DEEOIC Archived Announcements

A regulatory change to the EEOICPA Final Rule was published on February 8, 2019, and went into effect April 9, 2019. This change made OMB forms EE-17A and EE-17B required for initiating initial (claimant has never received services through EEOICPA) authorization requests for home health care, hospice, assisted living, and nursing home care. Upon implementation of the forms on June 3, 2019, medical providers will no longer submit authorization request forms to Conduent to initiate care for the aforementioned service types when the claimant requests care for the first time. However, the authorization details (approved, denied, or pending) concerning these requests will continue to be processed and transmitted to Conduent. All emergency temporary authorization requests, or requests for reauthorization, or requests for an amended level of care will continue to be submitted to Conduent using the existing processes.

To review the EE-17A and EE-17B forms click here.

Effective April 25, 2019, The Division of Energy Employees Occupational Illness Compensation (DEEOIC) released a new policy regarding Targeted Case Management (TCM). TCM authorization requests submitted prior to April 25, 2019, are not impacted by the new policy.

Targeted Case Management (TCM) can occur when a claimant is prescribed multiple types or levels of care related to their covered condition(s). TCM is the coordination of different care providers (such a Home Health Aids, RNs, Therapists, etc.), and the different treatments being provided to assure that the medical care is appropriately scheduled, and that treatments don't inappropriately overlap or have unintended negative impacts on the claimant's health. This process facilitates services provided and assists claimants in gaining access to needed medical, social, educational, and other services directly related to their DEEOIC accepted condition(s).

DEEOIC does not reimburse for the supervision and monitoring of staff by RNs or other higher credentialed individuals. DEEOIC considers the supervision of home health care staff to be the inherent responsibility of the medical provider that the claimant chooses to provide health care services. The training or continuing education of health care personnel is also not considered TCM or reimbursed.

For more information, click here.

Effective 5/22/2018, providers may notice a change in the timing of viewable pending authorizations regarding home health care services upon logging into the web bill processing portal. This change is the result of a system enhancement to improve electronic communications between Conduent and DEEOIC. A "Pending" status will indicate that the request is under review by a Medical Benefits Examiner (MBE). Subsequent determination (Approval/Denial) will follow as appropriate. For the status of an emergent care request, providers may continue to contact Conduent's Customer Service or the respective Medical Benefits Examiner as applicable.

Effective June 11, 2018, T1001 will no longer require prior authorization. T1001 is the HCPCS billing code utilized to identify an assessment/evaluation conducted by a nurse. Providers will still be required to submit the treating physician's prescription and/or Letter of Medical Necessity along with the nurse's assessment report with their claims upon billing for services rendered.

Effective January 16, 2018, the Division of Energy Employees Occupational Illness Compensation Program (DEEOICP) is changing how it evaluates requests for Physical therapy, Occupational therapy, Speech therapy, and other rehabilitative therapy services. A DEEOIC Policy Bulletin has been published that explains the changes in more detail. The Bulletin includes guidance relating to initial therapy assessments, medical evidence necessary to support requests, maximum levels of coverage and locations where therapy can occur. Requests for rehabilitative therapy authorization may continue to be faxed to 800-882-6147.

Effective May 1, 2017, Enteral Formula (Nutritional Supplements) now requires prior authorization. Enteral formulas are liquid preparations used for nutritional supplementation or replacement in patients who are unable to obtain adequate nutrition through their regular diet. These formulas are taken by mouth or through a feeding tube, and are used by the body for energy and to form substances needed for normal bodily functions. Failure to obtain prior authorization may delay reimbursement or result in a denial. Please click here to review this update.

Starting October 1, 2015, reimbursement for out of pocket expenses, such as qualified medical bills and medical travel expenses, is available for deposit directly into your checking or savings account. Electronic Funds Transfer(EFT) is a much faster and more secure way to receive reimbursement compared to paper checks. We strongly encourage DEEOIC beneficiaries to select EFT as the preferred payment method. To obtain the DIRECT DEPOSIT SIGN UP FORM click here.

Important information for Energy Employees Occupational Illness Compensation Program medical providers is now available click here.

Important information about the new Energy Employees Occupational Illness Compensation Program Medical Benefits Identification Card is now available.
Providers - click here:
Claimants - click here:

Subscribe to DEEOIC Medical Provider Updates via Email (click here)

Effective February 22nd, 2015, the Office of Workers' Compensation Programs (OWCP), Division of Energy Employees Occupational Illness Compensation (DEEOIC) will implement a new reimbursement methodology which will be based on the Medicare Outpatient Prospective Payment System (OPPS). The new payment method will utilize Medicare’s Ambulatory Payment Classifications (APC) as well as the OWCP fee schedule.

The new payment method will apply to outpatient care in all acute care hospitals including general hospitals, freestanding rehabilitation hospitals and long-term care hospitals, with the exception of critical access hospitals and Maryland hospitals. When submitting the OWCP-04 form for Outpatient services, providers will be required to enter their Medicare Number in box 51. If the Medicare number is missing or invalid, the bill will be denied.

Effective October 1, 2014, the Office of Workers' Compensation Programs(OWCP), Division of Federal Employees Compensation (DFEC) will implement a new reimbursement methodology which will be based on the Medicare Outpatient Prospective Payment System (OPPS). The new payment method will utilize medicare's Ambulatory Payment Classifications (APC) as well as the OWCP fee schedule.

The new payment method will apply to outpatient care in all acute care hosptials including general hospitals, freestanding rehabilitation hospitals and long-term care hospitals, with the exception of critical access hospitals and maryland hospitals. When submitting an OWCP-04 form for outpatient services, providers will be required to enter their medicare number in box 51. If the medicare number is missing or invalid, the bill will be denied.

Effective 5/22/2018, providers may notice a change in the timing of viewable pending authorizations regarding home health care services upon logging into the web bill processing portal. This change is the result of a system enhancement to improve electronic communications between Conduent and DEEOIC. A "Pending" status will indicate that the request is under review by a Medical Benefits Examiner (MBE). Subsequent determination (Approval/Denial) will follow as appropriate. For the status of an emergent care request, providers may continue to contact Conduent's Customer Service or the respective Medical Benefits Examiner as applicable.