STATISTICAL RECORD
OF THE VIRGINIA MEDICAID PROGRAM
AND OTHER INDIGENT HEALTH CARE PROGRAMS
FY 2006 EDITION
1. OVERVIEW OF THE VIRGINIA MEDICAID PROGRAM
General Information
Average Monthly Number of Individuals Eligible for Services from Virginia Medicaid
Payments Made on Behalf of Individuals Who Received Services from Virginia Medicaid
Payments for Medical Services by Type of Service
2. INDIVIDUALS ELIGIBLE FOR MEDICAID SERVICES
Summary of Measures of Individuals Eligible for Medicaid Services
Annual Unduplicated Individuals Eligible for Medicaid Services by Category of Eligibility and Age Group
Annual Unduplicated Individuals Eligible for Medicaid Services by Gender Race and Age Group
Annual Unduplicated Individuals Enrolled in Capitated Programs by Gender, Race and Age Group: MEDALLION II
Monthly Unduplicated Eligibles/Average Monthly Eligibles
Individuals Eligible for Medicaid Services by Eligibility Designation
Average Duration of Enrollment in Medicaid by Eligibility Category
3. INDIVIDUALS RECEIVING MEDICAID SERVICES
Annual Unduplicated Recipients by Category of Eligibility and Age Group
Annual Unduplicated Recipients by Gender, Race and Age Group
Annual Unduplicated Recipients by Type of Medical Service
Annual Unduplicated Recipients by Type of Medical Service and Age Group
Annual Unduplicated Recipients by Type of Medical Service and Basis of Eligibility
Monthly Unduplicated Recipients/Average Monthly Recipients: Fee-for- Service Programs
Monthly Unduplicated Recipients/Average Monthly Recipients: Capitated Programs
Immigrant and Refugee Recipients: Numbers and Payments by Category of Service
4. PROVIDERS
Number of Enrolled Providers at June 30
Number of Providers Receiving Payments from DMAS in Calendar Year 1985 - 2005
Payments to Providers by Service Type in Calendar Year 1985-2005
Medicaid Medical Payments to State Facilities
Changes to Provider Reimbursement Rates: 1985 - Present
Nursing Facility Data
Medicaid Payment System in Virginia by Provider Type
5. CLAIMS
Number of Original Claims Paid by Invoice Type and Provider Class: Fee-for- Service Programs
Number of Total Claims Adjudicated – All Programs by Submission Media and Disposition FYs 2004, 2005, 2006
6. UNITS OF SERVICE
Units of Service as Reported on HCFA/CMS-2082
Units of Service as Reported in DMAS Budget Forecasts
7. TOTAL PROGRAM EXPENDITURES
Total Program Expenditures by Fiscal Year: FY 1970-2006
Total Medicaid Expenditures Compared to Total State Expenditures
8. MEDICAL ASSISTANCE SERVICES EXPENDITURES
Annual Medicaid Expenditures for Medical Services by Major Category of Expenditure: FY 1985-2006
Annual Medicaid Expenditures for Medical Services by HCFA/CMS Category and State Object Code: FY 1985-2006
Annual Medicaid Expenditures for Medical Services by Type of Medical Service and Category of Eligibility
Annual Medicaid Expenditures for Medical Services by Type of Medical Service and Age Group
Annual Medicaid Expenditures For Medical Services By Recipient Locality And Program, 1997 - 2006
Average Medicaid Expenditure for Medical Services Per Eligible by Category of Eligibility
Average Medicaid Expenditure for Medical Services Per Recipient by Category of Eligibility
Average Medicaid Expenditure Per Recipient by Type of Medical Service
Payments of Deductibles Made on Behalf of Aged and Disabled Recipients
Payments of Co-insurance Made on Behalf of Aged and Disabled Recipients
Payments by Eligibility Designation: FY 1997 – 2006
9. ADMINISTRATION
Annual Expenditures for Administration by Major Category of Expenditure and Object Code
Maximum Employment Level (MEL)
DMAS Relationships with Other State Agencies
Administrative Expenditures, Revenue Transfers, and Payments to Other State Agencies
10. STATE CHILDREN’S HEALTH INSURANCE PROGRAMS
State Child Health Insurance Program: Overview
Monthly Enrollment in Children’s Health Insurance Program
Children’s Health Insurance Program Annual Unduplicated Individuals Eligible for Services and Annual
Expenditures forServices by Eligibility Category
State Health Insurance Program: FAMIS Annual Expenditures by HCFA/CMS Category and Object Code
Medicaid Expansion (AC94) M-CHIP Annual expenditures by HCFA Category and State Object Code
11. STATE AND LOCAL HOSPITALIZATION PROGRAM / INDIGENT HEALTH CARE TRUST FUND
State and Local Hospitalization Program: Overview
State and Local Hospitalization Program: Program Data Summary
State and Local Hospitalization Program: Annual Expenditures by Locality and Fund
State and Local Hospitalization Program: Annual Payments to Virginia Hospitals
Virginia Indigent Health Care Trust Fund: Overview
Indigent Health Care Trust Fund: Annual Payments to Virginia Hospitals
12. PROGRAM INFORMATION
Program Additions Other Than Provider Reimbursement Rate Changes:1985 - Present
Medicaid Cost Containment Measures Implemented: 1985 – Present
MEDALLION Waiver: Virginia Medicaid’s Primary Care Case Management Program
Home and Community Based Care Waivers: Elderly and Disabled with Consumer Direction Waiver
Home and Community Based Care Waivers: Technology Assisted Waiver
Home and Community Based Care Waivers: HIV/AIDS Waiver
Home and Community Based Care Waivers: Mental Retardation (MR) Waiver
Home and Community-Based Care Waivers: Individual and Family Developmental Disabilities Support (IFDD) Waiver
Home and Community Based Care Waivers: Day Support Waiver
Medicaid Reimbursement of School-Based Health Services
Virginia Implementation of Medicaid-Related Immigration Provisions Effective July 1, 1997
Medicare/Medicaid Dual Eligibles
13. OTHER INFORMATION
Federal and State Match Rates by Federal and State Fiscal Years
HHS Poverty Income Guidelines for All States and District of Columbia (Except Alaska and Hawaii)
by Size of Family Unit
HHS Poverty Income Limits to Specified Percentages Effective February, 2006/Medically Needy Income Levels
Medicaid and Title XXI Recipient Eligibility Designations
Internet Resources for Additional Information