Virginia Medicaid Agency announces emergency relief support for providers

Virginia

RICHMOND, Va. (WAVY) – The Virginia Department of Medical Assistance Services (DMAS) announced Governor Northam has approved an estimated $30 million for health providers who offer general health care services to Virginia Medicaid members during the COVID-19 pandemic.

DMAS said the estimated $30 million in emergency support will not have an impact on the state budget.

This will enable fast relief for struggling health care providers without the need for new expenditures from the state budget.

The plan will redirect existing dollars in the FY 2020 state budget to fund a 29% rate increase for patient office visits related to the evaluation and management of chronic conditions and other health needs, the Virginia Medicaid Agency said in a press release.

“By taking action to support these frontline providers, we can ensure access to care for our Medicaid members and preserve the health care network that is so critical for the well-being of families, children, low-income older adults, persons with disabilities, and individuals who have lost their jobs,” said Karen Kimsey, DMAS Director.

The rate increase is retroactive to March 1 and extends through June 30.

The six health insurance companies that serve Virginia Medicaid members through the state’s largest Medicaid managed care program. The companies will pay out the emergency funding using existing dollars provided to them under their FY 2020 contracts.

Virginia’s contracts with managed care plans assumed higher volumes of medical services for Medicaid members than have occurred because of social distancing requirements and a temporary ban on nonessential medical care that has now expired.

The expiration was negotiated before the COVID-19 health crisis, DMAS said Tuesday.

Statistics show profit margins for managed care plans have increased due to lower-than-anticipated payments to providers.

Virginia is directing its managed care plans to use these excess funds to pay providers in the form of a 29% rate increase for evaluation and management services.

Virginia Medicaid Agency said the Centers for Medicare and Medicaid Services recently granted states permission to retain some unspent dollars by directing managed care plans to make payments to providers in order to aid in the response to the coronavirus.


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