Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Medical Assistance Services intends to consider amending 12VAC30-80, Methods and Standards for Establishing Payment Rates; Other Types of Care. The purpose of the proposed action is to implement a prospective payment methodology for outpatient hospital services and to maintain reimbursement of drug rebates for outpatient hospital services. The current cost-based methodology is out of date, inefficient, and costly. The Department of Medical Assistance Services (DMAS) is proposing to implement the Enhanced Ambulatory Patient Group (EAPG) reimbursement methodology as authorized by Item 307 XX of Chapter 806 of the 2013 Acts of Assembly. The EAPG reimbursement methodology is deemed to be a more efficient and predictable reimbursement methodology for DMAS to pay hospitals that furnish services to Medicaid recipients in an outpatient hospital setting.

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.

Public Comment Deadline: January 1, 2014.

Agency Contact: Brian McCormick, Regulatory Supervisor, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-8856, FAX (804) 786-1680, or email brian.mccormick@dmas.virginia.gov.