{"data":{"id":"us-va/12vac30-120-395","jurisdiction":"us-va","citation":"12VAC30-120-395","heading":"Preauthorized, emergency, and post-stabilization services and payment rate for care provided by out-of-network providers","body":"The MCOs shall pay for preauthorized, emergency, and post-stabilization services  to members in compliance with the contract and 42 CFR 438.114. Preauthorized, emergency, and post-stabilization services provided to a managed care member by a provider or facility not participating in the MCO's network will be reimbursed according to the current Medicaid fee schedule. This reimbursement shall be considered payment in full to the provider or facility of emergency services.","path":["Title 12. Health","Agency 30. Department of Medical Assistance Services","Chapter 120. Waivered Services","Part VI. Medallion Mandatory Managed Care"],"source_url":"https://law.lis.virginia.gov/admincode/title12/agency30/chapter120/section395/","current_through":"2026 Regular Session (effective July 1, 2026)","vintage":"","retrieved_at":"2026-09-14T04:51:08Z","sha256":"62d3e0df5b8f091e591aef1d34d0a241bb406959535d454c8d2ed1e28f619962","source_id":"us-va-vac","stale":false,"prev":"us-va/12vac30-120-390","next":"us-va/12vac30-120-400"},"notice":"GroundRules: Original legal text. Not legal advice."}