Virginia Department of Medical Assistance Services

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.

This Quality Strategy outlines the long-term direction for the Commonwealth of Virginia Department of Medical Assistance Services (DMAS) from 2026 to 2028. The plan is designed to improve the health and well-being of Virginians by enhancing member care experiences, promoting access to safe and gold-standard patient care, supporting efficient and value-driven care, strengthening the health of families and communities, and providing whole-person care for vulnerable populations. Key initiatives include behavioral health enhancement through the 'Right Help, Right Now' program, increasing access to healthcare, and an enhanced managed care delivery system. The strategy emphasizes continuous quality improvement, data-driven decision-making, and stakeholder collaboration to achieve its goals.

The Board of Medical Assistance Services held a meeting where they welcomed new member Dr. Jeffrey Rich. They nominated and approved Jason Brewster as Chair, Basim Khan as Co-Chair, and Brooke Barlow as Board Secretary. Director Roberts presented Medicaid program updates, including Dental (Cardinal Care Smiles), Behavioral Health (Governor's Right Help, Right Now), Department of Justice Settlement, Maternal and Child Health, and Program Integrity. Chief Deputy Jeff Lunardi provided an overview of DMAS Legislative Role, 2025 GA Statistics, and a recap of the 2025 Legislation and Budget Amendments. Truman Horwitz presented budget updates, noting spending is on track with the forecast. The board was also provided with updated Regulatory activity.