§ 9374. Board membership; authority
(a)(1) On July 1, 2011, the Green Mountain Care Board is created and shall consist of a chair
and four members. The Chair and all of the members shall be State employees and shall
be exempt from the State classified system. The Chair shall receive compensation equal
to that of a Superior judge, and the compensation for the remaining members shall
be two-thirds of the amount received by the Chair.
(2) The Chair and the members of the Board shall be nominated by the Green Mountain Care
Board Nominating Committee established in subchapter 2 of this chapter using the qualifications
described in section 9392 of this chapter and shall be otherwise appointed and confirmed
in the manner of a Superior judge. The Governor shall not appoint a nominee who was
denied confirmation by the Senate within the past six years.
(b)(1) The term of each member of the Board, including the Chair, shall be six years.
(2) Any appointment to fill a vacancy shall be for the unexpired portion of the term vacated.
(3) A member may serve more than one term. A member may be reappointed to additional terms
subject to the requirements of section 9391 of this title.
(4) Members of the Board may be removed only for cause. The Board shall adopt rules pursuant
to 3 V.S.A. chapter 25 to define the basis and process for removal.
(c)(1) No Board member shall, during his or her term or terms on the Board, be an officer
of, director of, organizer of, employee of, consultant to, or attorney for any person
subject to supervision or regulation by the Board, provided that for a health care
practitioner, the employment restriction in this subdivision shall apply only to administrative
or managerial employment or affiliation with a hospital or other health care facility,
as defined in section 9432 of this title, and shall not be construed to limit generally the ability of the health care practitioner
to practice his or her profession.
(2) No Board member shall participate in creating or applying any law, rule, or policy
or in making any other determination if the Board member, individually or as a fiduciary,
or the Board member’s spouse, parent, or child wherever residing or any other member
of the Board member’s family residing in his or her household has an economic interest
in the matter before the Board or has any more than a de minimis interest that could
be substantially affected by the proceeding.
(3) The prohibitions contained in subdivisions (1) and (2) of this subsection shall not
be construed to prohibit a Board member from, or require a Board member to recuse
himself or herself from Board activities as a result of, any of the following:
(A) being an insurance policyholder or from receiving health services on the same terms
as are available to the public generally;
(B) owning a stock, bond, or other security in an entity subject to supervision or regulation
by the Board that is purchased by or through a mutual fund, blind trust, or other
mechanism where a person other than the Board member chooses the stock, bond, or security;
or
(C) receiving retirement benefits through a defined benefit plan from an entity subject
to supervision or regulation by the Board.
(4) No Board member shall, during his or her term or terms on the Board, solicit, engage
in negotiations for, or otherwise discuss future employment or a future business relationship
of any kind with any person subject to supervision or regulation by the Board.
(5) No Board member may appear before the Board or any other State agency on behalf of
a person subject to supervision or regulation by the Board for a period of one year
following his or her last day as a member of the Green Mountain Care Board.
(d)(1) The Chair shall have general charge of the offices and employees of the Board but
may hire a director to oversee the administration and operation.
(2)(A) Except for final decisions in regulatory matters over which the Board has jurisdiction,
a member of the Board, Board officer, or Board employee may perform any service that
is within the Board’s jurisdiction and that the Board delegates to the member, officer,
or employee.
(B) The Board shall establish procedures to ensure that Board employees have appropriate
supervision in their performance of delegated activities and that the Board remains
informed regarding these activities.
(e)(1) The Board shall establish a consumer, patient, business, and health care professional
advisory group to provide input and recommendations to the Board. Members of such
advisory group who are not State employees or whose participation is not supported
through their employment or association shall receive per diem compensation and reimbursement
of expenses pursuant to 32 V.S.A. § 1010, provided that the total amount expended for such compensation shall not exceed $5,000.00
per year.
(2) The Board may establish additional advisory groups and subcommittees as needed to
carry out its duties. The Board shall appoint diverse health care professionals to
the additional advisory groups and subcommittees as appropriate.
(3) To the extent funds are available, the Board may examine, on its own or through collaboration
or contracts with third parties, the effectiveness of existing requirements for health
care professionals, such as quality measures and prior authorization, and evaluate
alternatives that improve quality, reduce costs, and reduce administrative burden.
(f) In carrying out its duties pursuant to this chapter, the Board shall seek advice from
the Office of the Health Care Advocate. The Office shall advise the Board regarding
the policies, procedures, and rules established pursuant to this chapter. The Office
shall represent the interests of Vermont patients and Vermont consumers of health
insurance and may suggest policies, procedures, or rules to the Board in order to
protect patients’ and consumers’ interests.
(g) The Chair of the Board or designee may apply for grant funding, if available, to advance
or support any responsibility within the Board’s jurisdiction.
(h)(1)(A) Except as otherwise provided in subdivisions (1)(C) and (2) of this subsection (h),
the expenses of the Board shall be borne as follows:
(i) 40 percent by the State from State monies;
(ii) 36 percent by the hospitals; and
(iii) 24 percent by nonprofit hospital and medical service corporations licensed under 8 V.S.A. chapter 123 or 125, health insurance companies licensed under 8 V.S.A. chapter 101, and health maintenance organizations licensed under 8 V.S.A. chapter 139.
(B) Expenses under subdivision (A)(iii) of this subdivision (1) shall be allocated to
persons licensed under Title 8 based on premiums paid for health care coverage, which
for the purposes of this subdivision (1) shall include major medical, comprehensive
medical, hospital or surgical coverage, and comprehensive health care services plans,
but shall not include long-term care, limited benefits, disability, credit or stop
loss, or excess loss insurance coverage.
(C) Amounts assessed pursuant to the provisions of sections 9382 and 9441 of this title
shall not be assessed in accordance with the formula set forth in subdivision (A)
of this subdivision (1).
(2) The Board may determine the scope of the incurred expenses to be allocated pursuant
to the formula set forth in subdivision (1) of this subsection if, in the Board’s
discretion, the expenses to be allocated are in the best interests of the regulated
entities and of the State.
(3) If the amount of the proportional assessment to any entity calculated in accordance
with the formula set forth in subdivision (1)(A) of this subsection would be less
than $150.00, the Board shall assess the entity a minimum fee of $150.00. The Board
shall apply the amounts collected based on the difference between each applicable
entity’s proportional assessment amount and $150.00 to reduce the total amount assessed
to the regulated entities pursuant to subdivisions (1)(A)(ii) and (iii) of this subsection.
(4)(A) Annually on or before September 15, the Board shall report to the House and Senate
Committees on Appropriations the total amount of all expenses eligible for allocation
pursuant to this subsection (h) during the preceding State fiscal year and the total
amount actually billed back to the regulated entities during the same period. The
provisions of 2 V.S.A. § 20(d) (expiration of required reports) shall not apply to the report to be made under this
subdivision.
(B) The Board shall also present the information required by this subsection (h) to the
Joint Fiscal Committee annually at its September meeting.
(i)(1) In addition to any other penalties and in order to enforce the provisions of this
chapter and empower the Board to perform its duties, the Chair of the Board may issue
subpoenas, examine persons, administer oaths, and require production of papers and
records. Any subpoena or notice to produce may be served by registered or certified
mail or in person by an agent of the Chair. Service by registered or certified mail
shall be effective three business days after mailing. Any subpoena or notice to produce
shall provide at least six business days’ time from service within which to comply,
except that the Chair may shorten the time for compliance for good cause shown. Any
subpoena or notice to produce sent by registered or certified mail, postage prepaid,
shall constitute service on the person to whom it is addressed.
(2) Each witness who appears before the Chair under subpoena shall receive a fee and mileage
as provided for witnesses in civil cases in Superior Courts; provided, however, any
person subject to the Board’s authority shall not be eligible to receive fees or mileage
under this section.
(3) The Board may share any information, papers, or records it receives pursuant to a
subpoena or notice to produce issued under this section with the Agency of Human Services
or the Department of Financial Regulation, or both, as appropriate to the work of
the Agency or Department, provided that the Agency or Department agrees to maintain
the confidentiality of any information, papers, or records that are exempt from public
inspection and copying under the Public Records Act.
(j) A person who fails or refuses to appear, to testify, or to produce papers or records
for examination before the Chair upon properly being ordered to do so may be assessed
an administrative penalty by the Chair of not more than $2,000.00 for each day of
noncompliance and proceeded against as provided in the Administrative Procedure Act,
and the Chair may recommend to the appropriate licensing entity that the person’s
authority to do business be suspended for up to six months. (Added 2011, No. 48, § 3, eff. May 26, 2011; amended 2011, No. 171 (Adj. Sess.), § 5, eff. May 16, 2012; 2013, No. 79, § 35b, eff. Jan. 1, 2014; 2013, No. 79, § 37a; 2015, No. 113 (Adj. Sess.), § 9, eff. May 17, 2016; 2017, No. 154 (Adj. Sess.), § 23, eff. May 21, 2018; 2017, No. 167 (Adj. Sess.), § 13, eff. May 22, 2018; 2017, No. 167 (Adj. Sess.), § 17; 2019, No. 88 (Adj. Sess.), § 67, eff. March 4, 2020; 2021, No. 137 (Adj. Sess.), § 5, eff. July 1, 2022; 2023, No. 134 (Adj. Sess.), § 4, eff. May 30, 2024; 2023, No. 113 (Adj. Sess.), § E.345, eff. July 1, 2024; 2025, No. 27, § E.345, eff. July 1, 2025; 2025, No. 62, § 3, eff. July 1, 2025; 2025, No. 68, § 11, eff. June 12, 2025.)