WEST VIRGINIA MEDICAID PROGRAM
STATE PLAN AMENDMENT 22-0016
RESCISSIONS TO THE STATE’S DISASTER RELIEF POLICIES FOR THE COVID-19 NATIONAL EMERGENCY: NURSING FACILITY SERVICES RATE INCREASE AND ASSIGNED OCCUPANCY RATE
Pursuant to 42 U.S.C. §1396a(a)(13)(1997) and 42 C.F.R. §447.205, the Department of Health and Human Resources (“Department”), Bureau for Medical Services (“BMS”) provides notice of the filing of a state plan amendment (SPA), identified as SPA 22-0016, regarding rescissions to the Nursing Home Services Rate Increase and related nursing home rate-setting provisions related to the State’s disaster relief policies for the COVID-19 National Emergency. The State also rescinds the temporary reduction of assigned occupancy rate of 70 percent and returns to the original 90 percent for determinations of allowable costs per patient.
During the public health emergency (PHE), rates for Nursing Home Services for nonpublic facilities were increased by $20 per-patient-per-day. The $20 per-patient-per-day increase was used to offset COVID-related costs in a separate cost settlement process. The increase in rates and the temporary reduction of assigned occupancy rate of 70 percent was approved on August 13, 2020, in SPA WV-20-0004 and on December 17, 2020 in WV-20-0006 respectively.
As part of this SPA, the State proposes to add section 7.4.A. Rescissions to the State’s Disaster Relief Policies for the COVID-19 National Emergency to the State Plan. Specifically, this new section will rescind the $20 per-patient-per-day increase and related nursing home rate-setting provisions. In addition, this SPA will rescind the temporary reduction of assigned occupancy rate of 70 percent and return to the original 90 percent for determinations of allowable costs per patient. SPA 22-0016 will be effective for dates of service on or after May 1, 2022, pending CMS approval. The change would not increase costs in Federal Fiscal Year 2022 or increase costs in Federal Fiscal Year 2023.
The public notice period will be in effect between April 8, 2022, and May 8, 2022. Written comments may be sent to the West Virginia Department of Health and Human Resources, 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 business hours, 8:30 a.m. to 4:30 p.m.
Contact Information: For more information, please contact BMS at 304-558-1700.