Adoptions

Following the passage of Act 127 in 2024, the Department of Financial Regulation was directed to adopt rules to establish the licensing application, financial and reporting requirements for PBMs. Pharmacy Benefit Managers (PBMs) are intermediaries between health insurance companies and drug manufacturers. They negotiate prescription drug prices with manufacturers and separately, they negotiate the reimbursement payable to pharmacies to dispense the drugs.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This is a comprehensive update to rules governing adult-use cannabis establishments and the medical cannabis system. Amendments to Rule 1 streamline renewal; establish siting requirements for retailers; simplify license changes; provide for tier changes based on performance; require deposit accounts; increase flexibility to address past misconduct by applicants; and retire a cumbersome system of prequalification. Amendments to Rule 2 clarify safety standards and allowable use of the Inventory Tracking System; prohibit consignment; standardize transport manifests; disallow illusory brands; standardize warning symbols; provide for product remediation; provide for curbside transactions; implement propagation cultivator licensing; integrate hemp-derived additives; and prohibit cannabinoids in beverage alcohol. Amendments to Rule 3 provide for retailer medical endorsements and raise standards for medical products. Amendments to Rule 4 create a process for orders concerning adulterated products.

This update reflects changes in pharmacy's legal and practice landscape since 2015 by regulating, among other things: - new types of pharmacy entity, such as virtual distributors and manufacturers, 503B outsourcers, and third-party logistics providers; - the prescribing of opioids; - devices containing prescription drugs; - naloxone dispensing; and - changes to prescriptions for schedule II controlled substances. The rule also reflects statutory changes to pharmacy professionals' scopes of practice, including immunizations, and simplifies the licensing of pharmacy technicians into a single credential instead of the current two-tiered system. The rule creates standards for workplace conditions pharmacy staffing necessary to protect the public. The rule streamlines and narrows the legal duties of Pharmacy Managers, clarifying that licensed pharmacies are themselves responsible for compliance with the Rules.

The rule prescribes guidelines for distinguishing between “primary” and “specialty” mental health and substance abuse services. This revision designates interprofessional consulting and peer support services as "primary" mental health and substance abuse services and makes technical and stylistic changes to the rule.

The proposed rulemaking outlines Vermont Medicaid's obligations according to federal law in establishing, managing, and upholding an incident management system designed to safeguard the well-being of individuals enrolled in home and community-based services sanctioned under the Global Commitment to Health Waiver. The proposed rulemaking aligns with the federal law stipulating the essential components of such a system, which includes the identification, reporting, prioritization, investigation, resolution, tracking, and analysis of critical incidents.

This proposed rulemaking aligns with federal regulation for person-centered planning in delivering home and community-based services under the Global Commitment to Health Waiver, approved by CMS. The proposed rule establishes the requirements for the planning process, service plans, annual reviews, and the required documentation for modifications to the additional qualities of a home and community-based setting.

In 2024, EPA promulgated new PFAS regulations, including Maximum Contaminant Levels. States are required to implement these new standards into State regulation and be no less stringent. This rule incorporates the federal regulation but expedites the timeline due to our existing PFAS data and regulation. This will ensure systems in need of PFAS treatment seek and install such treatment while federal funding remains available, through 2027. It also updates state technical standards for PFAS treatment. We are also seeking updates to the regulation of bottled water in Vermont. EPA also promulgated updated regulations pertaining to Consumer Confidence Reports, a form of public notice providing essential information to be conveyed annually to water systems users. This state rule revision will incorporate those federal changes as well.