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The DC Department of Health (DC Health) strongly recommends the Measles, Mumps, and Rubella (MMR) vaccine, a safe and effective way to prevent measles, a highly contagious disease. Learn more.
News & Updates for Health Providers
Notifications for Providers
Provider Newsletters
COVID-19 Updates
To keep up to date on all Coronavirus (COVID-19) news and updates please see the following notifications:
- HSCSN Network Notice COVID Vaccine Requirements
- COVID-19 Procedures for Residents of PRTFs and ICFs
- COVID-19 Home Care Provider Enhanced Rates Notice
- DC Health Guidance for Universal Masking and Healthcare Personnel Monitoring, Restriction and Return to Work
- COVID-19 DME Provider Notification
- Updated Telehealth Billing Guidance during COVID-19 Containment Activities
- COVID-19 Home Care Notification
- COVID-19 Pharmacy Access Notification
- Department of Health Care Finance (DHCF) Notice to COVID-19 Medicaid Providers
- HSCSN Telehealth Update
- HSCSN's Coronavirus Resource Page
Pharmacy Notifications
- Provider Pharmacy Formulary Notification [PDF - 1.0 MB]
- Visit HSCSN's Pharmacy Formulary page
- CVS Formulary Exception/Prior Authorization Request Form [PDF - 440 KB]
- District of Columbia Prescription Drug Monitoring Program Notification [PDF - 154 KB]
General
- 2021 DHCF Opioid Use Collaborative Newsletter [PDF - 537 KB]
- No Shots, No School [PDF - 1.79 MB]
Claims/Billing
- HSCSN ABA (Applied Behavior Analysis) Billing Codes Change [PDF - 731 KB]
- Claims Denials for Invalid Diagnosis for Age of this Member [PDF - 465 KB]
Notice about submitting claims with the correct diagnosis or procedure code. - Notification of change to authorization summary [PDF - 665 KB]
Notice about changes to HSCSN's authorization summary document for speech therapy, occupational therapy, and physical therapy - Provider payment cycle change [PDF - 625 KB]
Notice about further improvements to the provider claims payment cycle
Prior Authorization
- Prior Authorization Update - Incontinence Supplies [PDF - 569 KB]
Notice about HSCSN's decision to remove the prior authorization requirements for incontinence supplies and nebulizers - Prior Authorization enforcement notification [PDF -694 KB]
Notice about HSCSN's enforcement of prior authorization requirements - Prior Authorization Update - Certain Medical Supplies [PDF - 388 KB]
Notice about HSCSN's decision to remove the prior authorization requirements for gloves when requested with incontinence supplies, CPAP supplies when an enrollee has a CPAP machine at home, and/or an active authorization for a CPAP machine on file, nor for breast pumps
Utilization Management
HSCSN’s Utilization Management Department has a new fax number for inpatient admission notification. Beginning March 1, 2020, all admission notifications, clinical reviews, requests for discharge coordination, and discharge summaries should be faxed to (202) 407-8955 or e-mailed to expeditedrequests@hschealth.org.
- Department of Health Care Finance Timely Access Standards for Non-Physician Services [PDF - 618 KB]
- Affirmative Incentive Statement [PDF - 598 KB]
- Notification about HSCSN's Inpatient Utilization Review Process [PDF - 628 KB]
- Notification for Respite Care Providers [PDF - 396 KB]
Notice about change in authorization process of respite care services - Long-Term Services & Supports (LTSS) Announcement Letter [PDF - 486 KB]
Changes to the Authorization Process for Personal Care Aide & Private-Duty Nursing - Prior Authorizations for Incontinence Supplies [PDF - 733 KB]
Applied Behavior Analysis
- Modification to the Provider Agreement with HSCSN [PDF - 833 KB]
Notice regarding ABA behavior specialist/technician requirements - Provider Request Form for ABA Evaluation [PDF - 681 KB]
Request form for a request for an ABA evaluation - UM Medical Necessity Documentation Form for ABA Services [PDF - 637 KB]
Documentation form for a request for ABA services
Behavioral Health
- Enrollment in DC Medicaid Program Required by April 30, 2020 [PDF - 1.1 MB]
Notice for all Medicaid Managed Care Behavior Health Network Providers
EPSDT Health Check
- Pediatric mental health and maternal depression screening coverage and tools [PDF - 600 KB]
DHCF Notice regarding Behavioral Health screenings
HIV
- HIV Services in the District of Columbia [PDF - 345 KB]
Services ranging from HIV testing locations to medical care, medications and support services, including nutrition services and housing.
Influenza
Obstetrical
- Progesterone shots health action information sheet [PDF - 288 KB]
Information about Progesterone shots for expecting mothers
Immunizations
- CDC Notification regarding the Serogroup B Meningococcal Vaccine [PDF - 193 KB]
Notice about the vaccine including risks, benefits, and resources to learn more. - DC Health Notification regarding Measles MMR Vaccine for DC schools [PDF - 125 KB]
Notice about the immunization of children in DC schools. - Top Ten Tips for HPV Vaccination Success [PDF - 167 KB]
CDC Fact Sheet about ways to increase HPV vaccination rates