VT S0194

Establishes monthly prospective payments to designated and specialized service agencies on the first day of each month, replacing the previous schedule of periodic rate studies conducted every five years

Monthly payment amounts calculated using per-member per-month rates based on most recently approved independent budgets and the number of individuals with approved individual budgets

Requires providers to submit monthly encounter data and invoices, with the Agency conducting at least annual reconciliation to verify census, funding accuracy, and value-based performance metrics

Retains requirements for annual inflationary rate adjustments, consideration of provider financial needs related to client absences (subject to CMS approval), and use of Vermont labor market rates and costs

Effective date: July 1, 2026