Long-Term Care & Medicaid
| Bills | Committee | Last action | Date |
| HB 1452 - Orrock - Medicaid Fraud Control Unit; appointment of sworn unit investigators to Unit, powers and duties. | (H) Committee on Appropriations (S) Committee on Finance and Appropriations | (G) Acts of Assembly Chapter text (CHAP0619) | 03/26/23 |
| notes: Allows the Attorney General to designate up to 30 persons in the Medicaid Fraud Control Unit as sworn unit investigators, with the power to investigate allegations of (i) fraud in the State Medical Assistance Plan; (ii) abuse and neglect of adults; (iii) misappropriation of a patient's private funds while in the care and custody of others; and (iv) any criminal offense ancillary to such allegations. The bill defines sworn unit investigators as law-enforcement officers eligible for Virginia Law Officers' Retirement System benefits and allows the Attorney General or his designee to request that the Director of the Department of Criminal Justice Services exempt a sworn unit investigator from compulsory minimum training standards for law enforcement officers on the basis of prior experience. The bill grants the Attorney General authority to issue identification and uniforms designating sworn unit investigators as law-enforcement officers, including use of the seal of the Commonwealth. | |||
| HB 1512 - Adams, D.M. - Medical assistance services; durable medical equipment, complex rehabilitation technology. | (H) Committee on Appropriations (S) Committee on Finance and Appropriations | (G) Acts of Assembly Chapter text (CHAP0266) | 03/22/23 |
| notes: Directs the Board of Medical Assistance Services (the Board) to amend the state plan for medical assistance services to include a provision for payment of medical assistance for the initial purchase or replacement of complex rehabilitative technology manual and power wheelchair bases and related accessories. The bill directs the Board to adopt emergency regulations to implement the provisions of the bill. | |||
| HB 1564 - Watts - Nursing homes; standards of care, administrative sanctions. | (H) Committee on Health, Welfare and Institutions | (H) Left in Health, Welfare and Institutions | 02/07/23 |
| notes: Requires regulations establishing the staffing and care standards in nursing homes to require a minimum number of hours of direct care services to each resident per 24-hour period, which minimum increases in specified phases from 3.5 hours to 4.1 hours. The bill gives the Commissioner of Health the power to impose administrative sanctions on nursing homes and directs the Board of Health to promulgate regulations related to the criteria and procedures for the imposition of administrative sanctions or initiation of court proceedings for violations of the bill. The bill establishes the Long-Term Care Services Fund for the purpose of making grants to assist in the provision of activities that protect or improve the quality of care or quality of life for residents, patients, and consumers of long-term care services. | |||
| HB 1599 - Wachsmann - Individuals with developmental disabilities; DMAS to amend certain waivers providing services, etc. | (H) Committee on Appropriations | (H) Left in Appropriations | 02/07/23 |
| notes: Directs the Department of Medical Assistance Services (the Department) to take steps to amend the Family and Individual Supports, Community Living, and Building Independence waivers to implement a medically needy spend down provision that allows otherwise eligible individuals to spend income in excess of the income limit for waiver services on medical expenses in order to meet the waiver income limit. The bill requires the Department to report on its activities and progress to the Governor and the General Assembly by December 1, 2023. | |||
| HB 1831 - Torian - Long-term services and supports screening; authorization to share assessments. | (H) Committee on Health, Welfare and Institutions | (H) Left in Health, Welfare and Institutions | 02/07/23 |
| notes: Allows completed screenings for long-term services and supports to be shared with local departments of social services. Such screenings may be used to determine eligibility without completion of additional screenings if they are received within 30 days of an individual's application for long-term services and supports. | |||
| HB 2083 - Mundon King - State plan for medical assistance services; dental care, anesthesia. | (H) Committee on Health, Welfare and Institutions | (H) Left in Health, Welfare and Institutions | 02/07/23 |
| notes: Directs the Board of Medical Assistance Services to amend the state plan for medical assistance services to provide for the payment of medical assistance for charges incurred and anesthetics provided in conjunction with dental care that is provided to a recipient (i) in a hospital or ambulatory surgical center if the recipient has a medical condition that requires hospitalization or general anesthesia for dental care or the recipient is a person with an autism spectrum disorder or a developmental disability, or is a person with a disability, or (ii) in the office of an oral or maxillofacial surgeon or a dentist who has obtained a permit for sedation and anesthesia, if the recipient is a person with an autism spectrum disorder or a developmental disability. | |||
| HB 2084 - Mundon King - Sickle cell disease; annual review of medication and treatment, report. | (H) Committee on Health, Welfare and Institutions | (H) Left in Health, Welfare and Institutions | 02/07/23 |
| notes: Directs the Department of Medical Assistance Services to conduct an annual review of all medications and forms of treatment for sickle cell disease, and services for enrollees with a diagnosis of sickle cell disease, that are eligible for coverage under the state plan for medical assistance. The bill requires the Department to report its findings and recommendations by November 15 each year to the Chairmen of the House Committee of Health, Welfare and Institutions and the Senate Committee on Education and Health and to the Joint Commission on Health Care. | |||
| HB 2093 - Mundon King - State plan for medical assistance services; payment for cranial prostheses. | (H) Committee on Appropriations | (H) Left in Appropriations | 02/07/23 |
| notes: Provides for the payment under the state plan for medical assistance services of medical assistance for cranial prostheses furnished to a patient when the patient's attending physician, physician assistant, or nurse practitioner certifies in writing the medical necessity of such prostheses as part of a proposed course of rehabilitative treatment. | |||
| HB 2190 - Rasoul - Managed care organizations; data collections and reporting requirements, report. | (H) Committee on Health, Welfare and Institutions (S) Committee on Education and Health | (G) Acts of Assembly Chapter text (CHAP0335) | 03/23/23 |
| notes: Requires the Department of Medical Assistance Services to include in its contracts with managed care organizations provisions that require the managed care organization to collect and report to the Department data regarding (i) the number and percentage of claims that are denied and the reasons for such denials and (ii) the number and percentage of claims that required resubmission prior to payment and the reasons for such resubmissions. The bill requires the Department to (a) examine such data and identify barriers that providers encounter when accepting and treating patients enrolled in the state plan for medical assistance services and (b) report such data and analysis by October 1 of each year to the Joint Commission on Health Care and the Joint Subcommittee for Health and Human Resources Oversight. | |||
| SB 925 - Cosgrove - Patient visitation; visitation from clergy members during declared public health emergency. | (S) Committee on Education and Health | (S) Passed by indefinitely in Education and Health (13-Y 2-N) | 01/19/23 |
| notes: Requires hospitals, nursing homes, and certified nursing facilities to allow patients to receive visits from clergy members during a declared public health emergency related to a communicable disease of public health threat. Under the bill, the hospital, nursing home, or certified nursing facility may require the clergy member to comply with all reasonable health and safety requirements and may restrict visits of a clergy member who fails a health screening measure or tests positive for a communicable disease of public health concern. If the health and safety requirement substantially burdens the clergy member's free exercise of religion, the hospital, nursing home, or certified nursing facility may require compliance only if the requirement furthers a compelling health and safety interest and imposes the least restrictive requirement. The bill provides immunity for hospitals, nursing homes, and certified nursing facilities and their employees and contractors from liability for injury or death due to exposure to a communicable disease of public health concern resulting from or related to such visitation, except in limited circumstances. The bill also allows a person or religious organization to bring a civil action against a hospital, nursing home, or certified nursing facility alleging a violation of such visitation provisions. | |||
| SB 945 - Suetterlein - Individuals with developmental disabilities; financial flexibility, report. | (H) Committee on Health, Welfare and Institutions (S) Committee on Finance and Appropriations | (G) Acts of Assembly Chapter text (CHAP0702) | 03/27/23 |
| notes: Directs the Department of Medical Assistance Services to take steps to amend the Family and Individual Supports, Community Living, and Building Independence waivers to provide greater financial flexibility to individuals with developmental disabilities who are receiving waiver services. The bill requires the Department to report on its progress to the Governor and the General Assembly by December 1, 2023. | |||
| SB 1270 - Edwards - Managed care organizations; data collections and reporting requirements, report. | (H) Committee on Health, Welfare and Institutions (S) Committee on Rules | (G) Acts of Assembly Chapter text (CHAP0336) | 03/23/23 |
| notes: Requires the Department of Medical Assistance Services to include in its contracts with managed care organizations provisions that require the managed care organization to collect and report to the Department data regarding (i) the number and percentage of claims that are denied and the reasons for such denials and (ii) the number and percentage of claims that required resubmission prior to payment and the reasons for such resubmissions. The bill requires the Department to (a) examine such data and identify barriers that providers encounter when accepting and treating patients enrolled in the state plan for medical assistance services and (b) report such data and analysis by October 1 of each year to the Joint Commission on Health Care and the Joint Subcommittee for Health and Human Resources Oversight. | |||
| SB 1418 - Pillion - State plan for medical assistance services; telemedicine, in-state presence. | (H) Committee on Health, Welfare and Institutions (S) Committee on Education and Health | (G) Acts of Assembly Chapter text (CHAP0113) | 03/21/23 |
| notes: Establishes that health care providers are not required to maintain a physical presence in the Commonwealth to maintain eligibility to enroll as a Medicaid provider. Additionally, the bill establishes that telemedicine services provider groups with health care providers duly licensed by the Commonwealth are not required to maintain an in-state service address to maintain eligibility to enroll as a Medicaid vendor or Medicaid provider group. | |||
| SB 1457 - Lewis - Long-term services and supports screening; screening after admission. | (H) Committee on Health, Welfare and Institutions (S) Committee on Finance and Appropriations | (G) Acts of Assembly Chapter text (CHAP0185) | 03/22/23 |
| notes: Provides that if an individual is admitted to a skilled nursing facility for skilled nursing services not covered by the Commonwealth's program of medical assistance services and such individual was not screened but is subsequently determined have been required to be screened prior to admission to the nursing home, then the screening may be conducted after admission. Under the bill, coverage of institutional long-term services and supports by the Commonwealth for such non-prescreened patients shall not begin until six months after the initial admission to the skilled nursing facility. During this six-month period, the skilled nursing facility in which the individual resides shall be responsible for all costs indicated for institutional long-term services and supports, in excess of available patient funds, excluding the personal needs allowance that would otherwise have been covered by the Commonwealth. The bill provides that if sufficient evidence indicates that the admission without screening was of no fault of the skilled nursing facility, the Department of Medical Assistance Services shall begin coverage of institutional long-term services and supports immediately upon the completion of the functional screening indicating skilled nursing facility level of care pending the financial eligibility determination. | |||
| SB 1508 - Mason - Assisted living facilities, adult day care centers, and child welfare agencies; provisional license. | (H) Committee on Health, Welfare and Institutions (S) Committee on Rehabilitation and Social Services | (G) Acts of Assembly Chapter text (CHAP0695) | 03/27/23 |
| notes: Increases from six months to 12 months the maximum period of time during which a person may operate an assisted living facility, adult day care center, or child welfare agency under a provisional license issued by the Commissioner of Social Services. | |||
| SB 1538 - Pillion - Medical assistance services; state plan, pharmacy services. | (H) Committee on Health, Welfare and Institutions (S) Committee on Education and Health | (G) Acts of Assembly Chapter text (CHAP0412) | 03/23/23 |
| notes: Requires the Department of Medical Assistance Services to provide reimbursement when the services provided for by the state plan for medical assistance services are services by a pharmacist, pharmacy technician, or pharmacy intern (i) performed under the terms of a collaborative agreement as defined in relevant law, (ii) related to services and treatment in accordance with relevant law, or (iii) performed under the terms of the state plan or managed care contractor of the Department. | |||