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
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—Inpatient Hospital Services and Methods and Standards for Establishing Payment Rates—Long Term Care Facilities. The Department intends to accomplish several reimbursement methodology changes designed to simplify provider reimbursement. The first is to simplify hospital reimbursement by eliminating recapture of hospital depreciation when a hospital is sold by eliminating the hospital outlier illustration, which is outdated.
The regulation also simplifies reimbursement for specialized care nursing facilities by 1) eliminating the case mix adjustment and 2) using the same inflation method and capital rate calculation used in the regular nursing facility reimbursement methodology. After recent changes to the covered groups, there is no longer a justification for the case mix adjustment and the associated reporting.
These changes are being made pursuant to the Department’s authority under Title XIX of the Social Security Act.
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 William Lessard, Director, Provider Reimbursement Division, DMAS, 600 Broad Street, Suite 1300, Richmond, VA 23219, and this notice is available for public review on the Regulatory Town Hall (www.townhall.com). Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Mr. Lessard and such comments are available for review at the same address.