2013 Session

Budget Amendments - HB1500 (Committee Approved)

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Increase Medicaid Adult Day Health Care Rates

Item 307 #5h

Item 307 #5h

First Year - FY2013 Second Year - FY2014
Health And Human Resources
Medical Assistance Services, Department of FY2013 $0 FY2014 $300,000 GF
FY2013 $0 FY2014 $300,000 NGF

Page 263, line 15, strike "$8,033,837,513" and insert "$8,034,437,513".
Page 280, after line 14, insert:
"JJJJ.  Out of this appropriation, $300,000 from the general fund and $300,000 from nongeneral funds  the second year shall be used to increase reimbursement rates for adult day health services provided through Medicaid home- and community-based waiver programs  by $5.00 per unit.  The department shall have the authority to implement this reimbursement change effective July 1, 2013, and prior to the completion of any regulatory process undertaken in order to effect such change."

(This amendment provides $300,000 from the general fund and $300,000 from matching federal Medicaid funds to provide a $5.00 per unit increase in the Medicaid waiver reimbursement rate for adult day health services. Adult day health care is much less expensive than alternative care in a nursing facility for which these clients qualify. Providers of adult day health care report a gap of $18.13 per client per day between actual costs and Medicaid reimbursement, which must be made up through contributions from individuals, churches, corporations, and foundations. These services are almost exclusively provided to Medicaid waiver recipients. This amendment will increase the statewide rate paid for Medicaid adult day health care services from $50.10/unit to about $55.10/unit in Northern Virginia and from $45.65/unit to about $50.65/unit in the rest of the state. A "unit" represents 6 or more hours in a day.)