By law, public notice of proposed rules must be given by publication in newspapers of record. The purpose of these notices is to give the public a chance to respond to the proposals. The public notices for administrative rules are now also available online at https://secure.vermont.gov/SOS/rules/ . The law requires an agency to hold a public hearing on a proposed rule, if requested to do so in writing by 25 persons or an association having at least 25 members.
To make special arrangements for individuals with disabilities or special needs please call or write the contact person listed below as soon as possible.
To obtain further information concerning any scheduled hearing(s), obtain copies of proposed rule(s) or submit comments regarding proposed rule(s), please call or write the contact person listed below. You may also submit comments in writing to the Legislative Committee on Administrative Rules, State House, Montpelier, Vermont 05602 (802-828-2231).
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NOTE: The six rules below have been promulgated by the Agency of Human Services who has requested the notices be combined to facilitate a savings for the agency. When contacting the agency about these rules please note the title and rule number of the proposed rule(s) you are interested in.
• Health Benefits Eligibility and Enrollment Rule, General Provisions and Definition (Part 1)
Vermont Proposed Rule: 25P025
• Health Benefits Eligibility and Enrollment Rule, Eligibility Standards (Part 2).
Vermont Proposed Rule: 25P026
• Health Benefits Eligibility and Enrollment Rule, Nonfinancial Eligibility Requirements (Part 3).
Vermont Proposed Rule: 25P027
• Health Benefits Eligibility and Enrollment Rule, Special Rules for Medicaid Coverage of Long-Term Care Services and Supports- Eligibility and Post-Eligibility (Part 4).
Vermont Proposed Rule: 25P028
• Health Benefits Eligibility and Enrollment Rule, Financial Methodologies (Part 5).
Vermont Proposed Rule: 25P029
• Health Benefits Eligibility and Enrollment Rule, Eligibility-and-Enrollment Procedures (Part 7). Vermont Proposed Rule: 25P030
AGENCY: Agency of Human Services
CONCISE SUMMARY: These proposed rules amend Parts 1-5 and 7 of the 8-part Health Benefits Eligibility and Enrollment (HBEE) rule. Parts 1, 4, and 5 were last amended effective January 1, 2024. Parts 2, 3, and 7 were last amended effective January 1, 2025. Substantive revisions include: adding coverage of pre-release services for up to 90 days before release for sentenced, incarcerated individuals enrolled in Medicaid; using the Low Income Subsidy (LIS) family size definition for Medicare Savings Program (MSP) eligibility determinations; raising the income limit for Qualified Medicare Beneficiaries from 100% to 145% of the Federal Poverty Level (FPL) and Qualifying Individuals 135% to 195% FPL; changing the household composition for the Access Plan; modifying noticing requirements for eligibility verifications; providing earlier Qualified Health Plan (QHP) effective dates for special enrollment periods and voluntary terminations.
FOR FURTHER INFORMATION, CONTACT: Dani Fuoco, Agency of Human Services, 280 State Drive, NOB 1 South, Waterbury, Vermont 05671-1010 Tel: 802-585-4265 Fax: 802-241-0450 E-Mail: dani.fuoco@vermont.gov URL: https://humanservices.vermont.gov/rules-policies/health-care-rules.
FOR COPIES: Jessica Ploesser, Agency of Human Services, 280 State Drive, NOB 1 South, Waterbury, Vermont 05671-1010 Tel: 802-241-0454 Fax: 802-241-0450 E-Mail: jessica.ploesser@vermont.gov.