Chapter 60 - STANDARDS ESTABLISHED AND METHODS USED TO ASSURE HIGH QUALITY CARE

  1. § 12VAC30-60-5 - [Effective until9/30/2022]Applicability of utilization review requirements
  2. § 12VAC30-60-5 - Applicability of utilization review requirements, version 2
  3. § 12VAC30-60-10 - Institutional care
  4. § 12VAC30-60-20 - Utilization control: general acute care hospitals; enrolled providers
  5. § 12VAC30-60-21 - Utilization control of nonparticipating out-of-state inpatient hospitals
  6. § 12VAC30-60-25 - Utilization control: freestanding psychiatric hospitals
  7. § 12VAC30-60-30 - Utilization control: Long-stay acute care hospitals (nonmental hospitals)
  8. § 12VAC30-60-40 - Utilization control: Nursing facilities
  9. § 12VAC30-60-50 - Utilization control: Intermediate care facilities for persons with intellectual and developmental disabilities and institutions for mental disease
  10. § 12VAC30-60-60 - Repealed
  11. § 12VAC30-60-61 - Services related to the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT); community mental health and behavioral therapy services for youth
  12. § 12VAC30-60-65 - Electronic visit verification
  13. § 12VAC30-60-70 - Utilization control: home health services
  14. § 12VAC30-60-75 - Durable medical equipment (DME) and supplies
  15. § 12VAC30-60-80 - Utilization control: Optometrists' services
  16. § 12VAC30-60-90 - Repealed
  17. § 12VAC30-60-100 - Utilization control: Incorporation of specialized quality standards
  18. § 12VAC30-60-110 - Utilization control: Effect of geographic boundaries on provision of care
  19. § 12VAC30-60-120 - Quality management: Intensive physical rehabilitative rehabilitation or CORF services
  20. § 12VAC30-60-130 - Hospice services
  21. § 12VAC30-60-140 - [Effective until9/30/2022]Community mental health services
  22. § 12VAC30-60-140 - Community mental health services, version 2
  23. § 12VAC30-60-143 - Mental health services utilization criteria; definitions
  24. § 12VAC30-60-145 - Mental retardation utilization criteria
  25. § 12VAC30-60-147 - Repealed
  26. § 12VAC30-60-150 - Quality management review of outpatient rehabilitation therapy services
  27. § 12VAC30-60-160 - Utilization review of case management for recipients of auxiliary grants
  28. § 12VAC30-60-170 - Utilization review of treatment foster care (TFC) case management services
  29. § 12VAC30-60-180 - Repealed
  30. § 12VAC30-60-181 - Utilization review of addiction and recovery treatment services
  31. § 12VAC30-60-185 - Utilization review of substance use case management
  32. § 12VAC30-60-200 - Ticket to Work and Work Incentives Improvement Act (TWWIIA) basic coverage group: alternative benefits for Medicaid Buy-In program
  33. § 12VAC30-60-300 - [Repealed]
  34. § 12VAC30-60-301 - [Effective2/16/2022Effective until8/15/2023]Definitions
  35. § 12VAC30-60-301 - [Effective8/15/2023]Definitions, version 2
  36. § 12VAC30-60-302 - Access to Medicaid-funded long-term services and supports
  37. § 12VAC30-60-302 - [Effective8/15/2023]Access to Medicaid-funded long-term services and supports, version 2
  38. § 12VAC30-60-303 - Screening criteria for Medicaid-funded long-term services and supports
  39. § 12VAC30-60-303 - [Effective8/15/2023]Screening criteria for Medicaid-funded long-term services and supports, version 2
  40. § 12VAC30-60-304 - Requests and referrals for LTSS screening for adults and children living in the community; adults and children in hospitals; and adults and children in nursing facilities
  41. § 12VAC30-60-304 - [Effective8/15/2023]Requests and referrals for screening for adults and children living in the community and adults and children in hospitals, version 2
  42. § 12VAC30-60-305 - Screenings in the community and hospitals and nursing facilities for Medicaid-funded long-term services and supports
  43. § 12VAC30-60-305 - [Effective8/15/2023]Screenings in the community and hospitals for Medicaid-funded long-term services and supports, version 2
  44. § 12VAC30-60-306 - Submission of LTSS screenings
  45. § 12VAC30-60-306 - [Effective8/15/2023]Submission of screenings, version 2
  46. § 12VAC30-60-307 - [Repealed]
  47. § 12VAC30-60-308 - Nursing facility admission for LTSS and level of care determination requirements
  48. § 12VAC30-60-308 - [Effective8/15/2023]Nursing facility admission and level of care determination requirements, version 2
  49. § 12VAC30-60-310 - Competency training and testing requirements
  50. § 12VAC30-60-310 - [Effective8/15/2023]Competency training and testing requirements, version 2
  51. § 12VAC30-60-312 - [Repealed]
  52. § 12VAC30-60-313 - Individuals determined to not meet criteria for Medicaid-funded long-term services and supports
  53. § 12VAC30-60-313 - [Effective8/15/2023]Individuals determined to not meet criteria for Medicaid-funded long-term services and supports, version 2
  54. § 12VAC30-60-315 - Periodic evaluations for individuals receiving Medicaid-funded long-term services and supports
  55. § 12VAC30-60-315 - [Effective8/15/2023]Periodic evaluations for individuals receiving Medicaid-funded long-term services and supports, version 2
  56. § 12VAC30-60-316 - Criteria for continued nursing facility care using the Minimum Data Set (MDS)
  57. § 12VAC30-60-318 - Definitions to be applied when completing the MDS
  58. § 12VAC30-60-320 - Adult ventilation/tracheostomy specialized care criteria
  59. § 12VAC30-60-330 - Reserved
  60. § 12VAC30-60-340 - Pediatric and adolescent specialized care criteria
  61. § 12VAC30-60-350 - Criteria for coverage of specialized treatment beds
  62. § 12VAC30-60-360 - [Repealed]
  63. § 12VAC30-60-361 - Criteria for supports and services in intermediate care facilities for individuals with intellectual disabilities
  64. § 12VAC30-60-500 - Repealed
  65. Form - FORMS (12VAC30-60)
  66. Form - [Effective8/15/2023]FORMS (12VAC30-60), version 2
  67. § - DOCUMENTS INCORPORATED BY REFERENCE (12VAC30-60)

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