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Virginia Administrative Code
Title 12. Health
Agency 5. Department of Health
Chapter 200. Regulations Governing Eligibility Standards and Charges for Medical Care Services to Individuals
2/4/2026

12VAC5-200-230. Waivers.

A. The commissioner is authorized, and may delegate the authority to a local health director, to grant or deny a waiver to all or a portion of a charge for reasons of unusually serious health problems or extraordinary financial hardship if a patient or the patient's guardian or legal representative applies for a waiver in writing. A resulting waived or partially waived charge shall be determined by the commissioner or designee and reviewed and revised as needed. The commissioner or designee shall also identify those expenses that are considered to be bills for medical care services and shall review and revise this determination as needed.

B. In the event of an adverse decision, the patient, guardian or other authorized person will be advised of their rights to appeal under Part VII (12VAC5-200-270) of this chapter.

C. An approved waiver shall only be effective for the duration of the health or financial hardship or 180 days, whichever is shorter. The commissioner or the commissioner's designee may grant an additional waiver related to the health or financial hardship if the patient or the patient's guardian or legal representative reapplies for the waiver.

D. No person believed to be eligible for Medicaid or any state-sponsored children's medical insurance program and who has failed to complete an application for these programs will be eligible for a waiver.

Statutory Authority

§§ 32.1-11 and 32.1-12 of the Code of Virginia.

Historical Notes

Derived from VR355-39-100 § 6.2 through § 6.5, eff. December 1, 1993; amended, Virginia Register Volume 20, Issue 22, eff. August 11, 2004; Volume 42, Issue 9, eff. January 29, 2026.

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