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.
- January 21, 2025 - Transcranial Magnetic Stimulation Services, Provider Requirements and Medical Necessity Criteria
- January 15, 2025 - Total Electric Hospital Bed Coverage Criteria
- October 11, 2024 - Temporary Suspension of Prior Authorization and Continued Stay Review Requirements
- July 29, 2024 - Prior Authorization Requirements When a Member Has Third Party Liability
- July 19, 2024 - New Personal Representative Option in the Qualitrac Portal
- June 28, 2024 - Temporary Suspension of Prior Authorization and Continued Stay Review Requirements
- May 10, 2024 - Ordering Genetic Lab Tests from Assurex Health
- April 23, 2024 - Prior Authorization Changes to Eyeglasses and Contacts
- April 8, 2024 - Negative Pressure Wound Therapy Pumps (E2402)
- April 2, 2024 - Temporary Suspension of Prior Authorization and Continued Stay Review Requirements
- February 8, 2024 - Complex Care Add-On Structure
- January 26, 2024 - Criteria Update for Gait Trainers – EPSDT Only
- November 8, 2023 - Prior Authorization Information
- October 6, 2023 - Temporary Suspension of Prior Authorizations and Continued Stay Reviews
- October 6, 2023 - Reminder DME Prior Authorization Requirements
- June 28, 2023 - Wheelchair and Bariatric Equipment Coverage for Nursing Facility Residents
- June 16, 2023 - New Dental Prior Authorization Process Through Qualitrac Portal
- June 2, 2023 - New Hearing Aid Review and Approval Process Through Qualitrac Portal
- May 5, 2023 - Medicaid Coverage of Abortion Services (Revised)
- May 1, 2023 - Non-Adjunctive (Therapeutic) and Adjunctive (Non-Therapeutic) Continuous Glucose Monitors
- May 1, 2023 - Medicaid Coverage of Abortion Services
- April 10, 2023 - Resumption of Face-to-Face Requirements for Selected Programs (Revised)
- March 22, 2023 - Resumption of Prior Authorization Requirements (Revised)
- March 22, 2023 - Reinstatement of the Primary Care Provider Referral for Passport
- March 22, 2023 - Non-Covered Services Agreement Policy Return to Requirements
- March 22, 2023 - Coverage and Reimbursement Policy for Telemedicine/Telehealth Services
- March 3, 2023 - End of Public Health Emergency
- January 31, 2023 - Omnipod Coverage
- January 23, 2023 - Youth Therapeutic Group Home Continued Stay Review Requirements
- May 27, 2022 - Resumption of Prior Authorizations and Continued Stay Reviews (Behavioral Health)
- May 11, 2022 - Prior Authorization Qualitrac Portal Reissued
- May 9, 2022 - Physician Administered Drug Prior Authorization Information (Revised)
- April 5, 2022 - Resumption of Prior Authorizations and Continued Stay Reviews for SUD Clinically Managed Hight-intensity Residential Treatment (ASAM 3.5)
- January 27, 2022 - Applied Behavior Analysis Services State Plan Amendment Approved
- January 3, 2022 - Non-Therapeutic CGM Devices
- December 14, 2021 - CFC / PAS COVID - 19 Reinstatement of Mountain Pacific Quality Health
- October 7, 2021 - Ambulance Appeal Submissions via the Portal
- September 23, 2021 - Prior Authorization Criteria for Synagis
- July 30, 2021 - Updated Criteria for ENTYVIO (Vedolizumab)
- July 20, 2021 - Fetal Chromosomal Aneuploidy Testing
- July 13, 2021 - Prior Authorization Required for Lemtrada
- June 11, 2021 - Procedure Code 58350, Chromotubation
- May 17, 2021 - Process to Enter PASRR Requests Through the Qualitrac Portal
- May 5, 2021 - Date Spans for Prior Authorization Through the Qualitrac Portal
- March 1, 2021 - Durable Medical Equipment (DME) and DME Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Prior Authorizations Through the Qualitrac Portal
- February 10, 2021 - Psychiatric Residential Treatment Facility Discharge Authorization Process
- December 4, 2020 - EPSDT Prior Authorization Request
- October 19, 2020 - Discarded Drugs and Biologicals and the Use of the JW Modifier
- September 10, 2020 - HMK-CHIP DMEPOS Claims Administration Change
- August 10, 2020 - Physician Administered Drug (PAD) Prior Authorization (PA) Requests (Revised)
- July 27, 2020 - Expanded Behavioral Health Services for Adults
- April 23, 2020 - Montana Healthcare Programs Notice: Elimination of Prior Authorization and Criteria Requests for MRI of the Head and CT of the Brain
- April 22, 2020 - Provider Notice for Suspension of Prior Authorizations or Continued Stay Reviews and Clinical Requirements for Some Medicaid Programs
- April 6, 2020 - Provider Notice for Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Request
- January 17, 2020 - Provider Notice for Prior Authorization and Continued Stay Requirements for SUD and Adult Mental Health
- December 30, 2019 - Provider Notice for Children's Mental Health Continued Stay Review Process
- November 14, 2019 - Provider Notice for Medicaid Behavioral Health Services
