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VermontH.132025-2026 SessionHouseWALLET

An act relating to Medicaid payment rates for community-based service providers

Sponsored By: Theresa A Wood (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 4 benefits, 0 costs, 0 mixed.

Centralized rates for designated agencies

Effective May 13, 2025, the Secretary of Human Services sets the Medicaid payment rates for designated and specialized service agencies. Rates must be reasonable and adequate, include adjustments for the cost of government mandates, and include a factor for inflation and labor market changes. The Secretary may also consider local differences in wages, benefits, housing, and real estate costs.

Stronger Medicaid rates for community care

Effective May 13, 2025, the state sets Medicaid rates for community-based care that are reasonable and adequate. When setting rates, the Secretary considers costs from government mandates, inflation, and wage and labor changes, and may factor in local cost differences. The Secretary must use a clear method: rate studies at least every five years, scheduled base‑rate reviews, and an annual inflation update. The method uses Vermont labor and operating costs and, if CMS allows, accounts for losses when clients are absent. Rates are recalculated each year and reported to lawmakers with the dollars needed to fund them.

Stabilization help for at-risk providers

Effective May 13, 2025, the Agency creates a process for provider stabilization. A community-based service provider whose finances put it at imminent risk of closing can ask the Agency for help. The goal is to keep essential Medicaid services open in the community.

What counts as community-based care

Effective May 13, 2025, the law defines which Medicaid services count as community-based care. It includes home and community supports for older adults and adults with disabilities, including enhanced residential care. It includes home health, hospice, adult day rehab, and assistive community care. It also includes home and community supports for people with mental health needs, substance use disorders, developmental or intellectual disabilities, or brain injury, but not clinical residential or private nonmedical residential settings.

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Sponsors & Cosponsors

Sponsor

  • Theresa A Wood

    Democratic • House

Cosponsors

  • Daniel A Noyes

    Democratic • House

Roll Call Votes

No roll call votes available for this bill.

Actions Timeline

  1. House message: Governor approved bill on May 13, 2025

    5/14/2025Senate

  2. Signed by Governor on May 13, 2025

    5/13/2025House

  3. Delivered to the Governor on May 7, 2025

    5/7/2025House

  4. House message: House concurred in Senate proposal of amendment

    4/30/2025Senate

  5. Senate proposal of amendment concurred in

    4/29/2025House

  6. Action Calendar: Unfinished Business

    4/29/2025House

  7. Action Calendar: Senate Proposal of Amendment

    4/28/2025House

  8. Notice Calendar: Senate Proposal of Amendment

    4/25/2025House

  9. Senate Message: Passed in concurrence with proposal of amendment

    4/24/2025House

  10. Read 3rd time & passed in concurrence with proposal of amendment

    4/23/2025Senate

  11. Pending third reading, motion to amend Senate proposal of amendment by Senator(s) Gulick, Cummings, Douglass, Hart, and Lyons agreed to

    4/23/2025Senate

  12. Proposal of amendment to be offered by Senator(s) Gulick

    4/23/2025Senate

  13. New Business/Third Reading

    4/23/2025Senate

  14. 3rd reading ordered

    4/22/2025Senate

  15. Proposal of amendment by Committee on Health and Welfare agreed to

    4/22/2025Senate

  16. Reported favorably by Senator Lyons for Committee on Appropriations

    4/22/2025Senate

  17. Read 2nd time, reported favorably with proposal of amendment by Senator Gulick for Committee on Health and Welfare

    4/22/2025Senate

  18. Favorable report by Committee on Appropriations

    4/22/2025Senate

  19. Favorable report with proposal of amendment by Committee on Health and Welfare

    4/22/2025Senate

  20. Second Reading

    4/22/2025Senate

  21. Favorable report by Committee on Appropriations

    4/18/2025Senate

  22. Favorable report with proposal of amendment by Committee on Health and Welfare

    4/18/2025Senate

  23. Second Reading

    4/18/2025Senate

  24. Entered on Notice Calendar

    4/18/2025Senate

  25. Referred to Committee on Appropriations per Senate Rule 31

    4/9/2025Senate

Bill Text

  • As Enacted (ACT 14)

    5/19/2025

    PDF

  • As Passed by Both Chambers

    5/5/2025

    PDF

  • As Passed by Both Chambers (Unofficial)

    5/5/2025

    PDF

  • Senate Proposal of Amendment

    4/25/2025

    PDF

  • Senate Proposal of Amendment (Unofficial)

    4/25/2025

    PDF

  • As Passed by the House

    2/21/2025

    PDF

  • As Passed by the House (Unofficial)

    2/21/2025

    PDF

  • As Introduced

    12/30/2024

    PDF

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