The 2022 Executive Budget Document
Governor Northam's Proposed Budget for the 2022-2024 Biennum
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Released on December 16, 2021 
 
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 Governor's Proposed Budget $6,058,670,941 $13,582,999,533 $19,641,670,474
    Base Budget $5,552,084,073 $13,028,216,409 $18,580,300,482
    Addenda (Changes to the Base) $506,586,868 $554,783,124 $1,061,369,992
2022-2024 2024 Governor's Proposed Budget $6,348,294,785 $14,411,526,103 $20,759,820,888
    Base Budget $5,552,084,073 $13,028,216,409 $18,580,300,482
    Addenda (Changes to the Base) $796,210,712 $1,383,309,694 $2,179,520,406
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 Proposed Positions 266.02 275.98 542.00
    Base Budget 263.02 272.98 536.00
    Addenda (Changes to the Base) 3.00 4.00 7.00
2012-2014 2024 Proposed Positions 266.02 275.98 542.00
    Base Budget 263.02 272.98 536.00
    Addenda (Changes to the Base) 3.00 3.00 6.00
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 2023 FY 2024
General Fund $291,278,394 $529,911,804
Nongeneral Fund $320,716,684 $1,068,681,199
•
Increase reimbursement rates for developmental disability waiver services Decision Package
  Increases Medicaid reimbursement rates for those developmental disability waiver services necessary to promote compliance with the settlement agreement.
 
  FY 2023 FY 2024
General Fund $137,130,639 $157,076,913
Nongeneral Fund $141,424,576 $161,995,423
•
Increase Medicaid reimbursement rates for primary care services Decision Package
  Increases Medicaid and FAMIS rates for physician primary care services, excluding those provided in emergency departments, to 80 percent of the federal FY 2021 Medicare equivalent as calculated by the department.
 
  FY 2023 FY 2024
General Fund $9,340,824 $10,699,490
Nongeneral Fund $28,835,866 $33,030,174
•
Fund 1,200 developmental disability waiver slots Decision Package
  Provides support for the creation of 100 Community Living (CL) and 500 Family and Individual Support (FIS) waiver slots in FY 2023. An additional 100 CL and 500 FIS waiver slots are created in FY 2024. The total number of additional slots funded by this package over the 2022-2024 biennium is 1,200.
 
  FY 2023 FY 2024
General Fund $13,014,050 $26,028,100
Nongeneral Fund $13,014,050 $26,028,100
•
Adjust Medicaid forecast to account for revised Medicare premiums Decision Package
  Accounts for Medicare premium rates that were published after the official Medicaid forecast was completed. During the development of the Medicaid forecast, due November 1, the Department of Medical Assistance Services had to use preliminary assumptions on Medicare premium rates. Since the forecast was finalized, the federal government has released actual Medicare Part A, B and D rates effective January 1, 2022. The forecast assumed 5 percent for Part A, 6.73 percent for Part B, and 4.86 percent for Part D; however the actual rates are 5.9 percent, 14.5 percent, and 7.31 percent respectively.CHAR(13) + CHAR(10)
 
  FY 2023 FY 2024
General Fund $22,943,316 $23,928,382
Nongeneral Fund $12,972,058 $13,467,403
•
Fund Family Access to Medical Insurance Security utilization and inflation Decision Package
  Adjusts funding for the FAMIS program to reflect the latest forecast of expenditures as projected by the Department of Medical Assistance Services.
 
  FY 2023 FY 2024
General Fund $12,662,470 $17,263,736
Nongeneral Fund $9,124,373 $18,142,452
•
Fund re-entry care coordination and outreach Decision Package
  Provides funding to provide care coordination services to individuals who are Medicaid eligible 30 days prior to release from incarceration.
 
  FY 2023 FY 2024
General Fund $1,062,185 $1,385,199
Nongeneral Fund $12,544,924 $17,857,653
•
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 2023 FY 2024
General Fund $8,730,923 $13,795,573
Nongeneral Fund ($3,467,369) $5,938,410
•
Increase reimbursement rates for obstetrics and gynecology services Decision Package
  Increases the Medicaid reimbursement rate for obstetrics and gynecology services by 15 percent.
 
  FY 2023 FY 2024
General Fund $3,272,840 $3,272,840
Nongeneral Fund $7,592,983 $7,592,983
•
Increase Medicaid reimbursement rates for dental services Decision Package
  Increases Medicaid reimbursement rates for dental services by five percent effective July 1, 2023.
 
  FY 2023 FY 2024
General Fund $0 $7,392,748
Nongeneral Fund $0 $13,459,781
•
Adjust Health Care Fund appropriation Decision Package
  Modifies the appropriation for the Virginia Health Care Fund to reflect the latest revenue estimates. Tobacco taxes are projected to increase by $9.6 million over the biennium based on the Department of Taxation's revised forecast. However, revenue from the Master Settlement Agreement and Medicaid recoveries are expected to remain unchanged. Since the fund is used as state match for Medicaid, any change in revenue to the fund impacts general fund support for Medicaid.
 
  FY 2023 FY 2024
General Fund ($2,200,000) ($7,400,000)
Nongeneral Fund $2,200,000 $7,400,000
•
Remove one-time funding Decision Package
  Removes funding and the associated language for one-time tasks that are required to be completed by July 1, 2022. This includes the one-time costs associated with facilitated enrollment efforts as well as an analysis of pregnancy and birth outcomes.
 
  FY 2023 FY 2024
General Fund ($968,480) ($968,480)
Nongeneral Fund ($5,996,545) ($5,996,545)
•
Increase reimbursement rates for vision services Decision Package
  Increases the Medicaid reimbursement rate for children's covered vision services by 30 percent.
 
  FY 2023 FY 2024
General Fund $3,122,860 $3,122,860
Nongeneral Fund $3,571,356 $3,571,356
•
Provide psychiatric residential treatment facilities with rebasing and annualized inflation Decision Package
  Requires the agency to implement annual inflation and triennial rebasing methodology for psychiatric residential treatment facilities.
 
  FY 2023 FY 2024
General Fund $731,393 $2,984,084
Nongeneral Fund $1,358,301 $5,541,870
•
Cover the cost of interoperability and patient access requirements Decision Package
  Supports the administrative cost of federally required interoperability. Chapter 552 provided $5.5 million ($2.4 million general fund) to support the costs associated with managed care organizations; however, the agency administrative portion was not funded due to delays associated with the implementation of the Medicaid Enterprise System. This request provides the administrative portion.
 
  FY 2023 FY 2024
General Fund $692,573 $142,076
Nongeneral Fund $6,619,427 $1,357,924
•
Fund direct care salary increases at training centers Decision Package
  Funds the second-year Medicaid costs of the salary increases for direct care staff at Southeastern Virginia Training Center and Hiram Davis Medical Center. This adjustment accounts for an additional statewide salary increase of five percent in the second year.
 
  FY 2023 FY 2024
General Fund $0 $3,892,304
Nongeneral Fund $0 $3,892,304
•
Adjust appropriation to reflect agency operations Decision Package
  Moves appropriation and a position between programs to ensure that all administrative services are properly budgeted. In addition, this package removes federal appropriation to reflect the end of federal health services grants and the available general fund support for training centers.
 
  FY 2023 FY 2024
Nongeneral Fund ($3,859,464) ($3,859,464)
•
Adjust appropriation for centrally funded five percent salary increase for state employees Base Budget Adjustment
  Adjusts appropriation for the five percent salary increase for state employees budgeted in Central Appropriations, Item 477 X. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund $1,654,603 $1,654,603
Nongeneral Fund $1,138,042 $1,138,042
•
Eliminate remaining Medicaid and FAMIS program copayments Decision Package
  Removes remaining copayment requirements for children in the Family Access to Medical Insurance Security managed care program and for adults in fee-for-service Medicaid. This action is effective April 1, 2022 or upon expiration of the federal public health emergency related to the Coronavirus Disease of 2019 (COVID-19) pandemic, whichever is earlier.
 
  FY 2023 FY 2024
General Fund $444,369 $426,391
Nongeneral Fund $2,095,303 $2,010,534
•
Cover preventive services and vaccines for eligible adult populations Decision Package
  Adds coverage of the preventive services provided pursuant to the Patient Protection and Affordable Care Act (ACA) for adult, full Medicaid individuals who are not enrolled pursuant to the ACA.
 
  FY 2023 FY 2024
General Fund $1,140,831 $1,199,049
Nongeneral Fund $1,140,831 $1,199,049
•
Exclude excess resources accumulated during the public health emergency for long-term supports and services recipients Decision Package
  Allows for the exclusion of resources accumulated by individuals receiving long-term supports and services (LTSS) for a period of 12 months after the end of the federal public health emergency (PHE). Federal rules prohibited Virginia from increasing patient pay associated with changes implemented during the PHE. Therefore, some LTSS recipients may have accumulated excess resources and would be at risk for losing Medicaid eligibility at the end of the federal PHE.
 
  FY 2023 FY 2024
General Fund $1,608,540 $0
Nongeneral Fund $1,608,540 $0
•
Adjust appropriation for centrally funded changes to agency information technology costs Base Budget Adjustment
  Adjusts appropriation for changes to information technology and telecommunications usage budgeted in Central Appropriations, Item 478 C. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund ($418,225) ($418,225)
Nongeneral Fund ($497,718) ($497,718)
•
Fund consolidation of managed care contracts Decision Package
  Provides funding to cover one-time system costs associated with combining the managed care programs as required by Appropriation Act language.
 
  FY 2023 FY 2024
General Fund $421,498 $0
Nongeneral Fund $1,188,142 $0
•
Enhance Medicaid financial oversight Decision Package
  Provides funding to hire five additional full-time positions dedicated to finance divisions that will improve the financial oversight of the Medicaid program. The department is required to address the most critical needs by adding these positions in the areas of budget, fiscal, and provider reimbursement.
 
  FY 2023 FY 2024
General Fund $300,000 $300,000
Nongeneral Fund $300,000 $300,000
Positions 5.00 5.00
•
Adjust appropriation for centrally funded retirement rate changes Base Budget Adjustment
  Adjusts appropriation for changes to contribution rates for state employee retirement plans budgeted in Central Appropriations, Item 477 H. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund $248,597 $248,597
Nongeneral Fund $170,983 $170,983
•
Increase funding for external quality review organization activities Decision Package
  Funds the higher than expected cost of federally required external quality review organization activities.
 
  FY 2023 FY 2024
General Fund $80,001 $80,001
Nongeneral Fund $335,250 $335,250
•
Adjust appropriation for centrally funded changes to Performance Budgeting system charges Base Budget Adjustment
  Adjusts appropriation for changes to Performance Budgeting system internal service fund charges budgeted in Central Appropriations, Item 478 H. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund ($21,394) ($21,394)
Nongeneral Fund $323,782 $323,782
•
Adjust appropriation for centrally funded changes to state health insurance premiums Base Budget Adjustment
  Adjusts appropriation for the employer’s share of health insurance premiums budgeted in Central Appropriations, Item 477 G. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund $178,126 $178,126
Nongeneral Fund $93,667 $93,667
•
Adjust appropriation for centrally funded changes to Cardinal Human Capital Management System charges Base Budget Adjustment
  Adjusts appropriation for changes to Cardinal Human Capital Management System internal service fund charges budgeted in Central Appropriations, Item 478 G. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund $144,383 $144,383
Nongeneral Fund $58,860 $58,860
•
Hire position to support provider reimbursement Decision Package
  Funds a full-time position with the actuarial and accounting experience necessary to provide ongoing expertise on nursing facility reimbursement and rate methodology issues.
 
  FY 2023 FY 2024
General Fund $90,000 $90,000
Nongeneral Fund $90,000 $90,000
Positions 1.00 1.00
•
Adjust appropriation for centrally funded workers’ compensation premium changes Base Budget Adjustment
  Adjusts appropriation for workers’ compensation premiums budgeted in Central Appropriations, Item 477 R. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund ($141,651) ($141,651)
Nongeneral Fund $12,009 $12,009
•
Fund study of human milk bank donation for babies Decision Package
  Requires a study of the cost and efficacy of donated human milk.
 
  FY 2023 FY 2024
General Fund $100,000 $0
Nongeneral Fund $100,000 $0
•
Adjust appropriation for centrally funded changes to Cardinal Financials System charges Base Budget Adjustment
  Adjusts appropriation for changes to Cardinal Financials System internal service fund charges budgeted in Central Appropriations, Item 478 F. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund ($60,729) ($60,729)
Nongeneral Fund ($30,894) ($30,894)
•
Adjust appropriation for centrally funded general liability premium charges Base Budget Adjustment
  Adjusts appropriation for general liability premiums billed by the Department of the Treasury’s Division of Risk Management budgeted in Central Appropriations, Item 478 J. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund $4,344 $4,344
Nongeneral Fund $4,344 $4,344
•
Adjust appropriation for centrally funded state employee other post-employment benefit rate changes Base Budget Adjustment
  Adjusts appropriation for changes to state employee other post-employment benefit rates budgeted in Central Appropriations, Item 477 K. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund $2,651 $2,651
Nongeneral Fund $1,819 $1,819
•
Adjust appropriation for centrally funded internal service fund charges for the Personnel Management Information System Base Budget Adjustment
  Adjusts appropriation for Personnel Management Information System internal service fund charges budgeted in Central Appropriations, Item 478 I. of Chapter 552, 2021 Acts of Assembly, Special Session I.
 
  FY 2023 FY 2024
General Fund ($3,063) ($3,063)
Nongeneral Fund ($1,056) ($1,056)
•
Review emergency room utilization program Decision Package
  Requires a review of the Medicaid emergency room (ER) utilization program to determine the program’s impact on member care, ER utilization, and treatment costs.
•
Clarify continuous eligibility for pregnant women Decision Package
  Clarifies current budget language to ensure that Virginia meets federal requirements to provide continuous coverage to enrollees for the duration of pregnancy through 12 months postpartum.
•
Forgo state share of Children’s Hospital of The King’s Daughters disproportionate share hospitals repayments Decision Package
  Allows the Children’s Hospital of The King’s Daughters (CHKD) to retain the state share of any federal disproportionate share hospitals repayments for the period of June 2, 2017 through June 30, 2020. This action is limited to refunds required under federal court decisions in connection to calculation of members with dual eligibility or third-party liability.
•
Allow the blending of third party liability rates Decision Package
  Provides the authority to create a blended rate model to merge capitation rates for those with third-party liability and those with no third party liability. The rate model shall be developed in an actuarially sound manner during the annual capitation calculation process.


pdocagy2014 - Executive Budget Document Agency Details - 04-04-2026 08:54:24