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Deadline For Public Comment

Deadline: Jul 05, 2013

The deadline for public comment has expired. Contact the agency or primary contact person listed below for assistance.

Rule Details

Rule Number: 13P019
Title: Methods, Standards and Principles for Establishing Medicaid Payment Rates for Long-Term Care Facilities
Type: Standard
Status: Adopted
Agency: Division of Rate Setting, Agency of Human Services.
Legal Authority: 33 V.S.A. ยงยง 904 (a) & 908 (c)
Summary: Vermont uses a case-mix classification system for setting nursing home Medicaid rates that allocates nursing resources based on residents' clinical needs. This rule is necessary to replace Vermont's outdated Resource Utilization Group (RUG) III case-mix classification system with the new federal RUG IV. Vermont's RUG III system was rendered obsolete when the federal government changed the Minimum Data Set (MDS) form from MDS 2.0 to MDS 3.0, which is used to record resident clinical information and which translates into a RUG for each resident. The MDS 3.0 form was not compatible with Vermont's RUG III system. In April 2011, Vermont began its transition from RUG III to RUG IV with a transitional rule that allowed the Division to use RUG IV case-mix data to set rates in combination with RUG III data. This new rule allows the Division to transition completely from the old Vermont-specific RUG III to RUG IV.
Persons Affected: The rule will affect Vermont nursing facilities participating in the Medicaid program, persons eligible for long-term care under the Medicaid program, the federal government and the State of Vermont.
Economic Impact: This rule is expected to save the Medicaid program $235,000. This is a one-time savings in state fiscal year 2014.
Posting date: May 29,2013

Hearing Information

Information for Hearing # 1
Hearing date:
06-28-2013 1:00 PM   
Location: Division of Rate Setting Conference Room
Address: 25 Omega Drive, Suite 201
City: Williston
State: VT
Zip: 05462
Hearing Notes:

Contact Information

Information for Contact # 1
Level: Primary    
Name: Leslie Wisdom, Division of Rate Setting    
Agency: Agency of Human Services    
Address: 103 South Main Street    
City: Waterbury    
State: VT    
Zip: 05671-2201    
Telephone: 802-652-6528    
Fax: 802-652-6538    
Email: 
leslie.wisdom@state.vt.us
     
 
   
Website Address:  www.humanservices.vermont.gov/departments/office-of-the-secretary/ahs-drs
     
 
   
Information for Contact # 2
Level: Secondary    
Name: Kathleen Denette, Division of Rate Setting    
Agency: Agency of Human Services    
Address: 103 South Main Street    
City: Waterbury    
State: VT    
Zip: 05671-2201    
Telephone: 802-652-6528    
Fax: 802-652-6538    
Email: 
kathleen.denette@state.vt.us
     
 
   
Website Address:  www.humanservices.vermont.gov/departments/office-of-the-secretary/ahs-drs
     
 
   

Keyword Information

Keywords:

Division of Rate Setting
RUG IV
case-mix
nursing homes
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