LEGAL NOTICE

COMMONWEALTH OF VIRGINIA

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

Notice of Intent to Increase Payments

for Certain Physician Services

Notice is hereby given that the Department of Medical Assistance Services (DMAS) intends to modify its reimbursement plan for physician services pursuant to the Department’s authority under Title XIX of the Social Security Act. 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).  The changes contained in this public notice are occurring in response to mandates from the 2005 General Assembly.

This regulatory action is intended to implement the mandated physician rate increases included in the 2005 Appropriation Act, Items 326 JJJ (2), VVV, WWW, and XXX directed various physician rate increases for an effective date of May 1, 2006.  Specifically, the Act mandated a 3% increase for Emergency Room Services, a 2.5% increase for Obstetrical and Gynecological Services, a 5% increase for Pediatric Services, and a 5% increase for Adult Primary and Preventative Care Services.  In order to implement these rate increases, 12VAC30-80-190 needs to be amended.  This section of the Administrative Code defines the methodology for physician fee schedule rate setting under the Resource Based Relative Value Scale (RBRVS) system.

A copy of this notice is available for public review from Scott Crawford, Director, Provider Reimbursement Division, DMAS, 600 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. Crawford and such comments are available for review at the same address.