reglab/housing_qa huggingface dataset:
33 V.S.A. § 1953
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1953. Hospital assessment

§ 1953. Hospital assessment|(a) Hospitals shall be subject to an annual assessment as follows:  (1) Beginning July 1, 2012, each hospital's annual assessment, except for hospitals assessed under subdivision (2) of this subsection, shall be six percent of its net patient revenues (less chronic, skilled, and swing bed revenues). (2) Beginning July 1, 2004, each mental hospital or psychiatric facility's annual assessment shall be 4.21 percent, provided that the U.S. Department of Health and Human Services grants a waiver to the uniform assessment rate, pursuant to 42 C.F.R. § 433.68(e). If the U.S. Department of Health and Human Services fails to grant a waiver, mental hospitals and psychiatric facilities shall be assessed under subdivision (1) of this subsection.   (b) Each hospital shall be notified in writing by the Department of the assessment made pursuant to this section. If no hospital submits a request for reconsideration under section 1958 of this title, the assessment shall be considered final.(c) Each hospital shall submit its assessment to the Department according to a payment schedule adopted by the Commissioner. Variations in payment schedules shall be permitted as deemed necessary by the Commissioner.(d) Any hospital that fails to make a payment to the Department on or before the specified schedule, or under any schedule for delayed payments established by the Commissioner, shall be assessed not more than $1,000.00. The Commissioner may waive this late payment assessment provided for in this subsection for good cause shown by the hospital. (Added 1991, No. 94, § 1; amended 1993, No. 56, § 1, eff. June 3, 1993; 1995, No. 5, § 26, eff. March 3, 1995; 1995, No. 14, § 2, eff. April 12, 1995; 1997, No. 59, §§ 69, 70, eff. June 30, 1997; 1999, No. 49, § 199; 2001, No. 65, § 13; 2003, No. 66, § 306; see effective date note set out below; 2003, No. 163 (Adj. Sess.), § 7; 2005, No. 71, § 285; 2007, No. 190 (Adj. Sess.), § 47, eff. June 6, 2008; 2009, No. 156 (Adj. Sess.), § E.309.4; 2011, No. 45, § 24, eff. May 24, 2011; 2011, No. 128 (Adj. Sess.), § 36.)
33 V.S.A. § 1954
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1954. Nursing home assessment

§ 1954. Nursing home assessment|(a) Beginning July 1, 2011, each nursing home's annual assessment shall be $4,509.57, and beginning October 1, 2011, $4,919.53 per bed licensed pursuant to section 7105 of this title on June 30 of the immediately preceding fiscal year. The annual assessment for each bed licensed as of the beginning of the fiscal year shall be prorated for the number of days during which the bed was actually licensed and any overpayment shall be refunded to the facility. To receive the refund, a facility shall notify the Commissioner in writing of the size of the decrease in the number of its licensed beds and dates on which the beds ceased to be licensed.(b) The Department shall provide written notification of the assessment amount to each nursing home. The assessment amount determined shall be considered final unless the home requests a reconsideration. Requests for reconsideration shall be subject to the provisions of section 1958 of this title.(c) Each nursing home shall submit its assessment to the Department according to a schedule adopted by the Commissioner. The Commissioner may permit variations in the schedule of payment as deemed necessary.(d) Any nursing home that fails to make a payment to the Department on or before the specified schedule, or under any schedule of delayed payments established by the Commissioner, shall be assessed not more than $1,000.00. The Commissioner may waive the late-payment assessment provided for in this subsection for good cause shown by the nursing home. (Added 1991, No. 94, § 1; amended 1991, No. 253 (Adj. Sess.), § 4; 1993, No. 56, § 1, eff. June 3, 1993; 1995, No. 5, § 27, eff. March 9, 1995; 1995, No. 14, § 3, eff. April 12, 1995; 1999, No. 49, § 202; 2001, No. 65, § 14; 2001, No. 142 (Adj. Sess.), § 120a; 2001, No. 143 (Adj. Sess.), § 49, eff. June 21, 2002; 2003, No. 66, § 307; 2003, No. 163 (Adj. Sess.), § 8; 2005, No. 71, § 286; 2007, No. 76, § 9, eff. June 7, 2007; 2007, No. 190 (Adj. Sess.), § 50, eff. June 6, 2008; 2009, No. 156 (Adj. Sess.), § I.54; 2011, No. 45, § 25, eff. May 24, 2011.)
33 V.S.A. § 1955
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1955. ICF/DD assessment

§ 1955. ICF/DD assessment|(a) Beginning October 1, 2011, each ICF/DD's annual assessment shall be 5.9 percent of the ICF/DD's total annual direct and indirect expenses for the most recently settled ICF/DD audit.(b) The Department shall provide written notification of the assessment amount to each ICF/DD. The assessment amount determined shall be considered final unless the facility requests a reconsideration. Requests for reconsideration shall be subject to the provisions of section 1958 of this title.(c) Each ICF/DD shall remit its assessment to the Department according to a schedule adopted by the Commissioner. The Commissioner may permit variations in the schedule of payment as deemed necessary.(d) Any ICF/DD that fails to make a payment to the Department on or before the specified schedule, or under any schedule of delayed payments established by the Commissioner, shall be assessed not more than $1,000.00. The Commissioner may waive the late-payment assessment provided for in this subsection for good cause shown by the ICF/DD. (Added 1991, No. 94, § 1; amended 1993, No. 56, § 1, eff. June 3, 1993; 2005, No. 71, § 287; 2007, No. 190 (Adj. Sess.), § 48, eff. June 6, 2008; 2009, No. 156 (Adj. Sess.), § I.55; 2011, No. 45, § 26, eff. May 24, 2011; 2013, No. 96 (Adj. Sess.), § 208.)
33 V.S.A. § 1955a
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1955a. Home health agency assessment

§ 1955a. Home health agency assessment|(a)(1) Each home health agency's assessment shall be 4.25 percent of its net patient revenues from home health services provided exclusively in Vermont.  (2) On or before May 1 of each year, each home health agency shall provide to the Department a copy of its most recent audited financial statement prepared in accordance with generally accepted accounting principles. The amount of the tax shall be determined by the Commissioner based on the home health net patient revenue attributable to services reported on the agency's financial statement. (3) For providers who began operations as a home health agency after January 1, 2005, the tax shall be assessed as follows:  (A) Until such time as the home health agency submits audited financial statements for its first full year of operation as a home health agency, the Commissioner, in consultation with the home health agency, shall annually estimate the amount of tax payable and shall prescribe a schedule for interim payments. (B) At such time as the full-year audited financial statement is filed, the final assessment shall be determined, and the home health agency shall pay any underpayment or the Department shall refund any overpayment. The assessment for the State fiscal year in which a provider commences operations as a home health agency shall be prorated for the proportion of the State fiscal year in which the new home health agency was in operation.    (b) Each home health agency shall be notified in writing by the Department of the assessment made pursuant to this section. If no home health agency submits a request for reconsideration under section 1958 of this title, the assessment shall be considered final.(c) Each home health agency shall submit its assessment to the Department according to a payment schedule adopted by the Commissioner. Variations in payment schedules shall be permitted as deemed necessary by the Commissioner.(d) Any home health agency that fails to make a payment to the Department on or before the specified schedule, or under any schedule for delayed payments established by the Commissioner, shall be assessed not more than $1,000.00. The Commissioner may waive the late-payment assessment provided for in this subsection for good cause shown by the home health agency. (Added 1999, No. 49, § 203; amended 2001, No. 65, § 15; 2003, No. 66, § 309; 2005, No. 71, § 288; 2009, No. 47, § 15; 2009, No. 156 (Adj. Sess.), § I.56; 2011, No. 45, § 23, eff. May 24, 2011; 2013, No. 73, § 55, eff. July 1, 2005, eff. June 5, 2013; 2017, No. 73, § 18a, eff. June 13, 2017; repealed on July 1, 2023 by 2021, No. 73 § 13.)
33 V.S.A. § 1955b
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1955b. Pharmacy assessment

§ 1955b. Pharmacy assessment|(a) Beginning July 1, 2005, each pharmacy's monthly assessment shall be $0.10 for each prescription filled and refilled.(b) Each pharmacy shall declare and provide supporting documentation to the Commissioner of the total number of prescriptions filled and refilled in the previous month and remit the assessment due for that month. The declaration and payment shall be due by the end of the following month.(c) Each pharmacy shall submit its assessment payment to the Department monthly. Variations in payment timing shall be permitted as deemed necessary by the Commissioner.(d) Any pharmacy that fails to pay an assessment to the Department on or before the due date shall be assessed a late payment penalty of two percent of the assessment amount for each month it remains unpaid; but late payment penalties for any one quarter shall not exceed $500.00. The Commissioner may waive a penalty under this subsection for good cause shown by the pharmacy, as determined by the Commissioner in his or her discretion. (Added 2005, No. 71, § 289; amended 2009, No. 156 (Adj. Sess.), § I.57.)
33 V.S.A. § 1956
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1956. Proceeds from assessments

§ 1956. Proceeds from assessments|All assessments, including late-payment assessments, from health care providers under this subchapter shall be deposited in the General Fund. No provision of this subchapter shall permit the State to reduce the level of State funds expended on the nursing home Medicaid program in any fiscal year below the level expended in fiscal year 1991 from the General Fund for the nursing home Medicaid program. (Added 1991, No. 94, § 1; amended 1991, No. 253 (Adj. Sess.), § 6; 1993, No. 56, § 1, eff. June 3, 1993; 1995, No. 14, § 4, eff. April 12, 1995; 1995, No. 174 (Adj. Sess.), § 3; 1999, No. 49, § 204; 1999, No. 147 (Adj. Sess.), § 4; 2001, No. 63, § 99a; 2001, No. 65, § 16; 2001, No. 143 (Adj. Sess.), § 50, eff. June 21, 2002; 2003, No. 66, § 310; 2003, No. 163 (Adj. Sess.), § 9; 2005, No. 71, § 291; 2005, No. 215 (Adj. Sess.), § 313; 2019, No. 6, § 76, eff. April 22, 2019.)
33 V.S.A. § 1957
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1957. Audits

§ 1957. Audits|The Commissioner may require the submission of audited information as needed from health care providers to determine that amounts received from health care providers were correct. If an audit identifies amounts received due to errors by the Department, the Commissioner shall make payments to any health care provider which the audit reveals paid amounts it should not have been required to pay. Payments made under this section shall be made from the Fund. (Added 1991, No. 94, § 1; amended 1991, No. 253 (Adj. Sess.), § 7; 1993, No. 56, § 1, eff. June 3, 1993; 2005, No. 71, § 292; 2009, No. 156 (Adj. Sess.), § I.58.)
33 V.S.A. § 1958
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1958. Appeals

§ 1958. Appeals|(a) Any health care provider may submit a written request to the Department for reconsideration of the determination of the assessment within 20 days of notice of the determination. The request shall be accompanied by written materials setting forth the basis for reconsideration. If requested, the Department shall hold a hearing within 90 days from the date on which the reconsideration request was received. The Department shall mail written notice of the date, time, and place of the hearing to the health care provider at least 30 days before the date of the hearing. On the basis of the evidence submitted to the Department or presented at the hearing, the Department shall reconsider and may adjust the assessment. Within 20 days following the hearing, the Department shall provide notice in writing to the health care provider of the final determination of the amount it is required to pay based on any adjustments made by it. Proceedings under this section are not subject to the requirements of 3 V.S.A. chapter 25.(b) Upon request, the Commissioner shall enter into nonbinding arbitration with any health care provider dissatisfied with the Department's decision regarding the amount it is required to pay. The arbitrator shall be selected by mutual consent, and compensation shall be provided jointly.(c) Any health care provider may appeal the decision of the Department as to the amount it is required to pay either before or after arbitration, to the Superior Court having jurisdiction over the health care provider. (Added 1991, No. 94, § 1; amended 1991, No. 253 (Adj. Sess.), § 8; 1993, No. 56, § 1, eff. June 3, 1993; 2005, No. 71, § 293; 2009, No. 156 (Adj. Sess.), § I.59; 2017, No. 210 (Adj. Sess.), § 4, eff. June 1, 2018.)
33 V.S.A. § 1959
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1959. Ambulance agency assessment

§ 1959. Ambulance agency assessment|(a)(1) The annual assessment for each ambulance agency shall be 3.3 percent of the ambulance agency's annual net patient revenues for services delivered to patients in Vermont during the most recent annual fiscal period. As used in this section, "net patient revenues" means the total amount of payments an ambulance agency received during the fiscal period from Medicaid, Medicare, commercial insurance, and all other payers as payment for services rendered. The term does not include municipal appropriations, donations from any source, or any other funding unrelated to the delivery of health care services.  (2) The Department shall determine the appropriate fiscal period as necessary to ensure compliance with federal law. (3) Ambulance agencies shall remit the assessment amount to the Department annually on or before June 1.   (b) The Department shall provide written notification of the assessment amount to each ambulance agency. The assessment amount determined shall be considered final unless the agency requests reconsideration. Requests for reconsideration shall be subject to the provisions of section 1958 of this title.(c) Each ambulance agency shall remit its assessment to the Department according to a schedule adopted by the Commissioner. The Commissioner may permit variations in the schedule of payment as deemed necessary.(d) Any ambulance agency that fails to make a payment to the Department on or before the specified schedule, or under any schedule of delayed payments established by the Commissioner, shall be assessed not more than $1,000.00. The Commissioner may waive the late-payment assessment provided in this subsection for good cause shown by the ambulance agency. (Added 2015, No. 134 (Adj. Sess.), § 30; amended 2017, No. 73, § 9, eff. June 13, 2017; 2017, No. 210 (Adj. Sess.), § 5, eff. June 1, 2018.)
33 V.S.A. § 1991
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1991. Definitions

§ 1991. Definitions|As used in this chapter:  (1) "Dental hygienist" means an individual licensed to practice as a dental hygienist under 26 V.S.A. chapter 12. (2) "Dental services" means preventive, diagnostic, or corrective procedures related to the teeth and associated structures of the oral cavity. (3) "Dental therapist" means an individual licensed to practice as a dental therapist under 26 V.S.A. chapter 12. (4) "Dentist" means an individual licensed to practice dentistry under 26 V.S.A. chapter 12. (Added 2019, No. 72, § E.306.1.)
33 V.S.A. § 1992
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1992. Medicaid coverage for adult dental services

§ 1992. Medicaid coverage for adult dental services|(a) Vermont Medicaid shall provide coverage for medically necessary dental services provided by a dentist, dental therapist, or dental hygienist working within the scope of the provider's license as follows:  (1) Up to two visits per calendar year for preventive services, including prophylaxis and fluoride treatment, with no co-payment. These services shall not be counted toward the annual maximum benefit amount set forth in subdivision (2) of this subsection. (2) Diagnostic, restorative, and endodontic procedures, to a maximum of $1,000.00 per calendar year, provided that the Department of Vermont Health Access may approve expenditures in excess of that amount when exceptional medical circumstances so require. (3) Other dental services as determined by the Department by rule.   (b) The Department of Vermont Health Access shall develop a reimbursement structure for dental services in the Vermont Medicaid program that encourages dentists, dental therapists, and dental hygienists to provide preventive care. (Added 2019, No. 72, § E.306.1.)
33 V.S.A. § 1997
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1997. Definitions

§ 1997. Definitions|As used in this subchapter:  (1) "Board" or "Drug Utilization Review Board" means the Drug Utilization Review Board established in connection with the Medicaid program. (2) "Commissioner" means the Commissioner of Vermont Health Access. (3) "Health benefit plan" means a health benefit plan with prescription drug coverage offered or administered by a health insurer, as defined by 18 V.S.A. § 9402, and the out-of-state counterparts to such plans. The term includes:  (A) any State public assistance program with a health benefit plan that provides coverage of prescription drugs; (B) any health benefit plan offered by or on behalf of the State of Vermont or any instrumentality of the State providing coverage for government employees and their dependents that agrees to participate in the Program; and (C) any insured or self-insured health benefit plan that agrees to participate in the Program.  (4) "Department" means the Department of Vermont Health Access. (5) "Participating health benefit plan" means a health benefit plan that has agreed to participate in one or more components of the Pharmacy Best Practices and Cost Control Program. (6) "Program" or "the Pharmacy Best Practices and Cost Control Program" means the Pharmacy Best Practices and Cost Control Program established by this subchapter. (7) "State public assistance program" includes the Medicaid program, VPharm, the State Children's Health Insurance Program, the State of Vermont AIDS Medication Assistance Program, the General Assistance program, the Pharmacy Discount Plan Program, and the out-of-state counterparts to such programs. (Added 2001, No. 127 (Adj. Sess.), § 1, eff. June 13, 2002; amended 2005, No. 174 (Adj. Sess.), § 100; 2009, No. 156 (Adj. Sess.), § I.61; 2013, No. 79, § 25, eff. Jan. 1, 2014.)
33 V.S.A. § 1998a
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 1998a. Pharmacy mail order

§ 1998a. Pharmacy mail order|The Pharmacy Best Practices and Cost Control Program shall require consumers to purchase prescription drugs using mail order for selected pharmacy products. (Added 2005, No. 71, § 307.)
33 V.S.A. § 2000
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 2000. Pharmacy benefit management

§ 2000. Pharmacy benefit management|The Commissioner may implement all or a portion of the Pharmacy Best Practices and Cost Control Program through a contract with a third party with expertise in the management of pharmacy benefits. (Added 2001, No. 127 (Adj. Sess.), § 1, eff. June 13, 2002; amended 2005, No. 174 (Adj. Sess.), § 102; 2009, No. 156 (Adj. Sess.), § I.63.)
33 V.S.A. § 2002
2021 Vermont Statutes|Title 33 - Human Services|Chapter 19 - Medical Assistance|§ 2002. Supplemental rebates

§ 2002. Supplemental rebates|(a) The Commissioner of Vermont Health Access, separately or in concert with the authorized representatives of any participating health benefit plan, shall use the preferred drug list authorized by the Pharmacy Best Practices and Cost Control Program to negotiate with pharmaceutical companies for the payment to the Commissioner of supplemental rebates or price discounts for Medicaid and for any other State public assistance health benefit plans designated by the Commissioner, in addition to those required by Title XIX of the Social Security Act. The Commissioner may also use the preferred drug list to negotiate for the payment of rebates or price discounts in connection with drugs covered under any other participating health benefit plan within or outside this State, provided that such negotiations and any subsequent agreement shall comply with the provisions of 42 U.S.C. § 1396r-8. The Program, or such portions of the Program as the Commissioner shall designate, shall constitute a State pharmaceutical assistance program under 42 U.S.C. § 1396r-8(c)(1)(C).(b) The Commissioner shall negotiate supplemental rebates, price discounts, and other mechanisms to reduce net prescription drug costs by means of any negotiation strategy that the Commissioner determines will result in the maximum economic benefit to the Program and to consumers in this State, while maintaining access to high-quality prescription drug therapies. The Commissioner may negotiate through a purchasing pool or directly with manufacturers. The provisions of this subsection do not authorize agreements with pharmaceutical manufacturers in which financial support for medical services covered by the Medicaid program is accepted as consideration for placement of one or more prescription drugs on the preferred drug list.(c) The Department of Vermont Health Access shall prohibit the public disclosure of information revealing company-identifiable trade secrets (including rebate and supplemental rebate amounts, and manufacturer's pricing) obtained by the Department, and by any officer, employee, or contractor of the Department in the course of negotiations conducted pursuant to this section. Such confidential information shall be exempt from public disclosure under 1 V.S.A. chapter 5, subchapter 3 (Public Records Act). (Added 2001, No. 127 (Adj. Sess.), § 1, eff. June 13, 2002; amended 2005, No. 71, § 311; 2005, No. 174 (Adj. Sess.), § 104; 2009, No. 156 (Adj. Sess.), § I.65; 2021, No. 20, § 307.)