Virginia Medicaid programs poised to receive more funding under budget deal

Several Medicaid programs in Virginia could receive additional funding and changes after the General Assembly approved changes to the state’s long-term budget last Wednesday.

Changes range from increased disability discharge rates and higher reimbursement rates for health and disability care to changes in early modern treatment guidelines and the discontinuation of certain diabetes medications. You have to get permission.

Although lawmakers barely talked about the new Medicaid rules last week, House Budget Chairman Rep. Del Barry Knight, R-Virginia Beach, told the House that the spending plan would “protect our most vulnerable citizens.

Those requirements include about $16.5 million in funding to create 500 developmental disability waiver positions beginning in January. 1 next year. These Medicaid-funded exempt services (for example, housing assistance, employment assistance, and medical assistance) are for people with long-term care needs, such as those with developmental disabilities. However, their number is limited due to the lack of personnel who can actually perform these tasks.

In addition to the 600 positions added in July, the new funding brings the total number of positions in Virginia to 1,100, the governor said. Glenn Youngkin’s “The Right Help, Now” aims to tackle the nation’s behavioral health crisis. The administration said the increase in the number of disability waivers would help put about 3,000 Virginia residents on the “Priority 1” waiting list in a year or less. We need supplies.

Virginia lot of money

The new budget increases personal care, companionship and temporary workers by 5% and costs $45 million. Currently, wages for these workers range from $12.70 to $21.79 an hour, depending on the job and location.

In early May, several disability advocates told the Mercury that higher compensation rates were needed to solve the “problem” of unemployment.

While a person with a disability should be able to find a provider within 30 days, the lack of caregivers makes that time difficult, said Sarah Carriano, senior health policy analyst at the Virginia Poverty Law Center. strong

“We want to make sure that we accommodate both sides and we want to make sure that these people get the care that they obviously deserve,” he said. Carriano said.

Reimbursement rates for services provided by Medicaid also increased by 10% for community-based behavioral health providers and 12.5% for children’s treatment systems to $30 million and $1 million, respectively. Financial resources are available.

Use emergency services.

Another item in the budget deal calls for the health department to implement a “revamped” emergency room utilization policy to reduce Medicaid emergency room visits for minor medical problems. He left but the crowd had to be reduced.

Under the previous system, starting in 2020, the state banned or reduced payments to doctors and hospitals treating Medicaid patients for “non-availability of emergency care.”

But the U.S. District Court for the Eastern District of Virginia ruled on April 26 that the law was inconsistent with federal law and ordered DMAS and health care companies to “cover only those who choose to include names” eligible for coverage. Access is denied. Rating, “minutes later.

According to a July 12 letter from the University of Virginia Department of Emergency Medicine, the Virginia Medical and Health Association and DMAS, the policy “creates an incalculable financial burden on hospitals and physicians.” Configure the installation.

Rep. Barbara Favola, D-Arlington, raised concerns on the Senate floor Wednesday that the current budget language calls for a “delay” policy that is too small to reduce emergency room use. The method does not reflect this.

Diabetes and weight loss medicine.

The budget also includes language requiring Medicaid authorization for the safe use of drugs.

Doug Gray, executive director of the Virginia Association of Health Plans, said DMAS has provided evidence to counter the statewide trend of using safe diabetes medications that don’t work, such as Ozempic.

Without a doubt

The budget also includes about $50 million for state insurance programs to reduce the cost of insurance by 15 percent under the federal Affordable Care Act. As first reported by the Richmond Times-Dispatch, the president’s budget freeze means personal spending would increase 28.5% by 2024. The National Trade Council said in a statement.

The move comes as more Virginians are considering getting insurance on the federal market, as the state continues to cut Medicaid coverage for those without it.

“We know the health care system needs reform. Too many people are living in poverty with medical bills,” said Minority Leader Don Scott, D-Portsmouth. Subsidized insurance programs “help lower premiums in the health insurance market, and give families access to care when they need it.”

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