Description | This chapter contains the Medicaid requirements applicable to specific services which must be met in order to assure appropriate quality of care. |
State Authority | COV 32.1-325 et seq . |
Federal Authority | Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) |
Text of Regulation | Link to Virginia Administrative Code |
Goals of Regulation | None entered |
Meetings |
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 |
---|---|---|
2020 Long Term Services and Supports (LTSS) Screening Changes | Fast-Track | Stage complete. This regulation became effective on 10/10/2024. |
Mental Health and Substance Use Case Management | Fast-Track | Submitted to the Registrar and awaiting publication (11/18/2024). |
Electronic Visit Verification (EVV) for Home Health and Waiver Services | - | |
Coverage of Medical Nutrition Therapy | - |
Past Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
Repeal of the Documents Incorporated by Reference – Chapter 60 | Fast-Track | Stage complete. This regulation became effective on 09/26/2024. |
Addiction and Recovery Treatment and Substance Use Disorder Services Updates | Fast-Track | Stage complete. This regulation became effective on 12/08/2022. |
Electronic Visit Verification | Final | Stage complete. This regulation became effective on 08/18/2021. |
Home Health Changes Due to Federal Regulatory Change
|
Final | Stage complete. This regulation became effective on 08/19/2020. |
Change from Service Specific Provider Intake to Comprehensive Needs Assessment | Fast-Track | Stage complete. This regulation became effective on 03/17/2022. |
LTSS Screening - Remove Three-Day Allowance After Hospital Discharge
|
Final | Stage complete. This regulation became effective on 12/25/2019. |
Removal of the 21 Out of 60 Day Limit | Fast-Track | Stage complete. This regulation became effective on 10/30/2020. |
CMH and Peers Updates | Fast-Track | Stage complete. This regulation became effective on 04/14/2021. |
ARTS Updates | Fast-Track | Stage complete. This regulation became effective on 03/05/2020. |
CMHRS Documentation of Qualifications | Fast-Track | Stage complete. This regulation became effective on 12/26/2019. |
Service Authorization | Emergency/NOIRA | Stage complete. Emergency regulation was set to expire on 10/01/2022 and was extended until 03/31/2023. |
EPSDT Behavioral Therapy Services | Final | Stage complete. This regulation became effective on 12/12/2018. |
2015 Long Term Services and Supports Screening Changes | Final | Stage complete. This regulation became effective on 08/22/2018. |
Home Health Accrediting Organizations | Fast-Track | Stage complete. This regulation became effective on 10/19/2017. |
VIDES Criteria for care in Intermediate Care Facilities for Individuals with Intellectual Disability | Fast-Track | Stage complete. This regulation became effective on 02/07/2019. |
Revision for CMS Conditions of Participation
|
Final | Stage complete. This regulation became effective on 01/13/2018. |
Face-to-Face Encounter Requirement for Home Health
|
Final | Stage complete. This regulation became effective on 07/13/2017. |
Institutions for Mental Disease Reimbursement Changes | Final | Stage complete. This regulation became effective on 03/08/2017. |
Mental Health Skill-building Services | Final | Stage complete. This regulation became effective on 07/27/2016. |
Repeal MEDALLION Primary Care Case Management Program | Fast-Track | Stage complete. This regulation became effective on 03/28/2014. |
2011 Mental Health Services Program Changes for Appropriate Utilization & Provider Qualifications | Final | Stage complete. This regulation became effective on 01/30/2015. |
Uniform Assessment Instrument Pediatric Guidance | Fast-Track | Stage complete. This regulation became effective on 02/01/2014. |
Technical Corrections for Utilization Review of Community Mental Health Rehabilitation Services | Fast-Track | Stage complete. This regulation became effective on 09/12/2013. |
Inpatient and Outpatient Rehabilitation Update | Fast-Track | Stage complete. This regulation became effective on 01/01/2016. |
Children's Exemption from Hospice Election
|
Final | Stage complete. This regulation became effective on 11/10/2010. |
Elimination of Disease Management Program
|
Final | Stage complete. This regulation became effective on 11/26/2009. |
Substance Abuse Treatment Services | Final | Stage complete. This regulation became effective on 01/21/2010. |
Disease Management Program | Final | Stage complete. This regulation became effective on 07/09/2009. |
Additional NF Reimbursement for Stage IV Pressure Ulcers | Final | Stage complete. This regulation became effective on 08/09/2006. |
Revision of Physician Certification Standards | Fast-Track | Stage complete. This regulation became effective on 08/15/2005. |
Discontinue Adult Specialized Care Services Reimbursement | Final | Stage complete. This regulation became effective on 07/01/2004. |
Home Health Services -- Technical Correction
|
Final | Stage complete. This regulation became effective on 11/28/2003. |
Community Mental Health Rehabilitation Services | Final | Stage complete. This regulation became effective on 12/03/2003. |
NF Administrative Criteria
|
Final | Stage complete. This regulation became effective on 06/20/2002. |
Limit Coverage of Out-of-State Inpatient Hospital Services | Final | Stage complete. This regulation became effective on 01/02/2002. |
Home Health Services Homebound Criterion
|
Final | Stage complete. This regulation became effective on 02/27/2002. |
Case Management for Treatment Foster Care | Final | Stage complete. This regulation became effective on 01/01/2001. |
Hospice Services and Payment Methodology | Final | Stage complete. This regulation became effective on 01/05/2000. |
Withdrawn Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
2020 Long Term Services and Supports (LTSS) Screening Changes | ||
Utilization Review Changes | Final | Stage withdrawn on 04/15/2021 after the Governor's office completed its review. |
Removal of the 21 Out of 60 Day Limit | ||
CMHRS Changes Required by CMS | NOIRA | Stage withdrawn on 11/29/2018 after the comment period had ended. |
Utilization Control: Nursing Facilities - Contract Termination | ||
Physician Face to Face Encounter for Home Health/DME Certification
|
Final | Stage withdrawn on 10/13/2016 prior to submitting for AG review. |
Nursing Facility Criteria and Recipient Eligibility
|
Final | Stage withdrawn on 11/12/2013 before submission to the Registrar. |
CH 0060 UAI for Children | ||
Medicaid Works, a Medicaid Buy-In Program | ||
Mental Health Services Program Changes to Ensure Appropriate Utilization and Provider Qualifications | Emergency/NOIRA | Stage withdrawn on 01/13/2012 after the comment period had ended. |
Periodic Reviews | ||
Last Activity | Status | |
---|---|---|
3/7/2012 Agency Completed | Amend |