Rule:26P031

The Vermont Agency of Human Services has filed a proposed rule, numbered 26P031, to amend and re-designate the existing Medicaid covered-services rule 7317 (titled "Rehabilitative Therapy Services") as Health Care Administrative Rule 4.219, titled "Physical Therapy, Occupational Therapy, and Speech Language Pathology Services." Legal authority is cited as 3 V.S.A. § 801(b)(11) and 33 V.S.A. § 1901(a)(1). The public comment deadline is November 16, 2026, and a hearing is scheduled for November 9, 2026. The substantive amendments increase the annual visit limit for adult Medicaid beneficiaries from 30 to 60 visits per calendar year for physical therapy, occupational therapy, and speech-language pathology services combined. For Medicaid members under the age of 21, the proposed rule removes visit limits entirely, eliminating the prior 30-visit annual cap for that population. Additional amendments clarify terms that were not previously defined in the existing rule, specify conditions required for coverage, and enumerate services that are not covered under the Vermont Medicaid program. The agency characterizes these additional changes as conforming the rule to current coverage criteria rather than expanding or contracting coverage in substance. The agency's economic impact statement asserts that the rule does not increase or lessen an economic burden on any person or entity and has no impact on the State's gross annualized budget. Persons identified as affected include Medicaid beneficiaries, Agency of Human Services departments, health care providers, and health law and advocacy organizations including the Office of Health Care Advocate.