DEPARTMENT OF ENVIRONMENTAL QUALITY
Proposed Enforcement Action for Energix EPC US LLC
An enforcement action has been proposed for Energix EPC US LLC for violations of the State Water Control Law at the Caden Energix Wytheville T-647 site in Wythe County. The Department of Environmental Quality (DEQ) proposes to issue a consent order to resolve violations associated with the site. A description of the proposed action is available at the DEQ office listed or online at www.deq.virginia.gov. The staff contact person listed will accept comments by email or postal mail from July 19, 2022, through August 18, 2022.
Contact Information: Jonathan Chapman, Enforcement Specialist, Department of Environmental Quality, Southwest Regional Office, 355-A Deadmore Street, Abingdon, VA 24210.
Proposed Enforcement Action for Fairlead Integrated, LLC
Fairlead Integrated LLC for violations at the Fairlead Integrated facility at 201 Wavy Street, Portsmouth, Virginia. The Virginia Department of Environmental Quality (DEQ) proposes to issue a consent order to Fairlead Integrated to address noncompliance with State Water Control Law. A description of the proposed action is available at the DEQ office listed or online at www.deq.virginia.gov. The staff contact will accept comments by email, fax, or postal mail from July 18, 2022, to August 17, 2022.
Contact Information: Russell Deppe, Enforcement Specialist, Department of Environmental Quality, 5636 Southern Boulevard, Virginia Beach, VA 23462, telephone (757) 647-8060, FAX (804) 698-4178, or email russell.deppe@deq.virginia.gov.
Proposed Enforcement Action for Kennington Place LLC
The Department of Environmental Quality (DEQ) proposes to issue a consent special order to Kennington Place LLC for alleged violation of the State Water Control Law at the Kennington office warehouse facility located at Anne Lane and Richmond Tappahannock Highway in King William County, Virginia. A description of the proposed action is available at the DEQ office listed or online at https://www.deq.virginia.gov/permits-regulations/public-notices/enforcement-orders. The staff contact person will accept comments by email or postal mail from July 18, 2022, through August 18, 2022.
Contact Information: Matt Richardson, Enforcement Specialist, Department of Environmental Quality, Piedmont Regional Office, 4949A Cox Road, Glen Allen, VA 23060, telephone (804) 659-2696, or email matthew.richardson@deq.virginia.gov.
Red Brick Solar Project Notice of Intent for Small Renewable Energy Project (Solar) - Lunenburg County
Red Brick Solar has provided the Department of Environmental Quality a notice of intent to submit the necessary documents for a permit by rule for a small renewable energy project (solar) in Lunenburg County. Red Brick Solar will be located west of Lunenburg, south of Lunenburg County Road, Route 40, and north and south of Courthouse Road, Route 49. Latitude and longitude coordinates are 36.9633, -78.3018. The proposed project will be located on approximately 1,938 acres of privately owned land. (The total fenced area, which indicates the disturbed acreage, is 1,309 acres). The project will have a maximum generating capacity of 130 megawatts alternating current and will utilize approximately 324,000 single-axis trackers.
Contact Information: Susan Tripp, Department of Environmental Quality, 1111 East Main Street, Richmond, VA 23219, telephone (804) 664-3470, or email susan.tripp@deq.virginia.gov.
Solar VA 2019 LLC Revised Notice of Intent for Small Renewable Energy Project (Solar) - Westmoreland County
Solar VA 2019 LLC has provided the Department of Environmental Quality a notice of intent to submit the necessary documentation for a permit by rule for a small renewable energy project (solar) in Westmoreland County. Solar VA 2019 LLC will be located approximately five miles south of the Town of Colonial Beach. Latitude and longitude coordinates are 38.185139, -76.987864. The project is on private land totaling approximately 125 acres. The project occupies an area approximately 0.5 miles long and 0.4 miles wide, utilizes approximately 32,000 solar modules, and will have a capacity of approximately 18 megawatts alternating current.
Contact Information: Susan Tripp, Department of Environmental Quality, 1111 East Main Street, Richmond, VA 23219, telephone (804) 664-3470, or email susan.tripp@deq.virginia.gov.
DEPARTMENT OF MEDICAL ASSISTANCE SERVICES
Draft Mental Health Services Appendix G Provider Manual
The draft Mental Health Services Provider Manual Appendix G is now available on the Department of Medical Assistance Services website at https://www.dmas.virginia.gov/for-providers/general-information/medicaid-provider-manual-drafts/.
Contact Information: 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, or email meredith.lee@dmas.virginia.gov.
Intent to Amend the Virginia State Plan for Medical Assistance Pursuant to § 1902(a)(13) of the Social Security Act (USC § 1396a(a)(13)) - Nursing Facility Value-Based Purchasing Program
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 for Long-Term Care (12VAC30-90).
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 in this notice. Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Meredith Lee, and such comments are available for review at the same address. Comments may also be submitted, in writing, on the Virginia Regulatory Town Hall at https://townhall.virginia.gov/L/generalnotice.cfm.
Methods and Standards for Establishing Payment Rates for Long-Term Care (12VAC30-90)
In accordance with Item 304 OOO of Chapter 1289 of the 2022 Acts of Assembly, Special Session I, the state plan is being revised to establish a unified, value-based purchasing (VBP) program that includes enhanced funding for facilities that meet or exceed performance or improvement thresholds as developed, reported, and consistently measured by DMAS in cooperation with participating facilities. Nursing facility performance evaluation under the program shall prioritize maintenance of adequate staffing levels and avoidance of negative care events, such as hospital admissions and emergency department visits. The program may also consider performance evaluation in the areas of preventive care; utilization of home and community-based services, including community transitions; and other relevant domains of care.
During the first year of this program, half of the available funding shall be distributed to participating nursing facilities to be invested in functions, staffing, and other efforts necessary to build their capacity to enhance the quality of care furnished to Medicaid members. This funding shall be administered as a Medicaid rate add-on. The remaining funding shall be allocated based on performance criteria as designated under the nursing facility VBP program. The amount of funding devoted to nursing facility quality of care investments shall be 25% of available funding in the second year of the program before the program transitions to payments based solely on nursing facility performance criteria in the third year of the program. In the third year of this program, such funds as appropriated for this purpose shall be fully disbursed according to the unified VBP arrangement to participating nursing facilities that qualify for the enhanced funding.
The department shall convene the stakeholders no less often than annually through at least the first two years of the program to review program progress and discuss potential modifications to components of the arrangement, including timing of enhanced payments, performance metrics, and threshold determinations.
Complete details, including technical information regarding program eligibility, performance measures, performance thresholds, and payments are available on the DMAS website at https://www.dmas.virginia.gov/about-us/value-based-purchasing/ and will be effective beginning July 1, 2022.
The expected increase in annual aggregate expenditures is $166,715 in state general funds, $458 in special funds, and $218,039 in federal funds in federal fiscal year 2022.
Contact Information: 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, or email meredith.lee@dmas.virginia.gov.
Intent to Amend the Virginia State Plan for Medical Assistance Pursuant to § 1902(a)(13) of the Social Security Act (USC § 1396a(a)(13)) - 2022 Institutional Provider Reimbursement Changes
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; Inpatient Hospital Care (12VAC30-70) and Methods and Standards for Establishing Payment Rates for Long-Term Care (12VAC30-90).
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 this notice.
DMAS is specifically soliciting input from stakeholders, providers, and beneficiaries on the potential impact of the proposed changes in this notice. Comments or inquiries may be submitted, in writing, within 30 days of this notice publication to Meredith Lee, and such comments are available for review at the same address. Comments may also be submitted, in writing, on the Virginia Regulatory Town Hall at https://townhall.virginia.gov/L/generalnotice.cfm.
Methods and Standards for Establishing Payment Rates; Inpatient Hospital Care (12VAC30-70)
1. In accordance with Item 304 BBBB of Chapter 1289 of the 2022 Acts of Assembly, Special Session I, the state plan is being revised to adjust the formula for indirect medical education (IME) reimbursement for managed care discharges for freestanding children's hospitals with greater than 50% Medicaid utilization in 2009 by increasing the case mix adjustment factor to the greater of 3.2962 or the most recent rebasing. Total payments for IME in combination with other payments for freestanding children's hospitals with greater than 50%t Medicaid utilization in 2009 may not exceed the hospital’s Medicaid costs.
The expected increase in annual aggregate expenditures is $1,009,781 in state general funds and $1,029,665 in federal funds in federal fiscal year 2022.
2. In accordance with Item 304 B(5) of Chapter 1289 of the 2022 Acts of Assembly, Special Session I, the state plan is being revised to clarify any hospitals acquired by or that become fully-owned by designated Type One hospitals shall be considered Type Two facilities for reimbursement including indirect medical education payments, graduate medical education payments, direct medical education payments, disproportionate share hospital payments, hospital rate-setting purposes, aggregated cost settlements, and physician supplemental payments. Facilities acquired prior to July 1, 2022, by Type One hospitals shall continue to be designated as Type One hospitals for reimbursement purposes.
There is no expected increase or decrease in annual aggregate expenditures as a result of this change.
3. In accordance with Item 304 X(2), Item 304 X(3), and Item 304 X(4) of Chapter 1289 of the 2022 Acts of Assembly, Special Session I, the state plan is being revised to establish rebasing of psychiatric residential treatment facilities (PRTF) rates every three years. The first rebasing of rates shall take effect July 1, 2023. All PRTF and addiction and rehabilitation treatment services (ARTS) providers that offer qualifying services under 12VAC30-70-418 C shall be required to submit cost reports as a part of rebasing. Out-of-state providers with more than 1,500 paid days for Virginia Medicaid members in the most recently completed state fiscal year shall also be required to submit a cost report. A rate ceiling shall be established based on a statewide weighted average cost per day. Rate ceilings shall be established independently for PRTFs and participating ARTS residential services. DMAS shall also establish inflation increases for each non-rebasing fiscal year for both PRTF and qualifying ARTS providers. Inflation rates shall be tied to the nursing facility moving average as established by IHS Markit (or its successor). The most recent four quarters will be averaged to create the PRTF inflation rate. Effective July 1, 2022, the department shall adjust PRTF rates by 8.89% to account for inflation since the last audited cost report of fiscal year 2018. The rate ceiling shall increase to $460.89 per day.
The expected increase in annual aggregate expenditures is $997,923 in state general funds, $2,668 in special funds, and $1,057,263 in federal funds in federal fiscal year 2022.
Methods and Standards for Establishing Payment Rates for Long-Term Care (12VAC30-90)
1. In accordance with Item 304 VV of Chapter 1289 of the 2022 Acts of Assembly, Special Session I, the state plan is being revised to establish a new direct and indirect care peer group for nursing facilities operating with at least 80% of the resident population having one or more of the following diagnoses: quadriplegia, traumatic brain injury, multiple sclerosis, paraplegia, or cerebral palsy. In addition, a qualifying facility must have at least 90% Medicaid utilization and a case mix index of 1.15 or higher in fiscal year 2014. The department shall utilize the data from the most recent rebasing to make this change effective for fiscal year 2023 and subsequent rate years until this change is incorporated into the next scheduled rebasing. This change shall not affect rates established in the most recent rebasing for facilities in any other direct and indirect care peer groups.
The expected increase in annual aggregate expenditures is $899,711 in state general funds and $993,238 in federal funds in federal fiscal year 2022.
2. In accordance with Item 304 WW of Chapter 1289 of the 2022 Acts of Assembly, Special Session I, the state plan is being revised to establish specialized care operating rates for fiscal years 2021, 2022, and 2023 by inflating the fiscal year 2020 rates using Virginia nursing home inflation. After fiscal year 2023, the department shall revert to the existing prospective methodology.
There is no expected increase or decrease in annual aggregate expenditures as a result of this change.
Contact Information: 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, or email meredith.lee@dmas.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.