Virginia Regulatory Town Hall
Health and Human Resources
Department of Medical Assistance Services
Board of Medical Assistance Services
Mandate 57

Mandate Information
Mandate Title:
Limit Outpatient Hospital Payment/Establish Prosp
Purpose of legislation
325 NNN requires DMAS to reduce the reimbursement of all outpatient costs from 94.2% of costs to 80% of allowable costs. The second part of the change intends to switch reimbursement to rehab. agencies (except CSBs) from an allowable cost basis to a prospective reimbursement methodology.
Legislation mandating a change
Budget item mandating a change Item 325 (2003)
VAC chapters to be amended Not yet determined.
Associated Regulatory Actions
Action 1288: Limit Outpatient Hosp Reimbursement to 80% of Allowable Cost; Establish Prospective Reimbursement for Rehab Agencies
Latest Stage: Final
Deadline for the regulation to become effective 7/1/2003
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