Virginia Regulatory Town Hall
 
Agency
Department of Medical Assistance Services
 
Board
Board of Medical Assistance Services
 
chapter
State Plan Under Title XIX of the Social Security Act Medical Assistance Program; General Provisions [12 VAC 30 ‑ 10]
 
Guidance Documents
Chapter Information
Description This chapter contains the federal preprinted State Plan pages that are prepared and issued by the Centers for Medicare and Medicaid Services.
State Authority COV 32.1-325
Federal Authority Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.)
Text of Regulation Link to Virginia Administrative Code
Goals of Regulation To protect public health, safety, and welfare with the least possible costs and intrusiveness to the citizens and businesses of the Commonwealth. This chapter permits the Commonwealth to claim billions of dollars of federal matching funds by conforming to the mandated page templates provided by the federal Medicaid authority (Centers for Medicare and Medicaid Services).
Meetings

Contact Information
Name / Title: Emily McClellan  / Regulatory Supervisor
Address: Policy Division, DMAS
600 East Broad St., 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
State-Based Exchange Fast-Track Attorney General review in progress.
Medicaid Enterprise System Updates
Action is Exempt from Article 2 of the Administrative Process Act
Final Attorney General review in progress.
Third Party Liability Update Fast-Track Attorney General review in progress.
12 Months Postpartum Emergency/NOIRA Attorney General review in progress.

Past Actions
Action Title Latest Stage Status
Tribal Consultation
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 11/11/2021.
SNAP Income to Determine Medicaid Eligibility Fast-Track Stage complete. This regulation became effective on 09/02/2021.
Update to Drug Utilization Review Program 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.
2016 Psychiatric Residential Treatment Services Program Changes Final Stage complete. This regulation became effective on 08/22/2019.
CH 0010 Requirements for LTC Facilities
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 10/19/2017.
Provider Screening Requirements
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 10/19/2016.
Public Assistance Reporting Information System (PARIS)
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 04/10/2013.
Recovery Audit Contractors
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 10/25/2012.
Medicaid Prohibition on Payments to Institutions or Entities Located Outside of the United States
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/06/2011.
Premium Assistance Option under CHIPRA Final Stage withdrawn on 09/28/2010 prior to submitting for AG review.
2010 Reimbursement and Provider Termination Changes
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/01/2010.
Managed Care Provider Exclusion
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 10/01/2009.
Estate Recovery Update Final Stage complete. This regulation became effective on 07/23/2009.
Attorney General Regulatory Reform Task Force Changes
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 04/15/2009.
Cooperation with Medicaid Integrity Program Efforts
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 11/26/2008.
Employee Education About False Claims Act
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 11/01/2007.
2007 Omnibus: False Claims Recoveries;Third Party Liability
Action is Exempt from Article 2 of the Administrative Process Act
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.
Program of All-Inclusive Care for the Elderly (PACE) Fast-Track Stage complete. This regulation became effective on 07/01/2007.
Periodic Review of Estate Recoveries NOIRA Stage withdrawn on 02/05/2007 after the comment period had ended.
Prospective Drug Utilization Review Final Stage complete. This regulation became effective on 01/03/2005.
2003 Omnibus Mandatory Revisions
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 07/01/2003.
2001 Technical (9-Part) Amendment
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 01/16/2002.
Provider Appeals Final Stage complete. This regulation became effective on 07/04/2001.
Central Processing Unit: Medicaid Eligibility Determination
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 08/01/2001.
Residential Psychiatric Treatment under EPSDT Final Stage complete. This regulation became effective on 01/01/2001.
Program of All-Inclusive Care for the Elderly (PACE) Final Stage complete. This regulation became effective on 07/01/2000.
Medicaid Fraud/Abuse Detection/ Investigation;Free Choice of Providers; Conflict of Interest
Action is Exempt from Article 2 of the Administrative Process Act
Final Stage complete. This regulation became effective on 10/13/1999.

Withdrawn Actions
Action Title Latest Stage Status
Removal of Cost-Sharing Fast-Track Stage withdrawn on 04/25/2024 prior to submitting for AG review.
Barrier Crimes Not Permitted Fast-Track Stage withdrawn on 09/29/2023 prior to submitting for AG review.
Requirements for LTC Facilities Final Stage withdrawn on 07/05/2017 prior to submitting for AG review.

Periodic Reviews
Last Activity Status
8/25/2014 Filed Pending