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

ANNOUNCEMENTS:

Notice of Public Comment Period

The Department of Medical Assistance Services (DMAS) and Department of Behavioral Health and Developmental Services (DBHDS) will welcome public comment regarding the submission to the U.S. Centers for Medicare and Medicaid Services (CMS) amendments to the following 1915(c) Home and Community Based Services (HCBS) Medicaid Waivers: Community Living (CL) and the Family and Individual Supports (FIS) waivers.

The intent of the amendment is to propose to the U.S. Centers for Medicare and Medicaid Services (CMS) a rate methodology for a customized rate for certain individuals receiving waiver services. Services that may qualify for a customized rate include:

  • Community Coaching
  • Group Day
  • Group Home
  • In-Home Support services
  • Supported Living

The amendment will also technically correct the number of slots in the CL waiver to reflect the number approved by the Virginia General Assembly.

This notice serves to open the 30 day public comment period, which began on January 4, 2016 and closes February 3, 2017 at 5:00pm Eastern Standard Time (EST). The 1915(c) HCBS waiver amendments can be located at the links below (see page, Item 2. Purpose(s) of Amendment):

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: Teri Morgan, 804-452-5468

EDCD WAIVER

Changes re: the Personal Care Aide (PCA) Program as it applies to the EDCD Waiver
EDCD Waiver Regulations – Effective February 13, 2015
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:
DBHDS Website
CONSUMER-DIRECTED EMPLOYER OF RECORD MANUAL – (REVISION MARCH 2015)
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.
Alzheimer’s Assisted Living (AAL) Waiver
Day Support
Elderly or Disabled with Consumer Direction (EDCD)
Individual and Family Developmental Disabilities Support (DD) Waiver
Intellectual Disability (ID)
Technology Assisted (Tech)
WAIVER STATS
Medicaid Waiver Services - Monthly Updates
SFY 2017 WAIVER RATES
Developmental Disabilities Waivers (Building Independence (BI), Family & Individual Support (FIS), and Community Living (CL)
Alzheimer’s Assisted Living Waiver
Elderly or Disabled With Consumer Direction
Technology Assisted
OTHER SERVICES
Personal Emergency Response System (PERS)
Assistive Technology and Environmental Modifications
For Consumer Directed Services Fiscal Agent, visit the Public Partnerships, LLC, website at this link
MANUALS AND FORMS
Developmental Milestones Assessment for Children under the Age of Six and at Developmental Risk
Virginia Medicaid Provider Manuals
Virginia Medicaid Forms