Title 18, Title 18: Health

§ 9375. Duties (a) The Board shall execute its duties consistent with the principles expressed in section 9371 of this title. (b) The Board shall have the following duties: (1) Oversee the development and implementation, and evaluate the effectiveness, of health care payment and …

§ 9376. Payment amounts; methods (a) Intent. It is the intent of the General Assembly to ensure payments to health care professionals that are consistent with efficiency, economy, and quality of care and will permit them to provide, on a solvent basis, effective and efficient hea…

§ 9377. Payment reform; pilots (a) It is the intent of the General Assembly to achieve the principles stated in section 9371 of this title. In order to achieve this goal and to ensure the success of health care reform, it is the intent of the General Assembly that payment reform …

§ 9377a. Prior authorization pilot program (a) The Green Mountain Care Board shall develop and implement a pilot program or programs for the purpose of measuring the change in system costs within primary care associated with eliminating prior authorization requirements for imagin…

§ 9378. Public process The Green Mountain Care Board shall provide a process for soliciting public input. The process may include receiving written comments on proposed new or amended rules or holding public hearings, or both. (Added 2011, No. 48, § 3, eff. May 26, 2011.)

§ 9379. Agency cooperation The Secretary of Administration shall ensure that, in accordance with State and federal privacy laws, the Green Mountain Care Board has access to data and analysis held by any Executive Branch agency that is necessary to carry out the Board’s duties as …

§ 9380. Rules The Board may adopt rules pursuant to 3 V.S.A. chapter 25 as needed to carry out the provisions of this chapter. (Added 2011, No. 48, § 3, eff. May 26, 2011.)

§ 9381. Appeals (a) The Green Mountain Care Board shall adopt procedures for administrative appeals of its actions, orders, or other determinations. Such procedures shall provide for the issuance of a final order and the creation of a record sufficient to serve as the basis for j…

§ 9382. Oversight of accountable care organizations [Subsection (a) effective until January 1, 2027; see also subsection (a) effective January 1, 2027, set out below] (a) In order to be eligible to receive payments from Medicaid or commercial insurance through any payment reform …

§ 9383. Expenditure analysis; health care spending estimate (a) The Board shall develop annually an expenditure analysis and an estimate of future health care spending covering a period of at least two years. These analyses shall contain data and information as set forth in this …

§ 9384. Reduction or reallocation of reimbursement rates; risks to health insurer solvency (a) As used in this section: (1) “Hospital” has the same meaning as in section 9451 of this title. (2) “Hospital network” means a system comprising two or more affiliated hospitals, and may…

§ 9390. Green Mountain Care Board Nominating Committee created; composition (a) The Green Mountain Care Board Nominating Committee is created for the nomination of the Chair and members of the Green Mountain Care Board. (b)(1) The Committee shall consist of nine members who shall…

§ 9391. Nomination and appointment process (a) Candidate selection process. (1) Unless a vacancy is filled by reappointment by the Governor pursuant to subsection (c) of this section, not later than 90 days prior to a known vacancy occurring on the Green Mountain Care Board the G…

§ 9392. Qualifications for nominees The Green Mountain Care Board Nominating Committee shall assess candidates using the following criteria: (1) commitment to the principles expressed in section 9371 of this title; (2) knowledge of or expertise in health care policy, health care …