Medicaid State Plan Amendments

This amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15. Vermont is also updating the converted MMDL language in the Health Homes SPA to include the assurance in accordance with federally mandated quality reporting for the Health Home Core Set as outlined with requirements in 42 CFR §§ 437.10 through
437.15 .

The purpose of this SPA is to limit the number of managed care plans in the Healthy Connections managed care program to no less than two and no more than four based on analyses of projected enrollees.

This plan amendment proposes a specified increase of 3.25 percent to reimbursement rates for intermediate care facilities for the intellectually disabled) (ICF/ID).

This amendment adds Federally Qualified Health Centers and Rural Health Clinics as providers of home telemonitoring services; clarifies that the term “home telemonitoring services” is synonymous with “remote patient monitoring;” and requires home telemonitoring providers to establish a plan of care with outcome measures for each patient and to share the plan and outcome measures with the patient’s physician.

This plan amendment proposes to add Health Equity Payments to Medicaid Enrolled Primary Care Practices that Serve a High Proportion of Marginalized Patients.

This SPA reflects updates to language around service labels, assessment tools, provider qualifications, reporting and management systems to align with the 1915( c) waivers, as well as a shift of Parent Support Partner (PSP) Services from the 1915(i). PSP services will be authorized in State Plan EPSDT.

Expands the settings to which an ambulance provider may transport a Medicaid beneficiary for emergency care in accordance with state law.
 

This plan amendment authorizes supplemental add-on payments to the fee schedule rates for eligible ground emergency transports provided between July 1, 2024, and June 30, 2025.

This SPA is to update state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

This plan amendment establishes an add-on rate for nursing facilities that serve high-acuity tracheostomy dependent patients.