Medicaid; oversight of services facilitation for consumer directed services.

Plain English Breakdown

The official source material does not provide specific details on funding or timelines for implementation.

Medicaid Oversight Rules

This bill directs the Virginia Department of Medical Assistance Services to enhance oversight of services facilitation in Medicaid's consumer-directed care programs.

What This Bill Does

• Directs the Department of Medical Assistance Services to enhance oversight of Medicaid services facilitation for people who receive Medicaid through consumer-directed care.
• Incorporates these services into a statewide contract with Fiscal Employer Agents.
• Develops a plan to monitor and oversee service providers, including timely authorizations and regular assessments.

Who It Names or Affects

• People who receive Medicaid through consumer-directed care programs
• Service facilitators in these programs
• The Virginia Department of Medical Assistance Services

Terms To Know

consumer-directed care

A type of Medicaid program where individuals choose their own caregivers and have more control over how services are provided.

Fiscal Employer Agent (FEA)

An organization that manages the financial aspects of Medicaid consumer-directed care programs, such as payroll and taxes for service providers.

Limits and Unknowns

• The bill does not specify how much funding will be provided to implement these changes.
• It is unclear when the Department of Medical Assistance Services will seek permission from the Centers for Medicare and Medicaid Services.

Official Summary Text

Department of Medical Assistance Services; enhanced oversight of services facilitators.
Directs the Department of Medical Assistance Services to enhance oversight of Medicaid services facilitation for consumer directed services, including incorporation of such services into the statewide Fiscal Employer Agent contract and development of a contract monitoring and oversight plan.

Current Bill Text

HOUSE BILL NO. 1495

AMENDMENT IN THE NATURE OF A SUBSTITUTE

(Proposed by the House Committee on Health and Human Services

on February 10, 2026)

(Patron Prior to Substitute--Delegate Tran)

A BILL to direct the Department of Medical Assistance Services to seek the necessary permission from the Centers for Medicare and Medicaid Services to enhance oversight of services facilitation.

Be it enacted by the General Assembly of Virginia:

1.
§ 1.
That the Department of Medical Assistance Services
(the Department)
shall
enhance oversight of Medicaid
services facilitation for consumer directed services
.
Such oversight shall include

incorporation of

the services into the statewide Fiscal Employer Agent contract

and the development of a contrac
t monitoring and oversight plan to ensure proper management of consumer directed care
.

Such plan shall include monitoring timely service authorization requests, annual plan of care and individualized service plan
ning, and reassessment visits.
The Department shall submit state plan amendments, apply for waivers, and
update provider manuals or guidance as necessary to
implement the provisions of this act.