Page 402

_ 402 Item Details($) Appropriations($) ITEM 288. First Year Second Year First Year Second Year FY2025 FY2026 FY2025 FY2026 implement these reimbursement changes consistent with effective date(s) approved by the Centers for Medicare and Medicaid Services (CMS). No payments shall be made without CMS approval. In the event that CMS recoups supplemental DSH hospital funds from the department, Chesapeake Regional Hospital shall reimburse such funds to the department. TT. The Department of Medical Assistance Services (DMAS) is authorized to amend the State Plan for Medical Assistance Services to implement a supplemental Medicaid payment for Department of Veterans Services (DVS) state government-owned nursing facilities. The total supplemental Medicaid payment for DVS state government owned nursing homes shall be based on the difference between the Upper Payment Limit of 42 CFR 447.272, as approved by the Centers for Medicare and Medicaid Services (CMS), and all other Medicaid payments subject to such limit made to such nursing homes. DMAS shall not submit any State Plan amendment to CMS that implements this payment until DMAS enters into an intergovernmental agreement with DVS. This agreement shall include the following provisions: 1) DVS shall transfer funds to DMAS for use as the state share of the full cost of the supplemental Medicaid payment for which each nursing home is entitled; 2) DVS must demonstrate that it has the authority and ability to transfer the necessary funds to DMAS; and, 3) DVS shall attest that any funds provided for state match will comply with federal law for use as the state share for the supplemental Medicaid payment. If DVS is unable to enter into or comply with the provisions of such an intergovernmental agreement, then DMAS shall immediately modify the Medicaid State Plan and adjust any supplemental payments accordingly. DMAS shall have the authority to implement the reimbursement changes consistent with the effective date in the State Plan amendment approved by CMS and prior to the completion of any regulatory process undertaken in order to effect such change. UU.1.a. Out of this appropriation, $5,850,000 the first year and $5,850,000 the second year from the general fund and $5,850,000 the first year and $5,850,000 the second year from nongeneral funds shall be used for supplemental payments to fund graduate medical education for 3 residents who began their residencies in July 2021; 1918 residents who began their residencies in July 2022; 3040 residents who began their residencies in July 2024; and 55 residents who began their residencies in July 2025. b. Of the amounts appropriated in UU.1.a., $1,000,000$300,000 the first year and $1,000,000$450,000 the second year from the general fund and $1,000,000$300,000 the first year and $1,000,000$450,000 the second year from nongeneral funds shall be used for supplemental payments to fund graduate medical residencies for 206 psychiatric residents who began their residencies in July 2024 and 3 additional psychiatric residents who began their residencies in July 2025. The Department of Medical Assistance Services shall pursue available administrative processes to initiate these residencies in FY 2025. c. Of the amounts appropriated in UU.1.a., $500,000$300,000 the first year and $500,000$400,000 the second year from the general fund and $500,000$300,000 the first year and $500,000$400,000 the second year from nongeneral funds shall be used for supplemental payments to fund graduate medical residencies for 106 obstetric-gynecological residents who began their residencies in July 2024 and 2 additional obstetric-gynecological residents who began their residencies in July 2025. The Department of Medical Assistance Services shall work with the Virginia Health Workforce Development Authority to pursue available administrative processes to initiate these residencies in fiscal year 2025. Two of these residencies shall be awarded to Johnston Memorial Hospital contingent on the hospital's intent to apply for and accept the residencies. 2.a. The supplemental payment for each qualifying residency slot shall be $100,000 annually minus any Medicare residency payment for which the sponsoring institution is eligible. For any residency program at a facility whose number of residency slots are above the cap set by the Centers for Medicare and Medicaid Services or have exceeded the Upper Payment Limit (UPL) set by CMS, the supplemental payments for each qualifying residency slot shall be $50,000 from the general fund annually minus any Medicare residency payments for which the residency program is eligible. Supplemental payments shall be made for up to four years for each qualifying resident. Payments shall be made quarterly following the same schedule used for other medical education payments b. Effective July 1, 2026, and notwithstanding § 32.1-325 et seq., Code of Virginia, the Department of Medical Assistance Services (DMAS) is authorized to amend the Medicaid