Stay Informed and Protect Your Health
Provider and Member Communication
The DVHA COVID-19 page contains important information about the Department’s actions in response to the COVID-19 Emergency. Some actions are required by the federal government due to the declaration of a federal public health emergency while other actions were taken by DVHA to help Vermonters access health care during this time. Thus, these actions may last for different lengths of time. This page will be updated when an activity ends, re-starts, or changes.
(For all up-to-date health updates regarding COVID-19, please visit the Vermont Department of Health website)
- In our ongoing effort to help protect the health and safety of Vermonters, the Vermont Department of Health has additional information to help prevent COVID-19 transmission. Visit the Masks on Vermont campaign to learn more.
- For additional FDA guidance about hand sanitizers, please visit the website FDA Updates on Hand Sanitizers with Methanol.
Additional Provider Billing:
The cost of PPE is not eligible for Medicaid reimbursement and any costs associated with the purchase of PPE may not be charged to Medicaid members. PPE are considered supplies that are incidental to a provider’s practice and may not be billed separately. Providers are required to submit claims for all Medicaid covered services and may not request payment from a Medicaid enrolled individual at the time of service. Vermont Medicaid cannot reimburse the member for services. To ensure access to care for Vermont Medicaid members, the Agency of Human Services has offered financial opportunities for providers and has developed a proposal for health care provider stabilization. As more information will be forthcoming, providers should continue to visit this webpage for the most up-to-date information. (6/10/2020)
Vermont Medicaid has:
- Eliminated co-payments for hospital outpatient services;
- Eliminated co-payments for medications that may be used to treat the symptoms of COVID-19.
These changes ensure that no co-payments apply to COVID-19 testing, diagnosis, and treatment services. (3/31/2020)
- Federal Financial Relief for Medicaid Providers through the CARES Act. The U.S. Department of Health and Human Services (HHS) has released additional information regarding the CARES Act Provider Relief Fund. For Medicaid and CHIP providers, providers must submit and complete an application (see instructions here) to the HHS’ provider portal by August 28, 2020. New: HHS announced an opportunity, starting the week of August 10, for certain Medicare providers who received automatic payments from the General Distribution to apply for the balance of their funding (up to 2 percent of their annual patient revenues). This should allow providers who received nominal payments to apply and receive the intended total payment. More information may be found at: https://www.hhs.gov/about/news/2020/07/31/hhs-extends-application-deadline-for-medicaid-providers-and-plans-to-reopen-portal-to-certain-medicare-providers.html. (8/04/2020)
- Postponement of Vermont Medicaid Fee Schedule Updates. (5/15/2020)
- Notice of Medicaid Long-Term Care Facility Financial Relief Provisions in response to the COVID-19 Public Health Emergency. (7/20/2020)
Telehealth, Telemedicine and Telephonic Coverage:
(For additional information visit the DVHA Telehealth webpage)
- Vermont Medicaid-participating providers are encouraged to continue the use of telemedicine for health care delivery when possible. Telehealth Resources.
- Vermont Medicaid Continuing Telemedicine Coverage for Dental Services & Temporary New Telephonic Coverage for Brief Communication Services for Dental Providers. (4/10/2020)
- 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. (4/23/2020)
- Vermont Medicaid Payments for Telephonic Services Furnished During the Emergency Response to COVID-19. (5/28/2020)
- 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.
Durable Medical Equipment:
- Important Update on Early Refill Overrides with Submission Clarification Code(SCC)=13. (effective 7/24/2020)
- Extension of Prior Authorizations - Response to the COVID-19 Emergency. (effective 5/1/2020)
- Covid-19 Update. (effective 3/27/2020)
- Important Pharmacy Information in Response to COVID-19. (3/30/2020)
- COVID-19 - Retail Pharmacy Home Delivery Options. (last updated 4/3/2020)
Eligibility and Enrollment: (updated 6/12/2020)
In order to manage our COVID-19 response, our temporary call center hours for Member Services will be 8:00 AM to 4:30 PM, Monday through Friday. Due to the COVID-19 Emergency, Vermont is facilitating initial and continuous health care enrollment by:
- Temporarily waiving financial verifications required for those seeking to enroll in health insurance;
- Extending Medicaid coverage periods (meaning the Department is not processing the annual “reviews” that could result in loss of Medicaid) until after the emergency ends;
- Not ending Medicaid coverage during the Emergency period unless the customer requests it;
- See below for more information on how Vermont is implementing these changes for Long-Term Care Medicaid.
- Temporarily waiving Dr. Dynasaur premiums, beginning with the April bills for the premium due in May;
- Offering a Special Enrollment Period 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). This Special Enrollment Period is currently open through August 14, 2020.
Long-Term Care Medicaid:
For Long-Term Care Medicaid, Vermont is:
- Accepting self-attestations for current income and resources from applicants for Long-Term Care Medicaid eligibility determinations and suspending transfer of asset rules (60 month look back period) during the Emergency;
- Extending the review period for Long-Term Care Medicaid members who had a review scheduled for March, April or May until the Emergency ends;
- Reviews are extended for all Long-Term Care Medicaid members scheduled for those three months whether or not they returned their review application;
- All Provider questions and concerns should be sent via EMAIL to the DVHA LTC Management Team at: AHS.DVHALTCMGMT@vermont.gov.