Vermont Statutes
Chapter 221 - Health Care Administration
§ 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 managed care organizations, to determine that health care services rendered were professionally indicated or were performed in compliance with the applicable standard of care, and that the cost of health care rendered was considered reasonable by the providers of professional health services in that area. The Commissioner of Health shall ensure that the information technology components of the quality assurance system comply with, and the Commissioner of Vermont Health Access shall ensure such components are incorporated into, the Statewide Health Information Technology Plan developed under section 9351 of this title and any other information technology initiatives coordinated pursuant to 3 V.S.A. § 3027.
(b) The Vermont Program for Quality in Health Care, Inc. shall file an annual report with the Commissioner of Health. The report shall include an assessment of progress in the areas designated by the Commissioner of Health, including comparative studies on the provision and outcomes of health care and professional accountability.
(c) Expenses incurred under this section by the Vermont Program for Quality in Health Care, Inc. shall be borne as follows: 35 percent by the hospitals, 15 percent by nonprofit hospital and medical service corporations licensed under 8 V.S.A. chapter 123 or 125, and 50 percent by health insurance companies licensed under 8 V.S.A. chapter 101, and health maintenance organizations licensed under 8 V.S.A. chapter 139. Expenses allocated under this section to persons licensed under 8 V.S.A. chapters 101 and 139 shall be billed based on premiums paid for health insurance coverage as defined in subsection 9415(b) of this title. Expenses allocated under this section shall not exceed 75 percent of the operating budget of the Vermont Program for Quality in Health Care, Inc. (Added 1995, No. 180 (Adj. Sess.), § 21a; amended 2005, No. 215 (Adj. Sess.), § 329; 2007, No. 70, § 33; 2009, No. 61, § 4; 2011, No. 171 (Adj. Sess.), § 30, eff. July 1, 2013; 2017, No. 85, § F.10, eff. June 28, 2017.)

Structure Vermont Statutes

Vermont Statutes

Title 18 - Health

Chapter 221 - Health Care Administration

§ 9401. Policy

§ 9402. Definitions

§ 9404. Administration

§ 9405. State Health Improvement Plan; Health Resource Allocation Plan

§ 9405a. Public participation and strategic planning

§ 9405b. Hospital community reports and ambulatory surgical center quality reports

§ 9405c. Notice of acquisition

§ 9408. Common claims forms and procedures

§ 9408a. Uniform provider credentialing

§ 9409. Health care provider bargaining groups

§ 9410. Health care database

§ 9411. Interactive price transparency dashboard

§ 9412. Enforcement

§ 9413. Health care quality and price comparison

§ 9414. Quality assurance for managed care

§ 9414a. Annual reporting by health insurers

§ 9416. Vermont Program for Quality in Health Care

§ 9417. Tax-advantaged accounts for health-related expenses; administration; rulemaking

§ 9418. Payment for health care services

§ 9418a. Processing claims, downcoding, and adherence to coding rules

§ 9418b. Prior authorization

§ 9418c. Fair contract standards

§ 9418d. Contract amendments

§ 9418e. Most favored nation clauses prohibited

§ 9418f. Rental network contracts

§ 9418g. Enforcement

§ 9419. Charges for access to medical records

§ 9420. Conversion of nonprofit hospitals

§ 9421. Pharmacy benefit management; registration; insurer audit of pharmacy benefit manager activities

§ 9422. Credit card payments optional for providers

§ 9431. Policy and purpose

§ 9432. Definitions

§ 9433. Administration

§ 9434. Certificate of need; general rules

§ 9435. Exclusions

§ 9437. Criteria

§ 9439. Competing applications

§ 9440. Procedures

§ 9440a. Applications, information, and testimony; oath required

§ 9440b. Information technology; review procedures

§ 9441. Fees

§ 9442. Bonds

§ 9443. Expiration of certificates of need

§ 9444. Revocation of certificates; material change

§ 9445. Enforcement

§ 9446. Home health agencies; geographic service areas

§ 9451. Definitions

§ 9453. Powers and duties

§ 9454. Hospitals; duties

§ 9456. Budget review

§ 9457. Information available to the public

§ 9461. Quality measures

§ 9462. Quality improvement projects

§ 9471. Definitions

§ 9472. Pharmacy benefit managers; required practices with respect to health insurers

§ 9472. Pharmacy benefit managers; required practices with respect to health insurers and covered persons

§ 9473. Pharmacy benefit managers; required practices with respect to pharmacies

§ 9473. Pharmacy benefit managers; required practices with respect to pharmacies

§ 9474. Enforcement

§ 9481. Definitions

§ 9482. Financial assistance policies for large health care facilities

§ 9483. Implementation of financial assistance policy

§ 9484. Public education and information

§ 9485. Prohibition on sale of medical debt

§ 9486. Prohibition of waiver of rights

§ 9487. Enforcement