President Releases his FY2016 Budget Proposal

Published in February 5, 2015 Issue

President Obama released his budget this week and it proposes significant cuts to Medicare by reducing the market basket, cutting bad debt reimbursement, etc.  AHCA/NCAL have already expressed their strong opposition to the cuts.  While it is not expected they will become law, VHCA wanted to provide you a  summary from AHCA/NCAL of the President’s budget provisions that would have a direct impact on the nursing and assisted living profession.

Virginia General Assembly

Governor Releases Budget Amendments for Consideration during 2015 Session – No Additional Actions on Nursing Facility Reimbursement

Published in December 18, 2014 Issue

On Wednesday, December 17, 2014, Governor McAuliffe presented his proposed amendments to the 2015/2016 Biennial Budget.  You may recall that late last spring, the Governor and General Assembly dealt with an unexpected budget shortfall, due to a significant overestimation of revenue.  In total, the shortfall for the biennium was estimated to be $2.4 billion.  The Governor and General Assembly took immediate action to deal with the bulk of the shortfall last spring, with an understanding that scheduled revisions to the revenue assumptions would guide the additional belt tightening necessary going forward.

Virginia General Assembly

State Budget Update

Published in October 30, 2014 Issue

Despite a fairly positive fiscal report issued earlier this month indicating revenue above the forecast, the Governor and General Assembly will still have to close a revenue gap currently estimated to be $272 million for State Fiscal Year (SFY) 2016 (begins July 1, 2015).  Therefore, the Governor recently announced budget cuts for the current year, focused primarily on layoffs of state workers in the Department of Corrections.  The Governor did not include any current year reductions in the Medicaid program.  As you recall, last spring we were able to retain most of the new funding for the current fiscal year, but we did our part in closing the revenue gap by absorbing cuts through an accelerated capital cost reimbursement reduction and, unfortunately, a deferral of inflationary adjustments for SFY 2016.

Virginia General Assembly

Virginia State Budget Update

Published in August 28, 2014 Issue

Governor McAuliffe addressed the “Money” committees of the General Assembly on August 15th informing them that the updated revenue estimate for the Commonwealth indicated an additional budgetary shortfall.  As reported back in June, lagging revenue collections forced budgetary cuts prior to passage of the two year budget for State fiscal years 2015 and 2016.  With the new revenue estimate, the Governor and General Assembly will need to address further revenue shortfalls beyond what the adopted budget had already reflected.

Virginia General Assembly

2015/2016 Biennial Budget Signed; Medicaid Price-Based Nursing Facility Payment System to Begin Phased Implementation July 1

Published in June 26, 2014 Issue

Budget provisions related to Medicaid Nursing Facility payment have been finalized and approved by the General Assembly and the Governor.  As previously reported, the two-year budget contains an estimated $81.4 million in “new” Medicaid funding for nursing facilities over and above current funding levels. 

Budget Agreement Reached by General Assembly – Awaits Governor’s Approval

Published in June 13, 2014 Issue

After a months-long delay, the Virginia General Assembly adopted a state budget late Thursday, acting after heated debate over whether the budget contained sufficient safeguards to ensure that Governor McAuliffe could not unilaterally authorize expansion of the Commonwealth’s Medicaid Program.  As midnight approached, the Senate approved plan moved over for consideration by the House of Delegates, where it quickly passed. It was expected to then head to the Governor’s desk, still lacking certainty that he would approve it and avert a government shutdown before July 1.

Virginia General Assembly

Virginia’s Revenue Shortfall Increases, Possible Budget Solution Offered

Published in May 30, 2014 Issue

Virginia’s House of Delegates and State Senate continue their standoff and refuse to negotiate their differences to enable passage of a biennial state budget.  To further complicate the issue, state revenues have fallen $300 million short of projections for this state fiscal year, and the revenue shortfall may be as high as $1 billion for the upcoming biennium.

President Obama Releases His FY2015 Proposed Budget

Published in March 6, 2014 Issue

Given its significance to our members, we are reproducing the content of a communication sent by American Health Care Association President Mark Parkinson on March 4th.

Governor McDonnell’s Budget Includes Significant Funding Increases for NFs

Published in December 19, 2013 Issue

Earlier this week, Governor Bob McDonnell introduced the 2014 - 2016 biennium State Budget.  For nursing facilities, the two-year budget provides full funding for Medicaid inflation and rebasing adjustments.  Under our current Medicaid payment methodology, cost ceilings for nursing facilities are scheduled to be rebased effective July 1, 2014.  The introduced budget provides $28.6 million to fund the rebasing in state fiscal year 2015.  Additionally, the Governor's proposed budget includes $15.1 million funding for a 1.7% inflation adjustment for the same fiscal period.  Finally, a prior budget adjustment restricting Medicaid capital payments under the Fair Rental Value (FRV) will expire effective June 30, 2014 allowing the FRV rental rate floor to return back to 9.0% in FY 2015.

Virginia General Assembly

Veto Session Action on State Budget

Published in April 10, 2013 Issue

The General Assembly convened in a “veto session” on April 3rd to address amendments that Governor McDonnell made to legislation, including the Biennial Budget that passed in the recent General Assembly Session.  The Governor made no amendments to the provisions affecting nursing facility and assisted living facility reimbursement so these provisions will be enacted as passed in February.  The General Assembly accepted the Governor’s amendments to the section of the Budget addressing Medicaid reform and Medicaid expansion under the federal Accountable Care Act. 

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Sequestration Threat About to Become Reality

Published in February 28, 2013 Issue

As an update to last week’s article, it is all but certain that the sequestration cuts will go into effect on March 1st.  Skilled nursing facilities should do budget and cash flow planning now to prepare for the impact on reimbursement.  Health care providers are hoping that a one-month delay in reductions to Medicare reimbursement rates under sequestration will give lawmakers enough time to develop and pass legislation to avert cuts under the sequester.  Sequestration will involve a two percent cut in Medicare payments, effective for services provided on or after April 1, 2013.  While there is little formal or practical guidance available to providers, it is our understanding that facilities should continue to bill at the FY2013 rates.  Any adjustments to reimbursement will be made by the Medicare Administrative Contractor (MAC) Palmetto GBA.

Virginia General Assembly

State Budget Update

Published in February 7, 2013 Issue

As they do every year, the House Appropriations and Senate Finance committees met on Sunday to present their budget amendments to Virginia's current two-year, $86 billion budget.  In addition to previewing what House and Senate budget negotiators will discuss in the final weeks of the legislative session, the presentation of the two money committee reports serve as a reminder of the political strains in the Senate that could hamper future budget action.

Governor McDonnell Announces Proposed Amendments to the 2012-2014 Budget

Published in December 18, 2012 Issue

On December 17th, Governor Bob McDonnell unveiled his proposed Budget Amendments for state fiscal year 2014 that would give teachers' raises, redirect some general fund revenue for roads and deposit more than $100 million in the state's rainy day fund.  Continuing the positive news from the 2012 General Assembly session, the Governor proposes that nursing facilities receive an increase of 2.2% to rates in SFY 2014 continuing the same adjustment factor that was applied in 2013.  This adjustment is estimated to increase funding for payment rates by $12.0 million or $2.00 per patient day on average over SFY 2013 levels.  Additionally, the increase in the fair rental value (FRV) rental rate floor to 8.5% continues into 2014.  The combined increase for these two provisions is estimated to raise rates by an average of $6.54 per Medicaid resident per day during the two-year budget period over 2012 levels.

General Assembly Passes Budget

Published in April 20, 2012 Issue

After a delay of more than a month, the Virginia Senate passed a two-year $85 billion budget on Wednesday.  The Senate’s 21 to 19 decision came after Sen. Chuck Colgan, a Democrat from Prince William, had a change of heart and decided to vote with Republicans for the budget plan that he had voted against on Tuesday.  Senate Democrats had held up the budget for weeks as they fought aggressively for an additional $300 million to pay for key transportation projects in Northern Virginia.