reglab/housing_qa huggingface dataset:
18 V.S.A. § 9381
2021 Vermont Statutes|Title 18 - Health|Chapter 220 - Green Mountain Care Board|§ 9381. Appeals

§ 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 judicial review pursuant to subsection (b) of this section.(b) Any person aggrieved by a final action, order, or other determination of the Green Mountain Care Board may, upon exhaustion of all administrative appeals available pursuant to subsection (a) of this section, appeal to the Supreme Court pursuant to the Vermont Rules of Appellate Procedure.(c) If an appeal or other petition for judicial review of a final order is not filed in connection with an order of the Green Mountain Care Board pursuant to subsection (b) of this section, the Chair may file a certified copy of the final order with the clerk of a court of competent jurisdiction. The order so filed has the same effect as a judgment of the court and may be recorded, enforced, or satisfied in the same manner as a judgment of the court.(d) A decision of the Board's approving, modifying, or disapproving a health insurer's proposed rate pursuant to 8 V.S.A. § 4062 shall be considered a final action of the Board and may be appealed to the Supreme Court pursuant to subsection (b) of this section. (Added 2011, No. 48, § 3, eff. May 26, 2011; amended 2011, No. 171 (Adj. Sess.), eff. May 16, 2012; 2013, No. 79, § 5m, eff. Jan. 1, 2014.)
18 V.S.A. § 9383
2021 Vermont Statutes|Title 18 - Health|Chapter 220 - Green Mountain Care Board|§ 9383. Expenditure analysis; health care spending estimate

§ 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 section that the Board shall consider and incorporate into its work in furtherance of its statutory duties, including using them as tools in the Board's review of health insurance rates and the budgets of hospitals and accountable care organizations. The analyses shall:  (1) inform the Board's regulatory processes in order to promote improved health outcomes, health care cost containment, quality of care, access to care, and appropriate resource allocation; and (2) quantify the total amount of money that has been and is estimated to be expended for all health care services provided by health care facilities and providers in Vermont and for health care services provided to residents of this State regardless of the site of service, to the extent data are available.   (b) The expenditure analysis and the estimate of future health care spending shall include breakdowns for broad sectors such as hospital, physician, mental health, home health, and pharmacy and may include estimates for disease prevention and health promotion activities and other social determinants of health. The analyses shall include:  (1) expenditures by commercial health plans, hospital and medical service corporations, and health maintenance organizations regulated by this State; and (2) expenditures for Medicare, Medicaid, self-insured employers, and other forms of health coverage, to the extent data are available.   (c) Annually on or before January 15, the Board shall submit the expenditure analysis and the estimate of future health care spending to the House Committees on Appropriations, on Health Care, and on Human Services and the Senate Committees on Appropriations, on Health and Welfare, and on Finance. (Added 2017, No. 167 (Adj. Sess.), § 9, eff. May 22, 2018.)
18 V.S.A. § 9390
2021 Vermont Statutes|Title 18 - Health|Chapter 220 - Green Mountain Care Board|§ 9390. Green Mountain Care Board Nominating Committee created; composition

§ 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 be selected as follows:   (A) Two members appointed by the Governor. (B) Two members of the Senate, who shall not be members of the same party, to be appointed by the Committee on Committees. (C) Two members of the House of Representatives, who shall not be members of the same party, to be appointed by the Speaker of the House of Representatives. (D) One member each to be appointed by the Governor, the President Pro Tempore of the Senate, and the Speaker of the House, with knowledge of or expertise in health care policy, health care delivery, or health care financing, to complement that of the remaining members of the Committee.  (2) The members of the Committee shall serve for terms of two years and may serve for no more than three consecutive terms. All appointments shall be made between January 1 and February 1 of each odd-numbered year, except to fill a vacancy. Members shall serve until their successors are appointed. (3) The members shall elect their own chair who shall serve for a term of two years.   (c) For Committee meetings held when the General Assembly is not in session, the legislative members of the Green Mountain Care Board Nominating Committee shall be entitled to per diem compensation and reimbursement of expenses in accordance with the provisions of 2 V.S.A. § 406. Committee members who are not legislators shall be entitled to per diem compensation and reimbursement of expenses on the same basis as that applicable to the legislative members, and their compensation and reimbursements shall be paid out of the budget of the Green Mountain Care Board.(d) The Green Mountain Care Board Nominating Committee shall use the qualifications described in section 9392 of this title for the nomination of candidates for the Chair and members of the Green Mountain Care Board. The Nominating Committee shall adopt procedures for a nomination process based on the rules adopted by the Judicial Nominating Board, and shall make such procedures available to the public.(e) A quorum of the Committee shall consist of five members.(f) The Board is authorized to use the staff and services of appropriate State agencies and departments as necessary to conduct investigations of applicants. (Added 2011, No. 48, § 3, eff. May 26, 2011.)
18 V.S.A. § 9391
2021 Vermont Statutes|Title 18 - Health|Chapter 220 - Green Mountain Care Board|§ 9391. Nomination and appointment process

§ 9391. Nomination and appointment process|(a) Whenever a vacancy occurs on the Green Mountain Care Board, or when an incumbent does not declare that he or she will be a candidate to succeed himself or herself, the Green Mountain Care Board Nominating Committee shall select for consideration by the Committee, by majority vote, provided that a quorum is present, from the applications for membership on the Green Mountain Care Board as many candidates as it deems qualified for the position or positions to be filled. The Committee shall base its determinations on the qualifications set forth in section 9392 of this section.(b) The Committee shall submit to the Governor the names of the persons it deems qualified to be appointed to fill the position or positions and the name of any incumbent who declares that he or she wishes to be a candidate to succeed himself or herself.(c) The Governor shall make an appointment to the Green Mountain Care Board from the list of qualified candidates submitted pursuant to subsection (b) of this section. The appointment shall be subject to the consent of the Senate. The names of candidates submitted and not selected shall remain confidential.(d) All proceedings of the Committee, including the names of candidates considered by the Committee and information about any candidate submitted by any source, shall be confidential. (Added 2011, No. 48, § 3, eff. May 26, 2011; amended 2011, No. 171 (Adj. Sess.), § 38, eff. May 16, 2012.)
18 V.S.A. § 9392
2021 Vermont Statutes|Title 18 - Health|Chapter 220 - Green Mountain Care Board|§ 9392. Qualifications for nominees

§ 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 delivery, or health care financing, and openness to alternative approaches to health care; (3) possession of desirable personal characteristics, including integrity, impartiality, health, empathy, experience, diligence, neutrality, administrative and communication skills, social consciousness, public service, and regard for the public good; (4) knowledge, expertise, and characteristics that complement those of the remaining members of the Board; (5) impartiality and the ability to remain free from undue influence by a personal, business, or professional relationship with any person subject to supervision or regulation by the Board. (Added 2011, No. 48, § 3, eff. May 26, 2011.)
18 V.S.A. § 9401
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 9401. Policy

§ 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 quality of health care services provided in Vermont and, until health care systems are successful in controlling their costs and resources, to oversee cost containment.(b) It is further the policy of the State of Vermont that the health care system should:  (1) maintain and improve the quality of health care services offered to Vermonters; (2) utilize planning, market, and other mechanisms that contain or reduce increases in the cost of delivering services so that health care costs do not consume a disproportionate share of Vermonters' incomes or the monies available for other services required to insure the health, safety, and welfare of Vermonters; (3) encourage regional and local participation in decisions about health care delivery, financing, and provider supply; (4) utilize planning, market, and other mechanisms that will achieve rational allocation of health care resources in the State; (5) facilitate universal access to preventive and medically necessary health care; (6) support efforts to integrate mental health and substance abuse services with overall medical care. (Added 1991, No. 160 (Adj. Sess.), § 1, eff. May 11, 1992; amended 1995, No. 180 (Adj. Sess.), § 7; 2009, No. 49, § 8; 2009, No. 128 (Adj. Sess.), § 8, eff. May 27, 2010.)
18 V.S.A. § 9404
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 9404. Administration

§ 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) The Commissioner and the Board may:  (1) apply for and accept gifts, grants, or contributions from any person for purposes consistent with this chapter; (2) adopt rules necessary to implement the provisions of this chapter; and (3) enter into contracts and perform such acts as are necessary to accomplish the purposes of this chapter.   (c) [Repealed.](d) There is hereby created a special fund to be known as the Green Mountain Care Board Regulatory and Administrative Fund pursuant to 32 V.S.A. chapter 7, subchapter 5, for the purpose of providing the financial means for the Green Mountain Care Board to administer its obligations, responsibilities, and duties as required by law, including pursuant to 8 V.S.A. § 4062, chapters 220 and 221 of this title, and 33 V.S.A. chapter 18. All fees, fines, penalties, and similar assessments received by the Board in the administration of its obligations, responsibilities, and duties shall be credited to the Fund. The Fund may also be used by the Department of Health to administer its obligations, responsibilities, and duties as required by chapter 221 of this title. (Added 1991, No. 160 (Adj. Sess.), § 1, eff. May 11, 1992; amended 1995, No. 180 (Adj. Sess.), §§ 10, 38(a); 1999, No. 49, § 222; 2013, No. 79, § 36; 2015, No. 54, § 34; 2015, No. 68 (Adj. Sess.), § 67.)
18 V.S.A. § 9405a
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 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 hospital shall post on its website a description of its identified needs, strategic initiatives developed to address the identified needs, annual progress on implementation of the proposed initiatives, opportunities for public participation, and the ways in which the hospital ensures access to appropriate mental health care that meets standards of quality, access, and affordability equivalent to other components of health care as part of an integrated, holistic system of care. Hospitals may meet the community health needs assessment and implementation plan requirement through compliance with the relevant Internal Revenue Service community health needs assessment requirements for nonprofit hospitals.(b) When a hospital is working on a new community health needs assessment, the hospital shall post on its website information about the process for developing the community needs assessment and opportunities for public participation in the process. (Added 2003, No. 53, § 4; amended 2005, No. 71, § 77a; 2007, No. 27, § 4; 2011, No. 48, § 21; 2015, No. 152 (Adj. Sess.), § 1, eff. May 31, 2016; 2017, No. 200 (Adj. Sess.), § 17; 2019, No. 14, § 56, eff. April 20, 2019.)
18 V.S.A. § 9405c
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 9405c. Notice of acquisition

§ 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 title. (3) "Medical practice" means a business through which one or more physicians practice medicine.   (b) Each hospital shall provide notice to the Office of the Attorney General at least 90 days or as soon as practicable prior to the effective date of a transaction through which the hospital will acquire a medical practice. The notice shall include at least the following information:  (1) the name and address of the hospital acquiring the medical practice and contact information for a representative of the hospital; and (2) the name and address of the medical practice being acquired and contact information for a representative of the medical practice.   (c) Information provided to the Office of the Attorney General pursuant to this section is exempt from public inspection and copying under the Public Records Act and shall be kept confidential except to the extent necessary to allow the Office to perform an inquiry into potentially anticompetitive practices. (Added 2015, No. 143 (Adj. Sess.), § 2.)
18 V.S.A. § 9408
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 9408. Common claims forms and procedures

§ 9408. Common claims forms and procedures|No 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. 160 (Adj. Sess.), § 1, eff. May 11, 1992; amended 1995, No. 180 (Adj. Sess.), § 14.)
18 V.S.A. § 9408a
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 9408a. Uniform provider credentialing

§ 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:  (A) provide health care services to an insured or hospital patients; and (B) receive reimbursement for the health care services.  (2) "Health care services" means health-care-related services or products rendered or sold by a provider within the scope of the provider's license or legal authorization, including hospital, medical, surgical, dental, vision, and pharmaceutical services or products. (3) "Insured" means an individual entitled to reimbursement for expenses of health care services under a policy issued or administered by an insurer. (4) "Insurer" has the same meaning as in subdivision 9402(8) of this title. (5) "Provider" has the same meaning as in subdivision 9402(7) of this title.   (b) The Department shall prescribe the credentialing application form used by the Council for Affordable Quality Healthcare (CAQH), or a similar, nationally recognized form prescribed by the Commissioner, in electronic or paper format, which must be used beginning January 1, 2007 by an insurer or a hospital that performs credentialing. The Commissioner may grant a hospital an extension to the implementation date for up to one year.(c) An insurer or a hospital shall notify a provider concerning a deficiency on a completed credentialing application form submitted by the provider not later than 30 business days after the insurer or hospital receives the completed credentialing application form.(d) A hospital shall notify a provider concerning the status of the provider's completed credentialing application not later than:  (1) 60 days after the hospital receives the completed credentialing application form; and (2) every 30 days after the notice is provided under subdivision (1) of this subsection, until the hospital makes a final credentialing determination concerning the provider.   (e) [Repealed.](f) An insurer shall act upon and finish the credentialing process of a completed application submitted by a provider within 60 calendar days of receipt of the application. An application shall be considered complete once the insurer has received all information and documentation necessary to make its credentialing determination as provided in subsections (b) and (c) of this section. (Added 2005, No. 191 (Adj. Sess.), § 56; amended 2007, No. 70, § 30; 2007, No. 203 (Adj. Sess.), § 30, eff. June 10, 2008; 2015, No. 152 (Adj. Sess.), § 3.)
18 V.S.A. § 9409
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 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 of Human Services, the Green Mountain Care Board, or the Commissioner of Labor with respect to any matter in this chapter; chapter 13, 219, 220, or 222 of this title; 21 V.S.A. chapter 9; and 33 V.S.A. chapters 18 and 19 with respect to provider regulation, provider reimbursement, administrative simplification, information technology, workforce planning, or quality of health care.(b) The Green Mountain Care Board shall adopt by rule criteria for forming and approving bargaining groups, and criteria and procedures for negotiations authorized by this section.(c) The rules relating to negotiations shall include a nonbinding arbitration process to assist in the resolution of disputes. Nothing in this section shall be construed to limit the authority of the Secretary of Administration, the Secretary of Human Services, the Green Mountain Care Board, or the Commissioner of Labor to reject the recommendation or decision of the arbiter. (Added 1991, No. 160 (Adj. Sess.), § 1, eff. May 11, 1992; amended 1995, No. 180 (Adj. Sess.), §§ 15, 38(a); 2005, No. 103 (Adj. Sess.), § 3, eff. April 5, 2006; 2011, No. 171 (Adj. Sess.), § 24, eff. May 16, 2012; 2015, No. 152 (Adj. Sess.), § 5.)
18 V.S.A. § 9411
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 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 section 9410 of this title, the dashboard shall provide the range of actual allowed amounts for selected health care services, showing both the amount paid by the health insurer or other payer and the amount of the member's responsibility, and shall allow the consumer to sort the information by geographic location, by health care provider, by payer type, and by the specific health care procedure or health care service. The Board shall provide a link on the dashboard to the statewide comparative hospital quality report published by the Commissioner of Health pursuant to section 9405b of this title.(b) The Board shall update the information in the interactive price transparency dashboard at least annually.
18 V.S.A. § 9412
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 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 plans, contracting entities, covered entities, and payers, as defined in section 9418 of this title, and may administer oaths and may issue subpoenas to a person to appear and testify or to produce documents or things.(b) In addition to any other power or duty authorized by law, the Commissioner of Financial Regulation shall in the case of health insurers, enforce a violation of a provision of this subchapter, or a rule adopted pursuant to a provision of this subchapter, as a violation of a requirement of Title 8 relating to health insurers. (Added 1991, No. 160 (Adj. Sess.), § 1, eff. May 11, 1992; amended 1995, No. 180 (Adj. Sess.), §§ 18, 38; 2009, No. 61, § 28; 2011, No. 171 (Adj. Sess.), § 14, eff. May 16, 2012.)
18 V.S.A. § 9413
2021 Vermont Statutes|Title 18 - Health|Chapter 221 - Health Care Administration|§ 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 and colonoscopy. The tool shall include provider quality information as available and to the extent consistent with other applicable laws and regulations. The tool shall allow members to compare price by selecting a specific service or procedure and a geographic region of the State. Based on the criteria specified, the tool shall provide the member with an estimate for each provider of the amount the member would pay for the service or procedure, an estimate of the amount the insurance plan would pay, and an estimate of the combined payments. The price information shall reflect the cost-sharing applicable to a member's specific plan, as well as any remaining balance on the member's deductible for the plan year. (Added 2015, No. 54, § 20, eff. July 1, 2016.)