State Plan Amendment (SPA) 24-0004, Regarding Nursing Facilities Public Notice!

Pursuant to 42 U.S.C. §1396a(a)(13)(1997) and 42 C.F.R. §447.205, the Department of Human Services

(“Department”), Bureau for Medical Services (“BMS”) provides notice of the filing of a state plan amendment (SPA),

identified as SPA 24-0004, regarding changes to the reimbursement structure for nursing facilities.

This SPA, if approved by the Centers for Medicare & Medicaid Services (CMS), will transition the historical West

Virginia-specific nursing facility acuity-based reimbursement system to one based on the Patient-Driven Payment

Model (PDPM). Utilizing PDPM allows for an acuity-based reimbursement system to continue, as CMS has stopped

collecting the necessary data elements to support the current West Virginia-specific acuity-based reimbursement

system.

This SPA will have an effective date of October 1, 2024, pending CMS approval. The changes proposed in the SPA

are estimated to increase Medicaid Expenditures by $22,631,331 in Fiscal Year (FY) 2025 and $35,307,929 in FY

2026.

This notice will be available for public inspection between July 9, 2024, and August 9, 2024. Written comments may

be sent between the above referenced dates to the West Virginia Department of Human Services, Bureau for Medical

Services, 350 Capitol Street, Suite 251, Charleston, WV 25301-3706, or by email at SPAComments@wv.gov.​

Any written comments received will be available for review at the above address during normal business hours, 8:30

a.m. to 4:30 p.m.

SPA 24-0004 Nursing Facilities Reimbu​rsement

​