SPA 26-0001 Ventilator Dependent Care (VDC) is being submitted to allow the Division of Medicaid (DOM) to update the ventilator dependent care (VDC) per diem rate, effective July 1, 2026. The current rate is insufficient to ensure access to ventilator dependent care to Medicaid beneficiaries in the state as required by 42 CFR § 447.204. The lack of provider participation is likely due to the rate being insufficient to cover the cost of staff and facilities necessary to provide the service. This places Medicaid beneficiaries that could otherwise be placed in a nursing facility in the state either in an out of state facility or requires that they continue to receive care in the inpatient hospital setting. Ensuring access to this service also ensures that the state’s resources are being used in the most efficient manner possible and that the appropriate level of care is being provided. The financial impact for this rate revision is a minor cost to the state considering the cost of the same beneficiary being cared for in an inpatient hospital setting.
For more information, read the proposed SPA pages.
