The State of Vermont has a process in place to handle any returned MDAAP incentive payments. By signing the MDAAP Participation Agreement, the provider agrees to begin engagement with business support services to start the needs assessment within 30 calendar days. The needs assessment must be completed with business support services for the provider to keep the incentive payment associated with signing the Participation Agreement. The provider and/or business support services may determine upon completion of the needs assessment that MDAAP participation is not a good fit for the provider at this time. In this circumstance, the provider shall keep the milestone incentive payment associated with signing the Participation Agreement, despite not completing additional milestones. If the provider has not engaged with business support services to start the needs assessment within 30 days but a provider does still wish to participate in MDAAP, the provider may request a grace period of 30 days beginning from the date requested but not to exceed December 1st, 2024 to engage with business support services. State administrators will only deny the request for the grace period if:
-
The request is made 60 or more calendar days after the Participation Agreement was signed;
-
The request is made on or after December 1st, 2024, as there will likely not be enough time left for a provider to participate who requires longer than average to complete milestones; or
-
State administrators are aware of a specific reason or objective indication that the provider will not proceed to any digitization or connection milestones during the project period.
If the provider does not follow the terms of the Participation Agreement and engage with business support services to start the needs assessment within 30 days, and does not request a grace period, or the grace period request is denied, then the provider must return the Participation Agreement incentive payment. Providers will be sent a letter by email, requesting the incentive payment be returned, which will include the MDAAP Return Payment Form, and state the provider can request a Reconsideration of the decision if they feel the findings are incorrect. The MDAAP offers a Reconsideration process that aligns with that of the Vermont Medicaid program and is detailed in Section 8 of The Green Mountain Care General Provider Manual, available here: https://www.vtmedicaid.com/assets/manuals/GeneralProviderManual.pdf. The request for Reconsideration must be made within 30 calendar days of the receipt of the letter and must be filed on the Request for MDAAP Reconsideration form located at https://healthdata.vermont.gov/mdaap/reconsideration-appeals. If the state MDAAP does not hear from the provider within 30 days, then the necessary adjustments to recover the overpayment will be made by recouping funds from future Medicaid remittances.
Providers wishing to return payment can send a check to our fiscal agent along with the MDAAP Return Payment Form, posted to this site. Providers can also request a repayment plan, or the incentive can be collected through future Medicaid remittances.
Forms: