2013 Session

Budget Amendments - HB1500 (Member Request)

View Budget Item
View Budget Item amendments

Chief Patron: Governor McDonnell
Provide Authority for Medicaid Reform Efforts (language only)

Item 307 #33g

Item 307 #33g

Health And Human Resources
Medical Assistance Services, Department of

Page 280, after line 14, insert:
"JJJJ. The Department of Medical Assistance Services shall seek federal authority through any necessary waiver(s) and/or State Plan authorization under Titles XIX and XXI of the Social Security Act to reform the Virginia Medicaid/FAMIS service delivery model for all recipients subject to a Modified Adjusted Gross Income (MAGI) methodology for program eligibility and any other recipient categories not excluded from the Medallion II managed care program.  The reformed service delivery model shall be predicated upon principles of commercial health insurance, including but not limited to benefit design and participant cost-sharing, and shall encourage the development and implementation of value-based, coordinated purchasing.  To administer this reformed delivery model, the department shall contract with qualified health plans to offer recipients a Medicaid benefit package adhering to these principles.  This reformed service delivery model shall be mandatory, to the extent allowed under the relevant authority granted by the federal government, for all relevant recipients in the Medicaid/FAMIS programs.  Additional services offered to relevant recipients outside of the reformed delivery model shall be at the discretion of the department, with federal approval, when deemed by the department to be cost-effective for the Commonwealth.  The department shall have authority to implement necessary changes when feasible after federal approval and prior to the completion of any regulatory process undertaken in order to effect such change."

(This amendment provides authority for the Department of Medical Assistance Services to seek waivers or state plan amendments in order to implement reforms in the Medicaid and FAMIS programs. These reforms are intended to improve Medicaid and FAMIS based on successful principles used in commercial health insurance.)