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2010 Adopted Rules and Procedure Changes

last modified 05/16/2011 - 08:56 AM
Contributors: Keri Andersen

Adopted rule changes are listed in reverse chronological order (latest listed first).

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Bulletin 10-19 - Vermont Blueprint for Health Rules - These rules are proposed in response to Act 128 of 2010 amending Act 191 of 2006 chapter 13 of 18 V.S.A. § 701 through § 709, as well as 8 V.S.A § 4088h, to codify the Blueprint for Health, beginning with a definition: The Blueprint for Health (Blueprint) means the state's program for integrating a system of health care for patients, improving the health of the overall population, and improving control over health care costs by promoting health maintenance, prevention, and care coordination and management. The statute provides substantial specificity about the program and its components, but certain elements are further defined in this series of rules covering: the process for provider enrollment in the Medical Home Program, the process of development of new Community Health Teams, the process for insurer participation, grievance, and appeals, and the process for hospital participation and certification.  The changes authorized by Act 128 move the Blueprint from a pilot to a broadly implemented, statewide program. As such, health care providers and insurers need additional guidance, beyond the statute, about how the program will be implemented as it grows from the current 12 pilot sites and three Community Health Teams to -- potentially -- over 240 primary care practice sites becoming certified as Blueprint Medical Homes and 20 or more designated Community Health Teams statewide. The rules provide guidance for the structure and sequence of the Blueprint expansion process, and they also detail the process for modification of the payment reforms and participation of hospitals in the statewide Health Information Exchange network to support the Blueprint's IT infrastructure.  These rules are effective beginning on March 5, 2011.  [Secretary of State ID#: 10P-040]

 

Bulletin 10-13 - State Fiscal Year 2011 Coverage Changes - This rule is being implemented as a permanent version of the emergency rules found in Bulletin 10-03, as directed by (H.789) Act 156 of the 2009 -2010 Legislative Session, An Act Making Appropriations for the Support of Government.  Section E309.1 of the Act authorizes DVHA to: 1) limit the number of covered visits for physical therapy, occupational therapy, and speech therapy to 30 visits per year for adults (and all VHAP beneficiaries), except that DVHA shall allow additional visits with the following diagnoses: spinal cord injury, traumatic brain injury, stroke, amputation, or severe burn; 2) limit lab services for urine drug testing to 8 tests per month for adults (and all VHAP beneficiaries); and 3) institute a prior authorization process for high-tech imaging.  These rules are effective beginning on February 26, 2011.  [Secretary of State ID#: 10P-032] 

 

Bulletin 10-11 - VPharm and Vscript Rebate Agreements -  This rule is being implemented as directed by (H.789) Act 156 of the 2009 -2010 Legislative Session, An Act Making Appropriations for the Support of Government.  Manufacturers of pharmaceuticals purchased by individuals receiving state pharmaceutical assistance are required to pay DVHA a rebate on all pharmaceuticals for which state-only funds are expended in an amount at least as favorable as the rebates provided in connection with the Medicaid program.  These rules are effective beginning on November 13, 2010.  [Secretaty of State ID#: 10P-031]

 

Bulletin 10-21: State Fiscal Year 2011 Coverage Changes - This bulletin changes the provision of Occupational Therapy Services, Physical Therapy Services, Speech/Language Therapy Services, Radiology Services and Laboaratory Services.  These changes are for Medicaid and VHAP beneficiaries. These rules are effective beginning on October 29, 2010. [Secretary of State ID: 10E-14]

 

Bulletin 10-01: Managed Care Grievances & Appeals - This bulletin changes the Managed Care Grievance and Appeal rules in order to implement the recommendations from the 2007 - 2008 external quality review, and clarify rule sections that experience has shown to be unclear. [Secretary of State ID#: 10P-016]

 

Bulletin 10-09: VHAP Procedure Changes - This bulletin updates VHAP Procedures with services that were changed in (H.789) Act 156 of the 2009 -2010 Legislative Session, An Act Making Appropriations for the Support of Government. It also incorporates multiple Interpretive Memos that have been issued explaining services, and applies consistent formatting.  These procedure changes are effective beginning on July 1, 2010.

 

Bulletin 10-03: State Fiscal Year 2011 Coverage Changes - This bulletin changes the provision of Occupational Therapy Services, Physical Therapy Services, Speech/Language Therapy Services, Radiology Services and Laboaratory Services.  These changes are for Medicaid and VHAP beneficiaries. These rules are effective beginning on July 1, 2010. [Secretary of State ID: 10E-05]