More Protections in Actions Brought by DMAS

By on June 12, 2013

Senate Bill 944 was passed and signed into law by Governor McDonnell on March 20, 2013.  This bill has the potential to be quite powerful for home health care providers, as it changes the Administrative Process Act—specifically, Virginia Code § 2.2-4027—to afford you more protections in actions brought by DMAS.

Virginia Code § 2.2-4027 has been altered in two important respects, both of which affect the standard by which a court is to review a DMAS final agency decision.  The first change gives the court greater latitude to reverse a finding by DMAS, when the weight of the evidence does not favor it significantly.

The second change permits the circuit courts to consider the law and how it applies to your case, without giving “deference” to DMAS’ own interpretation of the regulations and statutes.  In essence, the playing field has been greatly leveled and the private sector is more likely to receive a fair day in court when litigating a DMAS appeal of a demand for reimbursement.

The changes outlined above, effective July 1, 2013, may have dramatic impact on provider liability for those who challenge DMAS decisions at the circuit court level.  I encourage you to contact your attorney if you are facing a DMAS audit, if you have a current dispute with DMAS, or if you would like to learn more about what can be done to protect the resources you have earned, while caring for those in need.

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