Title 18, Health

§ 9316. Modification or termination of guardianship services (a) The Commissioner shall provide guardianship services in accordance with the order of the Probate Division or Family Division of the Superior Court until termination or modification thereof by the court. (b) The Comm…

§ 9317. General provision The Commissioner may delegate his or her powers and duties under this chapter to staff within the Department, and may adopt, pursuant to 3 V.S.A. chapter 25, rules necessary for the proper and efficient administration of this chapter. (Added 1977, No. 19…

§ 9331. Definitions For purposes of this chapter: (1) “Commissioner” means the Commissioner of Financial Regulation. (2) “DNA” means deoxyribonucleic acid and “RNA” means ribonucleic acid. (3) “Employee” has the same meaning as in 21 V.S.A. § 495d. (4) “Employer” has the same mea…

§ 9332. Genetic testing; limitations (a) No person shall be required to undergo genetic testing, except as provided in this chapter. (b) A person may be required to undergo genetic testing in connection with insurance subject to the limitations imposed under section 9334 of this …

§ 9333. Genetic testing; employment; membership in a labor organization; professional licensure (a) No person shall, directly or indirectly, do any of the following as a condition of, or to affect the terms, conditions, or privileges of employment, of membership in a labor organi…

§ 9334. Genetic testing as a condition of insurance coverage (a) No policy of insurance offered for delivery or issued in this State shall be underwritten or conditioned on the basis of: (1) any requirement or agreement of the individual to undergo genetic testing; or (2) the res…

§ 9335. Remedies (a) Any person who intentionally violates section 9333 or subsection 9334(a) of this chapter shall be imprisoned not more than one year or fined not more than $10,000.00, or both. (b) Any person aggrieved by a violation of this chapter may bring an action for civ…

§ 9351. Health Information Technology Plan (a)(1) The Department of Vermont Health Access, in consultation with the Department’s Health Information Exchange Steering Committee, shall be responsible for the overall coordination of Vermont’s statewide Health Information Technology …

§ 9352. Vermont Information Technology Leaders (a) Governance. The Vermont Information Technology Leaders, Inc. (VITL) Board of Directors shall consist of no fewer than nine nor more than 14 members. The term of each member shall be two years, except that of the members first app…

§ 9353. Integration of health care data; reports (a) The Agency of Human Services shall collaborate with the Health Information Exchange Steering Committee in the development of the Unified Health Data Space in order to improve patient and provider access to relevant information,…

§ 9361. Health care providers delivering health care services through telemedicine or by store-and-forward means (a) As used in this section, “distant site,” “health care provider,” “originating site,” “store-and-forward,” and “telemedicine” have the same meanings as in 8 V.S.A. …

§ 9362. Health care providers delivering health care services by audio-only telephone (a) As used in this section: (1) “Health insurance plan” has the same meaning as in 8 V.S.A. § 4011. (2) “Health care provider” has the same meaning as in 8 V.S.A. § 4098b. (3) “Telemedicine” ha…

§ 9371. Principles for health care reform The General Assembly adopts the following principles as a framework for reforming health care in Vermont: (1) The State of Vermont must ensure universal access to and coverage for high-quality, medically necessary health services for all …

§ 9372. Purpose It is the intent of the General Assembly to create an independent board to promote the general good of the State by: (1) improving the health of the population; (2) reducing the per-capita rate of growth in expenditures for health services in Vermont across all pa…

§ 9373. Definitions As used in this chapter: (1) “Board” means the Green Mountain Care Board established in this chapter. (2) “Chronic care” means health services provided by a health care professional for an established clinical condition that is expected to last a year or more …

§ 9374. Board membership; authority (a)(1) On July 1, 2011, the Green Mountain Care Board is created and shall consist of a chair and four members. The Chair and all of the members shall be State employees and shall be exempt from the State classified system. The Chair shall rece…

§ 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 (a)(1) In order to be eligible to operate in Vermont, each accountable care organization shall obtain and maintain certification from the Green Mountain Care Board. The Board shall adopt rules pursuant to 3 V.S.A. chapter 25 to …

§ 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 …

§ 9401. Policy (a) It is the policy of the State of Vermont that health care is a public good for all Vermonters and to ensure that all residents have access to quality health services at costs that are affordable. To achieve this policy, it is necessary that the State ensure the…

§ 9402. Definitions As used in this chapter, unless otherwise indicated: (1) “Commissioner” means the Commissioner of Financial Regulation or the Commissioner’s designee. (2) “Community report” means the hospital report prepared under section 9405a of this title. (3) “Department”…

§ 9403. Statewide Health Care Delivery Strategic Plan (a) The Agency of Human Services, in collaboration with the Green Mountain Care Board, the Department of Financial Regulation, the Vermont Program for Quality in Health Care, the Office of the Health Care Advocate, the Health …

§ 9403a. Health Care Delivery Advisory Committee (a) There is created the Health Care Delivery Advisory Committee to: (1) establish health care affordability benchmarks; (2) evaluate and monitor the performance of Vermont’s health care system and its impacts on population health …

§ 9403b. Vermont Steering Committee for Comprehensive Primary Health Care (a) There is created the Vermont Steering Committee for Comprehensive Primary Health Care to inform the work of State government, including the Blueprint for Health and the Office of Health Care Reform in t…

§ 9404. Administration (a) The Commissioner and the Green Mountain Care Board shall supervise and direct the execution of all laws vested in the Department and the Board, respectively, by this chapter, and shall formulate and carry out all policies relating to this chapter. (b) T…

§ 9405. State Health Improvement Plan; Health Resource Allocation Plan (a) The Secretary of Human Services or designee, in consultation with the Chair of the Green Mountain Care Board and health care professionals and after receipt of public comment, shall adopt a State Health Im…

§ 9405a. Public participation and strategic planning (a) Each hospital shall have a protocol for meaningful public participation in its strategic planning process for identifying and addressing health care needs that the hospital provides or could provide in its service area. Nee…

§ 9405b. Hospital community reports and ambulatory surgical center quality reports (a) The Commissioner of Health, in consultation with representatives from hospitals, other groups of health care professionals, and members of the public representing patient interests, shall adopt…

§ 9405c. Notice of acquisition (a) As used in this section: (1) “Acquire” means a purchase or transfer through which a hospital will own or control the business of a medical practice. (2) “Hospital” means a general hospital or hospital facility licensed under chapter 43 of this t…

§ 9405d. Hospital service eliminations; notice required (a)(1)(A) A hospital that is considering eliminating any of the following services shall provide a preliminary notice of intent to the Agency of Human Services, the Green Mountain Care Board, and the Office of the Health Car…

§ 9406. Reporting on participation in 340B drug pricing program [Repealed effective January 1, 2031] (a) Annually on or before January 31, each hospital participating in the federal 340B drug pricing program established by 42 U.S.C. § 256b shall submit to the Green Mountain Care …

§ 9407. Outpatient prescription drugs; limitations on hospital charges (a)(1) A hospital shall not submit a claim to a health insurer for reimbursement of a prescription drug administered in an outpatient or office setting in an amount that exceeds 120 percent of the average sale…

§ 9408. Common claims forms and procedures Not later than January 15, 1993, the Commissioner shall adopt by rule uniform health insurance claims forms and uniform standards and procedures for the processing of claims, including electronic claims forms submission. (Added 1991, No.…

§ 9408a. Uniform provider credentialing (a) Definitions. As used in this section: (1) “Credentialing” means a process through which an insurer or hospital makes a determination, based on criteria established by the insurer or hospital, concerning whether a provider is eligible to…

§ 9409. Health care provider bargaining groups (a) The Green Mountain Care Board may approve the creation of one or more health care provider bargaining groups, consisting of health care providers who choose to participate. A bargaining group is authorized to negotiate on behalf …