Virginia Regulatory Town Hall View Chapter

Department of Medical Assistance Services

Board of Medical Assistance Services

Eligibility Conditions and Requirements [12 VAC 30 ‑ 40]

Chapter Information

Description	This chapter contains all of the income and resource requirements and restrictions which must be met in order for an individual to be found to be eligible for one or more of the categories of eligibility, thereby qualifying the individual for Medicaid covered services.
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

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: ()-

Action Title	Latest Stage	Status
Current Actions
12 Months Postpartum	Emergency/NOIRA	Attorney General review in progress.

Action Title	Latest Stage	Status
Past Actions
Expansion-Related Changes - Expansion Group, FMAP, HIPP, Determination State	Fast-Track	Stage complete. This regulation became effective on 03/17/2022.
Disregard Sterilization Compensation in Eligibility Determinations	Final	Stage complete. This regulation became effective on 06/15/2017.
2015 Treatment of Annuities	Fast-Track	Stage complete. This regulation became effective on 07/27/2017.
CH 0040 Coverage in Approved Supportive Housing	Fast-Track	Stage complete. This regulation became effective on 06/29/2017.
Real Property Appraisals for Resource Eligibility	Final	Stage complete. This regulation became effective on 09/21/2016.
CH 0030 Modified Adjusted Gross Income (MAGI) Methodology	Fast-Track	Stage complete. This regulation became effective on 07/27/2017.
2014 Medicaid Works-Federal Changes	Fast-Track	Stage complete. This regulation became effective on 12/31/2015.
Coverage of Lawfully Residing Pregnant Women and Children	Final	Stage complete. This regulation became effective on 07/17/2013.
Asset Verification System	Final	Stage complete. This regulation became effective on 01/03/2013.
Update to Medicaid Works Income Limit	Fast-Track	Stage complete. This regulation became effective on 12/19/2013.
Increase Resource Limits for Medicare Savings Program Groups	Final	Stage complete. This regulation became effective on 04/14/2010.
Social Security Number Data Match for Verification of Citizenship and Identity	Fast-Track	Stage complete. This regulation became effective on 12/17/2015.
Coverage of Legal Immigrant Children	Fast-Track	Stage complete. This regulation became effective on 02/17/2011.
Medicaid Buy-In program	Final	Stage complete. This regulation became effective on 07/23/2009.
HIPP Program Modifications	Fast-Track	Stage complete. This regulation became effective on 07/23/2009.
Medicaid Eligibility Income Disregards	Fast-Track	Stage complete. This regulation became effective on 03/19/2009.
Personal Needs Allowance (PNA) Increase	Final	Stage complete. This regulation became effective on 07/01/2007.
Medicare Prescription Drug Program (Part D)	Final	Stage complete. This regulation became effective on 03/07/2007.
Long Term Care Partnership Insurance	Fast-Track	Stage complete. This regulation became effective on 09/01/2007.
Mandatory Changes Pursuant to the Federal Deficit Reduction Act	Final	Stage complete. This regulation became effective on 08/09/2006.
Mandatory changes under the federal Deficit Reduction Act of 2005	Final	Stage withdrawn on 06/14/2006 before Attorney General's office completed its review.
Treatment of Annuities in Medicaid Eligibility Determinations	Proposed	Stage withdrawn on 03/08/2006 before the Secretary's office completed its review.
Discontinue Resource Test and Counting of Earned Income for Family and Children Groups	Fast-Track	Stage complete. This regulation became effective on 09/25/2004.
Reasonable Limits on Amounts for Necessary Medical or Remedial Care	Final	Stage complete. This regulation became effective on 07/01/2004.
ADAPT	Final	Stage complete. This regulation became effective on 12/03/2003.
Freeze the CPI Adjustment for Categorically Needy, Medically Needy and Standards of Assistance Income Limits through FY 2004	Emergency	Stage complete. Emergency regulation expired on 06/30/2004.
Medicaid Eligibility Expansion to 133% of Federal Poverty Level	Final	Stage complete. This regulation became effective on 09/01/2002.
MNIL, Standards of Assistance, More Liberal Disregards	Final	Stage complete. This regulation became effective on 07/01/2002.
Medically Needy Income Limits	Final	Stage complete. This regulation became effective on 07/01/2001.
Medicaid Eligibility under Sec. 1931 REVISED	Final	Stage complete. This regulation became effective on 11/22/2000.
Eligibility under sec 1931 of the Act.	Final	Stage complete. This regulation became effective on 05/10/2000.

Action Title	Latest Stage	Status
Withdrawn Actions
Repeal of Out-of-Date and Unnecessary Regulations	Fast-Track	Stage withdrawn on 04/10/2024 before Attorney General's office completed its review.
Property Sales at Less Than Taxed Assessed Value	Fast-Track	Stage withdrawn on 10/06/2016 before the Governor's office completed its review.
2014 Medicaid Works-Federal Changes
Medicaid Buy-In	Emergency/NOIRA	Stage withdrawn on 03/06/2007 before the Secretary's office completed its review.
Medicaid Works, a Medicaid Buy-In Program	Emergency/NOIRA	Stage withdrawn on 01/16/2007 after Attorney General's review.
Coverage of Legal Immigrant Children	Fast-Track	Stage withdrawn on 11/20/2009 prior to publication in The Virginia Register.
Resources and Transfers	Proposed	Stage withdrawn on 03/03/2009 before the Secretary's office completed its review.
Treatment of Life Estates	Proposed	Stage withdrawn on 02/24/2009 before Attorney General's office completed its review.