Committee reviews bill to change Medicaid payment model for residential substance use disorder treatment

Senators and witnesses spent the committee session reviewing S.36, an act to align Vermont's Medicaid payment model with clinical needs for residential substance use disorder treatment and to remove confusing, delayed statute language on public inebriates.

Katie, legislative counsel with the Office of Legislative Council, told the committee the bill responds to recurring questions about the adequacy of current payments and who should authorize extended residential stays. "Episodic payments are for about 14 days," Katie said, and the bill is intended to address whether that episodic period matches clinical need.

The bill would require the Agency of Human Services (AHS) to provide coverage for "medically necessary" high-intensity, medically monitored and low-intensity, clinically managed residential treatment episodes for Medicaid beneficiaries with substance use disorder and co-occurring mental health conditions when prescribed by a health care…