New Medicaid Psychotherapy Provider Manual

The Department of Vermont Health Access (DVHA) has created a “Psychotherapy and Other Psychiatric Services Supplement” to the General Provider Manual and the Medicaid General Billing and and Forms Manual. Information for psychotherapy providers was consolidated into this new supplemental manual in order to increase accessibility and clarity for providers; none of the information in the supplement is new and there are no new requirements.

This supplement describes processes to be followed by enrolled Vermont Medicaid providers who are serving Vermont Medicaid members with psychotherapy and other psychiatric services. The new document can be located at: https://dvha.vermont.gov/providers/manuals.

Please contact the Provider Services Unit at Gainwell Technologies at 1-800-925-1706 with any additional questions.

Medicaid and the Change Healthcare cybersecurity incident

DVHA has come up a final solution to the issue of providers getting no—or delayed—reimbursement due to the Change Healthcare cybersecurity incident earlier this year.  You can read about what DVHA is going to do here:  https://humanservices.vermont.gov/sites/ahsnew/files/documents/24-029-F-GCR-Change-Healthcare-Response.pdf

In short, DVHA (Vermont Medicaid) made payments to impacted providers based on
historical average claims. For the period February 21, 2024, through
June 30, 2024, Medicaid providers were eligible to receive payment “in amounts representative of up to 7 days of claims payments for Medicaid services” that were not otherwise paid because of the Change Healthcare cybersecurity incident. You can find more information about the payment provisions at the link sent by DVHA: https://humanservices.vermont.gov/sites/ahsnew/files/documents/24-029-Att-4.19-Introduction-draft.pdf

Progress on PSYPACT

VPA has been advocating for the passage of PSYPACT, Vermont H.282, for some time. Great news! PSYPACT passed through the House Health Committee and has now gone to the House Ways and Means Committee. Here is written testimony from the Office of Professional Regulation from March 16, 2023, reporting on the Board of Psychological Examiners’ support for PSYPACT. We are hopeful this bill will pass through the House this session and complete its journey through the Senate in 2024. Here is where you can get more info on H.282.

As of this date, PSYPACT has been enacted and is effective in 34 states; 2 additional states have enacted PSYPACT but it is not yet effective in those states. You can see a map of states that have enacted PSYPACT here. If you support the passage of PSYPACT, please write your legislators and ask them to co-sponsor or at least support passage of this important legislation!

Medicare: Recent Changes

A number of changes to Medicare were passed in late 2022, including an expansion of the providers who can be reimbursed, an extension of telehealth waivers, and a new conversion factor.  You can see an easy-to-read summary of these changes written by APA staff here.