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.
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.
- AHS Grant Programs (Front-Line Employees Hazard Pay, Health Care Provider Stabilization)
- Federal Provider Relief
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 was open through August 14, 2020.
(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.
Vermont temporarily accepted self-attestations for applicants for Long-Term Care Medicaid. For applications received on and after October 5, 2020, normal processes apply, including verification of income, resources, and review of the transfer of assets during the 60-month look back period. More time will be allowed to provide requested verification.
The review period for Long-Term Care Medicaid members who had a review scheduled during the emergency period will be extended.
- All Provider questions and concerns should be sent via EMAIL to the DVHA LTC Management Team at: AHS.DVHALTCMGMT@vermont.gov
Information on COVID-19 Prior Authorization Extensions. (12/29/2020)
Important Billing Information for COVID-19 Vaccines. (12/24/2020)
- Pharmacist Enrollment Communication. (12/17/2020)
- Pharmacist Enrollment Required for Reimbursement of COVID-19 Vaccine Administration. (12/11/2020)
- Attention Pharmacies and Pharmacists - Administration of Vaccines to Children 3-18 Years of Age. (11/16/2020)
- Important Information about COVID-19 Specimen Collection by Pharmacists. (9/21/2020)
- Important Update on Early Refill Overrides with Submission Clarification Code(SCC)=13. (effective 7/24/2020)
- 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)
AHS Grant Agreements
- Retroactive grant agreements sent to providers for financial awards from AHS under the early Retainer programs:
- Any providers who received the COVID-19-specific Medicaid Retainer (April 2020), COVID-19 Sustained Monthly Retainer (in effect for the months of May, June, and July 2020), and COVID-19 Extraordinary Financial Relief for Nursing Homes and Private Non-Medical Institutions payment should have recently received a grant award following an initial memo from the Secretary of the Agency of Human Services on November 3, 2020. Grant agreements were subsequently sent to providers, beginning in the last week of November and continuing throughout the first couple of weeks in December.
- If providers have questions, or have not received their grants, they should email: AHS.COVID19Financial@vermont.gov for support and assistance. (12/14/2020)
Federal Provider Relief
- 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.
- On October 22, 2020, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the latest Provider Relief Fund (PRF) application period has been expanded to include provider applicants such as residential treatment facilities, chiropractors, and eye and vision providers that have not yet received Provider Relief Fund distributions. For more information, visit HHS Expands Relief Fund Eligibility and Updates Reporting Requirements.
- On October 1, 2020, HHS announced $20 billion in new funding for providers. Providers who have already received Provider Relief Fund payments are invited to apply for additional funding that considers financial losses and challenges in operating expenses caused by the novel coronavirus; providers who were previously ineligible and an expanded group of mental health providers may also be eligible for the Phase 3 General Distribution allocation. Providers may begin applying for funds on October 5, 2020; providers have through November 6, 2020 to apply for Phase 3 General Distribution funding. (10/7/2020)
- Federal Public Health Emergency Determination Renewed: Effective October 23, 2020, the determination that a federal public health emergency exists is renewed and will be effective until January 21, 2021. (10/7/2020)
- DVHA COVID -19 Testing Guidance (10/09/2020)
Gainwell provides Vermont Medicaid with essential business and technical services that are critical for ensuring access to health care services for Vermonters. DVHA and Gainwell leadership are working together daily to monitor the COVID-19 situation. Gainwell teams continue to perform all standard levels of provider services and claims operations virtually to ensure the safety and well-being of staff (with the exception of a small number of essential in-office job functions). Onsite visits to provider offices by the Provider Representatives are suspended until after the emergency has been lifted. Updates will be provided as the situation changes. (12/18/2020)
- COVID-19 Personal Protective Equipment (PPE), “COVID Fees,” and Billing Medicaid Members:
Supplies that are incidental to a provider’s practice may not be billed separately to Vermont Medicaid nor to Medicaid members. Specifically, the cost of personal protective equipment (PPE) is not eligible for Medicaid reimbursement and any costs associated with the purchase of PPE may not be charged to Medicaid members. 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 Medicaid members. To ensure access to care for Vermont Medicaid members, the Agency of Human Services offered financial opportunities for providers to receive stabilization funds for lost revenue and COVID-19-specific incurred expenses. (12/21/2020)
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.
- Provider reimbursement for COVID-19 testing and treatment services for uninsured individuals. (05/28/2020)
Two COVID-19 vaccines have received emergency use authorization from the U.S. Food and Drug Administration. Visit the Vermont Department of Health's website for more information:
- Health Alerts and Advisories. Up-to-date information about the two vaccines.
- COVID-19 Vaccine Dashboard. Weekly updates on the number of people in Vermont who have received the vaccine.