Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services

General Notice
Lump Sum Payment Adjustment for Hospitals
Date Posted: 10/19/2003
Expiration Date: 12/3/2003
Submitted to Registrar for publication: YES
No comment forum defined for this notice.
LEGAL NOTICE COMMONWEALTH OF VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES Notice of Intent to Modify the Percentage Reduce Payments to General Acute Care Hospitals Notice is hereby given that the Department of Medical Assistance Services (DMAS) intends to modify its reimbursement plan for general acute care hospitals pursuant to the Department’s authority under Title XIX of the Social Security Act. 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). The changes contained in this public notice are occurring in response to a mandate from the 2002 General Assembly Chapter 899, Item 325 KK. That mandate required DMAS to reduce inpatient hospital reimbursements up to a specified maximum. DMAS complied with this mandate by applying a percentage of 3.235857 to hospital reimbursements for State Fiscal Year 2003. Regulations implementing the 2002 General Assembly mandate also provided DMAS with the authority to change the percentage for 2004 based on differences in estimated reimbursement between 2003 and 2004. DMAS has considered estimated 2004 reimbursement and determined, should the same 3.235857 percentage be applied to the whole of State Fiscal Year 2004, that more dollars than permitted by the statute will accrue to the Commonwealth. Therefore, this change entails the modification of that percentage to 2.88572 for the last two quarters (January through June 2004) of SFY 2004 in order that the statutorily specified maximum not be exceeded. The agency’s methodology, as set out in 12 VAC 30-70-201, with the exception of the modified percentage stated above, is not changing. The agency does not expect there to be either an increase or decrease in expenditures. A copy of this notice is available for public review from Steven E. Ford, Health Care Policy & Reimbursement Manager, Division of Provider Reimbursement, DMAS, 600 Broad Street, Suite 1300, Richmond, VA 23219, and via electronic mail at Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Mr. Ford and such comments are available for review at the same address.

Contact Information
Name / Title: Victoria P. Simmons  / Regulatory Coordinator
Address: DMAS, 600 E. Broad Street, Suite 1300
Richmond, 23219
Email Address:
Telephone: (804)786-7959    FAX: (804)786-1680    TDD: (800)343-0634