This week the General Assembly started a special session to finish its legislative work. On Wednesday, the House and Senate money committees released their budgets. The proposals do not fully fund VHCA-VCAL’s request for continuation of the $20 per day Medicaid funding beyond June 30, 2021.

Medicaid and the Budget

The House Appropriations Committee included additional funding of $12 per day per resident for Medicaid nursing facility care beginning on July 1, 2021. The Senate Finance Committee did not include continuation of the $20 per day funding beyond June 30. VHCA-VCAL will be contacting legislators to emphasize the continuing and significant impact COVID-19 and outbreaks are having on resident care and facility operations.

VHCA-VCAL’s key budget priority was a continuation of the $20 per resident per day Medicaid add-on through June 30, 2022 while we work with legislators and the administration on developing permanent reimbursement reforms to replace the $20 per day. 

The Senate budget also includes a problematic amendment that would make any nursing facility which increases rates or adds special charges that are in excess of 10 percent more than the pre-COVID rates/charges during the public health emergency ineligible for the $20 per diem rate. VHCA-VCAL will be communicating with legislators to explain why this amendment is unnecessary and should be removed from the budget.

On a positive note, both committee budgets include language to defer rebasing of the Medicaid rates in order to not use the 2020 cost reports. Because this language is included in both versions of the budget, it is likely that it will be in the final approved package.

Next Steps

The House and Senate must approve their respective budgets. They then will take the procedural step of rejecting the opposite chamber’s budget, which begins the process to set up a conference committee to negotiate the final budget. Once the House and Senate agree on the budget language, they will forward it to the governor for his approval. VHCA-VCAL will continue its outreach to the budget conferees to emphasize the importance of funding the Medicaid program for nursing facility services.