VHCA Meets With Senior Administration Staff

VHCA (11/16/2007)

On November 14th, VHCA staff met with Health and Human Resources Secretary Marilyn Tavenner and the Governor’s Deputy Chief of Staff Steve Harms to discuss two areas of key concern for Virginia nursing facilities.  The two topics addressed during the meeting were the status of state budget funding for the annual cost rate (inflation) adjustment and for rebasing cost ceilings effective July 1, 2008 and to share our concerns about the Medicaid plan for the Integration of Acute and Long Term Care.

Given the state budget condition and the potential for cuts that may be necessary in state fiscal year 2009, we wanted a chance to meet face to face and stress the importance of fully funding both our Medicaid rebasing and cost rate (inflation) adjustments.  The good news is that as of now, the Governor intends to recommend full funding for both of these components.  This is only the first step in the budget process but it is an important one.  This favorable announcement could change should revenue forecasts be revised downward to reflect worsening economic conditions.

The second issue discussed during the November 14th meeting focused on the ALTC Integration plan and our concerns.  The Secretary appears to be a strong proponent of the plan and tried very hard to convince us that some of our concerns were not valid.  Despite those concerns, she confidently predicted that nursing facilities would perform well under the plan.  We spent a good deal of time during the meeting attempting to make clear to her the critical role that Medicare SNF revenues play in the overall financial performance and stability of our members and that it was very difficult to see how managed care organizations working as partners with the Department of Medical Assistance Services (DMAS) would not seek to cut back on payments or covered days for residents enrolled in Medicare Advantage/Special Needs Plans. 

The next significant step in the process that DMAS intends to follow as they work toward the development and implementation of their Acute and Long Term Care (ALTC) Integration plan is the release of a request for proposal (RFP).  This RFP is the document that managed care organizations will use to develop their own proposals for servicing (through the creation of provider networks) some or all geographic areas of the Commonwealth.  DMAS had previously indicated that the RFP (or at least a draft thereof) would be made available sometime in October of this year.  We have not been informed directly, but we have heard that in a recent meeting, Deputy Director Cindi Jones announced that the date for the RPF has been pushed back to March 2008.  It is not clear if she is referring to the final RFP or a draft for public comment.  This delay confirms our thinking that the Department has more work to do than originally anticipated and suggests that the August 2008 target roll-out date for the Tidewater area is less than certain.

VHCA staff will continue to monitor efforts underway by the state to move forward with the ALTC Integration plan development and integration and will provide updates to our members as developments  arise.