2000 Session

Budget Amendments - SB30 (Conference Report)

View Budget Item
View Budget Item amendments

JLARC Study Medicaid Rates for Hospitals (language only)

Item 20 #6c

Item 20 #6c

Legislative Department
Joint Legislative Audit and Review Commission

Page 14, after line 58, insert:
"G.  The Joint Legislative Audit and Review Commission shall examine the Virginia Medicaid program's methodology for determining hospital inpatient rates.  The review shall consider past General Assembly intent and direction concerning the implementation of a prospective hospital payment system and the extent to which it is reflected in the current reimbursement system.  The review also shall include  (i) a comparison of Virginia's reimbursement for hospital inpatient care with other states and other payors; (ii) the accuracy of the Department of Medical Assistance Services' claims data base; (iii) the appropriateness of the Department's rate setting and rebasing processes and the cost settlement of the 1997 and 1998 cost reports; (iv) the application of retroactive changes in reimbursement for services rendered during fiscal years 1998, 1999, and 2000, and options for addressing them, if warranted; (vi) a comparison of Diagnosis Related Groupings rates applied to hospital payments during fiscal years 1998, 1999, and 2000; (vii) the adequacy of current hospital rates, including whether they afford hospitals a reasonable opportunity to recover their costs; and (viii) other issues as may seem appropriate.  The Department shall cooperate fully as requested by JLARC and its staff.  The Commission shall report its findings and recommendations to the Chairmen of the Senate Finance and House Appropriations Committees by November 15, 2000."

(This amendment directs JLARC to evaluate the Medicaid payment methodology used for reimbursement of hospital inpatient care. A companion amendment in Item 319 provides funds to the Department of Medical Assistance Services for an adjustment in payments to hospitals.)