Portal &#8211; Home\",\"item\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Medicaid Portal &#8211; Provider News\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website\",\"url\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/\",\"name\":\"Mountain Pacific\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Medicaid Portal - Provider News - Mountain Pacific","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/","og_locale":"en_US","og_type":"article","og_title":"Medicaid Portal - Provider News - Mountain Pacific","og_description":"Portal Sign In Portal Registration &nbsp;     &nbsp;  Provider News Stay on top of the latest provider news from Mountain-Pacific including: implementation updates, stakeholder meetings, policy changes and other issues related to services provided to Montana Medicaid members. Prior Authorization Requirements When a Member Has Third Party Liability &#8211; July 29, 2024 New Personal Representative Option in the Qualitrac Portal &#8211; July 19, 2024 Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; June 28, 2024 Ordering Genetic Lab Tests from Assurex Health &#8211; May 10, 2024 Prior Authorization Changes to Eyeglasses and Contacts &#8211; April 23, 2024 Negative Pressure Wound Therapy Pumps (E2402) Do Not Require Prior Authorization &#8211; April 8, 2024 Temporary Suspension of Prior Authorization and Continued Stay Review Requirements &#8211; April 2, 2024 Complex Care Add-On Structure &#8211; February 8, 2024 Criteria Update for Gait Trainers &#8211; EPSDT Only &#8211; January 26, 2024 Prior Authorization Information &#8211; November 8, 2023 Temporary Suspension of Prior Authorizations and Continued Stay Reviews &#8211; October 6, 2023 Reminder DME Prior Authorization Requirements &#8211; October 6, 2023 Wheelchair and Bariatric Equipment Coverage for Nursing Facility Residents &#8211; June 28, 2023 New Dental Prior Authorization Process Through Qualitrac Portal &#8211; June 16, 2023 New Hearing Aid Review and Approval Process Through Qualitrac Portal &#8211; June 2, 2023 Medicaid Coverage of Abortion Services (Revised) &#8211; May 5, 2023 Non-Adjunctive (Therapeutic) and Adjunctive (Non-Therapeutic) Continuous Glucose Monitors &#8211; May 1, 2023 Medicaid Coverage of Abortion Services &#8211; May 1, 2023 Resumption of Face-to-Face Requirements for Selected Programs (Revised) &#8211; April 10, 2023 Resumption of Prior Authorization Requirements (Revised) &#8211; March 22, 2023 Reinstatement of the Primary Care Provider Referral for Passport &#8211; March 22, 2023 Non-Covered Services Agreement Policy Return to Requirements &#8211; March 22, 2023 Coverage and Reimbursement Policy for Telemedicine\/Telehealth Services &#8211; March 22, 2023 End of Public Health Emergency &#8211; March 3, 2023 Omnipod Coverage &#8211; January 31, 2023 Youth Therapeutic Group Home Continued Stay Review Requirements &#8211; January 23, 2023 Resumption of Prior Authorizations and Continued Stay Reviews (Behavioral Health) &#8211; May 27, 2022 Prior Authorization Qualitrac Portal Reissued &#8211; May 11, 2022 Physician Administered Drug Prior Authorization Information (Revised) &#8211; May 9, 2022\u00a0 Resumption of Prior Authorizations and Continued Stay Reviews for SUD Clinically Managed High-Intensity Residential Treatment (ASAM 3.5) &#8211; April 5, 2022 Applied Behavior Analysis Services State Plan Amendment Approved &#8211; January 27, 2022 Non-Therapeutic CGM Devices &#8211; January 3, 2022 CFC\/PAS COVID-19 Reinstatement of Mountain-Pacific Quality Health &#8211; December 14, 2021 Ambulance Appeal Submissions via the Portal &#8211; October 7, 2021 Prior Authorization Criteria for Synagis\u00ae &#8211; September 23, 2021 Updated Criteria for ENTYVIO (vedolizumab) &#8211; July 30, 2021 Fetal Chromosomal Aneuploidy Testing &#8211; July 20, 2021 Prior Authorization Required for Lemtrada &#8211; July 13, 2021 Procedure Code 58350, Chromotubation &#8211; June 11, 2021 Process to Enter PASRR Requests through the Qualitrac Portal &#8211; May 17, 2021 Date Spans for Prior Authorization Through the Qualitrac Portal &#8211; May 5, 2021 Durable Medical Equipment (DME) and DME Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Prior Authorizations through the Qualitrac Portal &#8211; March 1, 2021 Psychiatric Residential Treatment Facility Discharge Authorization Process &#8211; February 10, 2021 EPSDT Prior Authorization Requests &#8211; December 4, 2020 Discarded Drugs and Biologicals and the Use of the JW Modifier &#8211; October 19, 2020 HMK-CHIP DMEPOS Claims Administration Change &#8211; September 10, 2020 Physician Administered Drug (PAD) Prior Authorization (PA) Requests (Revised) &#8211; August 10, 2020 Expanded Behavioral Health Services for Adults &#8211; July 27, 2020 Montana Healthcare Programs Notice: Elimination of Prior Authorization and Criteria Requirements for MRI of the Head and CT of the Brain &#8211; April 23, 2020 Provider Notice for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs &#8211; April 22, 2020 FAQs for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs  Provider Notice for Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Requests &#8211; April 6, 2020 Provider Notice for Prior Authorization and Continued Stay Requirements for SUD and Adult Mental Health &#8211; January 17, 2020 Provider Notice for Children&#8217;s Mental Health Continued Stay Review Process &#8211; December 30, 2019 Provider Notice: New Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Review and Approval Process through Qualitrac Portal &#8211; November 22, 2019 Provider Notice for Medicaid Behavioral Health Services &#8211; November 14, 2019  This project is funded in whole or in part under a Contract with the Montana Department of Public Health and Human Services. The statements herein do not necessarily reflect the opinion of the Department.","og_url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/","og_site_name":"Mountain Pacific","article_modified_time":"2024-10-09T17:16:24+00:00","og_image":[{"url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png"}],"twitter_misc":{"Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/","url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/","name":"Medicaid Portal - Provider News - Mountain Pacific","isPartOf":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website"},"primaryImageOfPage":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#primaryimage"},"image":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#primaryimage"},"thumbnailUrl":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner-300x44.png","datePublished":"2019-03-04T16:58:12+00:00","dateModified":"2024-10-09T17:16:24+00:00","breadcrumb":{"@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#primaryimage","url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png","contentUrl":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/06\/Medicaid-Review-Banner.png","width":2456,"height":362},{"@type":"BreadcrumbList","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/medicaid-portal-provider-news\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/"},{"@type":"ListItem","position":2,"name":"Medicaid Portal &#8211; Home","item":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-provider-portal-home\/"},{"@type":"ListItem","position":3,"name":"Medicaid Portal &#8211; Provider News"}]},{"@type":"WebSite","@id":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/#website","url":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/","name":"Mountain Pacific","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages\/7060"}],"collection":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/comments?post=7060"}],"version-history":[{"count":0,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages\/7060\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/pages\/7056"}],"wp:attachment":[{"href":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-json\/wp\/v2\/media?parent=7060"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}