The Consolidated Appropriations Act of 2021 adds a mandatory Medicaid benefit at 1905(a)(30) of the Social Security Act for coverage of routine patient costs for services provided to a Vermont Medicaid member participating in a qualified clinical trial.
Vermont Medicaid has always provided coverage for covered services related to clinical trials. The item or service that is under investigation remains non-covered. Submission of the Clinical Medicaid Attestation Form below is required. If transportation is necessary for the member to get to the clinical trial, submission of the Non-Emergency Medical Transportation (NEMT) Physician Referral Form is required (see below).
- Medicaid Attestation Form on the Appropriateness of the Qualified Clinical Trial
- Vermont Elective Out-of-State/Out-of-Network Medical Office Visits
- Vermont Medicaid Out-of-Network Preadmission Request Form
- NEMT Physician Referral Form and additional resources - visit the Non-Emergency Medical Transportation webpage