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2020 Session

Budget Amendments - HB30 (Member Request)

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Chief Patron: Davis
Enhanced Rates for Private Acute Care Hospitals

Item 312 #1h

Item 312 #1h

First Year - FY2021 Second Year - FY2022
Health and Human Resources
Department of Medical Assistance Services FY2021 $15,402,333 FY2022 $15,402,333 NGF

Language
Page 293, line 25, strike "$251,515,129" and insert "$266,917,462".
Page 293, line 25, strike "$271,393,523" and insert "$286,795,856".

Page 293, line 29, strike "$251,515,129" and insert "266,917,462"

Page 293, line 29, strike "$271,393,523" and insert "286,795,856"

Page 294, after line 17, insert:

"G. The Department of Medical Assistance Services shall have the authority to amend the State Plan for Medical Assistance under Title XXI to (i) increase inpatient and outpatient payment rates paid to private acute care hospitals operating in Virginia to the upper payment limit gap and (ii) fill the managed care organization hospital payment gap. DMAS shall include such payments in the private acute care hospital enhanced payments authorized in Item 3-5.16 of this act. All other reimbursement for the Children's Health Insurance Security Plan shall take precedence over enhanced payments for private acute care hospitals. DMAS shall promulgate regulations to implement these provisions to be effective within 280 days of its enactment. The department may implement any changes necessary to implement these provisions prior to the promulgation of regulations undertaken in order to effect such changes."



Explanation

(This amendment provides $15.4 million from the nongeneral fund each year from the hospital Provider Payment Assessment to increase rates in the Family Access to Medical Insurance Security (FAMIS) program. When enhanced rate payments for private acute care hospitals was implemented in the Medicaid program in 2019, the Department of Medical Assistance Services did not include FAMIS claims in enhanced payments. This amendment would correct that omission and direct the department to pursue the federal authority necessary to enhance rate payments on FAMIS inpatient and outpatient services. The state share is funded through an assessment on the private acute care hospitals and an increase in payments would have no effect on the general fund.)