Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
Board
Board of Medical Assistance Services
 
chapter
Administration of Medical Assistance Services [12 VAC 30 ‑ 20]
Guidance Documents
Chapter Information
Description This chapter contains numerous topics: AG certification, state agency organization/function, definition of Medicaid HMO, requirements for advance directives, coordination of Medicare Parts A/B with Medicaid, applicant/ recipient information confidentiality, NF residents' drug utilization review, reserve bed payments for recipients' absence from facility, third party liability, NF sanctions/alternative remedies, definition of specialized services, categorical determinations, etc.
State Authority COV 32.1-325
Federal Authority Title XIX, 42 U.S.C. 1396 et seq.
Exempt from APA No, changes to this chapter are subject to the Administrative Process Act.
Text of Regulation Link to Virginia Administrative Code
Goals of Regulation None entered
Meetings

Contact Information
Name / Title: Emily McClellan  / Regulatory Supervisor
Address: Policy Division, DMAS
600 E. Broad Street, Suite 1300
Richmond, VA 23219
Email Address: Emily.McClellan@DMAS.Virginia.gov
Telephone: (804)371-4300    FAX: (804)786-1680    TDD: ()-
Current Actions
Action Title Latest Stage Status
Provider Appeals Update Fast-Track Secretary of Health and Human Resources review in progress.
Estate Recovery Update -
Removal of Cost-Sharing -
Medicaid Enterprise System Updates
Action is Exempt from Article 2 of the Administrative Process Act
-
Third Party Liability Update -
Increased Cost-Sharing Measures -

Past Actions
Action Title Latest Stage Status
Settlement Agreement Discussion Process Fast-Track Stage complete. This regulation became effective on 09/02/2021.
Expansion-Related Changes - Expansion Group, FMAP, HIPP, Determination State Fast-Track Stage complete. This regulation became effective on 03/17/2022.
Reconsideration of Final Agency Decision Final Stage complete. This regulation became effective on 12/13/2017.
Reduction in Inpatient Cost Sharing to Comply with Federal Regulation
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/01/2017.
Appeal Regulation Updates Final Stage complete. This regulation became effective on 08/10/2016.
Electronic Claims Submission Requirement Final Stage complete. This regulation became effective on 11/06/2014.
Estate Recovery Update under MIPPA
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 01/02/2013.
Informal Provider Appeals Update
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 08/17/2011.
Health Insurance Premium Payment (HIPP) Cost Effectiveness Methodology Final Stage complete. This regulation became effective on 10/25/2012.
Health Insurance Premium Payment (HIPP) for Kids Program Fast-Track Stage complete. This regulation became effective on 11/08/2012.
Estate Recovery Update Final Stage complete. This regulation became effective on 07/23/2009.
Attorney General Regulatory Reform Task Force Changes
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 04/15/2009.
HIPP Program Modifications Fast-Track Stage complete. This regulation became effective on 07/23/2009.
2007 Omnibus: False Claims Recoveries;Third Party Liability
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage withdrawn on 08/27/2007 prior to submitting for AG review.
Long Term Care Partnership Insurance Fast-Track Stage complete. This regulation became effective on 09/01/2007.
Periodic Review of Estate Recoveries NOIRA Stage withdrawn on 02/05/2007 after the comment period had ended.
Provider Appeals Final Stage complete. This regulation became effective on 07/04/2001.

Withdrawn Actions
Action Title Latest Stage Status
Third Party Liability - Payment of Claims
Reduction in Inpatient Cost Sharing to Comply With Federal Regulation Final Stage withdrawn on 07/06/2018 before DPB completed its review.
2015 HIPP Updates
Increase Cost-Sharing Measures Emergency/NOIRA Stage withdrawn on 03/12/2007 after the Governor's office completed its review.
Recipient Cost Sharing and Similar Charges Proposed Stage withdrawn on 07/24/2003 after the comment period had ended.

Periodic Reviews
Last Activity Status
8/25/2014 Filed Pending