| • |
| 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 as projected by the Department of Medical Assistance Services. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$175,061,715 |
$538,941,216 |
| Nongeneral Fund |
$2,701,200,980 |
$3,784,771,616 |
|
| • |
| Adjust 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 dollars. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$255,509,925 |
$253,409,925 |
| Nongeneral Fund |
($255,509,925) |
($253,409,925) |
|
| • |
| Add developmental disability waiver slots |
Decision Package |
|
| |
Increases the number of developmental disability waiver slots by 3,440 by adding 1,720 slots in each year of the biennium. Over the biennium, the number of Family and Individual Supports waiver slots will increase by 3,096 and the number of Community Living waiver slots will increase by 344. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$50,045,297 |
$100,208,162 |
| Nongeneral Fund |
$52,187,065 |
$104,256,563 |
|
| • |
| Continue Chapter 1 funding changes: Update revenue assumptions for the Virginia Health Care Fund |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes to the Virginia Health Care Fund included in Chapter 1, 2023 Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($42,648,535) |
($42,648,535) |
| Nongeneral Fund |
$42,648,535 |
$42,648,535 |
|
| • |
| Fund Family Access to Medical Insurance Security 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 2025 |
FY 2026 |
| General Fund |
$19,647,848 |
$27,309,014 |
| Nongeneral Fund |
$44,659,305 |
$59,432,008 |
|
| • |
| Continue Chapter 1 funding changes: Increase rates for personal care, respite, and companion services |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Increases rates by five percent. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$20,808,161 |
$20,808,161 |
| Nongeneral Fund |
$23,597,067 |
$23,597,067 |
|
| • |
| Continue Chapter 1 funding changes: Increase community-based mental health services rates |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Increases Medicaid reimbursement rates for community-based mental health services. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$8,699,568 |
$8,699,568 |
| Nongeneral Fund |
$18,486,674 |
$18,486,674 |
|
| • |
| 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 2025 |
FY 2026 |
| General Fund |
($11,090,611) |
($4,591,555) |
| Nongeneral Fund |
($14,654,599) |
($2,122,746) |
|
| • |
| Replace fiscal agent services system |
Decision Package |
|
| |
Provides funding to replace the fiscal agent services (FAS) system. The current FAS system is over twenty years old and the Centers for Medicare and Medicaid Services has informed the agency that future federal funding is dependent on system replacement.
|
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$1,000,000 |
$2,200,000 |
| Nongeneral Fund |
$8,000,000 |
$19,800,000 |
|
| • |
| Continue Chapter 1 funding changes: Add 500 developmental disability waiver slots |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Adds 500 developmental disability waiver slots. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$7,577,559 |
$7,577,559 |
| Nongeneral Fund |
$7,911,345 |
$7,911,345 |
|
| • |
| Eliminate Medicaid coverage of drugs for weight loss |
Decision Package |
|
| |
Eliminates Medicaid coverage for weight loss medication when prescribed for weight loss except in those instances where an individual has a body mass index greater than 40. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($4,060,985) |
($4,765,823) |
| Nongeneral Fund |
($9,996,258) |
($11,644,460) |
|
| • |
| Continue Chapter 1 funding changes: Provide physician supplemental payments for Children’s Hospital of The King’s Daughters |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Makes physician supplemental payments for managed care patients of Children’s Hospital of The King’s Daughters. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$5,153,878 |
$5,153,878 |
| Nongeneral Fund |
$5,896,122 |
$5,896,122 |
|
| • |
| 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 483 S. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$2,917,291 |
$2,917,291 |
| Nongeneral Fund |
$3,058,307 |
$3,058,307 |
|
| • |
| Adjust Medicaid appropriation for facilities to reflect anticipated costs |
Decision Package |
|
| |
Reduces appropriation to reflect anticipated Medicaid costs. This is a technical amendment as any adjustment will not have an impact on services. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($2,618,703) |
($2,584,681) |
| Nongeneral Fund |
($1,267,155) |
($1,301,177) |
|
| • |
| Continue Chapter 1 funding changes: Fund coverage of complex rehabilitative technology for Medicaid nursing facility members |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Provides for the initial purchase or replacement of complex rehabilitative technology manual and power wheelchair bases and related accessories for Medicaid patients residing in nursing facilities. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$1,272,060 |
$1,272,060 |
| Nongeneral Fund |
$1,335,690 |
$1,335,690 |
|
| • |
| Provide authorization and funding for changes in the managed care contract re-procurement |
Decision Package |
|
| |
Authorizes the expected changes to the re-procured Cardinal Care Managed Care contract. In addition, funding is provided to support the cost of anticipated changes and three positions to enhance managed care contract oversight. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$516,602 |
$676,502 |
| Nongeneral Fund |
$1,273,398 |
$1,613,498 |
| Positions |
3.00 |
3.00 |
|
| • |
| Provide funding to support graduate medical education residencies |
Decision Package |
|
| |
Adds funding to support 20 additional psychiatric residency slots funded through Medicaid beginning in 2025. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$1,000,000 |
$1,000,000 |
| Nongeneral Fund |
$1,000,000 |
$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 2025 |
FY 2026 |
| General Fund |
($2,366,962) |
($780,525) |
|
| • |
| Continue Chapter 1 funding changes: Increase rates for early intervention services |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Provides a 12.5 percent rate increase for early intervention services beginning January 1, 2024. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$558,509 |
$558,509 |
| Nongeneral Fund |
$593,974 |
$593,974 |
|
| • |
| Fund the modification of waiver service limits |
Decision Package |
|
| |
Supports the fiscal impact of Chapter 701, 2023 Virginia Acts of Assembly, which amends the Family and Individual Supports, Community Living, and Building Independence waivers to: (i) combine the maximum annual allowable amount for assistive technology and electronic home-based support services for an individual receiving waiver services to provide for greater flexibility and to better meet the needs of individuals receiving services; and (ii) provide that a total of $10,000 shall be available to an eligible individual for assistive technology and electronic home-based support services each year, which may be divided among such services in the manner that best meets the needs of the individual. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$549,756 |
$549,756 |
| Nongeneral Fund |
$597,222 |
$597,222 |
|
| • |
| Continue Chapter 1 funding changes: Provide for parity of mental health and substance use disorder rates |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Establishes reimbursement parity between substance use disorder (SUD) and mental health (MH) partial hospitalization (PHP) and intensive outpatient programs (IOP) by increasing the MH, PHP, and IOP reimbursement rates to the same reimbursement rate as SUD, PHP, and IOP. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$218,918 |
$218,918 |
| Nongeneral Fund |
$679,354 |
$679,354 |
|
| • |
| Continue Chapter 1 funding changes: Fund dental program enhancements |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Provides funding the second year for enhancements to dental services in Medicaid. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$214,136 |
$214,136 |
| Nongeneral Fund |
$347,386 |
$347,386 |
|
| • |
| Make technical clarification to coverage of prevention services for adults |
Decision Package |
|
| |
Amends existing budget language to clarify the coverage of preventative services for adult, full-benefit Medicaid individuals who are not enrolled pursuant to the Patient Protection and Affordable Care Act. This change would allow Virginia to receive an additional one percent in federal matching dollars for impacted services. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($251,690) |
($258,609) |
| Nongeneral Fund |
$251,690 |
$258,609 |
|
| • |
| Ensure Medicaid behavioral health services are evidence-based and trauma-informed |
Decision Package |
|
| |
Authorizes the replacement of legacy youth and adult behavioral health services with evidence-based and trauma-informed services. All changes must be budget neutral and be implemented by June 30, 2026. This transition is necessary for Virginia to secure federal support for a comprehensive continuum of behavioral health services through an 1115 serious mental illness waiver. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$500,000 |
$0 |
| Nongeneral Fund |
$500,000 |
$0 |
|
| • |
| Continue Chapter 1 funding changes: Provide funding for two percent salary increase |
Decision Package |
|
| |
Adjusts appropriation for the two percent salary increase for state and state supported local employees budgeted in Central Appropriations, Paragraphs S, T, U, and V of Item 483, Chapter 1, 2023 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$462,270 |
$462,270 |
|
| • |
| 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 483 G. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$196,489 |
$196,489 |
| Nongeneral Fund |
$144,211 |
$144,211 |
|
| • |
| 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 484 H. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($136,023) |
($136,023) |
| Nongeneral Fund |
($186,779) |
($186,779) |
|
| • |
| Continue Chapter 1 funding changes: Fund collaborative care management services for substance use treatment |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Provides Medicaid reimbursement for collaborative care services to treat mental health conditions and substance use disorders. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$21,589 |
$21,589 |
| Nongeneral Fund |
$191,917 |
$191,917 |
|
| • |
| Continue Chapter 1 funding changes: Increase early periodic screening diagnosis and treatment therapeutic group homes rates |
Decision Package |
|
| |
Provides for the ongoing impact of appropriation changes included in Chapter 1, 2023 Special Session I. Increases reimbursement for early periodic screening diagnosis and treatment therapeutic group homes. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$100,330 |
$100,330 |
| Nongeneral Fund |
$109,029 |
$109,029 |
|
| • |
| Transfer resources to fund developmental disability waiver responsibilities |
Decision Package |
|
| |
Moves funds and a position from the Department of Behavioral Health and Developmental Services to support agency responsibilities associated with developmental disability waiver services that was 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 2025 |
FY 2026 |
| General Fund |
$85,000 |
$85,000 |
| Nongeneral Fund |
$85,000 |
$85,000 |
| Positions |
1.00 |
1.00 |
|
| • |
| Adjust appropriation for centrally funded information technology auditors and security officers |
Base Budget Adjustment |
|
| |
Adjusts appropriation for information technology auditors and information security officers budgeted in Central Appropriations, Item 484 E. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$48,302 |
$48,302 |
| Nongeneral Fund |
$107,897 |
$107,897 |
|
| • |
| Adjust appropriation for centrally funded property insurance premium charges |
Base Budget Adjustment |
|
| |
Adjusts appropriation for property insurance premiums billed by the Department of the Treasury’s Division of Risk Management budgeted in Central Appropriations, Item 484 J. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$10,535 |
$10,535 |
| Nongeneral Fund |
$88,036 |
$88,036 |
|
| • |
| 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 484 G. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$28,036 |
$28,036 |
| Nongeneral Fund |
$49,721 |
$49,721 |
|
| • |
| 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 484 C. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($74,844) |
($74,844) |
|
| • |
| Adjust appropriation for centrally funded workers’ compensation premium changes |
Base Budget Adjustment |
|
| |
Adjusts appropriation for workers’ compensation premiums budgeted in Central Appropriations, Item 483 P. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($35,182) |
($35,182) |
| Nongeneral Fund |
$2,965 |
$2,965 |
|
| • |
| Adjust appropriation for centrally funded changes to agency leased space costs |
Base Budget Adjustment |
|
| |
Adjusts appropriation for to increased charges to customer agencies for the Department of General Services to perform lease administration services. budgeted in Central Appropriations, Item 485 K. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$11,607 |
$11,607 |
| Nongeneral Fund |
$11,607 |
$11,607 |
|
| • |
| Adjust appropriation for centrally funded minimum wage increases |
Base Budget Adjustment |
|
| |
Adjusts appropriation to reflect the increase in the Virginia minimum wage effective January 1, 2023, and budgeted in Central Appropriations, Item 483 R. of Chapter 2, 2022 Acts of Assembly, Special Session I. The amounts provided support the annualized general fund cost of increasing the Virginia minimum wage from $11.00 per hour to $12.00 per hour or the equivalent annual salary of $24,960. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$22,856 |
$22,856 |
|
| • |
| 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 484 I. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
($7,934) |
($7,934) |
| Nongeneral Fund |
($3,833) |
($3,833) |
|
| • |
| 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 484 F. of Chapter 2, 2022 Acts of Assembly, Special Session I. |
| |
| |
FY 2025 |
FY 2026 |
| General Fund |
$2,969 |
$2,969 |
| Nongeneral Fund |
$7,383 |
$7,383 |
|
| • |
| Align outpatient rehabilitation reimbursement methodology with industry standards |
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. |
| • |
| Improve third-party liability recoveries |
Decision Package |
|
| |
Adds three 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 2025 |
FY 2026 |
| Positions |
3.00 |
3.00 |
|
| • |
| 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. |
| • |
| Implement supplemental disproportionate share hospital pool |
Decision Package |
|
| |
Authorizes a supplemental disproportionate share hospital (DSH) redistribution methodology for DSH funds that allows the redistribution of excess DSH payments to other eligible DSH hospitals that have not met their uncompensated care costs. |
| • |
| 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. |
| • |
| Authorize the removal of obsolete supplemental payment language |
Decision Package |
|
| |
Allows the department to remove outdated provider supplemental payments that were authorized prior to July 1, 2021 from the Medicaid state plan and regulations. This technical change is necessary to ensure Medicaid governoring documents are up to date. There will be no impact to any potentially active supplemental payments. |
| • |
| Reduce reliance on contractual staff |
Decision Package |
|
| |
Replaces contractors in the eligbility and enrollment division with three classified positions No additional resources are required as the cost of the new positions will be offset by operational efficiencies. |
| |
| |
FY 2025 |
FY 2026 |
| Positions |
3.00 |
3.00 |
|
| • |
| Improve the identification of alternative health care coverage eligibility |
Decision Package |
|
| |
Requires agency to improve efforts to determine if individuals applying for and enrolled in Medicaid and Children's Health Insurance Program are eligible for alternative health care coverage. |
