COMMONWEALTH OF VIRGINIA
DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
NOTICE OF INTENT TO AMEND
(Pursuant to §1902(a)(13) of the Act (U.S.C. 1396a(a)(13))
THE VIRGINIA STATE PLAN FOR MEDICAL ASSISTANCE
This Notice was posted on February 23, 2021
The Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to amend the Virginia State Plan for Medical Assistance to provide for changes to the Methods and Standards for Establishing Payment Rates — Other Types of Care (12 VAC 30-80).
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). A copy of this notice is available for public review from Emily McClellan, DMAS, 600 Broad Street, Suite 1300, Richmond, VA 23219, or via e-mail at: Emily.McClellan@dmas.virginia.gov.
DMAS is specifically soliciting input from stakeholders, providers and beneficiaries, on the potential impact of the proposed changes discussed in this notice. Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Ms. McClellan and such comments are available for review at the same address. Comments may also be submitted, in writing, on the Town Hall public comment forum attached to this notice.
This notice is available for public review on the Regulatory Town Hall (www.townhall.com), on the General Notices page, found at: https://townhall.virginia.gov/L/generalnotice.cfm
The Centers for Medicare and Medicaid Services (CMS) published a State Health Official (SHO) #20-005 letter regarding the Mandatory Medicaid State Plan Coverage of Medication-Assisted Treatment (MAT) on December 30, 2020. CMS stated Section 1905(ee)(1) of the SUPPORT Act requires States to include as part of the new mandatory MAT benefit all forms of drugs and biologicals that the Food and Drug Administration (FDA) has approved or licensed for medications of opioid use disorder (MOUD), including medications of a manufacturer that does not participate in the federal rebate program with the Secretary of Health and Human Services (Section 1927). The Federal law requires DMAS to file a SPA to recognize and reimburse MOUDs that do not participate in the federal rebate program. Since DMAS currently covers all varieties of MOUD and the non-rebatable medications covered by these additional manufacturers offer no variety in ingredients, thus DMAS does not estimate a cost impact.
There is no expected increase or decrease in annual aggregate expenditures as a result of this change.