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Civil Money Penalty (CMP) Reinvestment Program Funding Opportunity

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Bulletin
Effective Date:

To:
All Long-Term Care Providers Participating in the Virginia Medical Assistance Program and Managed Care Organizations (Health Plans)
From:
Cheryl J. Roberts, Director Department of Medical Assistance Services (DMAS)

 

REVISED CIVIL MONEY PENALTY REINVESTMENT PROGRAM SCHEDULE FOR PROJECTS THAT WILL START DURING STATE FISCAL YEAR 2025

The Civil Money Penalty (CMP) reinvestment funds help improve the quality of life for individuals residing in nursing facilities within the Commonwealth.  This bulletin outlines this year’s timeline and process for projects applying for CMP reinvestment funding.  It also reminds potential applicants of requirements, exclusions, and frequently asked questions.

 

The CMP reinvestment fund is a collection of monetary penalties the U.S. Centers for Medicare & Medicaid Services (CMS) may impose on skilled nursing facilities (SNFs), nursing facilities (NFs), and dually-certified SNF/NF for either the number of days or for each instance a facility is not in substantial compliance with one or more Medicare and Medicaid participation requirements for Long-Term Care Facilities (LTC) (Code of Federal Regulations (CFR) 42 Part 488.430).  The requirements for participation with Medicare and Medicaid for (LTC) facilities may be found in CFR 42 Part 483.

 

Any entity may be granted funds for proper use of Centers for Medicare & Medicaid Services (CMS) approved CMP projects to protect or improve the quality of life or quality of care for long-term care (LTC) facility residents-provided the responsible receiving entity is: qualified and capable of carrying out the intended project or use; not in any conflict-of-interest relationship (or the appearance of conflict-of-interest) with the entity or entities that will benefit from the intended project or use; and not paid by a State or Federal source to perform the same function as the CMP project or use. CMP reinvestment funds may not be used to enlarge or enhance an existing appropriation or statutory purpose. If you would like confirmation of your organization’s eligibility to apply for CMP reinvestment funds, please contact the CMP Reinvestment Program Team at (CMPFunds@dmas.virginia.gov)

 

In Virginia, CMP reinvestment funds are used in accordance with federal regulations for projects that directly benefit individuals residing in a nursing facility in the Commonwealth. Projects must be reviewed by DMAS and approved by CMS.  The goal of the CMP Reinvestment Program is to help protect and improve the quality of care for individuals residing in nursing facilities.  Utilizing CMP reinvestment funds provides a unique opportunity to improve the lives of many individuals across the Commonwealth.  DMAS has the responsibility for administering these funds and providing direct oversight in accepting proposals.

CMP-REINVESTMENT PROGRAM PROJECTS

The Virginia General Assembly continues to appropriate CMP reinvestment funds for DMAS and CMS-approved projects that protect or improve the quality of life and care of individuals in nursing facilities.  Through an annual proposal submission and review process, DMAS will continue to ensure that CMP guidelines and policies are followed.  Upon review by the Commonwealth that the proposal is complete, DMAS will forward projects for review and final approval to CMS.  If approved by CMS, a contract will be issued and DMAS will oversee project progress by way of reviewing obligatory quarterly and final program and financial reports.

Information concerning awarded projects, including dollar amounts, recipients, project results, and other relevant information, can be found using this link:  https://www.dmas.virginia.gov/for-providers/long-term-care/programs-and-initiatives/civil-monetary-penalty/.

APPLICATION PROCESS

Applicants must submit a formal Project Application via Virginia’s electronic procurement system, eVA.  Applications must be submitted via eVA to be eligible for consideration.  It is strongly encouraged that applicants use the Application Guidelines and information from the website above when completing a Project Application. 

The timeline for submitting Project Applications for projects beginning July 2024 will be February 1, 2024 to February 29, 2024.

The full details on the proposal submission and review process, including how to submit proposals and requirements of proposals will be found on eVA, and provided on the DMAS website provided above.

CMP Reinvestment Program SFY2025 Timeline

Applications Accepted

January 2024 – February 2024

4 (no later than 5:00 p.m., E.T.)

DMAS Review

February 2024 - March 2024

CMS Review

March 2024 – April 2024

Contracting

May 2024

Project Start Date

July 1, 2024

ADDITIONAL INFORMATION

CMS revised the structure of the CMP Reinvestment Program in 2023. Descriptions of the program guidelines and a list of frequently asked questions compiled by the Center for Medicare and Medicaid Services (CMS) can be found on the CMS website at: https://www.cms.gov/medicare/health-safety-standards/quality-safety-oversight-general-information/civil-money-penalty-reinvestment-program.

Q1:    Where can additional application information be found?

A:  Additional information, application, and guidelines may be found here:  https://www.dmas.virginia.gov/for-providers/long-term-care/programs-and-initiatives/civil-monetary-penalty/.

Q2:    Who should I contact with additional questions?

A:  The Virginia DMAS CMP Reinvestment Program Team can be reached by email at:  CMPFunds@dmas.virginia.gov   or by telephone at (804) 629-7455.

PROVIDER CONTACT INFORMATION & RESOURCES

Virginia Medicaid Web Portal Automated Response System (ARS)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

https://vamedicaid.dmas.virginia.gov/

Medicall (Audio Response System)

Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice.

1-800-884-9730 or 1-800-772-9996

Acentra Health 

Service authorization information for fee-for-service members.

 

 

https://dmas.kepro.com/

Provider Appeals

DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal.

https://www.dmas.virginia.gov/appeals/

Managed Care Programs

Cardinal Care Managed Care and Program of All-Inclusive Care for the Elderly (PACE).   In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider.  The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals.

Cardinal Care Managed Care

https://www.dmas.virginia.gov/for-providers/managed-care/cardinal-care-…

PACE

http://www.dmas.virginia.gov/#/longtermprograms

Acentra Health 

Behavioral Health Services

 

https://dmas.kepro.com/

Provider Enrollment

In-State: 804-270-5105

Out of State Toll Free: 888-829-5373

Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com

Provider HELPLINE

Monday–Friday 8:00 a.m.-5:00 p.m.  For provider use only, have Medicaid Provider ID Number available.

1-804-786-6273

1-800-552-8627

Aetna Better Health of Virginia 

https://www.aetnabetterhealth.com/virginia/providers/index.html

 1-800-279-1878

 

Anthem HealthKeepers Plus 

http://www.anthem.com/

1-800-901-0020

 

Molina Complete Care

 

1-800-424-4524 

https://www.molinahealthcare.com/providers/va/medicaid/home.aspx

 

Sentara Community Plan

1-800-881-2166 https://www.sentarahealthplans.com/providers

 

United Healthcare 

www.uhcprovider.com/

1-844-284-0149

 

Dental Provider

DentaQuest

1-888-912-3456