VA SB357

Establishes the Office of Medicaid Financial Oversight as an independent state agency to provide financial oversight and fiscal accountability for Virginia's Medicaid and children's health insurance programs (FAMIS).

The Director is appointed by the Governor for a four-year term, subject to confirmation by the General Assembly, and must devote full time to the position.

Requires the Department of Medical Assistance Services to provide 30 days' notice before implementing any policy changes to Medicaid or FAMIS programs; changes with fiscal impact lacking federal requirement, state authorization, or legislative appropriation cannot take effect without General Assembly approval.

The Office must submit monthly budget variance reports, review expenditure forecasts, analyze managed care capitation rates annually, and monitor pharmacy rebate collections and provider assessments.

Mandates annual reports by October 15 on fiscal impacts of policy changes (tracking each change for six years) and by December 1 on overall Office activities, submitted to the Governor and General Assembly.