Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Section 1115 Demonstration Waiver: Five-Year Extension Request 

Pursuant to 42 CFR § 431.408, the Department of Medical Assistance Services (DMAS) is providing a notice of intent to submit to the federal Centers for Medicare and Medicaid Services (CMS) a request to extend for five years its Medicaid Section 1115 Demonstration Waiver, “Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Demonstration.”  DMAS is providing an opportunity for members of the public to review and provide input on the extension.  The public comment period will take place from May 30, 2024 through June 29, 2024. 

Virginia’s Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Demonstration” has three components. It provides SUD benefits to, including SUD treatment services to Medicaid beneficiaries who are short-term residents in residential treatment facilities (RTFs) that meet the definition of an IMD.  Second, it provides coverage for former foster care youth (FFCY) under age 26 who were in foster care under the responsibility of another state on the date they turned 18 years of age.  Lastly, it contains High Needs Supports benefits, which include (1) a work and community engagement program for certain adult populations, (2) a Health and Wellness program that included premiums and cost-sharing designed to promote healthy behavior for certain adult populations between 100 and 138 percent of the federal poverty level, and (3) a housing and employment supports benefit for high-need populations. 

DMAS plans to extend the Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Waiver that is scheduled to expire on December 31, 2024.  Through this extension, Virginia plans to request to: 

• Continue to provide SUD benefits, including SUD treatment services to Medicaid beneficiaries who are short-term residents in RTFs that meet the definition of an IMD.   

• Update the authority to specify that DMAS provides Medicaid coverage for FFCY up to age 26 who aged out of foster care in another state and now reside in Virginia, provided the member turned 18 prior to January 1, 2023. 

• Sunset the High Needs Supports benefits because the Virginia General Assembly has not provided funding that has enabled these services to be implemented.  

To read the full Public Notice and view the draft Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Extension Application, please visit the DMAS website at https://www.dmas.virginia.gov/about-us/1115-demonstration-waiver/.  Information regarding the Demonstration Extension Application can be found at that webpage, and DMAS will update the website throughout the public comment and application process.  

Public Comment 

The public comment period for the Demonstration extension will take place from May 30, 2024 to June 29, 2024.  The public can provide comment on the demonstration application at the Virginia Regulatory Town Hall, available here: https://townhall.virginia.gov/L/Forums.cfm (Scroll down to the Department of Medical Assistance Services and click on “View and Enter Comments.”)  Comments can also be submitted via regular mail, telephone, and email to: 

Virginia Department of Medical Assistance Services 
Building and Transforming Coverage, Services, and Supports for a Healthier Virginia Demonstration Renewal 
Attn: Jason Lowe 
600 East Broad Street 
Richmond, VA 23219 

804-659-8732 

jason.lowe@dmas.virginia.gov 

DMAS will host two?public hearings during the public comment period at the times and locations below. 

Public Hearing #1: 

Board of Medical Assistance Services Meeting