2023 Vermont Statutes › Title 33 - Human Services › Chapter 19 - Medical Assistance › § 1951. Definitions

§ 1951. Definitions
As used in this subchapter:
(1) “Assessment” means a tax levied on a health care provider pursuant to this chapter.
(2)(A) “Home health services” means any of the following:
(i) those medically necessary, intermittent, skilled home health services provided by Medicare-certified home health agencies of the type covered under Title XVIII (Medicare) or XIX (Medicaid) of the Social Security Act;
(ii) services covered under the adult and pediatric High Technology Home Care programs as of January 1, 2015;
(iii) personal care, respite care, and companion care services provided through the Choices for Care program contained within Vermont’s Global Commitment to Health Section 1115 demonstration; and
(iv) hospice services.
(B) The term “home health services” shall not include any other service provided by a home health agency, including:
(i) private duty services;
(ii) case management services, except to the extent that such services are performed in order to establish an individual’s eligibility for services described in subdivision (A) of this subdivision (2);
(iii) homemaker services;
(iv) adult day services;
(v) group-directed attendant care services;
(vi) primary care services;
(vii) nursing home room and board when a hospice patient is in a nursing home; and
(viii) health clinics, including occupational health, travel, and flu clinics.
(C) The term “home health services” shall not include any services provided by a home health agency under any other program or initiative unless the services fall into one or more of the categories described in subdivision (A) of this subdivision (2). Other programs and initiatives include:
(i) the Flexible Choices or Assistive Devices options under the Choices for Care program contained within Vermont’s Global Commitment to Health Section 1115 demonstration;
(ii) services provided to children under the early and periodic screening, diagnostic, and treatment Medicaid benefit;
(iii) services provided pursuant to the Money Follows the Person demonstration project;
(iv) services provided pursuant to the Traumatic Brain Injury Program; and
(v) maternal-child wellness services, including services provided through the Nurse Family Partnership program.
(3) “Commissioner” means the Commissioner of Vermont Health Access.
(4) [Repealed.]
(5) “Health care provider” means any hospital, nursing home, intermediate care facility for people with intellectual disabilities, home health agency, or retail pharmacy.
(6) “Home health agency” means an entity that has received a certificate of need from the State to provide home health services or is certified to provide services pursuant to 42 U.S.C. § 1395x(o).
(7) “Hospital” means a hospital licensed under 18 V.S.A. chapter 43.
(8) “Intermediate Care Facility for People with Developmental Disabilities” (ICF/DD) means a facility that provides long-term health related care to residents with developmental disabilities pursuant to subdivision 1902(a)(31) of the Social Security Act (42 U.S.C. § 1396a(a)(31)).
(9) “Mental hospital” or “psychiatric facility” means a hospital as defined in 18 V.S.A. § 1902(1)(B) or (H), but does not include psychiatric units of general hospitals.
(10) “Net patient revenues” means a provider’s gross charges related to patient care services less any deductions for bad debts, charity care, contractual allowances, and other payer discounts.
(11) “Nursing home” means a health care facility licensed under chapter 71 of this title.
(12) “Department” means the Department of Vermont Health Access.
(13) “Pharmacy” means a Vermont drug outlet licensed by the Vermont State Board of Pharmacy pursuant to 26 V.S.A. chapter 36 in which prescription drugs are sold at retail.
(14) “Secretary” means the Secretary of Human Services.
(15) “Ambulance agency” means an ambulance agency licensed pursuant to 18 V.S.A. chapter 17. (Added 1991, No. 94, § 1; amended 1991, No. 253 (Adj. Sess.), § 2; 1993, No. 56 § 1, eff. June 3, 1993; 1999, No. 49, § 200; 1999, No. 147 (Adj. Sess.), § 4; 2005, No. 71, § 283; 2005, No. 215 (Adj. Sess.), § 318; 2009, No. 156 (Adj. Sess.), § I.52; 2013, No. 96 (Adj. Sess.), § 207; 2013, No. 131 (Adj. Sess.), § 44, eff. May 20, 2014; 2015, No. 134 (Adj. Sess.), § 29; 2017, No. 73, § 18, eff. June 13, 2017; 2019, No. 6, § 75, eff. April 22, 2019.)