Terms Used In Vermont Statutes Title 18 Sec. 9377a

  • Board: means the Green Mountain Care Board established in this chapter. See
  • Green Mountain Care: means the public-private universal health care program designed to provide health benefits through a simplified, uniform, single administrative system pursuant to 33 Vt. See
  • State: when applied to the different parts of the United States may apply to the District of Columbia and any territory and the Commonwealth of Puerto Rico. See

§ 9377a. Prior authorization pilot program

(a) The Green Mountain Care Board shall develop and implement a pilot program or programs for the purpose of measuring the change in system costs within primary care associated with eliminating prior authorization requirements for imaging, medical procedures, prescription drugs, and home care. The program shall be designed to measure the effects of eliminating prior authorizations on provider satisfaction and on the number of requests for and expenditures on imaging, medical procedures, prescription drugs, and home care. In developing the pilot program proposal, the Board shall collaborate with health care professionals and health insurers throughout the State or regionally.

(b) The Board shall submit an update regarding implementation of prior authorization pilot programs as part of its annual report under subsection 9375(d) of this title. (Added 2013, No. 79, § 40a.)