Vermont Receives Innovative Medicaid Waiver for Mental Health Care

On Thursday, Vermont became one of the first places in the U.S. to receive approval from CMS to allow Medicaid reimbursement for inpatient stays at free-standing Institutions for Mental Disease (I MDs). Vermont was granted an amendment to its “Global Commitment to Health” Medicaid waiver which will allow the state to receive Medicaid reimbursement for inpatient stays at the Brattleboro Retreat and Vermont Psychiatric Care Hospital for Medicaid patients between the ages of 21 and 64.  

This is a vitally important advancement for our patients, because this waiver allows Vermont to preserve its current mental health system of care capacity. Without this waiver, Vermont would have to phase down funding for the Brattleboro Retreat and the Vermont Psychiatric Care Hospital. Phasing down Medicaid funding to these organizations would have devastated Vermont’s inpatient treatment capacity.
Under the new waiver, Vermont must achieve a series of milestones to support outpatient psychiatric care (many are already achieved) and maintain a statewide average length of stay of 30 days among Medicaid beneficiaries served at IMDs. Vermont’s current IMD length of stay is approximately  16 days on average. Reimbursement is not available for forensic psychiatric stays nor stays that exceed 60 days. VAHHS is working with a policy firm and with the state to develop options that maximize reimbursement options for these ineligible populations.
VAHHS provided public comment in support of the IMD waiver at both the state and federal levels. VAHHS also assisted the state in the waiver application by providing data to show that Vermont would be successful in achieving the requirements of the waiver and providing clarification to early drafts. We look forward to ensuring the effective and successful implementation of the waiver and ongoing efforts to fortify and optimize ourVermont Receives Innovative Medicaid Waiver for Mental Health Care