Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
Board
Board of Medical Assistance Services
 
chapter
Eligibility Conditions and Requirements [12 VAC 30 ‑ 40]
Guidance Documents
Chapter Information
Description This chapter contains all of the income and resource requirements and restrictions which must be met in order for an individual to be found to be eligible for one or more of the categories of eligibility, thereby qualifying the individual for Medicaid covered services.
State Authority COV 32.1-325 et seq .
Federal Authority Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
Exempt from APA No, changes to this chapter are subject to the Administrative Process Act.
Text of Regulation Link to Virginia Administrative Code
Goals of Regulation None entered
Meetings

Contact Information
Name / Title: Emily McClellan   / Regulatory Supervisor
Address: Policy Division, DMAS
600 E. Broad Street, Suite 1300
Richmond, VA 23219
Email Address: Emily.McClellan@DMAS.Virginia.gov
Telephone: (804)371-4300    FAX: (804)786-1680    TDD: ()-
Current Actions
Action Title Latest Stage Status
12 Months Postpartum -
Repeal of Out-of-Date and Unnecessary Regulations -

Past Actions
Action Title Latest Stage Status
Expansion-Related Changes - Expansion Group, FMAP, HIPP, Determination State Fast-Track Stage complete. This regulation became effective on 03/17/2022.
Disregard Sterilization Compensation in Eligibility Determinations Final Stage complete. This regulation became effective on 06/15/2017.
2015 Treatment of Annuities Fast-Track Stage complete. This regulation became effective on 07/27/2017.
CH 0040 Coverage in Approved Supportive Housing Fast-Track Stage complete. This regulation became effective on 06/29/2017.
Real Property Appraisals for Resource Eligibility
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 09/21/2016.
CH 0030 Modified Adjusted Gross Income (MAGI) Methodology Fast-Track Stage complete. This regulation became effective on 07/27/2017.
2014 Medicaid Works-Federal Changes Fast-Track Stage complete. This regulation became effective on 12/31/2015.
Coverage of Lawfully Residing Pregnant Women and Children
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/17/2013.
Asset Verification System
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 01/03/2013.
Update to Medicaid Works Income Limit Fast-Track Stage complete. This regulation became effective on 12/19/2013.
Increase Resource Limits for Medicare Savings Program Groups
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 04/14/2010.
Social Security Number Data Match for Verification of Citizenship and Identity Fast-Track Stage complete. This regulation became effective on 12/17/2015.
Coverage of Legal Immigrant Children Fast-Track Stage complete. This regulation became effective on 02/17/2011.
Medicaid Buy-In program Final Stage complete. This regulation became effective on 07/23/2009.
HIPP Program Modifications Fast-Track Stage complete. This regulation became effective on 07/23/2009.
Medicaid Eligibility Income Disregards Fast-Track Stage complete. This regulation became effective on 03/19/2009.
Personal Needs Allowance (PNA) Increase
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/01/2007.
Medicare Prescription Drug Program (Part D) Final Stage complete. This regulation became effective on 03/07/2007.
Long Term Care Partnership Insurance Fast-Track Stage complete. This regulation became effective on 09/01/2007.
Mandatory Changes Pursuant to the Federal Deficit Reduction Act
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 08/09/2006.
Mandatory changes under the federal Deficit Reduction Act of 2005
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage withdrawn on 06/14/2006 before Attorney General's office completed its review.
Treatment of Annuities in Medicaid Eligibility Determinations Proposed Stage withdrawn on 03/08/2006 before the Secretary's office completed its review.
Discontinue Resource Test and Counting of Earned Income for Family and Children Groups Fast-Track Stage complete. This regulation became effective on 09/25/2004.
Reasonable Limits on Amounts for Necessary Medical or Remedial Care Final Stage complete. This regulation became effective on 07/01/2004.
ADAPT Final Stage complete. This regulation became effective on 12/03/2003.
Freeze the CPI Adjustment for Categorically Needy, Medically Needy and Standards of Assistance Income Limits through FY 2004 Emergency Stage complete. Emergency regulation expired on 06/30/2004.
Medicaid Eligibility Expansion to 133% of Federal Poverty Level
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 09/01/2002.
MNIL, Standards of Assistance, More Liberal Disregards
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/01/2002.
Medically Needy Income Limits
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/01/2001.
Medicaid Eligibility under Sec. 1931 REVISED
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 11/22/2000.
Eligibility under sec 1931 of the Act.
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 05/10/2000.

Withdrawn Actions
Action Title Latest Stage Status
Property Sales at Less Than Taxed Assessed Value Fast-Track Stage withdrawn on 10/06/2016 before the Governor's office completed its review.
2014 Medicaid Works-Federal Changes
Medicaid Buy-In Emergency/NOIRA Stage withdrawn on 03/06/2007 before the Secretary's office completed its review.
Medicaid Works, a Medicaid Buy-In Program
Coverage of Legal Immigrant Children Fast-Track Stage withdrawn on 11/20/2009 prior to publication in The Virginia Register.
Resources and Transfers Proposed Stage withdrawn on 03/03/2009 before the Secretary's office completed its review.
Treatment of Life Estates Emergency/NOIRA Stage withdrawn on 02/24/2009 after the comment period had ended.