Title 18, Health

§ 9454. Hospitals; duties (a) Hospitals shall file the following information at the time and place and in the manner established by the Board: (1) a budget for the forthcoming fiscal year; (2) financial information, including costs of operation, revenues, assets, liabilities, fun…

§ 9456. Budget review (a) The Board shall conduct reviews of each hospital’s proposed budget based on the information provided pursuant to this subchapter and in accordance with a schedule established by the Board. Notwithstanding any provision of 3 V.S.A. chapter 25 to the contr…

§ 9457. Information available to the public (a) Information required to be filed under this subchapter shall be made available to the public upon request in accordance with 1 V.S.A. chapter 5, subchapter 3 (Public Records Act), except that information that directly or indirectly …

§ 9458. Hospital networks; structure; financial operations (a) The Board may review and evaluate the structure of a hospital network to determine: (1) whether any network operations should be organized and operated out of a hospital instead of at the network; and (2) whether the …

§ 9461. Quality measures (a) The Department of Financial Regulation shall develop performance quality measures to evaluate and ensure that health insurers, including managed care organizations that contract with health insurers to administer the insurers’ mental health benefits, …

§ 9462. Quality improvement projects The Green Mountain Care Board shall consider the results of any quality improvement projects not otherwise confidential or privileged undertaken by managed care organizations for mental health and substance abuse care and treatment pursuant to…

§ 9471. Definitions [Repealed effective July 1, 2029] As used in this subchapter: (1) “Beneficiary” means an individual enrolled in a health plan in which coverage of prescription drugs is administered by a pharmacy benefit manager and includes his or her dependent or other perso…

§ 9472. Pharmacy benefit managers; required practices with respect to health insurers and covered persons [Repealed effective July 1, 2029] (a) A pharmacy benefit manager that provides pharmacy benefit management for a health plan has a fiduciary duty to its health insurer client…

§ 9473. Pharmacy benefit managers; required practices with respect to pharmacies [Repealed effective July 1, 2029] (a) Within 14 calendar days following receipt of a pharmacy claim, a pharmacy benefit manager or other entity paying pharmacy claims shall do one of the following: (…

§ 9474. Enforcement [Repealed effective July 1, 2029] (a) Except as provided in subsection (d) of this section, in addition to any remedy available to the Commissioner under this title and any other remedy provided by law, a violation of this subchapter shall be considered a viol…

§ 9481. Definitions As used in this subchapter: (1) “Amount generally billed” means the amount a large health care facility generally bills to individuals for emergency or other medically necessary health care services, determined using the “look-back method” set forth in 26 C.F.…

§ 9482. Financial assistance policies for large health care facilities (a) Each large health care facility in this State shall develop a written financial assistance policy that, at a minimum, complies with the provisions of this subchapter and any applicable federal requirements…

§ 9483. Implementation of financial assistance policy (a) In addition to any other actions required by applicable State or federal law, a large health care facility shall take the following steps before seeking payment for any emergency or medically necessary health care services…

§ 9484. Public education and information (a) Each large health care facility shall publicize its financial assistance policy widely by: (1) making the financial assistance policy and application form easily accessible online through the facility’s website and through any patient …

§ 9485. Prohibition on sale or reporting of medical debt (a)(1) No large health care facility shall sell its medical debt except as provided in subdivision (2) of this subsection. (2) A large health care facility may sell or otherwise transfer its medical debt to an organization …

§ 9486. Prohibition of waiver of rights Any waiver by a patient or other individual of any protection provided by or any right of the patient or other individual under this subchapter is void and shall not be enforced by any court or any other person. (Added 2021, No. 119 (Adj. S…

§ 9487. Enforcement The Office of the Attorney General has the same authority to make rules, conduct civil investigations, enter into assurances of discontinuance, and bring civil actions for violations of this subchapter as is provided under 9 V.S.A. chapter 63, subchapter 1. (A…