VT LEG #380951 v.5
H.13 – An act relating to Medicaid payment rates for home-
and community-based service providers
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As Passed by the Senate
Bill Summary
he bill as passed by the Senate would address Medicaid payment rates for community-based service
providers, designated agencies (DAs), and specialized services agencies (SSAs). The bill would
amend 33 V.S.A. § 911 requiring the Secretary of Human Services to:
• Calculate payment rates for community-based services providers that are “reasonable and
adequate to achieve the required outcomes for the populations they serve;”
• Establish a methodology for calculating payment rates for community-based services
providers;
• Establish a process by which a provider whose financial condition places it at imminent risk of
closure may seek extraordinary financial relief from the Agency of Human Services (AHS); and
• Recalculate the payment rates for community-based services providers at least annually and
report on those rates and the amounts necessary to fund them to the legislative committees of
jurisdiction annually as part of the Agency’s budget presentation.
• Calculate the Departments of Health’s (VDH’s), of Mental Health’s (DMH’s), and of
Disabilities, Aging, and Independent Living’s (DAIL’s) rates of payments for DAs and SSAs in
accordance with the changes made to 33 V.S.A. § 911.
The bill as passed by the Senate would also amend the bill title after passage from “An act relating to
Medicaid payment rates for home- and community-based service providers” to “An act relating to Medicaid
payment rates for community-based service providers.”
Fiscal Impact
The bill requires the Secretary of Human Services to calculate reasonable and adequate rates for
community-based services providers, DAs, and SSAs. It also requires AHS to establish a process for
providers whose financial condition places them at risk of closure to seek extraordinary financial relief.
However, it neither requires AHS to increase rates nor provide extraordinary financial relief. Additionally,
there is no appropriation for rate increases or extraordinary financial relief in the bill. Therefore, the bill as
recommended by the Senate Committee on Health and Welfare would have no direct or immediate fiscal
impact.
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The Joint Fiscal Office (JFO) is a nonpartisan legislative office dedicated to producing unbiased fiscal analysis – this fiscal note is
meant to provide information for legislative consideration, not to provide policy recommendations.
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April 25, 2025 Nolan Langweil, Principal Fiscal Analyst H.13 – An act relating to Medicaid payment rates for home-and community-based service providers 2
VT LEG #380951 v.5
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The full fiscal note history is available on the fiscal tab of the bill page on the General Assembly website and can be pulled up through a
bill number search on the JFO page.