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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: 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 .
Summary: disregard two sources of income/resources: 1) any refundable credit against taxes made pursuant to Vermont's child tax credit or pursuant to a similar tax credit enacted by the State and intended by legislation to not be considered as countable income or resources for benefit programs; and 2) any wages that are made pursuant to Vermont's Premium Pay for Workforce Recruitment and Retention Program or a similar workforce recruitment and retention program enacted in Vermont and intended by the legislature to not be considered as countable income or resources in determining eligibility for benefit programs.
Summary: This amendment updates the compliance oversight process under the False Claims Act such that Vermont Medicaid will ensure provider compliance through a document review electronically or via written correspondence and will no longer conduct site visits unless deemed necessary. This SPA is being amended under Section 1902(a)(68) of the Social Security Act.
Summary: Effective January 1, 2021, this amendment expands the provider types that can authorize home health plans of care and order durable medical equipment.
