2019 Final Policies

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

• GCR 19-090: Personal Needs Allowance Increase (2/6/2020)
  • State Plan Amendment 20-0002 Approval (7/22/2020)
    • Effective Date: 1/1/2020

• GCR 19-084: Vermont Medicaid Next Generation ACO Program
  • Effective Date: 1/1/2020
  • ACO Coverage Document
  • ACO Reimbursement Document

• GCR 19-081: Fee-For-Service Payments for Durable Medical Equipment, Prosthetics/Orthotics, and Supplies
  • Effective Date: 1/1/2020

• GCR 19-080: Brattleboro Retreat Inpatient Psychiatric Services
  • Effective Date: 11/1/2019

• GCR 19-074: Specialized Therapeutic Residential Treatment
  • Effective Date: 12/1/2019

• GCR 19-070: Episodic Payment Rates for Substance Use Disorder Residential Treatment
  • Effective Date: 1/1/2020

• GCR 19-069: Integrating Family Services Rate Update
  • Effective Date: 1/1/2020

• GCR 19-060: Health Care Administrative Rules Update - Filing 9
  • Effective Date: 7/1/2020
  • Rules Included: 
    • 4.101 Medical Necessity for Covered Services
    • 4.106 Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services

• GCR 19-059: Health Care Administrative Rules Update - Choices for Care
  • Effective Date: 4/15/2020

• GCR 19-058: Health Care Administrative Rules Update - Filing 8
  • Effective Date: 1/1/2020
  • Rules included:
    • 4.213 Audiology Services
    • 4.214 Eyewear and Vision Care Services
    • 4.203 Dental Services for Beneficiaries Under Age 21, and Pregnant and Postpartum Women
    • 4.204 Dental Services for Beneficiaries Age 21 and Older
    • 6.100 Medicaid Cost Sharing
    • 4.232 Medically Complex Nursing Services
    • 4.239 In-home Lactation Consultation Services

• GCR 19-057: Substance Use Disorder Residential Treatment Episodic Payment
  • Effective Date: 10/1/2019

• GCR 19-056: Medicaid Dental Benefit Changes - SPAs 20-0005; 20-0009; 20-0011 (12/13/2019)
  • State Plan Amendments (SPAs) Approval Notice - 20-0009 & 20-0011 (7/22/2020)
  • Effective Date: 1/1/2020

• GCR 19-055: Global Commitment to Health 1115 Demonstration Amendment - Serious Mental Illness/Severe Emotional Disturbance
  • Approval Date: 12/5/2019

• GCR 19-054: Disproportionate Share Hospital Update
  • Effective Date: 10/1/2019

• GCR 19-051: Reimbursement for Federally Qualified Health Centers and Rural Health Clinics
  • Effective Date: State Plan policy is effective 12/12/2019; the new rates are effective 1/1/2020.

• GCR 19-048: Newly Enrolling Providers Within a Group Provider
  • Effective Date: 10/1/2019

•  GCR 19-045: Brattleboro Retreat Prior Authorization Pilot - Extended
  • Effective Date: Pilot extended through 12/31/2020

• GCR 19-044: Ostomy Supplies
  • Effective Date: 11/15/2019

• GCR 19-043: Pharmacist-Administered Vaccine Coverage and Reimbursement
  • Effective Date: 11/1/19

• GCR 19-039: Dental Hygienist Silver Diamine Fluoride Application
  • Effective Date: 10/1/2019

• GCR 19-037: Choices for Care, Traumatic Brain Injury, and Adult Day Rate Increase
  • Effective Date: 7/1/2019

• GCR 19-036: Low-Intensity Residential Treatment for Substance Use Disorder
  • Effective Date: 1/1/2020

• GCR 19-034: RBRVS Fee Schedule Update
  • Effective Date: 7/1/2019

• GCR 19-033: Assistive Community Care Services Rate Change
  • Effective Date: 7/1/2019

• GCR 19-032: Medicaid Transportation Reimbursement Rates
  • Effective Date: 7/1/2019

• GCR 19-031: Outpatient Prospective Payment System Update
  • Effective Date: 7/1/2019

• GCR 19-030: Medicaid State Plan Home Health Services Rate Increase
  • Effective Date: 7/1/2019

• GCR 19-028: Physician Administered Drugs Fee Schedule Update
  • Effective Date: 7/1/2019

• GCR 19-027: Long-Acting Reversible Contraceptive (LARC) - Inpatient Postpartum Add-on and Outpatient Update
  • Effective Date: 7/1/2019

• GCR 19-026: Children's Integrated Services Rate Update
  • Effective Date: 7/1/2019

• GCR 19-025: Expanding Access to Continuous Glucose Monitors
  • Effective Date: 10/1/2019

• GCR 19-021: Health Care Administrative Rules Update - Filing 7
  • Effective Date: 11/1/2019
  • Rules included:
    • 4.207 Prescribed Drugs
    • 4.238 Gender Affirmation Surgery for the Treatment of Gender Dysphoria
    • 7501 Pharmaceuticals, Medical Supplies and Equipment - General Information (Repeal)
    • 5447 VPharm Prescribed Drugs

•  GCR 19-020: Removal of Prior Authorization Requirements for Specific Codes - SPA 19-0007 (10/15/2019)
  • State Plan Amendment 19-0007 Approval (2/4/2020)
  • Effective Date: 10/15/2019

• GCR 19-019: Medicaid High Tech Nursing Program Changes
  • Effective Date: 10/1/2019

• GCR 19-017: Updated Federal Poverty Levels for MAGI-based Medicaid
  • Effective Date: 4/1/2019

• GCR 19-014: Clinical Diagnostic Laboratory Fee Schedule
  • Effective Date: 4/15/2019

• GCR 19-013: Pediatric Palliative Care - Removal of Annual Services Cap
  • Effective Date: 9/1/2019

• GCR 19-012: Home Oxygen Therapy
  • Effective Date: 1/1/2020

• GCR 19-011: Advance Care Planning Services
  • Effective Date: 8/15/2019

• GCR 19-009: Interim Partial Dentures
  • Effective Date: 7/1/2019

• GCR 19-005: Applied Behavior Analysis (ABA) - Adaptive Behavior Group Codes Changes
  • Effective Date: 6/1/2019

• GCR 19-003: Post Award Forum - Global Commitment to Health Demonstration Waiver
  • Forum Date: 2/25/2019
  • Waiver Effective Dates: 1/1/2017 - 12/31/2021

• GCR 19-002: Fiscal Employer Agent Rate Increase
  • Effective Date: 2/1/2019

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