Language to require the state employee health plan to implement a Medication Therapy Management program
This amendment modifies language adopted in Chapter Three regarding a Medication Therapy Management pilot program. The amended language instructs the Department of Human Resources to implement the pilot program
Funding for the Center for Health Innovation
This amendment provides $800,000 from the general fund in the first year to the Center for Health Innovation for grants to organizations for projects that are designed to reduce the rising cost of health care. The language requires a report on the grants.
An increase in funding for private duty nurses
This amendment provides $754,854 from the general fund and $754,854 in matching federal funds in the second year to increase Medicaid reimbursement for private duty nursing services under the Technology Assisted (TECH) waiver by 5 percent. The TECH Waiver provides a community-based alternative to placement in an acute care hospital, long stay hospital or specialized care nursing facility. Eligible individuals include children and adults who are chronically ill or severely impaired, needing both a medical device to compensate for the loss of a vital body function and requiring substantial and ongoing skilled nursing care to avert further disability or to sustain their lives.
An increase in the reimbursement rate for Medicaid adult day health services
This amendment provides $667,902 from the general fund and $667,902 from matching federal Medicaid funds to provide a $10.00 per unit increase in the Medicaid waiver reimbursement rate for adult day health services. Adult day health care is a less expensive alternative to placement in a nursing facility for which these clients qualify. Providers of adult day health care report a gap of $18.13 per client per day between actual costs and Medicaid reimbursement, which must be made up through contributions from individuals, churches, corporations and foundations. This amendment will increase the statewide rate paid for Medicaid adult day health care services from $50.10/unit to about $60.10/unit in Northern Virginia and from $45.65/unit to about $55.65/unit in the rest of the state. A "unit" represents six or more hours in a day.
Establishment of a Medicaid Physician and Managed Care Liaison Committee
This amendment adds language directing the Department of Medical Assistance Services to establish a Medicaid Physician and Managed Care Liaison Committee to ensure access to quality, cost-effective care through the Medicaid program.
Establishment of a workgroup to improve the audit process for home and community-based services
This amendment adds language directing the agency to establish an ongoing work group to continue improving the home- and community-based utilization and review audit process in order to reduce the number of retractions that are subsequently overturned on appeal.
Evaluation and assessment of residents of Virginia’s Training Centers prior to closing
This amendment requires the Commissioner of the Department of Behavioral Health and Developmental Services (DBHDS) to evaluate the needs of individuals residing in Intellectual Disabilities Training Centers at least six months prior to the closure of such facilities. The survey is designed to assess the patients’ medical care treatment needs and the capacity of the community to address those needs. The Commissioner is required to provide quarterly reports on his findings beginning October 1, 2013.