As practices evolve and coverage is provided under the State Plan for Medical Assistance, there are times when it becomes necessary to amend regulations to conform them to best practices and new guidance from Centers for Medicare and Medicaid Services (CMS).  this from the Agency Statement attached to this regulation...  So again WHY IS DMAS FIGHTING EXEMPTING LIVE IN PROVIDERS?  CMS said they could be Virginia said they wouldn't make more stringent requirements.