The Department of Vermont Health Access, Promoting Interoperability/Electronic Health Record Incentive Program (PIP/EHRIP) offers a Reconsideration and Appeal process that aligns with that of the Vermont Medicaid program, and is detailed in Section 8 of the Green Mountain Care General Manual Provider Manual, available here:
http://www.vtmedicaid.com/Downloads/manuals.html.
Reconsideration of PIP/EHRIP Decisions
Eligible Professionals and Eligible Hospitals may request Reconsideration of a PIP/EHRIP decision regarding eligibility for: payment amount, overpayment amount, or recoupment. The request must be made within thirty (30) calendar days of the receipt of the overpayment notice OR of the denial notice OR within thirty (30) calendar days of the date of the PIP/EHRIP payment in dispute. The request must be filed on the Request for PIP/EHRIP Reconsiderationform (below).
Please follow the instructions in the Green Mountain Care Provider Manual and note that all requests and forms are sent to:
Office of the General Counsel
PIP/EHRIP Appeals
Department of Vermont Health Access
NOB 1 South
280 State Drive
Waterbury, VT 05671-1010
Forms:
Request for PIP/EHRIP Reconsideration form(.DOC; 24 KB)
Request for Appeal of PIP/EHRIP Reconsideration form(.DOC; 24 KB)
Back to the Vermont Medicaid PIP/EHRIP Home Page
(Page last updated 8/5/2020)