Virginia Department of Medical Assistance Services

The meeting agenda includes the election of officers, a discussion regarding proposed bylaw changes, and time allotted for new business, old business, and public comment.

The agenda for the meeting included the election of officers and a discussion regarding virtual meeting policies. The Director provided a report, followed by presentations on provider assessments, rural health transformation initiatives, and Pharmacy Benefit Manager operations. Legislative updates from the General Assembly session were presented, along with a review of the organizational budget.

The regular meeting commenced with discussions concerning remote participation and the potential for all-virtual meetings, leading to a scheduled bylaw amendment vote at the next meeting. Key operational updates included the Director's report covering Medicaid program updates on Maternity Care Deserts, Cardinal Care Managed Care Program goals, Federal Policy Actions, and the Rural Health Transformation Program. The Board also received updates on the Fiscal Agent Solution (FAS) and the Redesign of Medicaid Behavioral Health Rehabilitative Services (RHRN). Furthermore, regulatory activity was reviewed, and a budget update indicated a projected need for $3.2 Billion in General Funds over the FY26-FY28 Biennium due to shifting enrollment to more expensive members and increased service utilization. Discussions also covered the Home and Community-Based Settings (HCBS) Final Rule compliance, ongoing monitoring plans, and future initiatives like the development of an HCBS portal and the Maternal Health Goals.

The regular meeting addressed several key agenda items. Discussion took place regarding remote participation and future amendments to the bylaws concerning all-virtual meetings. The Director presented updates on Medicaid programs, focusing on Maternity Care Deserts, Cardinal Care Managed Care Program goals, Federal Policy Actions, and the Rural Health Transformation Program. Updates were also provided to the Board concerning the Fiscal Agent Solution (FAS) and the Redesign of Medicaid Behavioral Health Rehabilitative Services. Additionally, the Board reviewed updated regulatory activity.

This document details the Virginia Department of Medical Assistance Services' (DMAS) Value-Based Purchasing (VBP) program methodology for State Fiscal Year (SFY) 2026. It outlines updates to the program, which is designed to improve the quality of care furnished to Medicaid members. The methodology focuses on six performance measures related to staffing and the avoidance of negative care events, defining payment tiers for both attainment and improvement, and specifying payment timing and responsibilities for the program's implementation.