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


chapter
Standards Established and Methods Used to Assure High Quality Care [12 VAC 30 ‑ 60]
Guidance Documents
Chapter Information
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 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
LTSS Screening - Remove Three-Day Allowance After Hospital Discharge
This action is exempt from the executive branch review process.
Final Submitted to the Registrar and awaiting publication (11/25/2019).
Removal of the 21 Out of 60 Day Limit Fast-Track Governor's office review in progress.
ARTS Updates Fast-Track DPB review in progress.
CMHRS Documentation of Qualifications Fast-Track Comment period is underway and will end on 12/11/2019.
Electronic Visit Verification Proposed Governor's office review in progress.
Utilization Review Changes Final Governor's office review in progress.

Past Actions
Action Title Latest Stage Status
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
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 01/13/2018.
Face-to-Face Encounter Requirement for Home Health
This action is exempt from the executive branch review process.
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
This action is exempt from the executive branch review process.
Final Stage complete. This regulation became effective on 11/10/2010.
Elimination of Disease Management Program
This action is exempt from the executive branch review process.
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
This action is exempt from the executive branch review process.
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
This action is exempt from the executive branch review process.
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
This action is exempt from the executive branch review process.
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.
CMH and Peers Updates
Coverage of Medical Nutrition Therapy
Service Authorization

Withdrawn Actions
Action Title Latest Stage Status
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
This action is exempt from the executive branch review process.
Final Stage withdrawn on 10/13/2016 prior to submitting for AG review.
Nursing Facility Criteria and Recipient Eligibility
This action is exempt from the executive branch review process.
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.

Past Periodic Reviews
Date Filed Status
3/7/2012 Amend