Health Care

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Transition Date for Compliance with Revisions of 8 V.S.A. § 4089b Health Insurance Coverage, Mental Health and Substance Abuse

Bulletin
Thursday, August 12, 2010
Health Care Bulletin #131

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/BUL-H-131.pdf

This Bulletin establishes the transition date for health insurance plans to be in compliance with the revision of8 V.S.A. § 4089b regarding coverage for mental health and substance abuse.

Certificate of Need Program Procedures

Regulation
Tuesday, August 17, 2010
Reg-H-2010-01

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/RULE-H-2010-01.pdf

Certificate of Need Program procedures.

Clarification of Effective Dates of Long Term Care Regulation H-2009-01

Bulletin
Monday, January 4, 2010
Health Care Bulletin #130

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/BUL-H-130.pdf

The purpose of this Bulletin is to clarify the Department's position on the effective dates for specific sections of long-term care regulation H 2009-01. The Commissioner is authorized to issue this Bulletin pursuant to 8 V.S.A. § 15.

Anthem Blue Cross & Blue Shield

Order
Tuesday, May 25, 2010
Docket No. 09-183-H

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/Order-09-183-H_0.pdf

Transacting insurance business in Vermont without a certificate of authority or license from the Commissioner of Banking, Insurance, Securities, and Health Care Administration in violation of 8 V.S.A. § 3361 and § 3368. Issuing and delivering certificates of coverage that were not filed with and approved by the Commissioner in violation of 8 V.S.A. § 4062.

 
Action taken was:
  1. Administrative penalty payment of $100,000.00
  2. Payment of the Department’s costs of $3,663.00
  3. Cease and Desist from entering into any master group policy contract to cover Vermont residents that would require it to have a Vermont certificate of authority or license, unless it holds such license.

Blue Cross and Blue Shield of Vermont

Order
Tuesday, June 1, 2010
Docket No. 09-131-H

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/Order-09-131-H.pdf
http://www.dfr.vermont.gov/sites/default/files/ExhibitsOrder-09-131-H.pdf

Commissioner's Order relating to medical cost containment, executive compensation, and the annual reporting of executive compensation by Blue Cross & Blue Shield of Vermont.

United Health Group

Order
Monday, March 8, 2010
Docket No. H-09-063

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/StipConsentUHC.pdf

Nature of Proceeding:

Stipulation and Consent Order

Violation:

Failure to fully and/or timely submit required health care claims data, eligibility data, provider files and other information relating to health care services provided to Vermont residents, pursuant to the authority in 18 V.S.A. $9410(g) and Regulation H-2008-001.

Action Taken:

United Health Group payment of an administrative penalty of Forty Five Thousand ($45,000) Dollars plus Five Thousand Dollars ($5,000) in costs.

Minimum Standards for Compliance with Title 8 V.S.A. §4080b (non-group)

Regulation
Monday, March 16, 1998
Reg-93-05

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/REG-I-93-5.pdf

 

The purpose of this regulation is to set forth rules for the enrollment of registered non-group carriers, requirements for the sale of individual insurance, requirements for the filing of rates, and standards and the process for approval of common health care plans.

Uniform Claims Forms and Uniform Standards and Procedures for Processing

Regulation
Thursday, June 3, 1993
Reg-93-4

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/REG-I-93-04.pdf

The purpose of this regulation is to promote efficiency and cost savings in the payment of health insurance claims by the use of common claim forms and procedures and to improve the availability and consistency of health services information.

Minimum Standards for Compliance with Title 8 V.S.A. §4980a (small group)

Regulation
Sunday, November 1, 1992
Reg-91-4b

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/REG-I-91-4b.pdf

The purpose of this regulation is to set forth the rules for registration of small group carriers, requirements for the sale of individual insurance and the standards and process for approval of common health care plans.

Advertisement of Accident and Sickness Insurance

Regulation
Thursday, March 1, 1973
Reg-71-1

File attachments: 

http://www.dfr.vermont.gov/sites/default/files/REG-I-71-1.pdf

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