CMS Approves Renewal of Vermont’s 1115 Demonstration

On June 28, 2022, the Centers for Medicare & Medicaid Services (CMS) approved a five-and-a-half-year renewal of Vermont’s Global Commitment to Health (Global Commitment) Section 1115 demonstration. The Global Commitment demonstration covers nearly all of Vermont’s Medicaid program; Vermont provides Medicaid services and supports to more than 200,000 Medicaid enrollees—nearly 30 percent of the state’s population.1 In addition to authorizing five home- and community-based services (HCBS) programs and providing flexibility to design and implement innovative payment reform initiatives, the Global Commitment demonstration has permitted several flexibilities that are unique or unusual among states. These flexibilities include the ability to strengthen its health care system and social safety net by using accrued savings to fund a diverse set of “investments” in public health, health care, and health-related services and coverage expansions for Vermonters with disabilities and/or serious mental illness (SMI).

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