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 August 2, 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 Emily.McClellan@dmas.virginia.gov 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
In accordance with the 2021 Special Session, Items 313.UUUUU, DMAS will be making the following changes:
Methods & Standards for Establishing Payment Rates-Other Types of Care (12 VAC 30-80)
The state plan is being revised to authorize reimbursement, using a budget neutral methodology, of pharmacy-administered immunizations for all vaccinations covered under the medical benefit for Medicaid members. Reimbursement for fee-for-service members will be the cost of the vaccine plus an administration fee not to exceed $16. Reimbursement for pharmacy-administered vaccinations for pediatric Medicaid members eligible for free vaccinations through the Vaccines For Children (VFC) program shall include only the administration fee.
The expected increase in annual aggregate expenditures is $6,369 in federal funds in federal fiscal year 2021.