Vermont Department of Health Access

The meeting agenda included a roll call and the approval of prior meeting minutes from January 26, 2026. Key discussion items centered on an update from the Beneficiary Advisory Committee (BAC), followed by committee business including a wrap-up of the Marketplace and Open Enrollment period. Specific attention was given to the proposed budget, Home and Community Based Services (HCBS) Quality Activities, updates from the Medicaid Director and the Commissioner's Office, and a period for public comment.

The meeting commenced with the approval of the December 1, 2025 meeting minutes. A key action taken was the appointment of Bryan Plant as MEAC co-chair, effective until June 30, 2027. Discussions covered the Beneficiary Advisory Committee's priority identification, and a wrap-up of the 2026 Open Enrollment period, noting an increase in customer service calls and the use of the Plan Comparison Tool, alongside a decline in enrollment. Updates on the Medicare Savings Program (MSP) highlighted eligibility increases for QMB, QI-1, and SLMB programs, and collaboration on public communications. Significant discussion focused on Applied Behavior Analysis (ABA) changes, including clarifying policies on concurrent billing (disallowing 97155 and 97153 together) and limiting telehealth to specific CPT codes, in response to federal audit findings regarding overpayments. The Medicaid Director provided an update on the $195 million awarded for the Rural Health Transformation Fund. Furthermore, Home and Community Based Services (HCBS) quality activities were reviewed, with updates pending on the Medicaid Quality Strategy revision. The Commissioner's Office update covered the Governor's Budget and details regarding Technical Bill H.611, which includes removing redundant reporting requirements and modifying CURB membership. Public comment raised concerns about the impact of ABA billing limitations on service access.

Key discussion topics included the Co-Chair Position, an update from the Beneficiary Advisory Committee (BAC), and a wrap-up of the Marketplace and Open Enrollment period, which included detailed dashboards on enrollment statistics. Significant time was dedicated to the Medicare Savings Program (MSP) expansion, detailing changes to eligibility for QMB and QI-1 programs, implementation steps involving automatic enrollment transitions for thousands of people, and ongoing outreach efforts. Another major segment addressed Applied Behavior Analysis (ABA) changes, focusing on necessary policy adjustments to disallow concurrent billing of CPT codes 97155 and 97153 to align with correct coding guidelines and reduce financial vulnerability, and a shift towards a hybrid model for ABA services based on clinical efficacy research. Updates were also provided by the Medicaid Director and on Home and Community Based Services (HCBS) Quality Activities, including the development of the Medicaid Quality Strategy and the HCBS Subcommittee workplan.

The meeting focused on several key areas, commencing with the approval of the October 27, 2025 meeting minutes. Discussions covered the revised Annual Budget Letter, which was approved to emphasize the importance of maintaining existing programs. The committee also addressed the Co-Chair Position, noting that Sharon Henault has been serving while a new beneficiary member is sought, with a vote scheduled for the January meeting. The Beneficiary Advisory Committee (BAC) update proposed sharing minutes between BAC and MEAC. Updates from the Medicaid Director included the submission of the Rural Health Transformation Fund Application to CMS, with responses expected by year-end. The Marketplace and Open Enrollment Update highlighted ongoing engagement, increased use of the self-service portal, and concerns regarding members choosing underinsured catastrophic plans due to premium costs. The Commissioner's Office provided a Legislative Preview, outlining DVHA priorities such as promoting coverage affordability and protecting existing eligibility, and listed required legislative reports. Furthermore, there was a detailed discussion regarding the Hospital Global Budget program, which involves voluntary fixed payments for participating hospitals.

The meeting included discussions on the annual budget letter, marketplace and open enrollment updates, the Rural Health Transformation Fund application, and updates from the Medicaid Director and Commissioner's Office. Priorities were refreshed, focusing on member-centric excellence, a high-quality provider network, population health, operational infrastructure, and organizational resilience. Updates were provided on the phases of HR 1 implementation, including changes to Medicaid and Marketplace eligibility based on immigration status, increased review frequency, and work requirements.