2022 Session

Budget Amendments - SB30 (Member Request)

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Chief Patron: Barker
Increase Rates for Psychiatric Residential Treatment Facilities

Item 304 #22s

Item 304 #22s

First Year - FY2023 Second Year - FY2024
Health and Human Resources
Department of Medical Assistance Services FY2023 $4,658,996 FY2024 $4,658,996 GF
FY2023 $4,977,330 FY2024 $4,977,330 NGF

Page 313, line 47, strike "$18,732,988,737" and insert "$18,742,625,063".
Page 313, line 47, strike "$19,820,607,534" and insert "$19,830,243,860".

Page 321, strike lines 35 through 50.

Page 339, strike line 44 through "daily rate.".

Page 339, line 45, strike "ceilings".

Page 339, line 46, after "services." insert:

"Beginning July 1, 2022 and until the next rebasing of rates is implemented, PRTF provider per diem rates shall be subject to a ceiling based at 120 percent of the statewide weighted average cost per day from the fiscal year 2018 cost report."

Page 339, strike line 47 and insert:

"weighted statewide average daily rate from the fiscal year 2018 cost report."

Page 339, after line 47, insert:

"2. In establishing ongoing rebasing of PRTFs, DMAS shall recommend a rate methodology that provides for network adequacy, avoids hospitalization for children, and allows the vast majority of Virginia children to be placed with in-state providers, provided that the appropriate services can be provided. The rate methodology shall include a review of rates paid to Virginia providers by other states and shall account for differences in geography, efficiencies in services provided, severity of the needs in populations served, and other relevant data that may better allow Virginia providers to serve children currently placed out-of-state due to cost limitations from previous rate setting."

Page 339, line 48, strike "2" and insert "3".

Page 339, line 51, after "inflation rate.", insert:

"The department shall also implement inflation increases for each fiscal year subsequent to the last audited cost report in 2018."

Page 339, line 54, strike "3" and insert "4".

Page 340, line 2, strike "4" and insert "5".

Page 340, line 3, after "rates above", strike "the" and insert "any applicable".

Page 340, line 4, after "ceiling.", insert:

"However, in order to prioritize placing Virginia children in-state, Virginia providers shall be given the opportunity to accept such a placement at the negotiated out-of-state rate or lower, if the increase above that in-state provider's rate makes the placement option viable and the in-state provider is able to provide the necessary and appropriate services for that placement."


(This amendment adds funding and language to increase the maximum per day payment for psychiatric residential treatment facilities (PRTFs) based on certified 2018 cost reports and provide an inflation adjustment in fiscal year 2023 that accounts for the years since the last rebasing calculation where inflation was not applied. Language is also added to include a review of rates paid to out-of-state providers and to provide in-state providers an opportunity to accept such placements at the negotiated out-of-state rate if able to meeting the needs for the placement.)