2013 Session

Budget Amendments - HB1500 (Committee Approved)

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Medicaid IME Payments for CHKD (language only)

Item 307 #8h

Item 307 #8h

Health And Human Resources
Medical Assistance Services, Department of

Page 280, after line 14, insert:  
"JJJJ.  The Department of Medical Assistance Services shall amend the State Plan for Medical Assistance to calculate an indirect medical education (IME) factor for Virginia freestanding children’s hospitals with greater than 50 percent Medicaid utilization in 2009 already eligible for IME in a manner similar to Type One hospitals.  Total payments for IME in combination with other payments for such freestanding children’s hospitals may not exceed the federal uncompensated care cost limit that disproportionate share hospital payments are subject to.  The Department shall have the authority to implement these reimbursement changes effective July 1, 2013, and prior to completion of any regulatory process undertaken in order to effect such change.”

(This amendment adds language to ensure continuation of Children's Hospital of the King's Daughters' (CHKD) ability to receive Medicaid reimbursement to cover its uncompensated care costs. This amendment protects Virginia’s only freestanding children’s hospital from cuts to the disproportionate share hospital (DSH) payment program directed through the federal Patient Protection and Affordable Care Act (PPACA). With greater than 50 percent of its inpatient days covered by Medicaid, CHKD’s Medicaid utilization is double the next closest provider, resulting in the receipt of more than half of Virginia’s DSH funds that are allocated to private hospitals. This amendment would not require additional funding from the state based on current DSH policy. This amendment significantly increases the amount of authorized indirect medical education (IME) funding to substitute for most or all of the DSH funds allocated to CHKD. It also provides that CHKD will continue to be reimbursed up to the federal uncompensated care cost limit.)