GENERAL NOTICES
Vol. 37 Iss. 15 - March 15, 2021

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

Draft Temporary Detention Order Supplement Provider Manual Available for Review

The draft Temporary Detention Order Supplement Provider Manual is now available on the Department of Medical Assistance Services website at https://www.dmas.virginia.gov/#/manualdraft for public comment until March 18, 2021.

Contact Information: Emily McClellan, Regulatory Manager, Division of Policy and Research, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680.

Intent to Amend the Virginia State Plan for Medical Assistance pursuant to § 1902(a)(13) of the Social Security Act (USC § 1396a(a)(13)) -
Behavioral Health Enhancement

Public Comment Period: February 22, 2021, to March 24, 2021.

The Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to amend the Virginia State Plan for Medical Assistance to provide for changes to the Methods and Standards for Establishing Payment Rates—Other Types of Care (12VAC30-80).

This notice is intended to satisfy the requirements of 42 CFR 447.205 and § 1902(a)(13) of the Social Security Act (42 USC § 1396a(a)(13)). A copy of this notice is available for public review from the contact listed at the end of the notice.

DMAS is specifically soliciting input from stakeholders, providers, and beneficiaries on the potential impact of the proposed changes discussed in this notice. Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to the contact provided, and such comments are available for review at the address provided. Comments may also be submitted in writing on the Virginia Regulatory Town Hall public comment forum at https://townhall.virginia.gov/L/generalnotice.cfm.

In accordance with Items 313.YYY(3) and 313.YYY(4) of Chapter 56 of the 2020 Acts of Assembly, Special Session I, DMAS will be making the following changes:

Methods and Standards for Establishing Payment Rates—Other Types of Care (12VAC30-80)

1. The state plan is being revised to implement:

Assertive community treatment, which will replace and be an enhancement of the current intensive community treatment service. This will continue to be a service for adults.

Mental health intensive outpatient programs, a new service for youth and adults.

Mental health partial hospitalization programs for youth and adults, which will replace the current partial hospitalization program for adults.

The expected increase in annual aggregate expenditures is $861,288 in state general funds and $1,608,325 in federal funds in federal fiscal year 2021.

Contact Information: Emily McClellan, Regulatory Manager, Division of Policy and Research, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680.

Public Comment Opportunity for FAMIS MOMS Demonstration Amendment: 12 Months Postpartum Coverage

Public Comment Period: February 19, 2021, through March 22, 2021.

Pursuant to 42 CFR 431.408, the Department of Medical Assistance Services (DMAS) is providing a notice of intent to submit to the federal Centers for Medicare and Medicaid Services (CMS) a request to amend its Title XXI § 1115 Demonstration for the FAMIS MOMS and FAMIS Select Programs.

DMAS is providing an opportunity for members of the public to review and provide input on the FAMIS MOMS § 1115 Demonstration Amendment: 12 Months Postpartum Coverage.

Virginia's Title XXI § 1115 Demonstration has two components. First, it expands Title XXI coverage to uninsured pregnant women with family income up to 205% of the federal poverty level (FPL) who are not eligible for Medicaid, through a program known as FAMIS MOMS. Second, it uses Title XXI funds to support a health insurance premium assistance program known as FAMIS Select.

DMAS plans to submit an amendment to the FAMIS MOMS and FAMIS Select § 1115 Demonstration that would extend health coverage from 60 days to 12 months postpartum for pregnant women with income below 205% of the FPL who are not eligible to transition to another coverage group postpartum. Through this amendment to the demonstration, Virginia will have the opportunity to test the hypotheses that 12-month postpartum coverage will reduce maternal and infant morbidity and mortality, improve health outcomes, and advance health equity.

This amendment is being submitted pursuant to a mandate from the Virginia General Assembly in the 2020 Special Session budget, directing DMAS to seek federal approval to provide extended postpartum coverage.

Read the full public notice and view the draft FAMIS MOMS Demonstration Amendment: 12 Months Postpartum Coverage at http://www.dmas.virginia.gov/#/hifawaiver. Information regarding the FAMIS MOMS Demonstration Amendment: 12 Months Postpartum Coverage can be found at that webpage. DMAS will update the website throughout the public comment and application process.

Read the most recent Prenatal Care and Birth Outcomes Focused Study reports from the DMAS External Quality Review Organization (EQRO) at http://www.dmas.virginia.gov/#/med3studies. Additional information about the FAMIS MOMS and FAMIS Select Demonstration is also available on the CMS website at https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=8648.

All public comments must be received by 11:59 p.m. on Monday, March 22, 2021. Public comments may be submitted by email to famismoms@dmas.virginia.gov or by telephone at (804) 225-3002. Due to the potential for mail distribution delays during the COVID-19 public health emergency, DMAS does not recommend submitting comments by postal mail or by UPS/FedEx at this time.

A virtual public hearing during, at which members of the public may comment on the demonstration amendment, will be held at the quarterly Children's Health Insurance Program Advisory Committee (CHIPAC) meeting on March 4, 2021, at 1:00 to 3:30 p.m. Comments will be limited to two minutes each. In order to participate in the public hearing, please use the following information:

Link to Join: https://zoom.us/j/98324876649?pwd=MDJUcDhrK0Z6N0NQNlU3bWxNQWFyUT09

Meeting ID: 983 2487 6649

Passcode: 909526

Call-in numbers (Dial by your location):

1 301 715 8592 US (Washington DC)

1 312 626 6799 US (Chicago)

1 929 205 6099 US (New York)

After considering public comments about the proposed demonstration amendment, DMAS will summarize these comments and agency responses, incorporate any changes based on the public comments into the application, and submit a revised application to CMS. The summary of comments, as well as copies of written comments received, will be posted for public viewing on the DMAS website along with the demonstration amendment application when it is submitted to CMS.

Contact Information: Emily McClellan, Regulatory Manager, Division of Policy and Research, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680.

Intent to Amend the Virginia State Plan for Medical Assistance pursuant to § 1902(a)(13) of the Social Security Act (USC § 1396a(a)(13)) -
Coverage of Mandatory Medication Assisted Treatment (MAT) Drugs

Public Comment Period: February 23, 2021, to March 25, 2021.

The Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to amend the Virginia State Plan for Medical Assistance to provide for changes to the Methods and Standards for Establishing Payment Rates—Other Types of Care (12VAC30-80).

This notice is intended to satisfy the requirements of 42 CFR 447.205 and of § 1902(a)(13) of the Social Security Act (42 USC § 1396a(a)(13)). A copy of this notice is available for public review from the contact listed at the end of the notice.

DMAS is specifically soliciting input from stakeholders, providers, and beneficiaries on the potential impact of the proposed changes discussed in this notice. Comments or inquiries may be submitted in writing within 30 days of this notice publication to the contact provided and such comments are available for review at the address provided. Comments may also be submitted in writing on the Virginia Regulatory Town Hall public comment forum at https://townhall.virginia.gov/L/generalnotice.cfm.

The Centers for Medicare and Medicaid Services (CMS) published a State Health Official (SHO) #20-005 letter regarding the Mandatory Medicaid State Plan Coverage of Medication-Assisted Treatment (MAT) on December 30, 2020. CMS stated § 1905(ee)(1) of the SUPPORT Act requires states to include as part of the new mandatory MAT benefit all forms of drugs and biologicals that the Food and Drug Administration (FDA) has approved or licensed for medications of opioid use disorder (MOUD), including medications of a manufacturer that does not participate in the federal rebate program with the Secretary of Health and Human Services (§ 1927). Federal law requires DMAS to file a state plan amendment (SPA) to recognize and reimburse MOUDs that do not participate in the federal rebate program. Since DMAS currently covers all varieties of MOUD and the non-rebatable medications covered by these additional manufacturers offer no variety in ingredients, thus DMAS does not estimate a cost impact.

There is no expected increase or decrease in annual aggregate expenditures as a result of this change.

Contact Information: Emily McClellan, Regulatory Manager, Division of Policy and Research, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680.

Intent to Amend the Virginia State Plan for Medical Assistance pursuant to § 1902(a)(13) of the Social Security Act (USC § 1396a(a)(13)) - Tribal Health Clinic

Public Comment Period: February 23, 2021, to March 25, 2021.

The Virginia Department of Medical Assistance Services (DMAS) hereby affords the public notice of its intention to amend the Virginia State Plan for Medical Assistance to provide for changes to the Methods and Standards for Establishing Payment Rates—Other Types of Care (12VAC30-80).

This notice is intended to satisfy the requirements of 42 CFR 447.205 and of § 1902(a)(13) of the Social Security Act (42 USC § 1396a(a)(13)). A copy of this notice is available for public review from the contact listed at the end of this notice.

DMAS is specifically soliciting input from stakeholders, providers, and beneficiaries on the potential impact of the proposed changes discussed in this notice. Comments or inquiries may be submitted in writing within 30 days of this notice publication to the contact provided and such comments are available for review at the address provided. Comments may also be submitted in writing on the Virginia Regulatory Town Hall public comment forum at: https://townhall.virginia.gov/L/generalnotice.cfm.

The Upper Mattaponi Tribe has established a Tribal Health Clinic (THC) to meet the primary care health needs of Tribal members, including those enrolled in Virginia Medicaid. Federal law requires DMAS to file a state plan amendment to recognize and reimburse THCs as Medicaid providers. The THC will be enrolled as a federally qualified health center and will be reimbursed for services to Medicaid members at a rate set annually by the federal government. The Centers for Medicare and Medicaid Services will cover 100% of DMAS payments to the Upper Mattaponi THC for services to Medicaid members.

There is no expected increase in annual aggregate expenditures.

Contact Information: Emily McClellan, Regulatory Manager, Division of Policy and Research, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680.

STATE WATER CONTROL BOARD

Proposed Enforcement Action for Buchanan County Public Service Authority

An enforcement action has been proposed for the Buchanan County Public Service Authority for violations of the State Water Control Law at the Conaway wastewater treatment plant in Buchanan County. A description of the proposed action is available at the Department of Environmental Quality office listed or online at www.deq.virginia.gov. The staff contact person will accept comments by email or postal mail from March 16, 2021, through April 15, 2021.

Contact Information: Jonathan Chapman, Department of Environmental Quality, Southwest Regional Office, 355-A Deadmore Street, Abingdon, VA 24210, or email jonathan.chapman@deq.virginia.gov.

Proposed Enforcement Action for Cedar Mountain Stone Corporation - Mitchells Facility

An enforcement action has been proposed for Cedar Mountain Stone Corporation for violations of the State Water Control Law and regulations at the Cedar Mountain Stone Mitchells facility located in Mitchells, Culpeper County, Virginia. The State Water Control Board proposes to issue a consent order to resolve violations associated with the Cedar Mountain Stone Mitchells facility. A description of the proposed action is available at the Department of Environmental Quality office listed or online at www.deq.virginia.gov. The staff contact person will accept comments by email or by postal mail from March 16, 2021, through April 15, 2021.

Contact Information: Benjamin Holland, Department of Environmental Quality, Northern Regional Office, 13901 Crown Court, Woodbridge, VA 22193, or email benjamin.holland@deq.virginia.gov.

Proposed Enforcement Action for Northstar Prime LLC

An enforcement action has been proposed for Northstar Prime LLC for violations of the State Water Control Law and regulations at a property located on Bull Run Post Office Road in Loudoun County, Virginia. A description of the proposed action is available at the Department of Environmental Quality office listed or online at www.deq.virginia.gov. The staff contact person will accept comments by email or postal mail from March 16, 2021, through April 15, 2021.

Contact Information: Jim Datko, Department of Environmental Quality, Northern Regional Office, 13901 Crown Court, Woodbridge, VA 22193, or email james.datko@deq.virginia.gov.

Proposed Enforcement Action for Waterside I LLC

An enforcement action has been proposed for Waterside I LLC for violations of the State Water Control Law and regulations at the Waterside Data Center and Davis Drive Extension project located in Loudoun County, Virginia. A description of the proposed action is available at the Department of Environmental Quality office listed or online at www.deq.virginia.gov. The staff contact person will accept comments by email or postal mail from March 16, 2021, through April 15, 2021.

Contact Information: Jim Datko, Department of Environmental Quality, Northern Regional Office, 13901 Crown Court, Woodbridge, VA 22193, or email james.datko@deq.virginia.gov.

VIRGINIA CODE COMMISSION

Notice to State Agencies

Contact Information: Mailing Address: Virginia Code Commission, Pocahontas Building, 900 East Main Street, 8th Floor, Richmond, VA 23219; Telephone: (804) 698-1810; Email: varegs@dls.virginia.gov.

Meeting Notices: Section 2.2-3707 C of the Code of Virginia requires state agencies to post meeting notices on their websites and on the Commonwealth Calendar at https://commonwealthcalendar.virginia.gov.

Cumulative Table of Virginia Administrative Code Sections Adopted, Amended, or Repealed: A table listing regulation sections that have been amended, added, or repealed in the Virginia Register of Regulations since the regulations were originally published or last supplemented in the print version of the Virginia Administrative Code is available at http://register.dls.virginia.gov/documents/cumultab.pdf.

Filing Material for Publication in the Virginia Register of Regulations: Agencies use the Regulation Information System (RIS) to file regulations and related items for publication in the Virginia Register of Regulations. The Registrar's office works closely with the Department of Planning and Budget (DPB) to coordinate the system with the Virginia Regulatory Town Hall. RIS and Town Hall complement and enhance one another by sharing pertinent regulatory information.