SD32 - Review of the Virginia Medicaid Program: Final Summary Report

  • Published: 1993
  • Author: Joint Legislative Audit and Review Commission
  • Enabling Authority: Senate Joint Resolution 180 (Regular Session, 1991)

Executive Summary:
The Virginia Medical Assistance Program, or Medicaid, is a joint federal-state program authorized under Title XIX of the Social Security Act and is the largest of the State's health care programs available to indigent persons. Over the past several years, the program has experienced rapid growth. Total program expenditures for medical care were almost $1.3 billion in FY 1991, representing a 30 percent increase from the previous fiscal year (Figure 1). In FY 1992, expenditures continued to grow, increasing by 16 percent to about $1.4 billion. The number of persons receiving Medicaid services has also increased significantly. In FY 1991, the number of recipients grew by 17 percent to 428,650. Growth continued in FY 1992, when the number of recipients grew about 16 percent to 495,516.

The continuing expansion of the Medicaid program and the significant amount of State general funds expended on it have fueled legislative concerns. The 1991 General Assembly passed Senate Joint Resolution SJR No. 180 in response to these concerns (Appendix A). The resolution directed the Joint Legislative Audit and Review Commission (JLARC) to conduct a comprehensive review of the Virginia Medicaid program.

Six reports on the Virginia Medicaid program were completed in 1992 and 1993 to address various issues outlined in SJR 180. The reports provide descriptive and analytic information about the structure of the Medicaid program in Virginia, program expenditures, eligibility for service, methods for reimbursing medical services provided through the program, and cost containment mechanisms. Information about specific findings and recommendations can be found in the following JLARC reports:

• "Special Report: Evaluation of a Health Insuring Organization for the Administration of Medicaid in Virginia," January 1992

• "Interim Report: Review of the Virginia Medicaid Program," February 1992

• "Medicaid-Financed Hospital Services in Virginia," November 1992

• "Medicaid Asset Transfers and Estate Recovery," November 1992

• "Medicaid-Financed Long-Term Care Services in Virginia," December 1992

• "Medicaid-Financed Physician and Pharmacy Services in Virginia," January 1993

This report summarizes major themes and issues that have been presented in the JLARC series of reports on the Virginia Medicaid program.