CHAPTER 336
An Act to require the Department of Medical Assistance Services to include in its contracts with managed care organizations requirements for the collection and reporting of certain data; report.
[S 1270]
Approved March 23, 2023
Be it enacted by the General Assembly of Virginia:
1. § 1. That the Department of Medical Assistance Services (the Department) shall collect and report (i) the number and percentage of claims submitted to managed care organizations that were denied and the reasons for such denials and (ii) the number and percentage of claims submitted to managed care organizations that required resubmission prior to payment and the reasons for such resubmissions. Such data shall be reported for each fiscal year from fiscal year 2018 through fiscal year 2022 and shall be organized by major provider type, including primary care providers and urgent care centers. The Department shall examine such data and identify barriers that providers encounter when accepting and treating patients enrolled in the state plan for medical assistance services. The Department shall report such data and analysis to the Joint Commission on Health Care and the Joint Subcommittee for Health and Human Resources Oversight by November 1, 2023.