LEGAL NOTICE

COMMONWEALTH OF VIRGINIA

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

NOTICE OF INTENT TO AMEND

(Pursuant to §1902(a)(13) of the Act (U.S.C. 1396a(a)(13))

THE VIRGINIA STATE PLAN FOR MEDICAL ASSISTANCE

This Notice was posted on August 7, 2021

The Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to amend the Virginia State Plan for Medical Assistance to provide for changes to the Methods and Standards for Establishing Payment Rates — Other Types of Care (12 VAC 30-80).  

This notice is intended to satisfy the requirements of 42 C.F.R. § 447.205 and of § 1902(a)(13) of the Social Security Act, 42 U.S.C. § 1396a(a)(13).  A copy of this notice is available for public review from Emily McClellan, DMAS, 600 Broad Street, Suite 1300, Richmond, VA  23219, or via e-mail at:  emily.mcclellan@dmas.virginia.gov

This notice is available for public review on the Regulatory Town Hall (www.townhall.com), on the General Notices page, found at:  https://townhall.virginia.gov/L/generalnotice.cfm

In accordance with the 2021 Appropriations Act, Items 313.YYYY, ZZZZ, and BBBBBB, DMAS will be making the following changes:

Methods & Standards for Establishing Payment Rates-Other Types of Care (12 VAC 30-80)

1. In accordance with the 2021 Special Session, Item 313.YYYY, the state plan is being revised to increase rates for skilled and private duty nursing services to 80 percent of the benchmark rate developed by DMAS.

The expected increase in annual aggregate expenditures is $1,230,321 in state general funds and $1,892,322 in federal funds in federal fiscal year 2021.

2. In accordance with the 2021 Special Session, Item 313.ZZZZ, DMAS will allow qualifying overtime to be paid at 150% of the rate (time and a half) for consumer-directed personal care services provided under the Early and Periodic Diagnostic and Treatment (EPSDT) program. 

The total cost for overtime across all coverage categories (including EPSDT) is $5,213,801 in state general funds and $6,009,750 in federal funds in federal fiscal year 2021. 

3.   In accordance with the 2021 Special Session, Item 313.BBBBBB, DMAS will implement a paid sick leave benefit for qualifying consumer-directed personal care services provided under the Early and Periodic Diagnostic and Treatment (EPSDT) program.

The total cost for qualifying sick across all coverage categories (including EPSDT) is $678,441 in state general funds and $690,791 in federal funds in federal fiscal year 2021.