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 shall implement a number of changes in reimbursement methodology July 1, 2012, pursuant to Item 307 of the 2012 Appropriation Act.

Reimbursement Changes Affecting Hospitals (12 VAC 30-70)

Limit Inflation to 2.6 Percent for Inpatient Hospitals (Including Long-Stay and Freestanding Psychiatric Hospitals)

12VAC30-70-50 is being amended to limit the inflation adjustment for long-stay hospitals to 2.6 percent. 12VAC30-70-351 is being amended to limit the inflation adjustment for inpatient hospital, including freestanding psychiatric hospital, operating rates to 2.6 percent.  These changes are mandated by Item 307.LLL of the 2012 Appropriation Act,

$14,721,558 GF; $11,767,125 NGF; $26,488,682 TF

12VAC30-70-351 is also being amended to:

1) Limit the inflation adjustment for inpatient hospital disproportionate share hospital (DSH) payments to 2.6 percent for all hospitals.  This change is mandated by Item 307.LLL of the 2012 Appropriation Act. $765,811 GF; $765,811 NGF; $1,531,622 TF

2) Limit the inflation adjustment for graduate medical education (GME) payments to 2.6 percent for all hospitals.  This change is mandated by Item 307.LLL of the 2012 Appropriation Act. $474,563 GF; $179,251 NGF; $653,814 TF

12VAC30-80-96 is being amended to increase the reimbursement for early intervention targeted case management services by 10 percent. This change is mandated by Item 307.PPP of the 2012 Appropriation Act. $274,752 GF; $274,752 NGF; $549,504 TF

12VAC30-80-180 is being amended to eliminate inflation adjustment for home health agencies for state fiscal year (SFY) 2013. This change is mandated by Item 307.GGG of the 2012 Appropriation Act. ($77,063) GF; ($77,063) NGF; ($154,126) TF

12VAC30-80-200 is being amended to eliminate inflation adjustment for outpatient rehabilitation agencies for SFY 2013. This change is mandated by Item 307.GGG of the 2012 Appropriation Act. ($206,872) GF; ($206,872) NGF; ($413,744) TF

Reimbursement Changes Affecting Nursing Facilities (12 VAC 30-90)

12VAC30-90-41 is being amended to eliminate rebasing in SFY 2013, limit the inflation adjustment for operating rates to 2.2 percent, and limit the inflation adjustment for ceilings to 3.2 percent for nursing facilities and specialized care facilities. This change is mandated by Item 307.MMM of the 2012 Appropriation Act. $11,529,215 GF; $11,529,215 NGF; $23,058,430 TF

12VAC30-90-36 is being amended to reduce the nursing facility capital rental rate floor from 9.0 to 8.5 percent, which would have been restored to 9.0 from 8.5 percent effective July 1, 2012. This change is mandated by Item 307.UUU of the 2012 Appropriation Act.

($2,500,000) GF; ($2,500,000) NGF; ($5,000,000) TF

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 East 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.