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2019 Session Virginia Senate Bill 13529 Session Virginia Senate Bill 1352

January 9, 2019

For the creation of an independent agency, the Office of Medicaid Fiscal Oversight and Accountability.

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Virginia state Sen. Ryan McDougle (R-Hanover) introduced a bill in the 2019 legislative session to move responsibility and oversight of Medicaid from the Department of Medical Assistance Services to a new state agency to be called the Office of Medicaid Fiscal Oversight.

"The purpose of my bill is to ensure what happened last year doesn’t ever happen again,” McDougle told Health Care News. “The nearly $500 million debacle that we are having to confront in the current budget is unacceptable. The Office of Medicaid Fiscal Oversight and Accountability will take politics out of the equation. The Office will have the ability and authority to prevent this from happening in the future, which is especially important as we are already learning about inaccurate projections and other fiscal dangers related to Obamacare’s Medicaid expansion."

The proposed office would issue a cost forecast, provide monthly oversight of Medicaid expenditures, and review the impact policy changes might have. The office would employ actuaries who would determine projections for growth in managed care rates. It is expected that the office would employ five to seven full-time people, including an economist and a data information analyst.

Current federal matching dollars would cover 50 percent of the new agency’s expenses. According to a fiscal statement on the bill, however, it is not clear whether an independent office would be eligible for federal reimbursement. The Department of Medical Assistance Services would still exist to maintain current activity, such as federal reporting and provider rate setting with the Centers for Medicare and Medicaid Services.