Prior Authorization Changes in Response to COVID-19 Public Health Emergency

Due to the COVID-19 Public Health Emergency, Vermont Medicaid is taking steps to ensure Vermonters have access to necessary care and that health care professionals can deliver that care in a safe and timely way. 

Remove prior authorizations

Prior authorization requirements are waived for the following services with the exception for items with the potential to cause imminent harm:

  • Imaging Services and Durable Medical Equipment and Supplies — including continuous glucose monitors obtained from a pharmacy
  • Dental Services including orthodontia

Extend pre-existing prior authorizations

  • DVHA has extended approved prior authorizations for certain clinical services set to exhaust in April for an additional six months. No additions or changes to services or units may be made. DVHA will continue to evaluate the need to extend prior authorizations for clinical services and drugs approved prior to the COVID-19 public health emergency.
  • Prior authorizations remain in effect for items and services with the potential to cause imminent harm, out of network services, and elective procedures.

 

Listing of codes:

Imminent Harm Codes

Waived Prior Authorization Codes

 

Information can be found at:

AHS Global Commitment Register, policy GCR 20-039.

 

Department of Vermont Health Access

280 State Drive
Waterbury, Vermont 05671-1010
Phone: 802-879-5900
Fax: 802-241-0260

Contact List for staff email, telephone & fax numbers

Hours of Operation: Monday-Friday (Excluding Holidays) 7:45am - 4:30pm

Public Record Requests
Kelly Provost
DVHA Public Records Officer
AHS.DVHALegal@Vermont.gov
Visit the Agency of Administration site for the Public Records Database

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