2020 Session

Budget Amendments - HB30 (Conference Report)

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Nursing Home Specialized Care Rates (language only)

Item 313 #8c

Item 313 #8c

Health and Human Resources
Department of Medical Assistance Services


Page 321, after line 18, insert:

"GGGG.  The Department of Medical Assistance Services shall amend the State Plan for Medical Assistance to establish Specialized Care operating rates for fiscal years 2021 and 2022 by inflating the fiscal year 2020 rates using Virginia nursing home inflation.  After fiscal year 2022, the department shall revert to the existing cost-based methodology.  The department has the authority to implement this change notwithstanding current regulations and consistent with the approved State Plan amendment."


(This amendment adds language authorizing the Department of Medical Assistance Services (DMAS) to use an alternate methodology for setting operating rates for nursing homes that provide specialized care (ventilator care, tracheotomy care, etc.) over the 2020-22 biennium until the agency has more reliable managed care cost data. Unlike nursing facility rates that are rebased every three years, specialized care rates are rebased every year. Only a handful of facilities provide specialized care and this is a completely separate rate development from the usual nursing facility rates. Because the most recent cost reports to be used for these rates have data integrity problems, this alternative methodology will allow the agency time to ensure the data is accurate and reliable in setting the rates beyond fiscal year 2022.)