2018 Final Policies

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

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

• GCR 18-128: Updated Financial Eligibility Standards for Green Mountain Care Programs
  • Effective Date: 1/1/2019

• GCR 18-127: Substance Use Disorder State Plan Update - SPA 19-0001 (4/4/2019)
  • State Plan Amendment 19-0001 Approval Notice (6/25/2019)
  • Effective Date: 1/1/2019
  • Updated draft State Plan page: Attachment 3.1-A page 6a

• GCR 18-126: Health Benefits Eligibility and Enrollment Rules Updates
  • Effective Date: 7/1/2019
  • Rules included:
    • HBEE Part 8 - State Fair Hearings and Expedited Eligibility Appeals

• GCR 18-124: Vermont Medicaid Next Generation ACO Program
  • Effective Date: 1/1/2019
  • ACO Program Coverage Document (Final)
  • ACO Program Reimbursement Document (Final)

• GCR 18-121: Therapy Prior Authorization Requirements for Beneficiaries Under 21
  • Effective Date: 1/1/2020

• GCR 18-119: Applied Behavior Analysis (ABA) Case Rate
  • Effective Date: 7/1/2019

• GCR 18-118: Applied Behavior Analysis (ABA) CPT Code and Rate Changes
  • Effective Date: 1/1/2019

• GCR 18-114: Adult Day Health Services - SPA 15-0007
  • Effective Date: 7/1/2015

• GCR 18-112: Discounting Policy for Non-Physician Services Update
  • Effective Date: 12/1/2018

• GCR 18-111: Reimbursements for Federally Qualified Health Centers and Rural Health Clinics
  • Effective Date: 12/16/2018 (State Plan policy); 1/1/2019 (rates)

• GCR 18-108: Human Leukocyte Antigen Codes
  • Effective Date: 2/1/2019

• GCR 18-101: Children's Integrated Services - New Bundled Provider
  • Effective Date: 1/1/2019

•  GCR 18-100: Substance Use Disorder Residential Treatment
  • Effective Date: 1/1/2019

• GCR 18-090: Blueprint Patient Centered Medical Home Base Payment Update
  • Effective Date: 1/1/2019

• GCR 18-086: Vermont Chronic Care Initiative Eligibility Changes
  • Effective Date: 10/1/2018

• GCR 18-083: Children's Personal Care Assessment - Rate Change
  • Effective Date: 2/1/2019

• GCR 18-082: Designated Agencies Rate Increase
  • Effective Date: 7/1/2018

• GCR 18-079: Primary Care Case Management Update
  • Effective Date: 7/20/2018

• GCR 18-078: Primary Care Case Management Update
  • Effective Date: 1/1/2019

• GCR 18-076: Choices for Care and Adult Day Rate Increase
  • Effective Date: 7/1/2018

• GCR 18-075: Fee-for-Service Payments for Durable Medical Equipment, Prosthetics/Orthotics, and Supplies Reimbursement Update
  • Effective Date: 7/1/2018

•  GCR 18-074: Psychiatric Residential Treatment Facilities Reimbursement
  • Effective Date: 7/1/2018

• GCR 18-073: Medicaid State Plan Home Health Services Rate Increase
  • Effective Date: 7/1/2018

• GCR 18-071: ARIS Rate Increase for Collective Bargaining Wage Increases
  • Effective Date: 7/1/2018

• GCR 18-070: Timely Filing Guidelines Update
  • Effective Date: 2/1/2019

• GCR 18-068: Development and Behavioral Screening Guidelines
  • Effective Date: 7/14/2018

• GCR 18-060 through 18-064: Health Benefits Eligibility & Enrollment Rules Updates
  • Effective Date: 1/15/2019
  • Rules included:
    • 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

• GCR 18-059: Outpatient Prospective Payment System and Outlier Policy
  • Effective Date: 7/1/2018

• GCR 18-058: RBRVS Fee Schedule Update
  • Effective Date: 7/1/2018

• GCR 18-053: Physician Administered Drugs Fee Schedule Update
  • Effective Date: 7/1/2018

•  GCR 18-052: Child Birth Education Classes Reimbursement Change
  • Effective Date: 8/1/2018

• GCR 18-051: Brattleboro Retreat Inpatient Psychiatric Services
  • Effective Date: 7/1/2018

• GCR 18-050: Department for Children & Families Targeted Case Management - SPA 08-023
  • Effective Date: 4/1/2008

• GCR 18-049: Agency of Education Targeted Case Management - SPA 08-021
  • Effective Date: 4/1/2008

• GCR 18-046: Prolaris Prostate Cancer Testing
  • Effective Date: 12/1/2018

• GCR 18-044: Durable Medical Equipment Reimbursement Update - Rental Supplies and Miscellaneous Equipment
  • Effective Date: 5/1/2018
  • Comment period ended June 15, 2018.

• GCR 18-040 & 18-041: Medicaid Payment Changes for Mental Health Services
  • Effective Date: 1/1/2019

• GCR 18-038: Nasal Endoscopy Eustachian Tube
  • Effective Date: 8/1/2018

• GCR 18-037: Health Care Administrative Rules Update (12/21/2018)
  • Effective Date: 1/7/2019
  • Rules included:
    • 1.101 HCAR Definitions
    • 4.231 Home Health Services
    • 4.209 Durable Medical Equipment
    • 4.210 Wheelchairs, Mobility Devices, and Seating Systems
    • 7702 Telemonitoring (Repeal)
    • 3.101 Telehealth

•  GCR 18-036: Genetic Testing for Cystic Fibrosis
  • Effective Date: 10/1/2018

• GCR 18-035: Disproportionate Share Hospital Update
  • Effective Date: 10/1/2018

• GCR 18-031: Airplane Ambulance Transportation Reimbursement Update
  • Effective Date: 8/1/2018

• GCR 18-028: Medication Assisted Treatment Guidelines
  • Effective Date: 6/1/2018
  • Vermont Substance Use Disorder Medication Assisted Treatment Guidelines (6/1/2018)

• GCR 18-026: Hearing Aids
  • Effective Date: 7/1/2018

• GCR 18-024: Inpatient Postpartum LARC Add-on Increase
  • Effective Date: 7/1/2018

• GCR 18-020: Store and Forward for Teledermatology and Teleophthalmology
  • Effective Date: 5/1/2019

• GCR 18-018: EndoPredict Test for Persons with Breast Cancer
  • Effective Date: 6/1/2018

• GCR 18-016: Corneal Cross Linking
  • Effective Date: 7/1/2018

• GCR 18-014: Colorectal Cancer Screening
  • Effective Date: 8/1/2018

• GCR 18-010: ADAP Case Management
  • Effective Date: 7/1/2018

•  GCR 18-009: Global Commitment 340B Drug Pricing Program Changes
  • Effective Date: 4/1/2018

• GCR 18-006: Clinical Diagnostic Laboratory Fee Schedule
  • Effective Date: 3/1/2018

• GCR 18-005: Amendment to Vermont's Global Commitment to Health 1115 Demonstration to Improve Treatment for Substance Use Disorder
  • Effective Date: 7/1/2018

• GCR 18-003: Outpatient Long-Acting Reversible Contraceptive Rate Update
  • Effective Date: 2/1/2018

• GCR 18-001: Global Commitment to Health Demonstration Waiver - Post Award Forum
  • Effective Date: 1/1/2017 - 12/31/2021

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