Department of Medical Assistance Services [602]
Secretarial Area: Health and Human Resources
Operating Budget Summary
This table shows the Governor's proposed budget for the next two years and the agency's official budget for the previous six years.
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Biennium Fiscal Year Source GF NGF Total
2012-2014 2013 Chapter 1, 2014 Acts of Assembly $3,547,761,312 $4,525,123,550 $8,072,884,862
2012-2014 2014 Chapter 1, 2014 Acts of Assembly $3,669,406,166 $4,829,310,906 $8,498,717,072
2014-2016 2015 Chapter 732, 2016 Acts of Assembly $3,846,847,641 $4,786,951,421 $8,633,799,062
2014-2016 2016 Chapter 732, 2016 Acts of Assembly $4,266,731,052 $5,073,691,875 $9,340,422,927
2016-2018 2017 Chapter 1, 2018 Acts of Assembly $4,450,859,097 $5,472,509,199 $9,923,368,296
2016-2018 2018 Chapter 1, 2018 Acts of Assembly $4,785,782,724 $5,892,680,250 $10,678,462,974
2018-2020 2019 Chapter 1283, 2020 Acts of Assembly $5,008,158,914 $7,594,157,772 $12,602,316,686
2018-2020 2019 Previous Legislative Appropriation $5,008,158,914 $7,594,157,772 $12,602,316,686
2018-2020 2019 Governor's Amendments $0 $0 $0
2018-2020 2019 General Assembly Adjustments $0 $0 $0
2018-2020 2020 Chapter 1283, 2020 Acts of Assembly $4,899,537,379 $10,228,886,509 $15,128,423,888
2018-2020 2020 Previous Legislative Appropriation $5,159,981,592 $10,545,577,374 $15,705,558,966
2018-2020 2020 Governor's Amendments ($254,816,801) ($311,570,695) ($566,387,496)
2018-2020 2020 General Assembly Adjustments ($5,627,412) ($5,120,170) ($10,747,582)
Positions Budget Summary
Biennium Fiscal Year Source GF NGF Total
2012-2014 2013 Chapter 1, 2014 Acts of Assembly 183.82 212.18 396.00
2012-2014 2014 Chapter 1, 2014 Acts of Assembly 198.32 226.68 425.00
2014-2016 2015 Chapter 732, 2016 Acts of Assembly 210.37 216.63 427.00
2014-2016 2016 Chapter 732, 2016 Acts of Assembly 225.02 234.98 460.00
2016-2018 2017 Chapter 1, 2018 Acts of Assembly 232.02 241.98 474.00
2016-2018 2018 Chapter 1, 2018 Acts of Assembly 240.02 249.98 490.00
2018-2020 2019 Chapter 1283, 2020 Acts of Assembly 257.52 273.48 531.00
2018-2020 2019 Previous Legislative Appropriation 257.52 273.48 531.00
2018-2020 2019 Governor's Amendments 0.00 0.00 0.00
2018-2020 2019 General Assembly Adjustments 0.00 0.00 0.00
2018-2020 2020 Chapter 1283, 2020 Acts of Assembly 259.52 275.48 535.00
2018-2020 2020 Previous Legislative Appropriation 259.52 275.48 535.00
2018-2020 2020 Governor's Amendments 0.00 0.00 0.00
2018-2020 2020 General Assembly Adjustments 0.00 0.00 0.00
Operating Budget Addenda (in order of greatest impact)
•
Fund FY 2020 Medicaid utilization and inflation Decision Package
  Adjusts funding for the FY 2020 cost of Medicaid as estimated in the most recent forecast expenditures.
 
  FY FY
General Fund $0 ($211,666,974)
Nongeneral Fund $0 ($356,372,127)
•
Adjust FY 2020 Health Care Fund appropriation Decision Package
  Modifies the appropriation for the Virginia Health Care Fund to reflect the latest revenue estimates. The FY 2020 estimate reflects less prior year pharmacy rebates ($6.8 million); a small increase in tobacco taxes ($0.2 million) and a decline ($2.1 million) in Master Settlement Agreement revenue. The estimates also account for $53.1 million in prior year balances carried over from 2019. Since the fund is used as state match for Medicaid, any change in revenue to the fund impacts general fund support for Medicaid.
 
  FY FY
General Fund $0 ($44,400,253)
Nongeneral Fund $0 $44,400,253
•
Fund FY 2020 Family Access to Medical Insurance Security (FAMIS) utilization and inflation Decision Package
  Adjusts funding for the FAMIS program to reflect the latest forecast of expenditures. The costs are primarily a result of higher managed care rates and increased enrollment.
 
  FY FY
General Fund $0 $2,234,451
Nongeneral Fund $0 $4,563,258
•
Fund FY 2020 medical assistance services for low-income children utilization and inflation Decision Package
  Adjusts funding for the Commonwealth's Medicaid Children's Health Insurance Program to reflect the latest expenditure forecast. Children between the ages of 6 and 19, with family income from 100 to 133 percent of the federal poverty level, are eligible for this program.
 
  FY FY
General Fund $0 ($984,025)
Nongeneral Fund $0 ($4,162,079)
•
Offset federal revenue losses for CHKD Decision Package
  Authorizes the department to create additional hospital supplemental payments for CHKD to replace payments that have been reduced due to the federal regulation on the definition of uncompensated care costs effective June 2, 2017. These new payments will equal what would have been paid to CHKD under the current disproportionate share hospital (DSH) formula.
•
Account for Final CCC Plus Contract Rates General Assembly Adjustment
  This amendment accounts for the Department of Medical Assistance Services adopting lower managed care rates for the Commonwealth Coordinated Care (CCC) Plus program (effective January 1, 2020) than those assumed in the November 1, 2019 official Medicaid forecast.
 
  FY FY
General Fund $0 ($3,435,651)
Nongeneral Fund $0 ($3,435,651)
•
Reduce Funding for Medicaid Expenditures General Assembly Adjustment
  This amendment reduces the general fund by $2.5 million the second year and a like amount of matching federal Medicaid funds to reflect Medicaid expenditure projections for the remainder of fiscal year 2020.
 
  FY FY
General Fund $0 ($2,500,000)
Nongeneral Fund $0 ($2,500,000)
•
Fund cost of initial COVID-19 response (Reconvened Amendment) General Assembly Adjustment
  Increases funding to cover the cost of policy changes implemented by the Department of Medical Assistance Services in response to COVID-19. These actions include expanding the use of telemedicine, waiving service authorizations and eliminating cost sharing.
 
  FY FY
General Fund $0 $308,239
Nongeneral Fund $0 $815,481
•
Authorize changes to medical assistance programs in response to COVID-19 (Reconvened Amendment) General Assembly Adjustment
  Provides DMAS temporary authority to make immediate changes to its medical assistance programs in response to COVID-19. Any change would be subject to the Governor’s approval and must be reported within 15 days. Authorization and any program changes will expire with the Governor’s emergency declaration.
•
Capture Excess Administrative Balance General Assembly Adjustment
  This amendment sets out Item 307 which was not set out in the introduced budget. The amendment includes a new paragraph FF, which reverts $3.0 million from the general fund from the Department of Medical Assistance Services' administrative budget in fiscal year 2020. Based on current spending projections and the agency's prepayment of rent and other July 2019 contractual payments out of fiscal year 2019 year end balances, that would have otherwise reverted to the general fund, this amendment captures the excess appropriation.
•
Increase nursing facility rates in response to COVID-19 (Reconvened Amendment) General Assembly Adjustment
  Increases nursing home and specialized care per diem rates by $20 per day per patient effective for the period of the Governor's Declaration of a State of Emergency due to COVID-19.
•
Provide flexibility to adjust medical assistance payment dates (Reconvened Amendment) General Assembly Adjustment
  Allows DMAS to advance any appropriate and allowable payment in an effort to take advantage of enhanced federal matching funds.
•
Unallot general fund FMAP savings (Reconvened Amendment) General Assembly Adjustment
  Requires that DMAS identify all state savings associated with the federal government increasing the FMAP rate (to 56.2%) for medical assistance services. Further, DPB is authorized to unallot an amount of state funds equal to the general fund savings identified by DMAS.


p3_bullets - Official Enacted Budget - 06-07-2025 13:52:53