BILLASINTRODUCEDANDPASSEDBYSENATE S.36
2025 Page1of4
S.36
IntroducedbySenatorsLyonsandGulick
ReferredtoCommitteeonHealthandWelfare
Date:January30,2025
Subject:Humanservices;Medicaid,substanceusedisorder;mentalhealth;
long-termresidentialtreatment
Statementofpurposeofbillasintroduced:Thisbillproposestorequirethe
AgencyofHumanServicestoprovidecoverageforlong-termresidential
treatmenttoMedicaidbeneficiarieswithsubstanceusedisorderandaco-
occurringmentalhealthcondition.
AnactrelatingtoMedicaidcoverageoflong-termresidentialtreatmentfor
co-occurringsubstanceusedisorderandmentalhealthconditionAnact
relatingtotheMedicaidpaymentmodelforresidentialsubstanceuse
disordertreatmentservices
ItisherebyenactedbytheGeneralAssemblyoftheStateofVermont:
Sec.1.33V.S.A.§ 1901misaddedtoread:
§ 1901m.LONG-TERMRESIDENTIALTREATMENTFORSUBSTANCE
USEDISORDERANDCO-OCCURRINGMENTALHEALTH
CONDITION
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(a)TheAgencyofHumanServicesshallprovidecoverageformedically
necessarylong-termresidentialtreatmenttoMedicaidbeneficiarieswith
substanceusedisorderandaco-occurringmentalhealthconditionwhenlong-
termresidentialtreatmentisprescribedbyahealthcareprofessionalpracticing
withinthescopeoftheprofessional’slicenseandtheresidentialtreatment
programisparticipatinginVermont’sMedicaidprogram.
(b)Coverageprovidedunderthissectionshallnotbeforlessthan:
(1)30daysifthebeneficiary’ssubstanceusedisordercanbe
successfullyaddressedbymedicationforopioidusedisorder;and
(2)60daysifthebeneficiary’ssubstanceusedisordercannotbe
successfullyaddressedbymedicationforopioidusedisorder.
Sec.2.33V.S.A.§ 1901misredesignatedtoread:
§ 1901m1901n.REIMBURSEMENT FOREMERGENCYMEDICAL
SERVICES
Sec.3.EFFECTIVEDATE
ThisactshalltakeeffectonJuly1,2025.
Sec.1.33V.S.A.§ 1901nisaddedtoread:
§ 1901n.HIGH-INTENSITYRESIDENTIALTREATMENTFOR
SUBSTANCEUSEDISORDERANDCO-OCCURRING
MENTALCONDITIONS
(a)TheAgencyofHumanServicesshallprovidecoverageformedically
necessaryhigh-intensity,medicallymonitoredresidentialtreatmentepisodesto
Medicaidbeneficiarieswithsubstanceusedisorderandaco-occurringmental
healthconditionwhenmedicallynecessaryhigh-intensity,medicallymonitored
residentialtreatmentepisodesareprescribedbyahealthcareprofessional
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employedbyaresidentialtreatmentprogramwhoispracticingwithinthe
scopeofthehealthprofessional’slicenseandtheresidentialtreatment
programisparticipatinginVermont’sMedicaidprogram.
(b)Coverageprovidedunderthissectionshallbefortheentirelengthof
stayprescribedbyahealthcareprofessionalemployedbyaresidential
treatmentprogram,whoshalltakeintoaccountcurrentbestpracticesforeach
levelofcarewithinthesubstanceusecontinuumofcare.
Sec.2.33V.S.A.§ 1901oisaddedtoread:
§ 1901o.LOW-INTENSITYRESIDENTIALTREATMENTFOR
SUBSTANCEUSEDISORDERANDCO-OCCURRING
MENTALCONDITIONS
(a)TheAgencyofHumanServicesshallprovidecoverageformedically
necessarylow-intensity,clinicallymanagedresidentialtreatmentepisodesto
Medicaidbeneficiarieswithsubstanceusedisorderandaco-occurringmental
healthconditionwhenmedicallynecessarylow-intensity,clinicallymanaged
residentialtreatmentepisodesareprescribedbyahealthcareprofessional
employedbyaresidentialtreatmentprogramwhoispracticingwithinthe
scopeofthehealthcareprofessional’slicenseandtheresidentialtreatment
programisparticipatinginVermont’sMedicaidprogram.
(b)Coverageprovidedunderthissectionshallbefortheentirelengthof
stayprescribedbyahealthcareprofessionalemployedbyaresidential
treatmentprogram,whoshalltakeintoaccountcurrentbestpracticesfor
levelsofcarewithinthesubstanceusecontinuumofcare.
Sec.3.REPORT;MEDICAIDPAYMENTMODELFORRESIDENTIAL
SUBSTANCEUSEDISORDERTREATMENTSERVICES
TheAgencyofHumanServicesshallconductareviewoftheMedicaid
paymentmodelforresidentialsubstanceusedisordertreatmentserviceswith
specialconsiderationgiventotheactualcostofprovidingresidentialtreatment
services,commensuratewithlengthofstay,co-occurringphysicalandmental
healthneeds,andpostresidentialtreatmentserviceneeds.Theresultsofthe
reviewshallbesubmittedtotheHouseCommitteeonHumanServicesandthe
SenateCommitteeonHealthandWelfareonorbeforeDecember1,2025.The
reviewshallincluderecommendationsandproposedlegislationto:
(1)aligntheMedicaidpaymentmodelwiththeclinicalneedsof
individualsreceivingresidentialsubstanceusedisordertreatmentservices;and
(2)ensurecoordinatedtransitionsbetweenresidentialsubstanceuse
disordertreatmentprovidersofferingvaryingacuityofcare. BILLASINTRODUCEDANDPASSEDBYSENATE S.36
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Sec.4.REPEAL
2019ActsandResolvesNo.6,Secs.99and100(amendmentsto18V.S.A.
§§ 4810(d)–(j)and4811thatprohibitedpublicinebriatesfrombeing
incarceratedinaDepartmentofCorrections’facility)arerepealed.
Sec.5. 2019ActsandResolvesNo.6,Sec.105isamendedtoread:
Sec.105. EFFECTIVEDATES
***
(c) Secs.99and100(amending18V.S.A.§§4910and4811)shalltake
effectonJuly1,2025. [Deleted.]
***
Sec.6.EFFECTIVEDATE
ThisactshalltakeeffectonJuly1,2025.