FINDINGS IN BRIEF

State oversight of the Medicaid program is necessary to ensure proper program implementation and appropriate use of funds

States may implement oversight activities to ensure state funds are used effectively and efficiently to accomplish the purpose and goals of the Medicaid program. In Virginia, the Department of Medical Assistance Services (DMAS) is responsible for administering the Medicaid program consistent with guidelines established and within the limits of funding appropriated by the General Assembly. Given the current growth in the cost and complexity of the program, additional efforts may be needed to improve the ongoing monitoring and analysis of the Medicaid program.

The General Assembly has implemented several strategies to enhance oversight of Medicaid program spending

Current oversight efforts include: (1) directing DMAS to report data and information about the Medicaid program to the General Assembly, (2) expanding the role of the General Assembly and legislative staff in the Medicaid forecasting process, (3) establishing the Joint Subcommittee for Health and Human Resources Oversight, and (4) directing the Joint Legislative Audit and Review Commission to study and provide analyses of Health and Human Resources agencies.

Current efforts provide information and data on the Medicaid program but do not incorporate all aspects of program oversight

Overall, current oversight efforts provide legislators with information and data on the Medicaid program but do not incorporate all aspects of program oversight. Oversight efforts are dispersed among numerous entities and are not structured or staffed to provide continuous, proactive, and preventative monitoring and analysis of the data and information received.

POLICY OPTIONS IN BRIEF

Option: Submit legislation and a budget amendment to establish a new legislative commission to provide oversight of the Medicaid program. (Option 1, Page 14)

Option: Submit legislation to direct the JLARC or the JCHC to provide oversight of the Medicaid program and a budget amendment to add four additional staff positions to JLARC or the JCHC to carry out oversight activities. (Option 2, Page 15)

Option: Submit a budget amendment to direct the Joint Subcommittee on Health and Human Resources Oversight to provide continuous oversight of Medicaid and to clarify the roles and responsibilities of supporting agencies. (Option 3, Page 16)

Option: Submit a budget amendment to add two staff positions to both the House Appropriations and Senate Finance and Appropriation Committees. (Option 4, Page 17)