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SB 1451

Supplemental payment to Medicaid member for transportation DMAS to seek fed. authority to provide.

2025 Regular Session Introduced by Kannan Srinivasan

Virginia DMAS must seek federal approval and create regulations to provide supplemental payments for Medicaid member transportation to medical appointments when other options aren’

Passed by indefinitely in Finance and Appropriations (14-Y 0-N)
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Bill Summary · SB 1451

SB 1451 — Summary

Status: Enacted (signed by Governor 6/20/2025; effective 9/1/2025)
Introduced: 2/19/2025
Primary Sponsor: Kannan Srinivasan (cosponsors listed)
Companion bills: HB 1132, HB 1425

Main purpose

Direct the Virginia Department of Medical Assistance Services (DMAS) to seek the necessary federal authority and to develop regulations to allow supplemental cash payments to Medicaid members to cover transportation to medical appointments when other transportation options are not available.

Key provisions

  • Requires DMAS to:
    • Seek federal approval/authority necessary to permit supplemental payments to Medicaid members for transportation.
    • Develop regulations that define when and under what circumstances such supplemental payments may be authorized and how they will be administered.
  • The supplemental payments are intended to be used only when other transportation options are not available (the bill does not define “other transportation options” or specific eligibility/payment amounts).
  • Implementation details (eligibility criteria, payment methodology, monitoring, and payment channels) are left to DMAS rulemaking and to federal approval.

Who is affected

  • Medicaid beneficiaries in Virginia — potentially any Medicaid enrollee who lacks available transportation to attend medical appointments.
  • DMAS and the Commonwealth’s health program administrators — will need to design, operate, and oversee the program.
  • Managed Care Organizations (MCOs) — operational coordination and monitoring may be required.
  • State budget and contracting resources — for administrative setup, hiring, contractor support, and ongoing payments.

Fiscal and operational impact

  • The Department of Planning and Budget (fiscal note, 1/26/2025) finds the fiscal impact is expected to be significant but indeterminate at the time of the note.
  • Administrative costs: substantial investment expected for eligibility criteria design, payment processes, monitoring and anti-fraud systems, staff, and contractors.
  • Service costs: difficult to estimate due to unknown utilization rates, unclear definitions of “unavailable” transportation, and unspecified payment methodology (e.g., modeling after non‑emergency transportation rates or mileage).
  • Illustrative (not definitive) example in the fiscal note: using a $0.70/mile IRS rate and an estimated $15 average supplemental payment, and assuming 20% of ~2.0 million Medicaid members use the benefit four times/year, annual cost could be on the order of ~$23.5 million. DMAS continues to develop more precise estimates.

Timeline and procedural notes

  • DMAS must seek federal authority before implementing payments (federal approval likely required because Medicaid is jointly state–federal).
  • DMAS must promulgate regulations specifying circumstances and operational rules for payments.
  • Bill enacted 6/20/2025; effective 9/1/2025.

Unresolved issues / considerations

  • The bill leaves key program design elements unspecified (eligibility criteria, amount, payment mechanism, and precise definition of when other options are “not available”), so the scope, cost, and operational design will depend on DMAS rulemaking and federal approval.

Compiled from official sources — confirm details with the bill’s official record.

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