2021 Session

Budget Amendments - HB1800 (Member Request)

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Chief Patron: Sickles
Continue Nursing Home $20 Per Diem Payment & Develop Rate Reform Proposals

Item 313 #25h

Item 313 #25h

First Year - FY2021 Second Year - FY2022
Health and Human Resources
Department of Medical Assistance Services FY2021 $0 FY2022 $55,526,740 GF
FY2021 $0 FY2022 $55,526,740 NGF

Page 345, line 39, strike "$17,494,923,315" and insert "$17,605,976,795".

Page 380, line 10, after "LLLLL." insert "1."

Page 380, line 11, strike "2021" and insert "2022".

Page 380, after line 17, insert:

"2. The Department of Medical Assistance Services in cooperation with the Office of the Secretary of Health and Human Resources, nursing facility representatives designated by the Virginia Health Care Association, LeadingAge Virginia, the Virginia Hospital and Healthcare Association and the staff of the House Appropriations and Senate Finance and Appropriations Committee, shall develop Medicaid reimbursement reform proposals designed to address the funding of Medicaid-covered nursing facility services, recognize infrastructure needs and modern building configurations, and incentivize quality improvement. Rate reforms considered shall include, but are not limited to: an increased percentage of Medicaid days with cost coverage; modification/elimination of outdated minimum occupancy requirements; recognition of private rooms through capital reimbursement; incentivizing building renovations for older infrastructure; and, elimination of outdated payment policy such as the Medicaid allowable limits for dual eligible Medicaid Part A crossover claims. The department shall also consider the development of an additional Medicaid payment for nursing facilities based on progressing toward or meeting quality improvement metrics. These reforms would apply to both the managed care and fee-for-service programs.

3. The department shall develop cost estimates of proposals which shall be completed by October 31, 2021 to allow for consideration by the Governor and General Assembly for inclusion in the Governor's introduced 2022-24 biennial budget.

4. It is intended that nursing facility payment reforms resulting from this process would be implemented upon the cessation of the $20 per diem payment as provided in paragraph LLLL.1. above.


(This amendment adds $55.5 million the second year from the general fund and a like amount of federal Medicaid matching funds to continue the $20 per day add-on through the current biennium while the Department of Medical Assistance Services works with the Office of the Secretary of Health and Human Resources, nursing facility and hospital representatives, aging services organizations, and staff of the money committees on more permanent reimbursement reforms to be considered for implementation in the 2022-24 biennium. The reforms to be considered should address dated funding policies which negatively impact the provision of high quality services and encourage reinvestment by nursing facilities in both facilities and quality improvement.)