Stay Informed and Protect Your Health.
Information and Guidance
- For up-to-date guidance regarding COVID-19, Vermonters can check the Vermont Department of Health webpage.
- Vermonters can also dial 2-1-1 for information or if you have questions.
- Visit the CDC webpage for regular updates and guidance.
Provider and Member Communication
- Provider Assistance:
- Telehealth, Telemedicine and Telephonic Coverage:
- Vermont Virtual Telehealth Town Hall Invitation. Thursday, April 2, 2020.
- Vermont Program for Quality in Health Care (VPQHC) State-Wide Telehealth Resource Page, Including Technical Assistance for Providers. (3/30/2020)
- Frequently Asked Questions. Vermont Medicaid Payments for Telephonic Services Furnished During the Emergency Response to COVID-19. (3/27/2020)
- Vermont Medicaid Payments for Telephonic Services Furnished During the Emergency Response to COVID-19. (3/18/2020)
- Telehealth, Telemedicine & Telephonic Coverage. Updated Guidance to Support Medicaid Providers During the Emergency Response to COVID 19. (3/20/2020)
- Please note as of March 24, 2020, Vermont Medicaid has corrected the reimbursement for telemedicine 02 place of service. Claims were being reimbursed at a facility rate rather than the non-facility rate as intended. Our goal was to pay for telemedicine services at the same rate as a face-to-face visit in the office 11 place of service. We apologize for the error and we will be adjusting any claims for dates of service on or after March 13, 2020 that were submitted before we implemented the correction. If you have claims prior to March 13, 2020 that need adjustment, please see Section 3.2 in the Vermont Medicaid General Billing and Forms Manual.
Vermont Medicaid-participating providers are encouraged to continue the use of telemedicine for health care delivery when possible. Services can be conducted by a provider at a distant site, for a Medicaid member at an originating site, for the purposes of: evaluation, diagnosis, consultation, or treatment, using telecommunications technology via two-way, real-time, audio and video interactive communication.
- Important Pharmacy Information. Changes to the Medicaid prescription drug benefits program effective 3/1/2020.
- COVID-19 Retail Pharmacy Home Delivery Options. (3/30/2020)
- Important Pharmacy Information in Response to COVID-19. (3/27/2020)
- Due to the COVID-19 emergency, Vermont will be temporarily waiving financial verifications required for those seeking to enroll in health insurance; Extending out coverage periods until after the emergency ends; Suspending certain terminations of health insurance; Offering a Special Enrollment Period (1 month) for those who do not currently have health insurance to enroll in a qualified health plan and receive premium and cost-sharing assistance, if eligible. (Eligible Vermonters can continue to apply for, and enroll in, Medicaid at any time.) (3/20/2020)
- Out-of-Pocket Expenses:
- Vermont Medicaid Waives Hospital Outpatient Copayments. (retroactive to 3/1/2020)
- LTC Medicaid Cases:
Extended review period for nursing facilities, adult day centers, ERC's, and home health agencies. The DVHA is extending the review period for active LTC Medicaid cases which are scheduled for a review in March, April or May 2020. The reviews are now rescheduled as follows: March 2020 reviews extended to June 30, 2020; April 2020 reviews extended to July 31, 2020; and the May 2020 reviews extended to August 31, 2020. The DVHA is extending the review period for those three months for all active LTC Medicaid cases whether or not the client returned their LTC review application. All Provider questions and concerns should be sent via EMAIL to the DVHA LTC Management Team at: AHS.DVHALTCMGMT@vermont.gov. (3/23/2020)
Additional Provider Billing:
Provider Audit Information:
HEDIS hybrid record retrieval started on March 4, 2020. Cotiviti is the medical record retrieval contractor for VT Medicaid. Providers are required to participate (at no cost) as stated in your signed Provider Enrollment Agreement: During the State of Vermont State of Emergency for COVID-19. The Department of Vermont Health Access (DVHA) will not enforce a 10% withholding of all VT Medicaid payments for providers that do not submit the required medical records within five (5) business days. We encourage you to submit records timely. It is imperative that we obtain medical records in order to complete the HEDIS measures. If you have questions regarding submission of Medical records, please outreach Clark.Eaton@vermont.gov or 802-241-9313. (3/30/2020)