§ 9409. Health care provider bargaining groups
§ 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 of all participating providers with the Secretary of Administration, the Secretary […]
§ 9410. Health care database
§ 9410. Health care database (a)(1) The Board shall establish and maintain a unified health care database to enable the Board to carry out its duties under this chapter, chapter 220 of this title, and Title 8, including: (A) determining the capacity and distribution of existing resources; (B) identifying health care needs and informing health […]
§ 9411. Interactive price transparency dashboard
§ 9411. Interactive price transparency dashboard (a) The Green Mountain Care Board shall develop and maintain a public, interactive, Internet-based price transparency dashboard that allows consumers to compare health care prices for certain health care services across the State. Using data from the Vermont Healthcare Claims Uniform Reporting and Evaluation System (VHCURES) established pursuant to […]
§ 9412. Enforcement
§ 9412. Enforcement (a) In order to carry out the duties under this chapter, in addition to the powers provided in this chapter, in chapter 220 of this title, and in Title 8, the Commissioner and the Board may examine the books, accounts, and papers of health insurers, health care providers, health care facilities, health […]
§ 9413. Health care quality and price comparison
§ 9413. Health care quality and price comparison Each health insurer with more than 200 covered lives in this State shall establish an Internet-based tool to enable its members to compare the price of health care in Vermont by service or procedure, including office visits, emergency care, radiologic services, and preventive care such as mammography […]
§ 9414. Quality assurance for managed care
§ 9414. Quality assurance for managed care (a) The Commissioner shall have the power and responsibility to ensure that each managed care organization provides quality health care to its members, in accordance with the provisions of this section. (1) In determining whether a managed care organization meets the requirements of this section, the Commissioner may […]
§ 9414a. Annual reporting by health insurers
§ 9414a. Annual reporting by health insurers (a) As used in this section: (1) “Adverse benefit determination” means a denial, reduction, modification, or termination of, or a failure to provide or make payment in whole or in part for, a benefit, including: (A) a denial, reduction, modification, termination, or failure to provide or make payment […]
§ 9416. Vermont Program for Quality in Health Care
§ 9416. Vermont Program for Quality in Health Care (a) The Commissioner of Health shall contract with the Vermont Program for Quality in Health Care, Inc. to implement and maintain a statewide quality assurance system to evaluate and improve the quality of health care services rendered by health care providers of health care facilities, including […]
§ 9405. State Health Improvement Plan; Health Resource Allocation Plan
§ 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 Improvement Plan that sets forth the health goals and values for […]
§ 9405a. Public participation and strategic planning
§ 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. Needs identified through the process shall be integrated with the hospital’s long-term planning. Each […]