Agencies | Governor
Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
Board
Board of Medical Assistance Services


chapter
Methods and Standards for Establishing Payment Rates for Long-Term Care [12 VAC 30 ‑ 90]
Guidance Documents   Periodic Reviews
Chapter Information
Description This chapter contains the reimbursement methodology for long-term care services (nursing facilities).
State Authority COV 32.1-325 et seq et seq.
Federal Authority Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
Exempt from APA No, changes to this chapter are subject to the Administrative Process Act and the standard executive branch review process.
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
Reimbursement Changes Affecting Long Term Care Fast-Track DPB review in progress.

Past Actions
Action Title Latest Stage Status
Institutional Provider Reimbursement Changes Fast-Track Stage complete. This regulation became effective on 12/1/2016.
Supplemental Payments for Various Provider Types (Hospitals, EVMS Physicians, NFs) Fast-Track Stage complete. This regulation became effective on 11/17/2016.
NF Price-Based Reimbursement Fast-Track Stage complete. This regulation became effective on 2/11/2016.
2013 Reimbursement Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 6/18/2014.
ICF/IID ceiling; cost report submission; credit balance reporting Fast-Track Stage complete. This regulation became effective on 1/1/2016.
Supplemental Payments for Institutional/Non-Institutional Providers Fast-Track Stage complete. This regulation became effective on 2/13/2015.
2012 Reimbursement Methodology Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 8/14/2013.
2011 Budget Reimbursement Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 7/1/2011.
2011 Technical Corrections for Reimbursment Regulations
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 4/27/2011.
2010 Reimbursement and Provider Termination Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 7/1/2010.
2009 Hospital, Home Health, and Nursing Facility Reimbursement Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 3/17/2010.
2008 Reimbursement Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 10/15/2008.
Simplify Hospital and Specialized Care Reimbursement Fast-Track Stage complete. This regulation became effective on 11/27/2008.
2007 Reimbursement Changes
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 7/1/2007.
Increase Reimbursement for Hospitals, Certain Physicians and Nursing Facilities Fast-Track Stage complete. This regulation became effective on 8/25/2007.
Reimbursement for NF Specialized Care Ancillary Services Final Stage complete. This regulation became effective on 4/19/2007.
Modifications to Supplemental Payment Methods for Medicaid Public Providers. Final Stage complete. This regulation became effective on 8/23/2006.
Additional NF Reimbursement for Stage IV Pressure Ulcers Final Stage complete. This regulation became effective on 8/9/2006.
Increase in Nursing Home Rates Fast-Track Stage complete. This regulation became effective on 7/1/2005.
Transition to New Capital Paym Method (R) Final Stage complete. This regulation became effective on 10/4/2004.
Discontinue Adult Specialized Care Services Reimbursement Final Stage complete. This regulation became effective on 7/1/2004.
Limit Indirect and Direct Care Inflation for FY 2004 Emergency Stage complete. Emergency regulation expired on 6/30/2004.
Supplemental Payments for Inpatient and Outpatient Services Final Stage complete. This regulation became effective on 1/28/2004.
NHPS: Revise Indirect Cost Formula Final Stage complete. This regulation became effective on 7/1/2003.
Nursing Home Payment System PIRS Methodology NOIRA Stage withdrawn on 7/2/2002 before the Governor's office completed its review.
Nursing Home Payment System: Resource Utilization Groups (RUGS) Final Stage complete. This regulation became effective on 7/1/2002.
Provider Appeals Final Stage complete. This regulation became effective on 7/4/2001.
2000 Nursing Home Payment System Final Stage complete. This regulation became effective on 7/1/2001.
Nursing Facility Reimbursement System NOIRA Stage withdrawn on 7/24/2000 after the Governor's office completed its review.
Nursing Home Payment System: Increase Payments for Increased Certified Nurse Aide Salaries and Other Direct Costs Emergency Stage withdrawn on 8/13/1999 prior to publication in The Virginia Register.
CH 0080 Reimbursement - Hospitals -
2016 and 2017 Provider Reimbursement Changes -
Intergovernmental Transfers (IGT) -

Withdrawn Actions
Action Title Latest Stage Status
Reimbursement Changes Affecting Long Term Care -
2016 Institutional Provider Reimbursement -
2010 Reimbursment Changes (Stimulus)
This action is exempt from the executive branch review process.
Final Stage withdrawn on 11/12/2013 before submission to the Registrar.
Reimbursement for NF Specialized Care Ancillary Services Proposed Stage withdrawn on 6/6/2007 before DPB completed its review.
NF Credit Balance Reporting NOIRA Stage withdrawn on 4/12/2004 after the comment period had ended.