COMMONWEALTH OF VIRGINIA
DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
NOTICE OF INTENT TO AMEND
THE VIRGINIA STATE PLAN FOR MEDICAL ASSISTANCE
This Notice was posted on June 7, 2018
Pursuant to 42 CFR 440.386, the Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to seek approval from the Centers for Medicare and Medicaid Services (CMS) of a state plan amendment (SPA) to establish an Alternative Benefit Plan (ABP) authorized under section 1937 of the Social Security Act for individuals aged 19 to 64 who are eligible for Medicaid pursuant to section 1902(a)(10)(A)(i)(VIII) of the Social Security Act.
CMS requires that DMAS develop an ABP for the Medicaid expansion population. DMAS developed an ABP that meets all of the federal requirements for the amount, duration, and scope of benefits. The benefits under the approved ABP will be available to all individuals eligible pursuant to section 1902(a)(10)(A)(i)(VIII) of the Social Security Act and will be delivered through managed care organizations. Beneficiaries may also receive services through the Medicaid fee-for-service program on a transitional basis. The ABP coverage will include essential health benefits (ambulatory services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, rehabilitation and habilitative services, prescription drugs, laboratory, preventive services, and pediatric services). Any service limits or cost sharing currently authorized under the approved Medicaid State Plan will apply to the ABP. The proposed ABP will include the full range of Early Periodic Screening, Diagnoses, and Treatment (EPSDT) program benefits available under the Virginia State Plan for individuals under the age of 21.
DMAS is soliciting input from stakeholders, providers and beneficiaries on the potential impact of the proposed state plan amendment to establish the ABP for individuals aged 19 to 64 who are eligible for Medicaid pursuant to section 1902(a)(10)(A)(i)(VIII) of the Social Security Act. Written comments or inquiries may be submitted within 14 days of this notice publication to Emily McClellan, Policy and Research Division, Department of Medical Assistance Services, 600 East Broad Street, Richmond, VA 23219, Emily.McClellan@dmas.virginia.gov or may be submitted on the Regulatory Town Hall website: http://townhall.virginia.gov/L/Forums.cfm
The State assures compliance with the provisions of Section 5006 (e) of the American Recovery and Reinvestment Act of 2009 related to Tribal populations. (There are no Indian Health Providers or Indian Health Services in the Commonwealth of Virginia.)
To request a copy of the ABP SPA or a copy of this notice, contact Emily McClellan, Policy and Research Division, Department of Medical Assistance Services, 600 East Broad Street, Richmond, VA 23219, or Emily.McClellan@dmas.virginia.gov