Virginia Regulatory Town Hall View Chapter

Department of Medical Assistance Services

Board of Medical Assistance Services

State Plan Under Title XIX of the Social Security Act Medical Assistance Program; General Provisions [12 VAC 30 ‑ 10]

Chapter Information

Description	This chapter contains the federal preprinted State Plan pages that are prepared and issued by the Centers for Medicare and Medicaid Services.
State Authority	COV 32.1-325
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	To protect public health, safety, and welfare with the least possible costs and intrusiveness to the citizens and businesses of the Commonwealth. This chapter permits the Commonwealth to claim billions of dollars of federal matching funds by conforming to the mandated page templates provided by the federal Medicaid authority (Centers for Medicare and Medicaid Services).
Meetings

Contact Information

Name / Title:	Emily McClellan / Regulatory Supervisor
Address:	Policy Division, DMAS 600 East Broad St., Suite 1300 Richmond, VA 23219
Email Address:	Emily.McClellan@DMAS.Virginia.gov
Telephone:	(804)371-4300 FAX: (804)786-1680 TDD: ()-

Action Title	Latest Stage	Status
Current Actions
State-Based Exchange	Fast-Track	Attorney General review in progress.
Medicaid Enterprise System Updates	Final	Attorney General review in progress.
Third Party Liability Update	Fast-Track	Stage complete. This regulation became effective on 05/08/2025.
12 Months Postpartum	Emergency/NOIRA	Attorney General review in progress.

Action Title	Latest Stage	Status
Past Actions
Tribal Consultation	Final	Stage complete. This regulation became effective on 11/11/2021.
SNAP Income to Determine Medicaid Eligibility	Fast-Track	Stage complete. This regulation became effective on 09/02/2021.
Update to Drug Utilization Review Program	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.
2016 Psychiatric Residential Treatment Services Program Changes	Final	Stage complete. This regulation became effective on 08/22/2019.
CH 0010 Requirements for LTC Facilities	Final	Stage complete. This regulation became effective on 10/19/2017.
Provider Screening Requirements	Final	Stage complete. This regulation became effective on 10/19/2016.
Public Assistance Reporting Information System (PARIS)	Final	Stage complete. This regulation became effective on 04/10/2013.
Recovery Audit Contractors	Final	Stage complete. This regulation became effective on 10/25/2012.
Medicaid Prohibition on Payments to Institutions or Entities Located Outside of the United States	Final	Stage complete. This regulation became effective on 07/06/2011.
Premium Assistance Option under CHIPRA	Final	Stage withdrawn on 09/28/2010 prior to submitting for AG review.
2010 Reimbursement and Provider Termination Changes	Final	Stage complete. This regulation became effective on 07/01/2010.
Managed Care Provider Exclusion	Final	Stage complete. This regulation became effective on 10/01/2009.
Estate Recovery Update	Final	Stage complete. This regulation became effective on 07/23/2009.
Attorney General Regulatory Reform Task Force Changes	Final	Stage complete. This regulation became effective on 04/15/2009.
Cooperation with Medicaid Integrity Program Efforts	Final	Stage complete. This regulation became effective on 11/26/2008.
Employee Education About False Claims Act	Final	Stage complete. This regulation became effective on 11/01/2007.
2007 Omnibus: False Claims Recoveries;Third Party Liability	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.
Program of All-Inclusive Care for the Elderly (PACE)	Fast-Track	Stage complete. This regulation became effective on 07/01/2007.
Periodic Review of Estate Recoveries	NOIRA	Stage withdrawn on 02/05/2007 after the comment period had ended.
Prospective Drug Utilization Review	Final	Stage complete. This regulation became effective on 01/03/2005.
2003 Omnibus Mandatory Revisions	Final	Stage complete. This regulation became effective on 07/01/2003.
2001 Technical (9-Part) Amendment	Final	Stage complete. This regulation became effective on 01/16/2002.
Provider Appeals	Final	Stage complete. This regulation became effective on 07/04/2001.
Central Processing Unit: Medicaid Eligibility Determination	Final	Stage complete. This regulation became effective on 08/01/2001.
Residential Psychiatric Treatment under EPSDT	Final	Stage complete. This regulation became effective on 01/01/2001.
Program of All-Inclusive Care for the Elderly (PACE)	Final	Stage complete. This regulation became effective on 07/01/2000.
Medicaid Fraud/Abuse Detection/ Investigation;Free Choice of Providers; Conflict of Interest	Final	Stage complete. This regulation became effective on 10/13/1999.

Action Title	Latest Stage	Status
Withdrawn Actions
Removal of Cost-Sharing	Fast-Track	Stage withdrawn on 04/25/2024 prior to submitting for AG review.
Barrier Crimes Not Permitted	Fast-Track	Stage withdrawn on 09/29/2023 prior to submitting for AG review.
Requirements for LTC Facilities	Final	Stage withdrawn on 07/05/2017 prior to submitting for AG review.

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