2016 Session

Budget Amendments - SB30 (Member Request)

View Budget Item
View Budget Item amendments

Chief Patron: McDougle
Increase Medicaid Rates for Adult Day Health Care Services (language only)

Item 306 #12s

Item 306 #12s

Health and Human Resources
Department of Medical Assistance Services


Page 274, after line 33, insert:

"SSSS.  Out of this appropriation, $636,037 from the general fund and $636,037 from nongeneral funds  the first year and $700,644 from the general fund and $700,644 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 20 percent.  The department shall have the authority to implement this reimbursement change effective July 1, 2016, and prior to the completion of any regulatory process undertaken in order to effect such change."


(This amendment adds funds to provide a 20 percent 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 $60.10/unit to $72.12/unit in Northern Virginia and from $55.65/unit to $66.78/unit in the rest of the state. A "unit" represents 6 or more hours in a day.)