What’s new: DMAS posted a new bulletin with information about using the Optional State Assessment (OSA) to generate a Virginia Medicaid RUG-IV billing code for DMAS claims payment.

• It includes information on completing the OSA, software requirements, and links to key resources.
• Providers are not required to assess members earlier than their normal scheduled MDS assessment due to the addition of the OSA effective October 1, 2023.
• The bulletin references the MDS coordinator at VDH OLC. You can reach Gary Gregory at help@vdh.virginia.gov.

Read the bulletin: Minimum Data Set (MDS) changes effective October 1, 2023.

VHCA-VCAL provided input on a draft of the bulletin. We are currently reviewing the final text in greater detail. However, we wanted to relay a link of the bulletin to you as soon as possible.

• We know this information is critical to your MDS coordinators and reimbursement teams.

For context: Since the announcement that the Patient-Driven Payment Model (PDPM) would replace the RUG payment system under Medicare, VHCA-VCAL has had frequent conversations with DMAS about alternatives to the RUG-IV system and its impact on Medicaid reimbursement.

• Contact April Payne and Steve Ford with any questions.