Virginia Administrative Code
Title 12 - HEALTH
Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
Chapter 60 - STANDARDS ESTABLISHED AND METHODS USED TO ASSURE HIGH QUALITY CARE
Section 12VAC30-60-306 - Submission of screenings

Universal Citation: 2 VA Admin Code 30-60-306

Current through Register Vol. 41, No. 3, September 23, 2024

A. The screening entity shall complete and submit the following forms to DMAS electronically via ePAS:

1. DMAS-95 - MI/IDD/RC (Supplemental Assessment Process Form Level I), as appropriate;

2. DMAS-96 (Medicaid-Funded Long-Term Care Service Authorization Form);

3. DMAS-97 (Individual Choice - Institutional Care or Waiver Services), as applicable;

4. UAI (Uniform Assessment Instrument);

5. DMAS-108 (Tech Waiver Adult Referral); and

6. DMAS-109 (Tech Waiver Pediatric Referral).

B. For screenings performed in the community, the screening entity shall submit to DMAS via ePAS each screening form listed in subsection A of this section within 30 days of the individual's request date for screening.

C. For screenings performed in a hospital, the hospital team shall submit to DMAS via ePAS each screening form listed in subsection A of this section, which shall be completed prior to the individual's discharge.

Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.

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