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Virginia Health Care Association | Virginia Center for Assisted Living

General Assembly Poised to Pass Budget – Over $20 Million Provided for Nursing Centers

General Assembly Poised to Pass Budget – Over $20 Million Provided for Nursing Centers

A view of the Virginia State Capitol Buiding.

The House of Delegates and Senate are expected to vote today, February 24, to approve the proposed budget for the remainder of fiscal year (FY) 2017 and FY 2018.  Budget conferees from both chambers provided their conference report on Wednesday evening.  The conference report includes over $20 million in additional Medicaid funding for nursing centers—$10.9 million for the FY 2018 inflation increase for nursing centers and $9.8 million to mitigate some of negative rebasing impact by raising the direct and indirect care peer group prices and addressing a geographic peer group issue from the Medicaid rebasing that could have caused nursing centers in the Danville area massive cuts.

All funding is contingent upon passage of the final budget by the General Assembly and acceptance by the governor.  VHCA-VCAL is grateful that Gov. Terry McAuliffe and the General Assembly have demonstrated their support of funding for nursing centers in the budget.

The budget conference report also includes the following amendments of note:

  • Language directing the Department of Medical Assistance Services (DMAS) to specify that all contracts with health plans in a Medicaid managed care delivery model, including long term services and supports (LTSS), require reimbursement to nursing facility and specialized care services at no less than the Medicaid established per diem rate for Medicaid covered days, using the department’s methodologies, unless the managed care organization and the nursing facility or specialized care services provider mutually agree to an alternative payment.
  • Language related to supplemental Medicaid payments for the five local government-owned nursing centers because new federal regulations prevent Medicaid from making supplemental payments to these facilities when DMAS implements its managed LTSS program (CCC Plus) on August 1, 2017. This language would exempt residents admitted to these facilities from the CCC Plus program, similar to how DMAS treats Virginia’s veteran nursing facilities, unless the department has secured federal approval to use a minimum fee schedule for these facilities. Language would prohibit CCC Plus contracted health plans from limiting Medicaid recipients from choosing to receive nursing home services from these facilities.
  • Language directing DMAS to implement various Joint Legislative Audit and Review Committee recommendations related to oversight of the Medicaid managed care programs, including caps on profits earned by managed care organizations.
  • $1.375 million in funding to improve the reliability of Medicaid screening using the Uniform Assessment Instrument (UAI) for long term services and supports, as well as language directing DMAS to work with stakeholders to assess whether hospital screening teams are making appropriate recommendations regarding placement in institutional care or home and community-based care, determine whether hospitals should have a role in the screening process, and determine what steps must be taken to ensure the UAI is implemented consistently and does not lead to unnecessary institutional placements.
  • Language establishing a Joint Subcommittee for Health and Human Resources Oversight to respond to federal health care changes and provide ongoing oversight of the Medicaid and children’s health insurance programs.  The subcommittee is tasked with monitoring, evaluating and responding to federal action related to the Affordable Care Act (ACA), Medicaid, and any proposals to block grant or change the method by which these programs are funded.  The subcommittee will also examine the progress being made to implement Medicaid managed care programs, including CCC Plus program.