TITLE 12. HEALTH

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Department of Medical Assistance Services intends to consider amending 12VAC30-50, Amount, Duration, and Scope of Medical and Remedial Care Services, and 12VAC30-80, Methods and Standards for Establishing Payment Rate; Other Types of Care. Pursuant to Items MM(1) and MM(2) of Chapter 1 of the 2023 Acts of Assembly, Special Session I, the purpose of the proposed action is to (i) adjust medical necessity criteria for Medicaid-funded private duty nursing services, including changes to services covered, provider qualifications, medical necessity criteria, and rates and rate methodologies for private duty nursing; and (ii) clarify that private duty nursing services are not covered unless an individual receives services under an Early and Periodic Screening, Diagnosis, and Treatment Services or a § 1915(c) Waiver.

The agency does not intend to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 32.1-325 of the Code of Virginia, 42 USC § 1396 et seq.

Public Comment Deadline: November 22, 2023.

Agency Contact: Meredith Lee, Policy, Regulations, and Manuals Supervisor, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-0552, FAX (804) 786-1680, email meredith.lee@dmas.virginia.gov.