2022 Session

Budget Amendments - HB30 (Floor Approved)

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Medicaid Mobile Vision Pilot Program

Item 304 #1h

Item 304 #1h

First Year - FY2023 Second Year - FY2024
Health and Human Resources
Department of Medical Assistance Services FY2023 $386,177 FY2024 $422,777 GF
FY2023 $485,837 FY2024 $295,637 NGF
FY2023 2.00 FY2024 2.00 FTE

Page 313, line 47, strike "$18,732,988,737" and insert "$18,733,860,751".
Page 313, line 47, strike "$19,820,607,534" and insert "$19,821,325,948".

Page 340, after line 10, insert:

"PPPP.1. Effective July 1, 2022, the Department of Medical Assistance Services (DMAS) shall issue a Request for Proposal and implement a two-year mobile vision provider pilot program. The pilot program will identify at least two mobile vision providers to provide comprehensive vision care services to children in school-based settings as provided in this paragraph. The pilot will evaluate the health and financial outcomes in at least one urban/suburban area and at least one rural area. To cover these services for children enrolled with a Medicaid managed care organization (MCO), the Department shall revise its MCO contracts to require the pilot mobile vision providers to participate in MCO networks as participating providers and receive additional subsidy to cover the cost of services for uninsured/underinsured students and general administrative and operational costs connected with mobile service provision. Mobile vision providers participating in the pilot program are responsible for facilitating data matching activities in order to identify Medicaid and Family Access to Medical Insurance Security (FAMIS) eligible children and bill their assigned MCOs for eligible services provided.

2. Mobile vision providers shall provide comprehensive vision services including, at a minimum, a comprehensive vision  exam  in compliance with recognized clinical standards to include the use of wide angle technology, lenses, frames, and fittings.

3. In order to participate in the pilot, a mobile vision provider shall have a written agreement with the school or school division where such services are provided. The agreement shall establish (i) how children will be referred for school-located vision services, (ii) a mechanism for ensuring parental or legal guardian notification, and (iii) a referral process for children needing follow up care. Such services shall be provided by a Virginia-licensed optometrist or ophthalmologist employed by or under contract with the mobile vision provider.

4. To demonstrate the impact that school-based mobile vision providers have on children enrolled in Medicaid and FAMIS, such mobile vision providers shall  participate in an independent evaluation of the pilot in its second year. The Department of Medical Assistance Services is authorized to submit any appropriate federal regulatory documentation necessary to support implementation of this paragraph. This language does not exempt mobile vision providers under this paragraph from complying with all relevant federal, state, and DMAS provider requirements.

5.  The Department of Medical Assistance Services shall require the Medicaid MCOs to expedite the enrollment and credentialing of the pilot mobile vision providers in the MCO networks."


(This amendment adds funding, language and two positions within the Department of Medical Assistance Services (DMAS) to begin a two-year pilot program for Medicaid and Family Access to Medical Insurance Security (FAMIS) coverage of mobile vision clinics in school-based settings. Eye exams and glasses provided at “bricks and mortar” optometry practices are currently covered by Medicaid and FAMIS. This budget amendment does not expand Medicaid benefits or services, instead it establishes an alternative delivery model to provide currently covered services in a way that increases access for children. It is intended that the comprehensive vision exam described in the language allows for the use of wide angle technology that bypasses the need for dilation of the eye. The two positions at DMAS will develop and administer the pilot program. Funding is included to cover children who are uninsured or underinsured, and to complete an independent evaluation of the program. A companion amendment in this item requires the department to work with the managed care organizations to offer a variety of lens and frame options for children. It is the intent of the General Assembly that in the enrolling of this act, funding included in this item shall be allocated among appropriate items within DMAS.)