Description | This chapter contains the reimbursement methodology for long-term care services (nursing facilities). |
State Authority | COV 32.1-325 et seq . |
Federal Authority | Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) |
Text of Regulation | Link to Virginia Administrative Code |
Goals of Regulation | None entered |
Meetings |
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 |
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None |
Past Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
2020 Provider Reimbursement Changes
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Final | Stage complete. This regulation became effective on 12/23/2020. |
Fair Rental Value for New and Renovated Nursing Facilities | Fast-Track | Stage complete. This regulation became effective on 04/15/2021. |
2018 Institutional Provider Reimbursement Updates - Final Exempt
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Final | Stage complete. This regulation became effective on 10/02/2019. |
Reimbursement Changes Affecting Long Term Care | Fast-Track | Stage complete. This regulation became effective on 09/20/2018. |
2016 and 2017 Provider Reimbursement Changes
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Final | Stage complete. This regulation became effective on 02/21/2018. |
Institutional Provider Reimbursement Changes | Fast-Track | Stage complete. This regulation became effective on 12/01/2016. |
Supplemental Payments for Various Provider Types (Hospitals, EVMS Physicians, NFs) | Fast-Track | Stage complete. This regulation became effective on 11/17/2016. |
NF Price-Based Reimbursement | Fast-Track | Stage complete. This regulation became effective on 02/11/2016. |
2013 Reimbursement Changes
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Final | Stage complete. This regulation became effective on 06/18/2014. |
ICF/IID ceiling; cost report submission; credit balance reporting | Fast-Track | Stage complete. This regulation became effective on 01/01/2016. |
Supplemental Payments for Institutional/Non-Institutional Providers | Fast-Track | Stage complete. This regulation became effective on 02/13/2015. |
2012 Reimbursement Methodology Changes
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Final | Stage complete. This regulation became effective on 08/14/2013. |
2011 Budget Reimbursement Changes
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Final | Stage complete. This regulation became effective on 07/01/2011. |
2011 Technical Corrections for Reimbursment Regulations
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Final | Stage complete. This regulation became effective on 04/27/2011. |
2010 Reimbursement and Provider Termination Changes
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Final | Stage complete. This regulation became effective on 07/01/2010. |
2009 Hospital, Home Health, and Nursing Facility Reimbursement Changes
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Final | Stage complete. This regulation became effective on 03/17/2010. |
2008 Reimbursement Changes
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Final | Stage complete. This regulation became effective on 10/15/2008. |
Simplify Hospital and Specialized Care Reimbursement | Fast-Track | Stage complete. This regulation became effective on 11/27/2008. |
2007 Reimbursement Changes
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Final | Stage complete. This regulation became effective on 07/01/2007. |
Increase Reimbursement for Hospitals, Certain Physicians and Nursing Facilities | Fast-Track | Stage complete. This regulation became effective on 08/25/2007. |
Reimbursement for NF Specialized Care Ancillary Services | Final | Stage complete. This regulation became effective on 04/19/2007. |
Modifications to Supplemental Payment Methods for Medicaid Public Providers. | Final | Stage complete. This regulation became effective on 08/23/2006. |
Additional NF Reimbursement for Stage IV Pressure Ulcers | Final | Stage complete. This regulation became effective on 08/09/2006. |
Increase in Nursing Home Rates | Fast-Track | Stage complete. This regulation became effective on 07/01/2005. |
Transition to New Capital Paym Method (R) | Final | Stage complete. This regulation became effective on 10/04/2004. |
Discontinue Adult Specialized Care Services Reimbursement | Final | Stage complete. This regulation became effective on 07/01/2004. |
Limit Indirect and Direct Care Inflation for FY 2004 | Emergency | Stage complete. Emergency regulation expired on 06/30/2004. |
Supplemental Payments for Inpatient and Outpatient Services | Final | Stage complete. This regulation became effective on 01/28/2004. |
NHPS: Revise Indirect Cost Formula | Final | Stage complete. This regulation became effective on 07/01/2003. |
Nursing Home Payment System PIRS Methodology | NOIRA | Stage withdrawn on 07/02/2002 before the Governor's office completed its review. |
Nursing Home Payment System: Resource Utilization Groups (RUGS) | Final | Stage complete. This regulation became effective on 07/01/2002. |
Provider Appeals | Final | Stage complete. This regulation became effective on 07/04/2001. |
2000 Nursing Home Payment System | Final | Stage complete. This regulation became effective on 07/01/2001. |
Intergovernmental Transfers (IGT) | NOIRA | Stage withdrawn on 09/04/2001 prior to submission to DPB. |
Nursing Facility Reimbursement System | NOIRA | Stage withdrawn on 07/24/2000 after the Governor's office completed its review. |
Nursing Home Payment System: Increase Payments for Increased Certified Nurse Aide Salaries and Other Direct Costs | Emergency | Stage withdrawn on 08/13/1999 prior to publication in The Virginia Register. |
Withdrawn Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
CH 0080 Reimbursement - Hospitals | Fast-Track | Stage withdrawn on 03/10/2017 prior to submitting for AG review. |
Reimbursement Changes Affecting Long Term Care | Fast-Track | Stage withdrawn on 09/22/2017 prior to submitting for AG review. |
2016 Institutional Provider Reimbursement | Fast-Track | Stage withdrawn on 08/08/2017 before Attorney General's office completed its review. |
2010 Reimbursment Changes (Stimulus)
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Final | Stage withdrawn on 11/12/2013 before submission to the Registrar. |
Reimbursement for NF Specialized Care Ancillary Services | Proposed | Stage withdrawn on 06/06/2007 before DPB completed its review. |
NF Credit Balance Reporting | NOIRA | Stage withdrawn on 04/12/2004 after the comment period had ended. |