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.
- GCR 16-120: Health Care Administrative Rules Update (3/16/2017)
- Health Care Administrative Rules Update (2/23/2017)
- Health Care Administrative Rules Update (12/7/2016)
- Rules included:
- 4.211 Augmentative and Alternative Communication Devices/Systems (moved to GCR 17-013)
- 4.202 Dental Services for Beneficiaries Age 21 and Older
- 4.203 Dental Services for Beneficiaries Under Age 21, And Pregnant and Postpartum Women
- 4.204 Medical and Surgical Services of a Dentist
- 4.205 Orthodontic Treatment
- 4.220 Chiropractic Services
- 10.100 Pharmaceutical Manufacturer Fee
- Comments received and responses.
- Rules included:
- GCR 16-119: Women's Health Initiative
- GCR 16-113: Developmental Disabilities Services Rule Update (3/3/2017)
- GCR 16-109: Recovery Audit Contractor - SPA 17-0003
- Draft SPA page: 36b
- No comments were received.
- GCR 16-103: Vermont Medicaid Pathway Delivery and Payment Reform
- Information Gathering Process Document
- Stakeholder feedback and state response available here.
- Medicaid Pathway Overview (posted 12/29/2016)
- GCR 16-101: Health Benefits Eligibility and Enrollment Part 8 - Fair Healting/Expedited Administrative Appeals (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 8 - Fair Healting/Expedited Administrative Appeals (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 8 - Fair Healting/Expedited Administrative Appeals (10/5/2016)
- No comments were received.
- GCR 16-100: Health Benefits Eligibility and Enrollment Part 7 - Eligibility-and-Enrollment Procedures (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 7 - Eligibility-and-Enrollment Procedures (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 7 - Eligibility-and-Enrollment Procedures (10/5/2016)
- No comments were received.
- GCR 16-099: Health Benefits Eligibility and Enrollment Part 6 - Small Employer Health-Benefits Program Rules (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 6 - Small Employer Health-Benefits Program Rules (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 6 - Small Employer Health-Benefits Program Rules (10/5/2016)
- No comments were received.
- GCR 16-098: Health Benefits Eligibility and Enrollment Part 5 - Financial Methodologies (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 5 - Financial Methodologies (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 5 - Financial Methodologies (10/5/2016)
- No comments were received.
- GCR 16-097: Health Benefits Eligibility and Enrollment Part 4 - Special Rules for Medicaid Coverage of Long-Term Care Services and Supports - Eligibility and Post-Eligibility (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 4 - Special Rules for Medicaid Coverage of Long-Term Care Services and Supports - Eligibility and Post-Eligibility (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 4 - Special Rules for Medicaid Coverage of Long-Term Care Services and Supports - Eligibility and Post-Eligibility (10/5/2016)
- No comments were received.
- GCR 16-096: Health Benefits Eligibility and Enrollment Part 3 - Nonfinancial Eligibility Requirements (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 3 - Nonfinancial Eligibility Requirements (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 3 - Nonfinancial Eligibility Requirements (10/5/2016)
- No comments were received.
- GCR 16-095: Health Benefits Eligibility and Enrollment Part 2 - Eligibility Standards (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 2 - Eligibility Standards (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 2 - Eligibility Standards (10/5/2016)
- No comments were received.
- GCR 16-094: Health Benefits Eligibility and Enrollment Part 1 - General Provisions and Definitions (11/17/2016)
- Health Benefits Eligibility and Enrollment Part 1 - General Provisions and Definitions (Corrected 10/6/2016)
- Health Benefits Eligibility and Enrollment Part 1 - General Provisions and Definitions (10/5/2016)
- No comments were received.
- GCR 16-092: Hospice Rates 2017
- No comments were received.
- GCR 16-090: Medicaid Access to Care Plan - Notice
- Medicaid Access to Care Plan - Report (draft - the final report is available here)
- No comments were received.
- GCR 16-077: Assistant Surgeon Modifiers
- No comments were received.
- GCR 16-076: Health Care Administrative Rules Update (10/3/2016)
- Health Care Administrative Rules Update (7/27/20160
- Rules included:
- 1.100 Health Care Administrative Rules Introduction
- 1.101 Health Care Administrative Rules Definitions
- 4.213 Audiology Services/Hearing Aids
- 4.214 Eyewear and Vision Care Services
- Repeal - Planned Parenthood of Vermont
- Comments received and responses are available here.
- GCR 16-074: Rate Increase for Enhanced Primary Care Payments - SPA 16-0021
- Draft SPA page: Attachment 4.19-B page 10
- No comments were received.
- GCR 16-072: Pharmacy Reimbursement - SPA 17-0005 (3/30/2017)
- Pharmacy Reimbursement - SPA 17-0005 (3/21/2017)
- Draft SPA pages: Attachment 4.19-B pages 4a(1), 4a, 4b
- Questions and Comments related to the Pharmacy Reimbursement Changes Effective 4/1/2017 (6/8/2017)
- The comment period was 3/21/2017 - 4/24/2017. See above document for comments and information.
- Pharmacy Reimbursement - SPA 17-0005 (3/21/2017)
- GCR 16-061: Standards for Issuers Participating in the Vermont Health Benefit Exchange - Final Proposed Rule (9/29/2016)
- Standards for Issuers Participating in the Vermont Health Benefit Exchange - Proposed Rule (7/1/2016)
- Comments received, responses, and a summary of changes are available here.
- GCR 16-058: Cardiac Imaging Prior Authorization (8/22/2016 Correction)
- Cardiac Imaging Prior Authorization (8/12/2016)
- The comment received and response is available here.
- GCR 16-055: Howard Center ARCh Program Rate
- No comments were received.
- GCR 16-054: Northeastern Family Institute Bundled Rate
- No comments were received.
- GCR 16-051: Medicaid Contraceptives Policy - SPA 16-0019
- No comments were received.
- GCR 16-050: Integrating Family Services Rate Allocation Change
- No comments were received.
- GCR 16-048: Increase to NCSS Budget for ABA Medicaid Beneficiaries
- No comments were received.
- GCR 16-047: Applied Behavior Analysis Rates - SPA 16-0015
- Draft SPA page: Attachment 4.19-B page 3a
- ABA Fee Schedule
- No comments were received.
- GCR 16-046: Ambulance Provider Reimbursement Rates SPA 16-0013
- Draft SPA page: Attachment 4.19-B page 7
- No comments were received.
- GCR 16-043: Code Correction for Specialized Rehabilitation Services
- DMH Memorandum to Designated Agencies - Billing Coding Change
- No comments were received.
- GCR 16-041: Elimination of Provider-Based Billing for Hospital-Owned Clinics
- The following comment was received: Click here.
- GCR 16-040: Vermont Medicaid All Payer Model ACO Program (7/14/2016)
- Coverage Document
- Reimbursement Document
- No comments were received.
- Vermont Medicaid Next Generation ACO Program (12/30/2016)
- Updated Coverage Document
- Updated Reimbursement Document
- No comments were received.
- GCR 16-035: Hemochromatosis Genetic Test
- No comments were received.
- GCR 16-034: Outpatient Prospective Payment System - SPA 16-0011 (6/22/2016)
- Draft SPA pages: Attachment 4.19-B pages 2a(1a), 2a(1b), and 2a(1c)
- Hospital Specific Percentages for SFY 2017
- Outpatient Prospective Payment System (initial notice issued 5/26/2016)
- No comments were received.
- GCR 16-030: CPT Codes that Require Prior Authorization
- No comments were received.
- GCR 16-029: Health Care Administrative Rules Update (6/17/2016)
- Health Care Administrative Rules Update (4/20/2016)
- No comments were received.
- Health Care Administrative Rules Update (4/20/2016)
- GCR 16-027: Modifier/Code Logic for Outpatient Claims
- The following comment was received: Click here.
- GCR 16-023: Family Supportive Housing Providers
- No comments were received.
- GCR 16-021: Hospital-Based Intensive Outpatient/PHP Reimbursement
- Implementation was delayed until 10/1/2016. Please see GCR Clarification 16-021.
- The following comment was received: click here.
- GCR 16-020: Medicaid for Working People with Disabilities Eligibility Expansion - SPA 16-0002
- Draft SPA pages: Attachment 2.6-A Supp 8a page 2 and 2.6-A Supp 8b page 2
- No comments were received.
- GCR 16-017: Serenity House Transportation
- No comments were received.
- GCR 16-012: VPharm Rule Update (8/8/2016)
- VPharm Rule Update (4/4/2016)
- The following comments were received: click here.
- GCR 16-011: Health Benefits Eligibility & Enrollment Rule Update (4/4/2016)
- Health Benefits Eligibility & Enrollment Rule Update (7/1/2016)
- Current Adopted Rule
- Comments received and responses can be viewed here.
- GCR 16-010: ARIS Solutions Rate Increase
- No comments were received.
- GCR 16-009: New IEP Medical Necessity Authorization Code
- No comments were received.
- GCR 16-007: Follow-up Treatment After Select Dental Procedures
- No comments were received.
- GCR 16-006: Section 1332 ACA Waiver Request
- Full Draft Section 1332 ACA Waiver Request for Public Comment
- The following comments were received: click here.
- GCR 16-005: Outpatient Prospective Payment System (OPPS) 2016
- Draft SPA pages: Attachment 4.19-B page 2a(1a)
- No comments were received.
- GCR 15-015: Hospice Rates January 2016 - SPA 16-001
- Draft SPA page: Attachment 4.19-B page 6
- The following comments were received: click here.
- GCR 15-011: Use of GY Modifier
- No comments were received.
- GCR 15-010: National Correct Coding Initiative Add-on Code Edits
- No comments were received.
- GCR 15-009: Update to Neonate Add-on Payment - SPA 16-003
- Draft SPA page: Attachment 4.19-A page 1c-7
- No comments were received.
- GCR 15-008: Waiting Placement Add-on for Cost-to-Charge Ratio
- No comments were received.
- GCR 15-007: Physician Administered Drug Fee Schedule - SPA 16-007
- Draft SPA page: Attachment 4.19-B page 3
- No comments were received.
- GCR 15-006: Clinical Diagnostic Laboratory Fee Schedule - SPA 16-005
- Draft SPA pages: Attachment 4.19-B pages 2a(2) and 2a(3)
- No comments were received.
- GCR 15-003: Interrupted Psychiatric Stays
- No comments were received.
To access the final policies and policy clarifications in the Global Commitment Register, click here.