{"id":246487,"date":"2023-09-26T14:13:32","date_gmt":"2023-09-26T18:13:32","guid":{"rendered":"http:\/\/onecare.mysites.io\/?page_id=246487"},"modified":"2024-05-16T11:20:10","modified_gmt":"2024-05-16T15:20:10","slug":"waivers","status":"publish","type":"page","link":"https:\/\/www.onecarevt.org\/waivers\/","title":{"rendered":"Waivers"},"content":{"rendered":"

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Waivers for Health Care Delivery Innovation<\/h1>\n

[\/et_pb_text][et_pb_divider color=”#ffffff” divider_weight=”4px” disabled_on=”on|on|off” _builder_version=”4.17.6″ max_width=”120px” custom_margin=”9px||||false|false” animation_direction=”top” global_colors_info=”{}”][\/et_pb_divider][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ admin_label=”OneCare is a Community of Providers (Full Row & Contents)” _builder_version=”4.17.6″ custom_margin=”||0px||false|false” custom_padding=”||30px||false|false” da_disable_devices=”off|off|off” collapsed=”on” global_colors_info=”{}” da_is_popup=”off” da_exit_intent=”off” da_has_close=”on” da_alt_close=”off” da_dark_close=”off” da_not_modal=”on” da_is_singular=”off” da_with_loader=”off” da_has_shadow=”on”][et_pb_row _builder_version=”4.17.6″ _module_preset=”default” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.17.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.17.6″ _module_preset=”default” header_2_text_color=”#45A142″ header_2_font_size=”42px” header_2_line_height=”1.2em” header_3_text_color=”#3e9991″ header_3_font_size=”28px” header_3_line_height=”1.3em” header_4_text_color=”#545456″ header_4_font_size=”21px” header_4_line_height=”1.5em” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false” global_colors_info=”{}”]<\/p>\n

Table of Contents<\/h2>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ _builder_version=”4.16″ custom_margin=”24px||||false|false” custom_padding=”0|0px|27px|0px|false|false” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_blurb title=”About” url=”#about” use_icon=”on” font_icon=”||divi||400″ icon_color=”#2f8083″ icon_placement=”left” image_icon_width=”34px” _builder_version=”4.17.6″ header_text_color=”#2f8083″ header_font_size=”20px” header_line_height=”1.7em” body_line_height=”1em” custom_margin=”15px||0px||false|false” custom_padding=”0px||6px||false|false” border_width_bottom=”3px” border_color_bottom=”#CCCCCC” icon_font_size=”48px” global_colors_info=”{}”][\/et_pb_blurb][et_pb_blurb title=”Participation Waiver” url=”#participation-waiver” use_icon=”on” font_icon=”||divi||400″ icon_color=”#2f8083″ icon_placement=”left” image_icon_width=”34px” _builder_version=”4.17.6″ header_text_color=”#2f8083″ header_font_size=”20px” header_line_height=”1.7em” body_line_height=”1em” custom_margin=”15px||0px||false|false” custom_padding=”0px||6px||false|false” border_width_bottom=”3px” border_color_bottom=”#CCCCCC” icon_font_size=”48px” global_colors_info=”{}”][\/et_pb_blurb][et_pb_blurb title=”Patient Engagement Incentives Waiver” url=”#Patient-Engagement-Waiver” use_icon=”on” font_icon=”||divi||400″ icon_color=”#2f8083″ icon_placement=”left” image_icon_width=”34px” _builder_version=”4.17.6″ header_text_color=”#2f8083″ header_font_size=”20px” header_line_height=”1.7em” body_line_height=”1em” custom_margin=”15px||0px||false|false” custom_padding=”0px||6px||false|false” border_width_bottom=”3px” border_color_bottom=”#CCCCCC” icon_font_size=”48px” global_colors_info=”{}”][\/et_pb_blurb][\/et_pb_column][et_pb_column type=”1_2″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_blurb title=”Currently Approved Waivers” url=”#approved-waivers” use_icon=”on” font_icon=”||divi||400″ icon_color=”#2f8083″ icon_placement=”left” image_icon_width=”34px” _builder_version=”4.17.6″ header_text_color=”#2f8083″ header_font_size=”20px” header_line_height=”1.7em” body_line_height=”1em” custom_margin=”15px||0px||false|false” custom_padding=”0px||6px||false|false” border_width_bottom=”3px” border_color_bottom=”#CCCCCC” icon_font_size=”48px” global_colors_info=”{}”][\/et_pb_blurb][et_pb_blurb title=”Application Form” url=”#apply” use_icon=”on” font_icon=”||divi||400″ icon_color=”#2f8083″ icon_placement=”left” image_icon_width=”34px” _builder_version=”4.17.6″ header_text_color=”#2f8083″ header_font_size=”20px” header_line_height=”1.7em” body_line_height=”1em” custom_margin=”15px||0px||false|false” custom_padding=”0px||6px||false|false” border_width_bottom=”3px” border_color_bottom=”#CCCCCC” icon_font_size=”48px” global_colors_info=”{}”][\/et_pb_blurb][et_pb_blurb title=”Questions\/Contact” url=”#contact” use_icon=”on” font_icon=”||divi||400″ icon_color=”#2f8083″ icon_placement=”left” image_icon_width=”34px” _builder_version=”4.17.6″ header_text_color=”#2f8083″ header_font_size=”20px” header_line_height=”1.7em” body_line_height=”1em” custom_margin=”15px||0px||false|false” custom_padding=”0px||6px||false|false” border_width_bottom=”3px” border_color_bottom=”#CCCCCC” icon_font_size=”48px” global_colors_info=”{}”][\/et_pb_blurb][\/et_pb_column][\/et_pb_row][et_pb_row make_equal=”on” custom_padding_last_edited=”on|desktop” module_id=”spotlight1″ _builder_version=”4.17.6″ _module_preset=”default” background_color=”#ffffff” custom_margin=”30px||30px||true|false” custom_padding=”40px|40px|40px|40px|true|true” custom_padding_tablet=”40px|40px|40px|40px|true|true” custom_padding_phone=”20px|20px|20px|20px|true|true” animation_style=”slide” animation_direction=”left” animation_intensity_slide=”14%” hover_enabled=”0″ border_radii=”on|5px|5px|5px|5px” 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header_2_line_height=”1.1em” header_3_text_color=”#40a07d” header_3_font_size=”27px” header_3_line_height=”1.3em” custom_margin=”||20px||false|false” custom_padding=”||0px||false|false” hover_enabled=”0″ text_font_size_tablet=”” text_font_size_phone=”16px” text_font_size_last_edited=”on|phone” header_2_font_size_tablet=”23px” header_2_font_size_phone=”20px” header_2_font_size_last_edited=”on|phone” global_colors_info=”{}” sticky_enabled=”0″]<\/p>\n

OneCare Vermont Announces Six New Waivers to Improve Health Care Quality and Access<\/h3>\n

OneCare Vermont has introduced six new waivers aimed at improving mental health care access, reducing hospital readmissions, and enhancing overall health care accessibility in Vermont, allocating $100,000 to fund innovative projects to achieve these goals<\/p>\n

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\n[\/et_pb_button][\/et_pb_column][\/et_pb_row][et_pb_row module_id=”about” _builder_version=”4.17.6″ _module_preset=”default” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.17.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.17.6″ _module_preset=”default” header_2_text_color=”#45A142″ header_2_font_size=”37px” header_2_line_height=”1.2em” header_3_text_color=”#3e9991″ header_3_font_size=”28px” header_3_line_height=”1.3em” header_4_text_color=”#545456″ header_4_font_size=”21px” header_4_line_height=”1.5em” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” global_colors_info=”{}”]<\/p>\n

About Waivers<\/h2>\n

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OneCare Vermont, as an accountable care organization (ACO) participating in Vermont\u2019s All-Payer Model, has been provided waivers\u2014known as \u201cFraud and Abuse Waivers\u201d and “Benefit Enhancement Waivers”\u2014that are specific to the Vermont All-Payer Model. These waivers are provided to make it easier for the health care providers who work with OneCare to provide high quality care at lower costs to Vermonters.<\/p>\n

Using the waivers, OneCare has been able to support new care delivery projects for patients like free medical nutrition counseling, genomic testing and counseling, and personal care services \u2013 all of which are restricted under federal rules and regulations. The waivers have also been used to promote partnerships between providers like ambulance transport from the emergency department to treatment, or providing care in the home to patients who don\u2019t qualify for home health or sharing data and analytics tools.<\/p>\n

The intention is to promote delivery system innovation amongst unrelated provider organizations (like between a hospital and a designated agency) working together on cost and quality of care as part of the OneCare Vermont ACO in Vermont\u2019s All-Payer Model. Unrelated provider organization arrangements that meet the criteria of these waivers are protected from enforcement under Anti-Kickback, Stark and Civil Monetary Penalties laws.<\/p>\n

After considering the specific needs in Vermont, OneCare has determined that, although it will consider any waiver request, it is particularly interested in using waivers to help patients leave the hospital when they are ready for step down care. This includes transportation, paying for needed medications at skilled nursing facilities, and providing support at home once patients return there.<\/p>\n

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The Waiver Tools and How OneCare Uses Them<\/h2>\n

[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row column_structure=”1_2,1_2″ module_id=”overview” _builder_version=”4.17.6″ _module_preset=”default” custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false” border_color_all=”RGBA(255,255,255,0)” border_style_all=”none” border_width_bottom=”6px” border_color_bottom=”#4CB49F” global_colors_info=”{}”][et_pb_column type=”1_2″ _builder_version=”4.17.6″ _module_preset=”default” global_colors_info=”{}”][et_pb_text _builder_version=”4.17.6″ _module_preset=”default” header_2_text_color=”#45A142″ header_2_font_size=”37px” header_2_line_height=”1.2em” header_3_text_color=”#4CB49F” header_3_font_size=”32px” header_3_line_height=”1.3em” header_4_text_color=”#545456″ header_4_font_size=”21px” header_4_line_height=”1.5em” custom_margin=”||0px||false|false” custom_padding=”||0px||false|false” global_colors_info=”{}”]<\/p>\n

Participation Waiver<\/h3>\n

This waiver offers flexibility provided by Medicare and Medicaid to allow OneCare Vermont and its participants to create financial and clinical arrangements that promote success in the Vermont All-Payer Model without risking regulatory penalties; in other words, giving providers more flexibility in improving the value of care. The participation waiver removes detailed requirements and allows participating providers to be creative and design pathways for delivering care that improve the care experience while more efficiently spending health care resources.<\/p>\n

Laws waived:<\/strong> Anti-Kickback Statute & Stark Law: these laws govern financial relationships between providers for Medicare and VT Medicaid patients<\/p>\n

<\/h3>\n

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Eligible population:<\/strong> Medicare, VT Medicaid, Commercial<\/p>\n

Eligible ideas:<\/strong> Arrangements for clinical services, IT, and social services can be made between OneCare and\/or OneCare participant with or without other parties.<\/p>\n

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Conditions:<\/strong><\/h4>\n

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