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This state plan amendment revises the payment for Medicare Part B services for the dual eligible population to the Medicare allowable rate for specific ambulance transports.
This amendment purposes to transition from the use of Medicare Severity Diagnosis Groups (MS-DRG) to the 3M All Patient Refined Diagnosis Related Groups (APR-DRG) for inpatient hospital reimbursement.
This amendment changes the methodology for the distribution of Disproportionate Share Hospitals (DSH) reimbursements for specific categories of hospitals. Additionally, the amendment updates page for consistency and renumber lists.
Conforming the existing Virginia Medicaid Works ABP to the requirements of the Affordable Care Act by adding to the package Essential Health Benefits that were not previously provided.