The Board shall amend the state plan and promulgate regulations to establish the Medicaid Prior Authorization Advisory Committee, composed of 11 members to be appointed by the Board. Five members shall be physicians, at least three of whom shall care for a significant number of Medicaid patients; four shall be pharmacists, two of whom shall be community pharmacists; one member shall be an individual receiving mental health services; and one member shall be a Medicaid recipient. A quorum for action of the Committee shall consist of six members. The members shall serve at the pleasure of the Board, and vacancies shall be filled in the same manner as the original appointment. The Board shall consider nominations made by The Medical Society of Virginia, the Old Dominion Medical Society, the Psychiatric Society of Virginia, the Virginia Pharmaceutical Association, the National Alliance on Mental Illness of Virginia and the Virginia Mental Health Consumers Association when making appointments to the Committee.
The Committee shall elect its own officers, establish its own procedural rules, and meet as needed or as called by the Board, the Director, or any two members of the Committee. The Department shall provide appropriate staffing to the Committee.
1993, c. 537; 1996, c. 515; 2012, cc. 476, 507.
Structure Code of Virginia
Chapter 10 - Department of Medical Assistance Services
§ 32.1-323. Department of Medical Assistance Services
§ 32.1-323.1. Department to submit forecast of expenditures
§ 32.1-323.2. Elimination of waiting lists for certain waivers
§ 32.1-323.3. Dependents of foreign service members; waiting lists for certain waivers
§ 32.1-323.4. Department to facilitate transition of persons between certain waiver programs
§ 32.1-324. Board of Medical Assistance Services
§ 32.1-324.2. Director to facilitate communication
§ 32.1-324.3. Uninsured Medical Catastrophe Fund established
§ 32.1-325.01. Certain term life insurance considered resources
§ 32.1-325.1. Adverse initial determination of overpayment; appeals of agency determinations
§ 32.1-325.1:1. Definitions; recovery of overpayment for medical assistance services
§ 32.1-325.2. Department is payor of last resort
§ 32.1-325.4. Penalty for violation
§ 32.1-326. Director may make payments to or for eligible persons in state-owned medical facilities
§ 32.1-326.1. Department to operate program of estate recovery
§ 32.1-326.2. Pilot school/community health centers
§ 32.1-327. Claim against indigent's estate for payments made
§ 32.1-330. Long-term services and supports screening required
§ 32.1-330.01. Reports related to long-term services and supports
§ 32.1-330.1. Department to implement premium assistance program for HIV-positive individuals
§ 32.1-330.2. Medicaid managed care programs; program information documents; plain language required
§ 32.1-330.3. Operation of a PACE plan; oversight by Department of Medical Assistance Services
§ 32.1-330.4. Uniform assessment instrument for PACE plans
§ 32.1-330.5. Reports related to eligibility renewal
§ 32.1-331.01. Health Care Coverage Assessment Fund
§ 32.1-331.02. Health Care Provider Payment Rate Assessment Fund
§ 32.1-331.03. Process for payment directly to nursing facility or ICF/MR
§ 32.1-331.04. Personal care aides; orientation program
§ 32.1-331.05. Coordinated specialty care; work group
§ 32.1-331.13. Medicaid Prior Authorization Advisory Committee; membership
§ 32.1-331.14. Duties of the Committee
§ 32.1-331.15. Prior authorization of prescription drug products; coverage under state plan