COMMONWEALTH OF VIRGINIA
DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
Notice of Intent to Enhance IME Payments to High Medicaid Neonatal Intensive Care Unit (NICU) Providers
Notice is hereby given that the Department of Medical Assistance Services (DMAS) intends to modify its reimbursement plan for inpatient hospitals with recognized Medicaid NICU days in excess of 4,500 (as reported to DMAS by March 1, 2005). This payment is for hospitals that do not otherwise receive an enhanced IME payment based upon the 2004 Appropriations Act (Chapter 4, Item 326 HHH) that mandated additional payments for hospitals with higher NICU utilization rates, 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 change contained in this public notice is in response to the 2005 Appropriations Act language directing DMAS to enhance indirect medical education (IME) payments to high NICU utilization hospitals.
The 2005 General Assembly directed DMAS, through the 2005 Appropriations Act (Chapter 951, Item 326 ZZZ), to provide this additional payment and allocated $0.5 million total funds ($250,000 General Funds) for enhancements to IME at Type Two hospitals with recognized Medicaid NICU days in excess of 4,500. These additional monies shall be apportioned among the hospitals meeting this standard that do not otherwise receive an enhanced IME payment based upon the 2004 Appropriations Act.
A copy of this notice is available for public review from Scott Crawford, Director, Provider Reimbursement Division, DMAS, 600 Broad Street, Suite 1300, Richmond, VA 23219, and this notice is available for public review on the Regulatory Town Hall (www.townhall.com). Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Mr. Crawford and such comments are available for review at the same address.