2017 Final Policies

This page contains final policies to the Global Commitment Register (GCR) for the Medicaid program.

• GCR 17-111: Medicaid State Plan 340B Drug Pricing Program Changes (5/4/18)
  • State Plan Amendment 18-0001 Approval Notice (7/3/18)
  • Effective Date: 4/1/18
     
• GCR 17-109: Inpatient Hospital Outlier Threshold and Psychiatric Payment Methodology
  • Effective Date: 1/1/18
     
• GCR 17-108: Hospital Presumptive Eligibility
  • Effective Date: 12/29/17
• GCR 17-107: Asset Verification System
  • Effective Date: 12/29/17
     
• GCR 17-106: National Drug Codes on Medical Claims
  • Effective Date: 4/1/18
     
• GCR 17-105: Miscellaneous Services Reimbursement Update
  • Effective Date: 1/1/18
     
• GCR 17-104: Physician Administered Drugs Fee Schedule Update
  • Effective Date: 1/1/18
     
• GCR 17-097: Department of Mental Health Psychotherapy Coding Updates
  • Effective Date: 1/1/18
     
• GCR 17-096: Reimbursement for Federally Qualified Health Centers and Rural Health Clinics
  • Effective Date: The state plan policy is effective 12/30/17. The new rates are effective 1/1/18.
     
• GCR 17-090: Health Care Administrative Rules Update (5/16/18)
  • Effective Date: 6/1/18

Rules included:

1.101 Health Care Administrative Rules Definitions

 7101 Medicaid Benefit Delivery

4.102 Emergency Services

6.100 Medicaid Cost Sharing

8.100 Internal Appeals, Grievances, Notices, and State Fair Hearings on Medicaid Services

7110 Global Commitment Appeals and Grievances (Repealed)
 

• GCR 17-091: Fee-for-Service Payments for Durable Medical Equipment, Prosthetics/Orthotics, and Supplies
  • Effective Date: 1/1/18
     
• GCR 17-087: Vermont Medicaid Next Generation ACO Program
  • Effective Date: 1/1/18
  • VT Medicaid Next Generation Model ACO Program Coverage Document (Final)
  • VT Medicaid Next Generation Model ACO Program Reimbursement Document (Final)
     
• GCR 17-082: Inpatient Prospective Payment System
  • Effective Date: 1/1/18
     
• GCR 17-080: Electric Breast Pump Coverage Change
  • Effective Date: 8/1/18
     
• GCR 17-076: Outpatient Prospective Payment System
  • Effective Date: 10/1/17
     
• GCR 17-074: Face-to-Face Visit Verification
  • Effective Date: 4/1/18
     
• GCR 17-073: Health Care Administrative Rules Update - Adopted Rule (2/7/18)
  • Effective Date: 2/22/18

Rules included:

7303 Acupuncture (Repealed)

7306 Fertility Services (Repealed)

7307 Massage Therapy (Repealed)

7310 Surgery (Repealed)

4.103 Medicaid Non-Covered Services

4.223 Abortion

9.103 Supervised Billing
 

• GCR 17-072: Telemedicine
  • Effective Date: 10/1/17
     
• GCR 17-071: Fetal Chromosomal Genetic Testing
  • Effective Date: 6/1/18
     
• GCR 17-067: Digital Breast Tomosynthesis - 3D Mammography
  • Effective Date: 11/1/17
     
• GCR 17-063: Inpatient Postpartum Long-Acting Reversible Contraceptive Add-on Increase
  • Effective Date: 10/1/17
     
• GCR 17-062: Women's Health Initiative Expansion to Primary Care Providers
  • Effective Date: 10/1/17
     
• GCR 17-061: RBRVS Fee Schedule Update and Policy Changes
  • Effective Date: 8/1/17
     
• GCR 17-060: Medicaid State Plan Home Health Services Rate Increase
  • Rates Effective 7/1/2017
  • Effective Date: 7/1/17
     
• GCR 17-056: Choices for Care HCBS Rate Increase
  • Effective Date: 7/1/17
     
• GCR 17-055: Brattleboro Retreat Prior Authorization Pilot - Extended (8/13/18)
  • Brattleboro Retreat Prior Authorization Pilot (8/2/17)
  • Effective Date: 7/1/17
     
• GCR 17-051: Rutland Regional Level 1 Rate Change
  • Effective Date: 7/1/17
     
• GCR 17-043 through 17-049: Health Benefits Eligibility & Enrollment Rules Update - Adopted Rules (12/29/17)
  • Effective Date: 1/1/18
     
• GCR 17-037: In-Home Lactation Consultations (5/2/18) - State Plan Amendments 18-0003 & 18-0005
  • State Plan Amendment 18-0003 Approval Notice (7/30/18)
  • Effective Date: 6/1/18
     
• GCR 17-034: Children's Integrated Services Revised Medicaid Reimbursement Methodology
  • Effective Date: 7/1/17
•  
• GCR 17-026: Adult Crisis Bed Fee-for-Service Reimbursement
  • Effective Date: 2/6/18
     
• GCR 17-021: Choices for Care Group Directed Attendant Care Rate Increase
  • Effective Date: 6/1/17
     
• GCR 17-019: Adolescent Hospital Diversion Program
  • Effective Date: 8/1/17
     
• GCR 17-017: Global Commitment to Health Comprehensive Quality Strategy
  • Effective Date: 11/30/17
     
• GCR 17-016: Rate Increase for Choices for Care Enhanced Residential Care
  • Effective Date: 5/1/17
     
• GCR 17-013: Health Care Administrative Rules Update - Adopted Rules (6/20/17)
  • Rule included: 4.211 Augmentative Communication Devices and Systems
  • Effective Date: 6/20/17
     
• GCR 17-010: Silver Diamine Fluoride Application
  • Effective Date: 1/1/18
     
• GCR 17-004: Adult High Technology Services Rate
  • Effective Date: 4/15/17