2016 Session

Budget Amendments - SB30 (Member Request)

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Chief Patron: Howell
Physician Supplemental Payments for Children's National Health System

Item 306 #19s

Item 306 #19s

First Year - FY2017 Second Year - FY2018
Health and Human Resources
Department of Medical Assistance Services FY2017 $1,419,065 FY2018 $1,419,065 GF

Page 250, line 34, strike "$9,740,405,698" and insert "$9,741,824,763".
Page 250, line 34, strike "$11,552,255,000" and insert "$11,553,674,065".

Page 270, after line 31, insert:

"5.  The Department of Medical Assistance Services shall amend the State Plan for Medical Assistance to increase the supplemental physician payments for physicians employed at a freestanding children's hospital serving children in Planning District 8 with more than 50 percent Medicaid inpatient utilization in fiscal year 2014 to the maximum allowed by the Centers for Medicare and Medicaid Services.  The total supplemental Medicaid payment shall be based on the Upper Payment Limit approved by the Centers for Medicare and Medicaid Services and all other Virginia Medicaid payments. The department shall have the authority to implement these reimbursement  changes effective July 1, 2016, and prior to the completion of any regulatory process undertaken in order to effect such change."


(This amendment provides funding to Children's National Health System to ensure that they are able to continue to provide the highest level of care to thousands of Virginia children with a broad spectrum of chronic and acute health needs in Northern and Central Virginia regardless of their families' ability to pay. These payments also ensure that Children's Virginia patients have access to every type of pediatric subspecialist, surgeon and pediatrician needed in a highly coordinated, efficient and regionalized system of care in greater Northern Virginia. These payments further ensure access to Children's 313 NICU and Inpatient beds, including a dedicated 54 Level IV NICU (American Academy of Pediatrics' highest designation), as well as the region's only pediatric-only trained flight teams-rapid helicopter transport service, and STAT MedEvac. Physician Supplemental Payments would help Children's address critical workforce development needs as the region's premier teaching hospital for pediatrics and would help by bridging the gap between the pediatric Medicaid rate paid by Virginia to Children's and the Medicare rates. The $1.4 million is less than 15 percent of Children's $11.3 million in physician costs.)