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State of Vermont Amends Medicaid Waiver

December 9, 2019

Montpelier, Vt – Monday, Governor Phil Scott announced the Centers for Medicare and Medicaid Services (CMS) recently approved an amendment to Vermont’s Global Commitment To Health Medicaid demonstration to enable federal payments for Vermont Medicaid beneficiaries requiring short-term treatment for diagnosis of serious mental illness (SMI) and/or serious emotional disturbance (SED) at institutions for mental disease (IMDs). The approval from CMS means health care services provided to Medicaid-eligible Vermonters at these institutions are now authorized state expenditures for federal financial participation and will be reimbursed like other medical expenses in the Medicaid program.

Today Vermont uses shrinking Medicaid investment dollars to pay for services provided in these inpatient settings but is required to phase-out this spending in future years. This amendment means that Vermont no longer needs to use investments to pay for most short-term treatment at IMDs.

“I want to thank CMS and the Federal Administration for their continued support and partnership with the State of Vermont,” said Governor Scott. “Over the years, our federal partners have given us a lot of flexibility to demonstrate we can meet the goals of the Medicaid program in innovative ways. As health care costs continue to outpace the growth in almost all other sectors – in Vermont and nationally – it’s important we continue our reform efforts and continue to innovate the way we provide and pay for these services,” Governor Scott added.

Simultaneous with the approval of the IMD SMI/SED demonstration amendment, CMS also approved Vermont’s Implementation Plan, which seeks to reduce utilization and lengths of stay in Emergency Departments for mental health treatment, readmissions to hospitals, and improve the availability of crisis stabilization services for persons experiencing serious mental health challenges.

“This amendment, in a lot of ways, gives us room to continue to improve our whole-person system of care,” said Human Services Secretary Mike Smith. “Our waiver with the federal government allows us to use a certain portion of our Medicaid funding to make investments we think will increase health and help reduce future pressures on the Medicaid program. This new Federal Financial Participation frees up capacity for innovation,” Secretary Smith said.

To read the full amendment, click here.