LEGAL NOTICE
COMMONWEALTH OF VIRGINIA
DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
NOTICE OF INTENT TO AMEND
(Pursuant to §1902(a)(13) of the Act (U.S.C. 1396a(a)(13))
THE VIRGINIA STATE PLAN FOR MEDICAL ASSISTANCE
The Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to amend the Virginia State Plan for Medical Assistance to provide for changes to the Methods and Standards for Establishing Payment Rates—Inpatient Hospital Services (12 VAC 30-70); Methods and Standards for Establishing Payment Rates—Other Types of Care (12 VAC 30-80); and Methods and Standards for Establishing Payment Rates—Long Term Care (12 VAC 30-90). The Department intends to implement a number of changes and clarifications in reimbursement methodology effective July 1, 2010.
Reimbursement Changes Affecting Hospitals (12 VAC 30-70)
The State Plan for Medical Assistance is being amended to clarify that reimbursement to facilities operated by the Department of Behavioral Health and Developmental Services (DBHDS) is based on costs. In addition, the formula for Disproportionate Share Hospital payments to DBHDS facilities will be revised to maintain the same level of total reimbursement even if some of the facilities exceed the hospital specific DSH limit.
Reimbursement Changes Affecting Other Providers (12 VAC 30-80)
The State Plan for Medical Assistance is being amended to make a supplemental payment for hospital outpatient services to Type One hospitals (state teaching hospitals) to fully cover its costs.
Reimbursement Changes Affecting Nursing Facilities (12 VAC 30-90)
The State Plan for Medical Assistance is being amended to clarify that reimbursement to nursing facilities and intermediate care facilities operated by the Department of Behavioral Health and Developmental Services and nursing facilities operated by the Department of Veterans Affairs is based on costs.
The State Plan for Medical Assistance is being amended to clarify that DMAS may grant an exception to the minimum occupancy requirement for reimbursement purposes for beds taken out of service for renovation.
This notice is intended to satisfy the requirements of 42 C.F.R. § 447.205 and of § 1902(a)(13) of the Social Security Act, 42 U.S.C. § 1396a(a)(13). A copy of this notice is available for public review from William Lessard, Provider Reimbursement Division, DMAS, 600 Broad Street, Suite 1300, Richmond, VA 23219, and this notice is available for public review on the Regulatory Town Hall (www.townhall.com). Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Mr. Lessard and such comments are available for review at the same address.
