Payment for Inpatient Days. Effective for Inpatient Days under the term of this Contract, as defined in Attachment A, State shall issue monthly prospective payments to Contractor as reimbursement for Inpatient Days. Inpatient Days (both voluntary and involuntary admissions) when Medicaid is not the primary payer are excluded. All other services, rendered by Contractor for Vermont Medicaid members will continue to be reimbursed using existing Medicaid reimbursement methodologies. The time period March 1, 2021 through December 31, 2021, is defined as Alternative Payment Model (APM) Year 1. For APM Year 1, the prospective monthly payment per Inpatient Day (APM Payment) is computed using a weighted average per diem amount of $1,838,33. The time period January 1, 2022 through December 31, 2022, is defined as APM Year 2. For the APM Year 2, the APM Payment for January 1, 2022 through June 30, 2022 is computed using a weighted average per diem amount of $2,550.00. The APM Payment for July 1, 2022 through December 31, 2022 is computed using a weighted average per diem amount of $3,100.00. The time period January 1, 2023 through December 31, 2023, is defined as APM Year 3. For the APM Year 3, the APM Payment is computed using a weighted average per diem amount of $3,100.00.
Payment for Inpatient Days. Effective for Inpatient Days beginning March 1, 2021 and ending December 31, 2021, State shall issue monthly prospective payments to Contractor as reimbursement for Inpatient Days. Inpatient Days (both voluntary and involuntary admissions) when Medicaid is not the primary payer are excluded. All other services, rendered by Contractor for Vermont Medicaid members will continue to be reimbursed using existing Medicaid reimbursement methodologies. The time period March 1 through December 31, 2021 is defined as Alternative Payment Model (APM) Year 1. For the APM Year 1, the prospective monthly payment per Inpatient Day (APM PAYMENT) is computed using a weighted average per diem amount of $1,838.33.
