Department of Medical Assistance Services
WAIVER SERVICES AND RATES
WAIVER SERVICES AND RATES IMAGE

ANNOUNCEMENTS:

Notice of Public Comment Period – Adult Day Health Care (ADHC) Rate Methodology – Comments due 03/22/17

The Department of Medical Assistance Services (DMAS) will welcome public comment regarding the submission to the U.S. Centers for Medicare and Medicaid Services (CMS) a rate methodology for services in the Elderly or Disabled with Consumer Direction 1915(c) Home and Community Based Services (HCBS) Medicaid Waiver.

The intent of the submission is to propose to the U.S. Centers for Medicare and Medicaid Services (CMS) a rate methodology for the Adult Day Health Care (ADHC) services for individuals receiving waiver services. The rate methodology establishes a benchmark rate for ADHC services; current rates will not be changed based on the methodology.

This notice serves to open the 30 day public comment period, which begins on February 21, 2017 and closes March 22, 2017 at 5:00pm Eastern Standard Time (EST). Detail on the rate methodology can be located at the links below:

  • ADHC Rate Calculation
  • Rate Methods Public Notice
  • Instructions for Public Comment Submission:

    Electronic Submission - Comments should be sent to HCBSComments@dmas.virginia.gov Comments may be sent within the body of an email or placed within a Microsoft Word document.

    Or, submit via US postal mail to:
    The Department of Medical Assistance Services
    Suite 1300
    600 East Broad Street
    Richmond, Virginia 23219

    Or, Fax to: Beth Jones, 804-371-8892


    EDCD WAIVER

    bullet Changes re: the Personal Care Aide (PCA) Program as it applies to the EDCD Waiver
    bullet EDCD Waiver Regulations – Effective February 13, 2015
    bullet Services Facilitator Training – March 2015
    NEW! EFFECTIVE JULY 1, 2016 the Individual and Family Developmental Disabilities Support Waiver (DD Waiver) will be transitioning from KEPRO to the Department of Behavioral Health and Developmental Services (DBHDS)! KEPRO’s last day to receive DD Waiver service authorization requests is June 30, 2016. All cases received on June 30, 2016 will be processed by KEPRO. If you have a case that was pended by KEPRO you must respond back to KEPRO via the provider web portal Atrezzo, by the required timeframe noted on the pend request. As of 7/1/2016, the Department of Behavioral Health and Developmental Services (DBHDS) will begin accepting all DD Waiver requests. All requests for services submitted on or after 7/1/2016, must be submitted to DBHDS. Please refer to the Department of Medical Assistance Services (DMAS) memo dated (5/18/2016), and the DBHDS memo dated (5/17/2016), for information pertaining to this change. You may also contact the DMAS Helpline at 1-800-552-8627 or 804-786-6273. For additional information regarding upcoming individual and family training offered by DBHDS, and frequently asked questions pertaining to the transition. Please click the link below to access the DBHDS website:
    bullet DBHDS Website
    CONSUMER-DIRECTED EMPLOYER OF RECORD MANUAL – (REVISION MARCH 2015)
    bullet Consumer-Directed Employer of Record Manual (Revision March 2015)
    OVERVIEW OF WAIVER SERVICES
    The Medicaid home and community based waivers are programs offered to eligible individuals who require assistance with activities of daily living and/or supportive services and would prefer to live in their own home or the community rather than in a facility setting.
    There are six Medicaid waivers that are administered by the Commonwealth of Virginia: Three waiver programs (EDCD, Technology Assisted, and Alzheimer’s Assisted Living) are managed by the Department of Medical Assistance Services (DMAS). Three waiver programs (Day Support, Developmental Disability, and Intellectual Disability), are managed by the Department of Behavioral Health and Developmental Services (DBHDS), in collaboration with DMAS. The DMAS Long Term Care Division staff is responsible for the development, oversight, and quality management review of all six waivers. The LTC Division staff responds to requests for policy interpretation and technical assistance to providers.
    bullet Alzheimer’s Assisted Living (AAL) Waiver
    bullet Day Support
    bullet Elderly or Disabled with Consumer Direction (EDCD)
    bullet Individual and Family Developmental Disabilities Support (DD) Waiver
    bullet Intellectual Disability (ID)
    bullet Technology Assisted (Tech)
    WAIVER STATS
    bullet Medicaid Waiver Services - Monthly Updates
    SFY 2017 WAIVER RATES
    bullet Developmental Disabilities Waivers (Building Independence (BI), Family & Individual Support (FIS), and Community Living (CL)
    bullet Alzheimer’s Assisted Living Waiver
    bullet Elderly or Disabled With Consumer Direction
    bullet Technology Assisted
    OTHER SERVICES
    bullet Personal Emergency Response System (PERS)
    bullet Assistive Technology and Environmental Modifications
    bullet For Consumer Directed Services Fiscal Agent, visit the Public Partnerships, LLC, website at this link
    MANUALS AND FORMS
    bullet Developmental Milestones Assessment for Children under the Age of Six and at Developmental Risk
    bullet Virginia Medicaid Provider Manuals
    bullet Virginia Medicaid Forms