2018 Proposed Policies

This page contains proposed policies to the Global Commitment Register (GCR) for the Medicaid program. The proposed policies below are open to public comment. Click on the title of the GCR proposed policy to learn more and find out how to provide public comment.

To access the final policies and policy clarifications in the Global Commitment Register, click here.

Unless otherwise stated in a specific GCR proposed policy, comments on a proposed policy can be sent to:

Medicaid Policy Unit, 280 State Drive, Center Building, Waterbury, Vermont 05671-1000

or email AHS.MedicaidPolicy@vermont.gov

• GCR 18-127: Substance Use Disorder State Plan Update - SPA #19-0001
  • Draft State Plan pages: Attachment 3.1-A pages 6a and 6b
  • Comment period ended 1/28/2019. No comments were received.

• GCR 18-126: Health Benefits Eligibility and Enrollment Rules Updates (5/9/2019)
• Health Benefits Eligibility and Enrollment Rules Updates (2/6/2019)
  • 18-126: HBEE Part 8 - State Fair Hearings and Expedited Eligibility Appeals
  • The public comment period ended 3/19/2019.
    • Comments Received and Responsiveness Summary can be viewed here.

• GCR 18-124: Vermont Medicaid Next Generation ACO Program
  • Draft ACO Coverage Document
  • Draft ACO Reimbursement Document
  • The comment period ended 1/28/2019. Comments and state response can be viewed here.

• GCR 18-121: Therapy Prior Authorization Requirements for Beneficiaries Under 21
  • Comment period ended 12/27/2019. No comments were received.

• GCR 18-119: Applied Behavior Analysis (ABA) Case Rate
  • ABA Medical Policy document
  • ABA Clinical Guidelines document
  • The comment period ended 12/17/2018. State response to comments received can be viewed here.

• GCR 18-118: Applied Behavior Analysis (ABA) CPT Code and Rate Changes
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 3a
  • ABA CPT Codes
  • The comment period ended 12/17/2018. State response to comments received can be viewed here.

• GCR 18-112: Discounting Policy for Non-Physician Services Update
  • Comment period ended 12/31/2018. No comments were received.

• GCR 18-111: Reimbursements for Federally Qualified Health Centers and Rural Health Clinics
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 2a(2)
  • Provider Rate Election Form
  • Estimated Fiscal Impact by Provider
  • The comment period ended 12/14/2018. One comment was received.

• GCR 18-108: Human Leukocyte Antigen Codes
  • The comment period ended 2/25/2019. No comments were received.

• GCR 18-101: Children's Integrated Services - New Bundled Provider
  • Comment period ended 1/28/2019. No comments were received.

• GCR 18-100: Substance Use Disorder Residential Treatment
  • Comment period ended 12/28/2018. No comments were received.

• GCR 18-090: Blueprint Patient Centered Medical Home Base Payment Update
  • Comment period ended 1/28/2019. No comments were received.

• GCR 18-086: Vermont Chronic Care Initiative Elgibility Changes
  • New VCCI Referral Form (draft, please visit VCCI page for up to date form)
  • The comment period ended 10/18/2018. No comments were received.

• GCR 18-083: Children's Personal Care Assessment - Rate Change
  • The comment period ended 1/22/2019. No comments were received.

• GCR 18-082: Designated Agencies Rate Increase
  • The comment period ended 8/13/2018. No comments were received.

• GCR 18-079: Primary Care Case Management Update
  • The comment period ended 8/12/2018. One comment was received.

• GCR 18-078: Primary Care Case Management Update
  • Comment period ended 1/28/2019. No comments were received.

•  GCR 18-076: Choices for Care and Adult Day Rate Increase
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 5a
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-075: Fee-for-Service Payments for Durable Medical Equipment, Prosthetics/Orthotics, and Supplies Reimbursement Update
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 17
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-074: Psychiatric Residential Treatment Facilities Reimbursement - SPA 18-0007
  • Draft State Plan Pages: Attachment 4.19-A pages 1j and 1k
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-073: Medicaid State Plan Home Health Services Rate Increase
  • Draft Global Commitment Amended State Plan Pages: Attachment 4.19-B pages 3(a)1 and 6
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-071: ARIS Rate Increase for Collective Bargaining Wage Increases
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-070: Timely Filing Guidelines Update
  • The comment period ended 11/8/2018. Comments received, and state response can be viewed here.

• GCR 18-068: Developmental and Behavioral Screening Guidelines
  • Draft Vermont Developmental and Behavioral Screening Guidelines
  • The comment period ended 7/13/2018. No comments were received.

•  GCR 18-060 through 18-064: Health Benefits Eligibility and Enrollment Rules Updates (10/30/2018)
  • Health Benefits Eligibility and Enrollment Rules Updates (9/5/2018)
    • GCR 18-060: HBEE Part 1 - General Provisions and Definitions
    • GCR 18-061: HBEE Part 2 - Eligibility Standards
    • GCR 18-062: HBEE Part 3 - Nonfinancial Eligibility Requirements
    • GCR 18-063: HBEE Part 5 - Financial Methodologies
    • GCR 18-064: HBEE Part 7 - Eligibility and Enrollment Procedures
    • FORMATTING CHANGE ONLY: HBEE Part 4 - Special Rules for Medicaid Coverage of Long-Term Care Services and Supports - Eligibility and Post-Eligibility
    • The comment period ended October 16, 2018. No comments were received.

• GCR 18-059: Outpatient Prospective Payment System and Outlier Policy
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 2a(1a)
  • The comment period ended 6/30/2018. No comments were received.

• GCR 18-058: RBRVS Fee Schedule Update
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 10
  • The comment period ended 6/30/2018. One comment was received.

•  GCR 18-053: Physician Administered Drugs Fee Schedule Update
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-B page 4b(1)
  • The comment period ended 6/30/2018. Comments receievd, and state response can be viewed here.

• GCR 18-052: Child Birth Education Classes Reimbursement Change
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-051: Brattleboro Retreat Inpatient Psychiatric Services (6/22/2018)
  • Brattleboro Retreat Inpatient Psychiatric Services (5/21/2018)
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-A page 1c-8
  • Comment period ended 6/27/2018. The comments received and state response can be viewed here.

• GCR 18-046: Prolaris Prostate Cancer Testing
  • The comment period ended 12/3/2018. No comments were received.

• GCR 18-040 & 18-041: Medicaid Payment Changes for Mental Health Services
  • The comment period ended 1/14/2019. Comments received and state response can be viewed here.

• GCR 18-038: Nasal Endoscopy Eustachian Tube
  • The comment period ended 7/29/2018. No comments were received.

• GCR 18-037: Health Care Administratiev Rules Update - Filing 6 (11/7/2018)
  • Health Care Administrative Rules Update - Filing 6 (7/2/2018)
    • The public comment period ended August 13, 2018. Comments received and state responses can be viewed here.

•  GCR 18-036: Genetic Testing for Cystic Fibrosis
  • The comment period ended 10/1/2018. No comments were received.

• GCR 18-035: Disproportionate Share Hospital Update
  • Draft Global Commitment Amended State Plan Page: Attachment 4.19-A page 1f, 1g, 1h
  • The comment period ended 10/1/2018. No comments were received.

• 18-031: Airplane Ambulance Transportation Reimbursement Update
  • The comment period ended 7/25/2018. No comments were received.

• GCR 18-028: Medication Assisted Treatment Guidelines
  • Vermont Substance Use Disorder Medication Treatment Guidelines - Draft
  • The comment period ended 5/11/2018. The comments received, and state response can be viewed here.

• GCR 18-026: Hearing Aids
  • The comment period ended on 6/30/2018. Comments and state responses can be viewed at this link.

• GCR 18-024: Inpatient Postpartum LARC Add-on Increase
  • The comment period ended 7/25/2018. No comments were received.

•  GCR 18-021: Unspecified Diagnosis Code List Update (8/20/2018)
  • Unspecified Diagnosis Code List Update (7/23/2018)
  • Comment Period: 7/23/2018 - 9/24/2018

• GCR 18-020: Store and Forward for Teledermatology and Teleophthalmology
  • Comment period ended 5/10/2019. No comments were received.

• GCR 18-018: EndoPredict Test for Persons with Breast Cancer
  • The public comment period ended 6/16/2018. No comments were received.

• GCR 18-016: Corneal Cross Linking
  • The public comment period ended 6/18/2018. No comments were received.

• GCR 18-014: Colorectal Cancer Screening
  • The comment period ended 7/29/2018. Comment and response can be viewed here.

• GCR 18-010: ADAP Case Management
  • The comment period ended 6/30/2018. Comments and responses can be viewed here.

• GCR 18-009: Global Commitment 340B Drug Pricing Program Changes
  • Comment period ended 4/9/2018. No comments were received.

• GCR 18-007: Personal Care Electronic Visit Verification (4/16/2018)
• Personal Care Electronic Visit Verification (1/31/2018)
  • The initial public comment period was held 2/1/2018 - 3/2/2018. Comments received can be viewed here.
  • A second public comment period was held 4/16/2018 - 6/16/2018. Comments received can be viewed here.

• GCR 18-006: Clinical Diagnostic Laboratory Fee Schedule
  • Comment period ended 2/28/2018. No comments were received.

• GCR 18-005: Proposed Amendment to Vermont's Global Commitment to Health 1115 Demonstration
  • Public Hearing Date: January 30, 2018
  • Location: Department of Vermont Health Access, Small Conference Room, 312 Hurricane Lane, Williston, Vermont 05495

• GCR 18-003: Outpatient Long-Acting Reversible Contraceptive Rate Update
  • Comment period ended 3/2/2018. No comments were received.

To access the final policies and policy clarifications in the Global Commitment Register, click here.