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
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 2020 Chapter 1283, 2020 Acts of Assembly $4,899,537,379 $10,228,886,509 $15,128,423,888
2020-2022 2021 Chapter 1, 2022 Acts of Assembly $4,545,328,030 $12,527,356,462 $17,072,684,492
2020-2022 2022 Chapter 1, 2022 Acts of Assembly $4,649,993,559 $14,472,732,262 $19,122,725,821
2022-2024 2023 Chapter 1, 2023 Acts of Assembly, Special Session 1 $5,824,897,704 $14,857,958,805 $20,682,856,509
2022-2024 2023 Previous Legislative Appropriation $5,824,897,704 $14,857,958,805 $20,682,856,509
2022-2024 2023 Governor's Amendments ($504,132,322) $1,717,074,905 $1,212,942,583
2022-2024 2023 General Assembly Adjustments $504,132,322 ($1,717,074,905) ($1,212,942,583)
2022-2024 2024 Chapter 1, 2023 Acts of Assembly, Special Session 1 $6,026,900,220 $17,013,668,597 $23,040,568,817
2022-2024 2024 Previous Legislative Appropriation $6,244,987,584 $14,971,692,667 $21,216,680,251
2022-2024 2024 Governor's Amendments $189,287,780 $2,475,847,199 $2,665,134,979
2022-2024 2024 General Assembly Adjustments ($407,375,144) ($433,871,269) ($841,246,413)
Positions Budget Summary
Biennium Fiscal Year Source GF NGF Total
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 2020 Chapter 1283, 2020 Acts of Assembly 259.52 275.48 535.00
2020-2022 2021 Chapter 1, 2022 Acts of Assembly 260.02 269.98 530.00
2020-2022 2022 Chapter 1, 2022 Acts of Assembly 263.02 272.98 536.00
2022-2024 2023 Chapter 1, 2023 Acts of Assembly, Special Session 1 266.02 276.98 543.00
2022-2024 2023 Previous Legislative Appropriation 266.02 276.98 543.00
2022-2024 2023 Governor's Amendments 0.00 0.00 0.00
2022-2024 2023 General Assembly Adjustments 0.00 0.00 0.00
2022-2024 2024 Chapter 1, 2023 Acts of Assembly, Special Session 1 263.52 279.48 543.00
2022-2024 2024 Previous Legislative Appropriation 263.52 274.48 538.00
2022-2024 2024 Governor's Amendments 4.00 4.00 8.00
2022-2024 2024 General Assembly Adjustments (4.00) 1.00 (3.00)
Operating Budget Addenda (in order of greatest impact)
•
Fund Medicaid utilization and inflation Decision Package
  Provides funding for the cost of Medicaid utilization and inflation as estimated in the most recent expenditure forecast.
 
  FY FY
General Fund ($279,325,319) $12,266,384
Nongeneral Fund $1,483,717,796 $1,356,069,626
•
Account for extension of the federal public health emergency Decision Package
  Adjusts Medicaid and Children's Health Insurance Program appropriations to account for the anticipated extension of the national public health emergency through April 11, 2023. The expected extension would mean that the federal continuous enrollment requirement would expire on?April 30, 2023, and the federal Medicaid Assistance Percentages enhancement would continue through?June 30, 2023. Language is added allowing the Department of Planning and Budget to move appropriation between fiscal years as necessary to maximize federal reimbursements.
 
  FY FY
General Fund ($157,800,861) $53,439,303
Nongeneral Fund $153,859,144 $1,113,615,681
•
Adjust Virginia Health Care Fund appropriation Decision Package
  Modifies appropriation in the Virginia Health Care Fund to reflect the latest revenue estimates. Since the Health Care Fund is used as state match for Medicaid, any increase in revenue offsets general fund support for Medicaid and any decrease requires additional general fund support.
 
  FY FY
General Fund ($50,436,557) $67,732,794
Nongeneral Fund $50,436,557 ($67,732,794)
•
Increase rates for personal care, respite, and companion services Decision Package
  Increases provider rates for agency- and consumer-directed personal care, respite, and companion services by five percent effective July 1, 2023.
 
  FY FY
General Fund $0 $41,616,322
Nongeneral Fund $0 $47,194,131
•
Add 500 developmental disability waiver slots Decision Package
  Increases the number of developmental disability waiver slots beginning on July 1, 2023, to 1,100 by adding 500 additional slots. This amendment increases the number of new Family and Individual Supports waiver slots in 2024 from 500 to 930 and the number of new Community Living waiver slots from 100 to 170 in 2024.
 
  FY FY
General Fund $0 $15,155,118
Nongeneral Fund $0 $15,822,689
•
Fund Family Access to Medical Insurance Security program utilization and inflation Decision Package
  Adjusts funding for the Family Access to Medical Insurance Security program to reflect the latest forecast of expenditures as projected by the Department of Medical Assistance Services.
 
  FY FY
General Fund ($13,143,045) ($321,954)
Nongeneral Fund $7,098,020 $5,279,027
•
Fund 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 as projected by the Department of Medical Assistance Services.
 
  FY FY
General Fund ($5,888,208) ($2,820,997)
Nongeneral Fund $16,495,016 $634,327
•
Fund capitated contract cost escalations Decision Package
  Provides additional nongeneral fund appropriation to cover the anticipated cost of required contracts. This amendment will avoid the need for future administrative adjustments.
 
  FY FY
Nongeneral Fund $2,410,933 $2,410,933
•
Reprocure Medicaid managed care program Decision Package
  Authorizes the department to reprocure the Commonwealth’s managed care service delivery system with an expected implementation date of July 1, 2024. Funds are also provided to support one-time costs associated with the reprocurement.
 
  FY FY
General Fund $1,689,750 $0
Nongeneral Fund $2,594,750 $0
•
Fund costs associated with settlement Decision Package
  Provides one-time funding necessary to cover a required settlement with the Cover Virginia vendor.
 
  FY FY
General Fund $2,271,918 $0
Nongeneral Fund $462,689 $0
•
Increase rates for Early Intervention services Decision Package
  Provides a 12.5 percent rate increase for Early Intervention services beginning July 1, 2023.
 
  FY FY
General Fund $0 $1,117,018
Nongeneral Fund $0 $1,187,947
•
Add 20 psychiatric residencies through graduate medical education Decision Package
  Adds funding to support 20 additional psychiatric residency slots funded through Medicaid beginning in 2024.
 
  FY FY
General Fund $0 $1,000,000
Nongeneral Fund $0 $1,000,000
•
Adjust funding for medical services for involuntary mental commitments Decision Package
  Adjusts funding for the estimated cost of hospital and physician services for persons subject to an involuntary mental commitment. The most recent forecast of expenditures projects lower costs than previously estimated.
 
  FY FY
General Fund ($1,500,000) ($250,000)
•
Account for the Medicaid portion of state facility salary actions Decision Package
  Appropriates the Medicaid share of salary augmentation costs for food services and environmental services staff at Southeastern Virginia Training Center and Hiram Davis Medical Center.
 
  FY FY
General Fund $0 $268,792
Nongeneral Fund $0 $280,632
•
Transfer resources to fund developmental disability waiver responsibilities Decision Package
  Moves funds from the Department of Behavioral Health and Developmental Services to support agency responsibilities associated with developmental disability waiver services that will be transferred effective July 1, 2023. This amendment also includes Appropriation Act language designating the Department of Medical Assistance Services as the agency responsible for all financial analysis, rates, and budget work associated with Virginia’s developmental disability waiver services.
 
  FY FY
General Fund $0 $85,000
Nongeneral Fund $0 $85,000
Positions 0.00 1.00
•
Align outpatient rehabilitation reimbursement methodology with Medicare Decision Package
  Updates the reimbursement methodology for outpatient rehabilitation services to the Resource Based Relative Value Scale. This change is necessary to align Virginia's reimbursement methodology with Medicare and industry standards. All changes must be budget neutral.
•
Convene a workgroup to examine inclusion of residential treatment services in managed care Decision Package
  Requires the department to convene a workgroup to examine the impact of including residential treatment services in the managed care program. This workgroup must examine potential cost, program, and system of care impacts, including how local funding and the federally required independent assessment process for these services must be accounted for in managed care.
•
Implement telehealth service delivery options for developmental disability waivers Decision Package
  Provides the authority to implement telehealth service delivery options for developmental disability waiver services currently authorized by the Appropriation Act or Code of Virginia.
•
Improve access to peer recovery support services Decision Package
  Expands the availablity of peer recovery specialists in Medicaid by implementing measures that would reduce administrative barriers that limit access to services.
•
Improve third-party liability recoveries Decision Package
  Funds seven positions to increase the amount of third-party liability recoveries. It is expected that these positions will generate sufficient savings in the Medicaid program to offset the new administrative costs.
 
  FY FY
Positions 0.00 7.00
•
2023 Special Session I Amendments: Medicaid Funding Adjustment General Assembly Adjustment
 
 
  FY FY
General Fund $0 ($216,670,586)
Nongeneral Fund $0 $1,934,265,573
•
Reverse Introduced Operating Budget Amendments - 1 of 3 (2023 Session HB 1400 Conference Action) General Assembly Adjustment
  This amendment reverses the operating budget amendments proposed in HB 1400 / SB 800 as introduced. The passage of the conference substitute to HB 1400 nullifies the introduced amendments. To reflect the General Assembly action, this amendment reverses the aggregate total of proposed introduced budget changes for this agency.
 
  FY FY
General Fund $168,044,107 ($63,095,929)
Nongeneral Fund ($572,358,301) ($825,282,401)
Positions 0.00 (8.00)
•
Reverse Introduced Operating Budget Amendments - 2 of 3 (2023 Session HB 1400 Conference Action) General Assembly Adjustment
  This amendment reverses the operating budget amendments proposed in HB 1400 / SB 800 as introduced. The passage of the conference substitute to HB 1400 nullifies the introduced amendments. To reflect the General Assembly action, this amendment reverses the aggregate total of proposed introduced budget changes for this agency.
 
  FY FY
General Fund $168,044,107 ($63,095,929)
Nongeneral Fund ($572,358,301) ($825,282,401)
•
Reverse Introduced Operating Budget Amendments - 3 of 3 (2023 Session HB 1400 Conference Action) General Assembly Adjustment
  This amendment reverses the operating budget amendments proposed in HB 1400 / SB 800 as introduced. The passage of the conference substitute to HB 1400 nullifies the introduced amendments. To reflect the General Assembly action, this amendment reverses the aggregate total of proposed introduced budget changes for this agency.
 
  FY FY
General Fund $168,044,108 ($63,095,922)
Nongeneral Fund ($572,358,303) ($825,282,397)
•
2023 Special Session I Amendments: Virginia Health Care Fund Adjustment General Assembly Adjustment
 
 
  FY FY
General Fund $0 ($42,648,535)
Nongeneral Fund $0 $42,648,535
•
2023 Special Session I Amendments: Personal Care, Respite, and Companion Services Rates General Assembly Adjustment
 
 
  FY FY
General Fund $0 $20,808,161
Nongeneral Fund $0 $23,597,067
•
2023 Special Session I Amendments: Medicaid Rates for Community-Based Behav. Health Services General Assembly Adjustment
 
 
  FY FY
General Fund $0 $8,699,568
Nongeneral Fund $0 $18,486,674
•
2023 Special Session I Amendments: Add 500 Developmental Disability Waiver Slots General Assembly Adjustment
 
 
  FY FY
General Fund $0 $7,577,559
Nongeneral Fund $0 $7,911,345
•
2023 Special Session I Amendments: Children's Hospital of The King's Daughters Payments General Assembly Adjustment
 
 
  FY FY
General Fund $0 $5,153,878
Nongeneral Fund $0 $5,896,122
•
2023 Special Session I Amendments: Family Access to Medical Insurance Security Program Funding Adjustment General Assembly Adjustment
 
 
  FY FY
General Fund $0 ($321,954)
Nongeneral Fund $0 $5,279,027
•
2023 Special Session I Amendments: Medical Assistance Services for Low-income Children Funding Adjustment General Assembly Adjustment
 
 
  FY FY
General Fund $0 ($2,820,997)
Nongeneral Fund $0 $634,237
•
2023 Special Session I Amendments: Fund Complex Rehab. Tech. for Medicaid Nursing Facility Members General Assembly Adjustment
 
 
  FY FY
General Fund $0 $1,272,060
Nongeneral Fund $0 $1,335,690
•
2023 Special Session I Amendments: Early Intervention Services General Assembly Adjustment
 
 
  FY FY
General Fund $0 $558,509
Nongeneral Fund $0 $593,974
•
2023 Special Session I Amendments: Medicaid Parity of Mental Health and Substance Use Disorder Rates General Assembly Adjustment
 
 
  FY FY
General Fund $0 $218,918
Nongeneral Fund $0 $679,354
•
2023 Special Session I Amendments: Medicaid Dental Program Enhancements General Assembly Adjustment
 
 
  FY FY
General Fund $0 $214,136
Nongeneral Fund $0 $347,386
•
2023 Special Session I Amendments: Medical Services for Involuntary Mental Commitments General Assembly Adjustment
 
 
  FY FY
General Fund $0 ($250,000)
•
2023 Special Session I Amendments: Collaborative Care Management Services for Substance Use Treatment General Assembly Adjustment
 
 
  FY FY
General Fund $0 $21,589
Nongeneral Fund $0 $191,917
•
2023 Special Session I Amendments: EPSDT Therapeutic Group Homes Rate Increase General Assembly Adjustment
 
 
  FY FY
General Fund $0 $100,330
Nongeneral Fund $0 $109,029
•
2023 Special Session I Amendments: Medicaid Coverage of Weight Loss and Diabetic Drugs General Assembly Adjustment
 
•
2023 Special Session I Amendments: Medicaid Managed Care Reprocurement General Assembly Adjustment
 
•
2023 Special Session I Amendments: Medicaid Private Hospital Supplemental & IME Payments General Assembly Adjustment
 
 
  FY FY
Positions 0.00 5.00
•
2023 Special Session I Amendments: Modify Emergency Room Utilization Program General Assembly Adjustment
 


p3_bullets - Official Enacted Budget - 06-07-2025 13:40:58