Code of Vermont Rules › Agency 80 - ADMINISTRATIVE AND ADVISORY AGENCIES › Sub-Agency 280 - GREEN MOUNTAIN CARE BOARD › Chapter 007 - RULE 9.000: DATA RELEASE › Section 80 280 007 - RULE 9.000: DATA RELEASE

Current through June, 2024
9.100 GENERAL PROVISIONS
9.101 Authority.
The Board adopts this Rule pursuant to   18 V.S.A. §§
											9404 and  9410.
9.102 Purpose.
The Green Mountain Care Board ("Board" or "GMCB") stewards two data sets (collectively "the health care database"). The Vermont Health Care Uniform Reporting and Evaluation System ("VHCURES") data set contains information related to health care utilization, costs, and resources provided in Vermont and to Vermont residents in other states. The Vermont Uniform Hospital Discharge Data Set ("VUHDDS") contains information related to health care provided to patients at health care facilities in Vermont and health care provided to Vermont residents at health care facilities in other states.
Subject to certain restrictions and limitations, the Board makes some of the information in the health care database available as a resource for individuals and entities to review health care utilization, expenditures, and performance in Vermont. This rule establishes processes by which the Board will make data in the health care database available to support legitimate and beneficial research and analysis.
9.103 Definitions.
For purposes of this rule:
(1) "Analytic table" means a file developed to answer specialized questions with detailed information related to claims, patients, health insurers, or health care providers.
(2) "Authorized User" means a person authorized by the Board to access restricted data under the terms of a data use agreement.
(3) "Board" or "GMCB" means the Green Mountain Care Board established in Title 18, Chapter 220 of the Vermont Statutes Annotated, the Board's staff, or other designee of the Board.
(4) "Council Chair" means the chair of the Data Governance Council.
(5) "Data Governance Council" or "Council" means the committee established by the Board and given responsibilities for the Board's data governance program.
(6) "Data set" means a collection of logical individual data records, regardless of format.
(7) "Data use agreement" or "DUA" means a written agreement detailing an Authorized User's commitment to data privacy and security and setting forth restrictions, limitations, and conditions on the use and disclosure of data from the health care database.
(8) "Data Use and Disclosure Manuals" means the publicly available manuals created and maintained by the Board that specify procedures for the submission and review of applications for data from the VHCURES and VUHDDS data sets, limitations on the availability of such data, and requirements that persons seeking or receiving such data must comply with to ensure that the privacy and security of the data is maintained.
(9) "Data Release Schedules" means the documents created and maintained by the Board that classify data elements based on the risk that release would pose for identification of individuals and disclosure of proprietary or other sensitive information.
(10) "Health care database" means the VHCURES and VUHDDS data sets, collectively.
(11) "Health care facility" has the same meaning as in   18 V.S.A. §
											9432(8).
(12) "Health care provider" has the same meaning as in   18 V.S.A. §
											9432(9).
(13) "Health insurer" has the same meaning as in   18 V.S.A. §
											9410(j)(1).
(14) "Individual user affidavit" means the form created and maintained by the Board for Principal Investigators and any individual who will be allowed to access data under a DUA acknowledge and affirm that they have read, understand, and agree to abide by the DUA's terms and conditions.
(15) "Insured" has the same meaning as in   18 V.S.A. §
											9418(a)(10).
(16) "Limited data set" has the same meaning as in 45 C.F.R. §
											164.514(e)(2).
(17) "Member" means the insured subscriber and any other person(s) eligible for health care benefits under the subscriber's policy, such as the subscriber's spouse or dependent.
(18) "Patient" means any person in a data set that is the subject of the activities of the claim performed by the health care provider.
(19) "Person" means any natural person, business entity, municipality, the State of Vermont or any department, agency, or subdivision of the State, and any partnership, unincorporated association, or other legal entity.
(20) "Principal Investigator" means the individual designated by an Authorized User to be responsible for ensuring compliance with the requirements in a DUA. An Authorized User may also be a Principal Investigator.
(21) "Secure Analytic Environment" or "SAE" means a secure, virtual remote desktop, server, or other portal that provides access to restricted data in a data set through individual accounts provided to Authorized Users as specified in their Individual User Affidavit.
(22) "Standard report" means a recurring report derived from the VHCURES or VUHDDS data sets that is intended to provide information pertaining to claims, members, patients, health insurers, health insurance, health care providers, and/or health care services.
(23) "Subscriber" means the individual responsible for payment of premiums or whose employment, income, or other circumstances is the basis for eligibility for membership in a health benefit plan.
(24) "Vermont Health Care Uniform Reporting and Evaluation System" or "VHCURES" means the data set containing information related to eligibility, health care claims, and related data submitted by health care insurers to the GMCB.
(25) "Vermont Uniform Hospital Discharge Data Set" or "VUHDDS" means the data set consisting of inpatient discharge data, outpatient procedures and services data, and emergency department data submitted by general hospitals, ambulatory surgery centers, and psychiatric hospitals that is maintained by the Vermont Department of Health.