Deadline For Public Comment
Deadline: Unavailable.
The deadline for public comment is unavailable for this rule. Contact the agency or primary contact person listed below for assistance.
Rule Details
Rule Number: 20E01
Title: Suspension of Credentialing Verification Practices.
Type: Emergency
Status: Adopted
Agency: Department of Financial Regulation
Legal Authority: 18 V.S.A. § 9414 and 8 V.S.A. § § 15
Summary: During the COVID-19 State of Emergency, this emergency rule temporarily suspends Section 5.2 of Rule H-2009-03 and requires health insurers to relax credentialing requirements for health care providers. Section 5.2 specifies certain provider credentialing verification requirements and procedures that managed care organizations must follow and implement. Temporarily suspending these credentialing verification requirements and requiring health insurers to relaxing their credentialing requirements during the State of Emergency is intended to facilitate reimbursement through the Medicaid program or commercial insurance during the State of Emergency for health care services provided in the State of Vermont by physicians or other health care professionals who hold and equivalent license in another state
Persons Affected: Managed Care Organizations regulated by the State of Vermont. The Vermont Association of Hospitals and Health Systems, VNAs of Vermont, Bayada Home Health & Hospice, Vermont Health Care Association (long term care facilities), Vermont Care Partners, Bi-State Primary Care Association, the Vermont Medical Society, the Vermont Association of Adult Days and Dartmouth Hitchcock Health. Physicians or other health care professionals who hold an equivalent license in another State. Patients and members insured by Managed Care Organizations regulated by the State of Vermont.
Economic Impact: Responding to the COVID-19 pandemic may require the provision of health care services by physicians or other health care professionals who hold an equivalent license in another state and may require health care professionals to work at physical locations where such providers are not credentialed to provide services. Facilitating the reimbursement for such services by health insurers is expected to significantly decrease the out of pocket costs incurred by Vermont patients. Health Insurers are likely to pay out more money to reimburse providers for the provision of such services.
Posting date: Mar 20,2020
Hearing Information
There are not Hearings scheduled for this Rule
Contact Information
Information for Primary Contact
PRIMARY CONTACT PERSON - A PERSON WHO IS ABLE TO ANSWER QUESTIONS ABOUT THE CONTENT OF THE RULE.
Level: Primary
Name: Ethan McLaughlin
Agency: Department of Financial Regulation
Address: 89 Main Street
City:Montpelier
State: VT
Zip: 05620
Telephone: 802-828-4859
Fax:
Email: ethan.mclaughlin@vermont.gov
Website Address: https://dfr.vermont.gov/about-us/legal-general-counsel/proposed-rules-and-public-comment
Information for Secondary Contact
Secondary CONTACT PERSON A SPECIFIC PERSON FROM WHOM COPIES OF FILINGS MAY BE REQUESTED OR WHO MAY ANSWER QUESTIONS ABOUT FORMS SUBMITTED FOR FILING IF DIFFERENT FROM THE PRIMARY CONTACT PERSON.
Level: Secondary
Name: Gavin Boyles
Agency: Department of Financial Regulation
Address: 89 Main Street
City: Montpelier
State: VT
Zip: 05620
Telephone: 802-828-1425
Fax: 802-828-1919
Email: gavin.boyles@vermont.gov