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Medicaid/CHIP Data Requirements in Vermont

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Vermont’s Medicaid program is established to offer access to health care services to low-income individuals and their families.1 Vermont law addresses the need to administer the Medicaid program in a low cost and efficient manner. The state established various committees and programs to improve health care services, review utilization of health care services, and contain costs.2  The commissioner of Vermont health access must coordinate with the director of the Blueprint for Health to provide chronic care management for individuals with one or more chronic conditions who are enrolled in Medicaid, the Vermont health access plan, or Dr. Dynasaur.3 Nursing facilities must comply with Medicaid’s financial reporting requirements and may be financially awarded for superior performance.4 The commissioner of Vermont Health access must submit to the state legislature a quarterly report on enrollment and total expenditures by Medicaid beneficiaries.5

 

Footnotes

  • 1. 33 Vermont Statutes §1901, 1902, 1973
  • 2. 2 Vermont Statutes §852; 33 Vermont Statutes §402, 2001, 2031, 2032
  • 3. 33 Vermont Statutes §1903a
  • 4. Vermont Administrative Code §12-2-200:1; 12-2-200:9
  • 5. 33 Vermont Statutes §1901f

 

Medicaid/CHIP Data Requirements in Vermont

Subtopic Statute/Regulation Description
Medicaid/CHIP Data Requirements 12-2 Vt. Code R. 200:1 - General provisions under the agency of human services regulations “General provisions under the agency of human services regulations” Nursing facilities providing services to Medicaid residents must...
12-2 Vt. Code R. 200:9 - Private nursing facility and state nursing facility Medicaid rates under the agency of human services regulations “Private nursing facility and state nursing facility rates under the agency of human services regulations” The Medicaid program may...
12-3 Vt. Code R. 211:4100 - Medicaid program under the agency of human services regulations “Medicaid program under the agency of human services regulations” Medicaid is a federal-state program of financial help with the cost of...
12-3 Vt. Code R. 211:4101 - Purpose – Medicaid program under the agency of human services regulations “Purpose – Medicaid program under the agency of human services regulations” Vermont’s Medicaid program is established to...
12-3 Vt. Code R. 211:4102 - Vermont Health Access Plan (VHAP) under the agency of human services regulations “Vermont Health Access Plan (VHAP) under the agency of human services regulations” The Vermont Health Access Plan (VHAP) provides health...
12-3 Vt. Code R. 211:4104 - Quality control review under the agency of human services regulations “Quality control review under the agency of human services regulations” Quality control review must be conducted to be sure that Medicaid...
12-4 Vt. Code R. 102:1 - Choices for Care Medicaid waiver purpose and scope under the agency of human services regulations “Purpose and scope under the agency of human services regulations” The “Choices for Care” Medicaid waiver is a research and...
12-4 Vt. Code R. 102:4 - Eligibility under the agency of human services regulations “Eligibility under the agency of human services regulations” An individual is eligible to receive benefits from the Choices for Care...
12-7 Vt. Code R. 1:7101 - Medicaid benefit delivery under the agency of human services regulations “Medicaid benefit delivery under the agency of human services regulations” The Office of Vermont Health Access must develop and maintain...
12-7 Vt. Code R. 1:7107 - Utilization control under the Agency of Human Services regulations “Utilization control under the Agency of Human Services regulations” The Department for Children and Families must establish a statewide...
Vermont Administrative Code § 12-4-102:13 - Quality assurance / quality improvement under the agency of human services regulations “Quality assurance / quality improvement under the agency of human services regulations” The Department of Disabilities, Aging and...
Vt. Stat. Ann. tit. 33, § 1901 - Administration of Medicaid program under the human services law “Administration of program under the human services law” The Department of Human Services is responsible for administering the Medicaid...
Vt. Stat. Ann. tit. 33, § 1901f - Medicaid program enrollment and expenditure reports under the human services law “Medicaid program enrollment and expenditure reports under the human services law” The commissioner of Vermont Health access must submit...
Vt. Stat. Ann. tit. 33, § 1902 - Qualification for medical assistance under the human services law “Qualification for medical assistance under the human services law” The secretary of the agency of human services must use an income...
Vt. Stat. Ann. tit. 33, § 1903a - Care management program under the human services law “Care management program under the human services law” The commissioner of Vermont Health Access must coordinate with the director of the...
Vt. Stat. Ann. tit. 33, § 1998 - Pharmacy best practices and cost control program for Medicaid established under the human services law “Pharmacy best practices and cost control program established under the human services law” The commissioner of Vermont health access...
Vt. Stat. Ann. tit. 33, § 2001 - Legislative oversight under the human services law “Legislative oversight under the human services law” The pharmacy best practices and cost control program is subject to legislative...
Vt. Stat. Ann. tit. 33, § 2031 - Creation of clinical utilization review board for Medicaid purposes under the human services law “Creation of clinical utilization review board under the human services law” The Department of Vermont Health Access must create a...
Vt. Stat. Ann. tit. 33, § 2032 - Role of department of Vermont health access under the human services law “Role of department of Vermont health access under the human services law” The Department of Vermont Health Access must provide the...
Vt. Stat. Ann. tit. 33, § 402 - Medicaid and exchange advisory committee under the human services law “Medicaid and exchange advisory committee under the human services law”  (a) A Medicaid and exchange advisory committee is created...
Click on the individual state law in the table above to see our summary of the individual law.


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