2022 Session

Budget Amendments - HB30 (Member Request)

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Chief Patron: Carr
Medicaid Mobile Vision Pilot Program

Item 304 #21h

Item 304 #21h

First Year - FY2023 Second Year - FY2024
Health and Human Resources
Department of Medical Assistance Services FY2023 $0 FY2024 $382,823 GF
FY2023 $0 FY2024 $478,712 NGF

Page 313, line 47, strike "$19,820,607,534" and insert "$19,821,469,069".

Page 340, after line 10, insert:

"PPPP.1. Effective July 1, 2023, the Department of Medical Assistance Services shall reimburse mobile vision clinics providing comprehensive vision care services to children in a school-based setting as provided in this paragraph. To cover these services for children enrolled with a Medicaid managed care organization, the Department shall revise its MCO contracts to provide for direct reimbursement to such clinics by the MCO at the fee-for-service rate. For children not enrolled with a Medicaid MCO, the Department shall directly reimburse the clinic for services provided at the fee-for-service rate.

2. Mobile vision services shall be reimbursed in full for necessary comprehensive vision services including, at a minimum, an eye exam, lenses, frames, and fitting.  In order to be eligible for reimbursement for mobile vision clinic services, a clinic 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 opthalmalogist employed by or under contract with the mobile vision clinic.

3. To demonstrate the impact that school-based mobile vision clinic services have on children enrolled in Medicaid and Family Access to Medical Insurance Security (FAMIS), such mobile vision clinics shall report annually by September 1 to the Board of Medical Assistance Services and the Medicaid Managed Care Organization Workgroup on the number of children it has served through the mobile vision clinic model, the rate of children obtaining vision care after being identified as needing vision care through an in-school vision screening or other school-based referral, and the number of children served through the mobile vision clinic model who are referred for further care. 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 clinics under this paragraph from complying with all relevant federal, state, and DMAS provider requirements."


(This amendment adds language clarifies Medicaid and Family Access to Medical Insurance Security (FAMIS) coverage of mobile vision clinics serving schools and removes restrictions that limit access to this service. 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. It establishes an alternative delivery model to provide currently covered services in a way that exponentially increases access for children.)