February 22, 2017
We were very successful in getting almost all of the items we supported in our letter to the conferees including:
In the Medicaid budget –
- The Department of Medical Assistance Services, in collaboration with the Department of Behavioral Health and Developmental Services, shall convene a stakeholder workgroup, to meet at least once annually, with representatives of the Virginia Association of Community Services Boards, the Virginia Network of Private Providers, the Virginia Association of Centers for Independent Living, Virginia Association of Community Rehabilitation Programs (VaACCSES), the disAbility Law Center of Virginia, the ARC of Virginia, and other stakeholders including representative family members, as deemed appropriate by the Department of Medical Assistance Services. The workgroup shall: (i) review data from the previous year on the distribution of the SIS levels and tiers by region and by waiver; (ii) review the process, information considered, scoring, and calculations used to assign individuals to their levels and reimbursement tiers; (iii) review the communication which informs individuals, families, providers, case managers and other appropriate parties about the SIS tool, the administration, and the opportunities for review to ensure transparency; and (iv) review other information as deemed necessary by the workgroup. The department shall report on the results and recommendations of the workgroup to the General Assembly by October 1 of each year.
- Effective upon enactment of this act, the Department of Medical Assistance Services, in collaboration with the Department of Behavioral Health and Developmental Services, shall make sponsored residential services eligible for customized rates. The department may implement any changes necessary to implement this provision prior to the promulgation of regulations undertaken in order to effect such changes.
- This amendment modifies language in the introduced budget approved by the 2016 General Assembly to have the Department of Medical Assistance Services, in cooperation with the Department of Behavioral Health and Developmental Services, collect information and feedback related to payments to family homes and the impact of changes to the rates on family homes statewide from sponsored residential providers and family home providers. Language extends collaborative efforts to collect information and feedback to other provider groups and specifies additional data elements to review. Language also requires a report on the findings of this analysis to the Governor and the Chairmen of the money committees
- This amendment adds 144 Family and Individual Support Waiver slots in the second year. Funding is contained in the introduced budget to provide funding for these slots. Projections of utilization of the newly designed Building Independence, Family and Individual Supports and Community Living Waivers programs have resulted in the ability to serve more individuals than originally anticipated. Language in the introduced budget is eliminated which would have delayed access to additional waiver slots in fiscal year 2018
- This amendment adds language regarding the Medicaid appeals process to: (i) amend regulations to clarify that the informal appeals agent shall have the ability to close an informal appeal based on settlement between the parties up to $250,000; (ii) direct the agency to convene a workgroup to develop a plan to avoid or adjust retractions of Medicaid payments for non-material breaches of the Provider Participation Agreement when the provider has substantially complied with it; and (iii) require the agency to report on the status of the plan to avoid retractions to the Chairmen of House Appropriations and Senate Finance Committees.
In the DBHDS Budget –
- This amendment eliminates language in the introduced budget which authorizes the Department of Behavioral Health and Developmental Services to promulgate emergency regulations to establish a licensing fee per application for all adult behavioral health and developmental services licensed by the agency. A companion amendment in Item 313 eliminates the funding and one position to collect and process these fees. Revenue assumed from the fees is also eliminated in Item 0
We did not support the following:
- This amendment adds $371,000 from the general fund and $3.0 million from matching federal Medicaid funds for the fiscal impact of House Bill 2417 which directs the Department of Medical Assistance Services to establish a program using prepayment analytics to mitigate the risk of improper payments to providers of services furnished under the state plan for medical assistance who commit fraud, abuse, or errors
And it appears that the following is not included in the Conference Report:
- Implementation Plan to Transfer CSA Funding for Students with Disabilities to DOE; however a workgroup is created:
- This amendment directs the staff of the House Appropriations and Senate Finance Committees to help facilitate the scope of work by the Joint Subcommittee for Health and Human Resources Oversight. Further, staff of the Health and Human Resources and Elementary and Secondary Education Subcommittees of the two committees are directed to facilitate a workgroup, in collaboration with relevant state agencies, to examine options and determine the actions necessary to better manage the quality and costs of private day educational programs currently funded through the Children’s Services Act (CSA). A report was issued in November 2016 detailing various options for the General Assembly to consider related to private day educational program placements. This workgroup moves forward with the next step to examine options and determine the actions for consideration by the House Appropriations and Senate Finance Committees to be included in the 2018-20 biennial budget. In light of cost increases in recent years, various options are being considered to ensure appropriate alignment of decision making and the financial responsibility for private day educational program placements.
A copy of this document that you can print is here.