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Public Notice for Proposed Changes to Medicaid

last modified 09/27/2016 - 10:06 AM

Public notice for proposed changes to Medicaid policy or the the Medicaid State Plan

Please note that public notices are no longer posted on this page.

To access public notices, please visit the Global Commitment Register.

 

Policy: Hospice Fee Schedule

          Proposed Policy

          Effective Date: 1/1/2016

          No comments were received.

 

Policy: Outpatient Prospective Payment System

          Proposed Policy

          Effective Date: 1/1/2016

          No comments were received.

 

Policy: Physician Administered Drug Fee Schedule

          Proposed Policy

          The following comments were received:  Click here.

 

Policy: Clinical Diagnostic Laboratory Fee Schedule

          Proposed Policy

          Effective Date: 01/01/2016

          No comments were received.

 

1115 Global Commitment to Health waiver extension request--accepting public notice through 12/10/15

 

SPA 15-031: Home Health ABP

Public Notice

ABP5 pages 43 and 44

No Comments were received.

 

SPA 15-029: Hospice Rates

Public Notice

Att. 4.19-B page 6

No comments were received.

 

SPA 15-021: Licensed Alcohol and Drug Abuse Counselors

Public Notice

Att. 3.1-A page 3d

The following comment was received: Click here

 

SPA 15-023: Licensed Dental Hygienist Services

Public Notice I

Public Notice II

Att. 3.1-A page 3d(2); Att. 4.19-B page 3(1)b

No comments were received. 

 

SPA 15-009: Alternative Benefit Plan (ABP) - Licensed Dental Hygienist Services

Public Notice

ABP5 page 41

No comments were received. 

 

SPA 15-025: Disproportionate Share Hospital (DSH)

Public Notice

Att. 4.19-A pages 1f and 1g

No comments were received.

 

Vemont Global Commitment to Health Comprehensive Quality Strategy (CQS)

A CQS is a CMS required document for all states implementing Managed Care in its Medicaid Program. The Vermont CQS Outline serves as a blueprint or road map for Vermont and its public Managed Care Organization in assessing the quality of care that beneficiaries receive, as well as for setting forth measurable goals and targets for improvement.

Public Notice

Overview of CQS (PowerPoint Presentation)

CQS Public Notice and Submission Timeline

CQS Outline

Comprehensive Quality Strategy draft

Comprehensive Quality Strategy CMS Submission (9/15/15)

Driver Diagram - The Global Commitment to Health (GC) driver diagram is a tool used to display the components of Vermont’s improvement efforts in its Medicaid Program (via the waiver), as well as, to communicate the waiver’s theory of change. The driver diagram displays the goals of the waiver, identifies their drivers, shows how the drivers are connected, and ultimately provides the basis for how Vermont will measure its performance relative to the goals.

Comments Received 

CQS CMS Feedback

 

SPA 15-009: Alternative Benefit Plan (ABP)

Public Notice

ABP5 pages 38 and 39

No comments were received.

 

SPA 15-007: Adult Day Health

Public Notice

Att 3.1-A pg 6n

No comments were received.

 

SPA 15-011: Vermont Medicaid Shared Savings Program (VMSSP)

Public Notice

Att. 3.1-A pg 13-13E

Att. 4.19-B pg 12-17

No comments were received.

 

SPA 15-013: Increased Primary Care Payments

Public Notice

Att. 4.19-B pg 10

No comments were received.

 

Policy: Reimbursement for group psychotherapy

Final policy

Effective date: 7/1/15

The following comments were received: click here.

  

SPA 15-001: Licensed Behavior Analysts and SPA 15-009: Alternative Benefit Plan (ABP)

Att. 3.1-A page 3d(1); Att. 4.19-B page 3a and 3a(1)

Att 3.1-L (ABP5) pages 22 and 23

Effective date: 7/1/15

The following comments were received: click here. Final documents: coverage guidelines and reimbursement rates.

 

SPA 15-005: Resourse Based Relative Value Scale (RBRVS)

Att. 4.19-B pages 3, 9, and 10

Effective Date: 1/1/15

The following comments were received: click here.

 

SPA 15-003: Outpatient Prospective Payment System (OPPS)

Att. 4.19-B pages 2a(1a) and 2a(1b)

Effective Date: 1/1/15

The following comments were received: click here.

 

Policy: Outpatient Prospective Payment System (OPPS)

Click here to view the final policy.

Effective date: 1/1/15

See comments for SPA 15-003 above.

 

Policy: Professional rates valued under the Resource Based Relative Value System (RBRVS)

Click here to view the final policy.

Effective Date:  1/1/15

See comments for SPA 15-005 above.

 

SPA 14-010: Companion Aide Pilot Project

Attachment 4.19-D Addendum A (Cover and pages 4, 35, and 41-45)

Effective Date: 12/15/14

The following comments were received: click here

 

SPA 14-027: Alternative Benefit Plan

ABP5 pages 16-17 and pages 20-21

Effective date: 12/31/14

No comments were received.

 

SPA 14-025: Rural Health Clinic Services/Federally Qualified Health Centers

Att. 4.19-B page 2a(2)

Effective Date:  10/01/14

No comments were received.

 

Public Announcement for changes to rates paid for hospice care services. (Note: This is not a state plan amendment.)

       Supplementary material

       Effective Date:  10/1/14

       No comments were received.

 

Policy: Inpatient Same/Next Day Readmission Policy

       Click here to view proposed policy change

       Effective Date:  10/1/14

       The following comment was received: click here.

 

Policy: Adding additional discharge status codes to the Vermont Medicaid transfer/short stay payment methodology

       Click here to view proposed policy change

       Effective Date:  10/1/14

       The following comment was received: click here.

 

SPA 14-021: Home Telemonitoring Services

       Att. 4.19-D page 19

       Effective Date:  8/1/14

         No comments were received.

 

SPA 14-023: DSH Federal Fiscal Year 2015

       Att. 4.19-A pages 1f, 1g, 1h

       Effective Date:  10/1/14

         No comments were received.

           

Public Annountment for changes to rates paid for hospice care services. (Note: This is not a state plan amendment.)

       Supplementary material

       Effective Date:  10/1/13

         The following comment was recevied and responded to by DVHA: Public comment 

 

 SPA 14-017 ACO Shared Saving

    Att. 3.1-A pg 13

    Att. 4.19-B pg 11

    Effective Date:  1/1/14

     No comments were recieved.

 

 SPA 14-015 OPPS

    Att. 4.19-B page 2a(1a) and 2a(1b)

    OPPS Impact Table

    Effective Date:  1/1/14

      No comments were recieved.

 

SPA 14-013: RBRVS

    Att. 4.19-B pages 3, 31, 3a, 4,6, 7, 9, 10

   RBRVS Impact Table

    Effective Date:  1/1/14

      No comments were recieved.

 

SPA 14-009: Tobacco Cessation

    Att. 3.1-A pages 2 and 2c1

    Att. 4.19-B page 11

    Effective Date:  1/1/14

      No comments were recieved.

  

SPA 14-005: Elimination of Premiums for Pregnant Women

     Att. 4.18-D page 1

     Effective Date:  1/1/14

      No comments were recieved.

 

SPA 14-003: Dental Cap

     Att. 3.1-A page 4

     Effective Date:  1/1/14

       No comments were recieved. 

 

 SPA 14-007: Health Homes

       Draft Spa 

       Hub and Spoke Health Home Framework Payment 

       Effective Date: 1/1/14

       No comments were recieved.

 

SPA 13-043: FQHC and RHC Rates

     Att. 4.19-B page 2a(2)

     Effective Date:  1/1/14

      No comments were recieved. 

 

SPA 13-041: Dental Rates

      Att. 4.19-B page 4      

      Effective Date:  11/1/13

        No comments were recieved. 
 

SPA 13-039: RBRVS

       Att. 4.19-B page 10

       Effective Date:  11/1/13

         Written comments should be addressed to Kara Suter, Director of Payment Reform and Reimbursement, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495, and must be received no later than 4:30 pm on Friday, 10/25/2013.

       No comments were recieved. 
  

SPA 13-037: OPPS

       Att. 4.19-B page 2a(1a)

       Table on OPPS Impact

       Effective Date:  11/1/13

         Written comments should be addressed to Kara Suter, Director of Payment Reform and Reimbursement, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495, and must be received no later than 4:30 pm on Friday, 10/25/2013. 

      No comments were recieved. 
 

 SPA 13-035: IPPS

       Att. 4.19-A pages 1c-5, 1c-8, and 1c-10

       Table on IPPS Impact

       Effective Date:  11/1/13

         Written comments should be addressed to Kara Suter, Director of Payment Reform and Reimbursement, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495, and must be received no later than 4:30 pm on Friday, 10/25/2013.

       No comments were recieved. 
 

 SPA 13-031: DSH

       Att. 4.19-A pages 1f and 1g

       Table on DSH payments

       Effective Date:  10/1/13

         Written comments should be addressed to Kara Suter, Director of Payment Reform and Reimbursement, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495, and must be received no later than 4:30 pm on 9/30/2013.

          No comments were recieved. 

 

SPA 13-002: MAGI-Based Eligibility Group

       Draft SPA 

       Effective Date: 1/1/14

        Written comments should be addressed to Ashley Berliner, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495,      or  Ashley.Berliner@state.vt.us, and must be received no later than 4:00 pm on 9/25/2013.

       No comments were recieved.
 

SPA 13-004: Citizenship and Immigration

       Draft Spa 

       Effective Date: 1/1/14       

         Written comments should be addressed to Ashley Berliner, DVHA, 312 Hurricane Lane, Suite 201, Williston,    VT 05495,      or  Ashley.Berliner@state.vt.us, and must be received no later than 4:00 pm on 9/25/2013.

         No comments were recieved. 
 

SPA 13-006: Eligibility Process

       Draft Spa 

       Effective Date: 10/1/13

        Written comments should be addressed to Ashley Berliner, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495,      or  Ashley.Berliner@state.vt.us, and must be received no later than 4:00 pm on 9/25/2013.

        No comments were recieved. 
 

SPA 13-010: MAGI-Income Methodology

       Draft Spa 

       Effective Date: 1/1/14

        Written comments should be addressed to Ashley Berliner, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495,      or  Ashley.Berliner@state.vt.us, and must be received no later than 4:00 pm on 9/25/2013.       

        No comments were recieved. 
 

 

SPA 13-012: Residency

       Draft Spa 

       Effective Date: 1/1/14

        Written comments should be addressed to Ashley Berliner, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495,      or  Ashley.Berliner@state.vt.us, and must be received no later than 4:00 pm on 9/25/2013.    

        No comments were recieved.

 

 SPA 13-021: Health Homes

       Draft Spa 

       Hub and Spoke Health Home Framework Payment 

       Effective Date: 7/1/13

        Written comments should be addressed to Kelly Gordon, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495, and must be received no later than 4:00 pm on 6/25/13.

         No comments were recieved.

 

  SPA 13-001: Health Homes

       Draft Spa 

       Hub and Spoke Health Home Framework Payment 

       Effective Date:  1/1/13

         Written comments should be addressed to Kelly Gordon, DVHA, 312 Hurricane Lane, Suite 201, Williston, VT 05495, and must be received no later than 4:00 pm on 12/21/2012.

         Comments received will be posted to the DVHA website for viewing by 12/28/12.

 

Chronological listing of approved changes