News on the 1st of July!

July 01, 2026

DD Waiver Rates and Billing:

• It seems a bit doubtful that DMAS will post the General Assembly approved rates today, but we can certainly expect them soon!  You should absolutely use the revised rates for billing for services provided on or after July 1!   Payment at the new rate is dependent on the approval of CMS (highly unlikely that they will disapprove), however,  you can comfortably affirm that the new rates are your “usual and customary” rates.   Note: We have asked that DMAS do an adjustment to payments when they have received CMS approval – it will be easier both for your accountant and for whomever would need to go back and manually adjust the amounts.  
• We will not create rate charts – we will keep you informed about when they are posted.  The information that we are sure of is contained in this NewsPost in Item 291#8c.   
• Behavioral Health Redesign comments on Version 3 closed last night; thank you to all who expressed their views!  There were 77 comments from private providers, Community Services Boards, and private citizens, some quite detailed, which printed to 91 pages.  I think it is safe to say that there is still a lot of concern about whether any provider can operationalize CPST and whether “Redesign” will in any fashion provide the support needed for the fragile population we serve! 
• Also last evening the news broke about three Medicaid Fraud cases from Virginia currently in Federal Court – the cases are described here.  We are always ambivalent about highlighting bad behavior – on the one hand it gives ammunition to those who want to say “See – I told you private providers are committing fraud!,”  but on the other hand it supports our position that if the systems in place at both the State and Federal level  do their jobs, the “bad actors” will not prevail and the honest brokers will perhaps not be overburdened with duplicative and time consuming regulations!