Description | This chapter contains numerous topics: AG certification, state agency organization/function, definition of Medicaid HMO, requirements for advance directives, coordination of Medicare Parts A/B with Medicaid, applicant/ recipient information confidentiality, NF residents' drug utilization review, reserve bed payments for recipients' absence from facility, third party liability, NF sanctions/alternative remedies, definition of specialized services, categorical determinations, etc. |
State Authority | COV 32.1-325 |
Federal Authority | Title XIX, 42 U.S.C. 1396 et seq. |
Text of Regulation | Link to Virginia Administrative Code |
Goals of Regulation | None entered |
Meetings |
Name / Title: | Emily McClellan / Regulatory Supervisor |
Address: |
Policy Division, DMAS 600 E. Broad Street, Suite 1300 Richmond, VA 23219 |
Email Address: | Emily.McClellan@DMAS.Virginia.gov |
Telephone: | (804)371-4300 FAX: (804)786-1680 TDD: ()- |
Current Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
Estate Recovery Update | - | |
Medicaid Enterprise System Updates
|
- | |
Third Party Liability Update | - | |
Increased Cost-Sharing Measures | - |
Past Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
Provider Appeals Update | Fast-Track | Stage complete. This regulation became effective on 08/01/2024. |
Settlement Agreement Discussion Process | Fast-Track | Stage complete. This regulation became effective on 09/02/2021. |
Expansion-Related Changes - Expansion Group, FMAP, HIPP, Determination State | Fast-Track | Stage complete. This regulation became effective on 03/17/2022. |
Reconsideration of Final Agency Decision | Final | Stage complete. This regulation became effective on 12/13/2017. |
Reduction in Inpatient Cost Sharing to Comply with Federal Regulation
|
Final | Stage complete. This regulation became effective on 07/01/2017. |
Appeal Regulation Updates | Final | Stage complete. This regulation became effective on 08/10/2016. |
Electronic Claims Submission Requirement | Final | Stage complete. This regulation became effective on 11/06/2014. |
Estate Recovery Update under MIPPA
|
Final | Stage complete. This regulation became effective on 01/02/2013. |
Informal Provider Appeals Update
|
Final | Stage complete. This regulation became effective on 08/17/2011. |
Health Insurance Premium Payment (HIPP) Cost Effectiveness Methodology | Final | Stage complete. This regulation became effective on 10/25/2012. |
Health Insurance Premium Payment (HIPP) for Kids Program | Fast-Track | Stage complete. This regulation became effective on 11/08/2012. |
Estate Recovery Update | Final | Stage complete. This regulation became effective on 07/23/2009. |
Attorney General Regulatory Reform Task Force Changes
|
Final | Stage complete. This regulation became effective on 04/15/2009. |
HIPP Program Modifications | Fast-Track | Stage complete. This regulation became effective on 07/23/2009. |
2007 Omnibus: False Claims Recoveries;Third Party Liability
|
Final | Stage withdrawn on 08/27/2007 prior to submitting for AG review. |
Long Term Care Partnership Insurance | Fast-Track | Stage complete. This regulation became effective on 09/01/2007. |
Periodic Review of Estate Recoveries | NOIRA | Stage withdrawn on 02/05/2007 after the comment period had ended. |
Provider Appeals | Final | Stage complete. This regulation became effective on 07/04/2001. |
Withdrawn Actions | ||
Action Title | Latest Stage | Status |
---|---|---|
Removal of Cost-Sharing | ||
Third Party Liability - Payment of Claims | ||
Reduction in Inpatient Cost Sharing to Comply With Federal Regulation | Final | Stage withdrawn on 07/06/2018 before DPB completed its review. |
2015 HIPP Updates | ||
Increase Cost-Sharing Measures | Emergency/NOIRA | Stage withdrawn on 03/12/2007 after the Governor's office completed its review. |
Recipient Cost Sharing and Similar Charges | Proposed | Stage withdrawn on 07/24/2003 after the comment period had ended. |
Periodic Reviews | ||
Last Activity | Status | |
---|---|---|
8/25/2014 Filed | Pending |