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

This Notice was posted on April 6, 2017

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).

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 Broad Street, Suite 1300, Richmond, VA  23219, or via e-mail at:  William.Lessard@dmas.virginia.gov.

DMAS is specifically soliciting input from stakeholders, providers and beneficiaries, on the potential impact of the proposed change in methodology for setting disproportionate share hospital (DSH) payment rates for Piedmont and Catawba hospitals.  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.  Comments may also be submitted, in writing, on the Town Hall public comment forum attached to this notice.

This notice is available for public review on the Regulatory Town Hall (www.townhall.com), on the General Notices page, found at:  https://townhall.virginia.gov/L/generalnotice.cfm

DMAS is making these changes in its methods and standards for setting payment rates for services in order to comply with a request from the Center for Medicare and Medicaid Services (CMS) to modify the method for making payments under the DSH program for two facilities operated by the Department of Behavioral Health and Development Services. The change would even out the payments to Piedmont and Catawba hospitals so that neither payment would exceed the amount allowed under Medicaid but it would not change the total amount paid to the two hospitals.

This change is necessary because under the current methodology, the DSH payments to Piedmont Hospital often exceed the amount that can be paid to that hospital. The current method allows for the extra payments to be paid to Catawba Hospital (up to the Medicaid limits) at the time of cost settlement. With this change, DMAS could avoid making excess DSH payments to Piedmont Hospital.

The expected increase in annual aggregate expenditures is $0.