Healthcare facilities and providers in Virginia are subject to dueling regulations - one set for state licensure and another for Medicare/ Medicaid certification. Virginia’s regulations in these cases are not just a waste of time on the government side, the administrative burden on healthcare providers is very heavy and entirely unnecessary and the regulations violate both Virginia law and the Governor’s executive order on regulations.
Virginia regulations must be changed to conform to federal Medicare and Medicaid regulations for long-term care facilities to comply with the clear direction of Code of Virginia § 32.1-127. That law requires that Virginia regulations for hospitals and nursing homes “conform” to “health and safety standards established under provisions of Title XVIII (Medicare) and Title XIX (Medicaid) of the Social Security Act.”For example, virtually all of Virginia’s hospitals and hospices and 95% of Virginia’s nursing facilities are certified providers of Medicare or Medicaid or both. It is expensive, counterproductive and in some cases illegal under Virginia law for Virginia to have different regulations for the same facilities, yet we do.
Compliance with that Executive Order that sets out procedures and requirements to ensure the efficiency and quality of Virginia’s regulatory process demands changes in Virginia’s current healthcare regulations.
Code of Federal Regulations Title 42 – Public Health, Chapter IV Subchapter G – Standards and Certification, contain Medicare and Medicaid regulations for every type of healthcare facility and provider. Examplesinclude Parts
42 Code of Federal Regulations (CFR) Part 483 – Requirements for States and Long Term Care Facilities regulates Medicare and Medicaid certification pursuant to Title XVIII and Title XIX requirements.12 VAC 5-371, Rules and Regulations for the Licensure of Nursing Facilities contains Virginia licensure regulations for the same facilities.The Virginia licensure regulations not only do not conform to their federal certification counterparts, but are weaker across the board.Ninety-Five percent of Virginia NFs and SNF’s seek certification for Medicare and/or Medicaid and thus must comply with the more stringent federal regulations.There is no reason that Virginia regulations for licensing the other 5% should be different, and by Virginia law they may not be.