At the beginning of the week, the House Appropriations Committee and the Senate Finance Appropriations Committees released their amendments to the introduced 2026-2028 budget.

• While neither chamber included funding for inflation of Medicaid rates for any providers, the budgets leave intact funding for the Medicaid Value-Based Purchasing program.
• Both budgets also include language to defer the scheduled Medicaid rebasing to address methodological issues with how nursing home rates are set and allow for time for the development of quality component. The House and Senate language have some technical differences, which VHCA-VCAL is continuing to assess.

Next steps: The House and Senate will pass their respective budgets. Procedurally the chambers will then reject the budget passed by the other body and appoint a conference committee of leading legislators to negotiate a compromise between the two.

Other legislation: Committees are now working through bill dockets to consider bills passed by the opposite chamber. Most bills of interest to VHCA-VCAL are advancing in a similar to posture as we reported last week or are awaiting hearings.

• Of note, the House Health and Human Services Committee voted to consolidate two Senate bills. The Committee incorporated SB 555, the bill on Periodic visits and resident assessments conducted by medical directors, into SB 429, the bill directing a study of VDH nursing home oversight and accountability. In its current form the bill 1) does not imposed and additional requirements on providers unless the federal physician visit schedule is not met, in which case notice must be provided to the resident and the resident’s representative; and 2) directs VDH to enhance recruitment efforts and expand workforce capacity in the Office of Licensure and Certification (OLC), accelerate training and onboarding initiatives, and explore measures to reduce administrative burdens. The VDH Commissioner would be required to submit an annual report with recommendations for continuing improvement of nursing home quality and oversight.