2017 Session

Budget Amendments - HB1500 (Member Request)

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Chief Patron: Ingram
Co-Patron(s): Anderson, Austin, Garrett, Minchew, O'Bannon
Modify Supplemental Payment Methodology for Public Nursing Homes (language only)

Item 306 #9h

Item 306 #9h

Health and Human Resources
Department of Medical Assistance Services


Page 304, line 46, after "3." insert "a."

Page 305, after line 7 insert:

"b. If by June 30, 2017 DMAS has not secured CMS approval to use a minimum fee schedule pursuant to 42 C.F.R. § 438.6(c)(1)(iii) for local government-owned nursing homes participating in Commonwealth Coordinated Care Plus (CCC Plus) at the same level as and in lieu of the supplemental Medicaid payments authorized in Section RRR.3.a., then DMAS shall: (i) exclude Medicaid recipients who elect to receive nursing home services in local government-owned nursing homes from CCC Plus; (ii) pay for such excluded recipient's nursing home services on a fee-for-service basis, including the related supplemental Medicaid payments as authorized herein; and (iii) prohibit CCC Plus contracted health plans from in any way limiting Medicaid recipients from electing to receive nursing home services from local government-owned nursing homes."


(This amendment adds language related to supplemental Medicaid payments for local government-owned nursing homes. Currently five local -government owned nursing homes provide Department of Medical Assistance Services (DMAS) with funding to draw down matching federal funds for reimbursement for services provided to Medicaid recipients. A portion of the matching federal funds are retained by DMAS as Certified Public Expenditure Revenues. New federal regulations prevent Medicaid from making supplemental payments to these facilities when the Department of Medical Assistance Services (DMAS) implements its managed long-term care services and supports program (CCC Plus) on July 1, 2017. This language would allow DMAS to exempt residents admitted to these facilities from the CCC Plus program, similar to how DMAS treats Virginia's veteran nursing facilities. Language would prohibit CCC Plus contracted health plans from limiting Medicaid recipients from choosing to receive nursing home services from these facilities.)