The Vermont Statutes Online
§ 4750. Definitions
As used in this chapter:
(1) "Health insurance plan" has the same meaning as in 8 V.S.A. § 4089b.
(2) "Medication-assisted treatment" means the use of U.S. Food and Drug Administration-approved medications, in combination with counseling and behavioral therapies, to provide a whole patient approach to the treatment of substance use disorders. (Added 2017, No. 153 (Adj. Sess.), § 1a, eff. May 21, 2018; amended 2017, No. 176 (Adj. Sess.), § 2; 2019, No. 14, § 51, eff. April 30, 2019; 2019, No. 43, § 2.)
§ 4751. Purpose
It is the purpose of this chapter to authorize the Departments of Health and of Vermont Health Access to establish a regional system of opioid addiction treatment. (Added 2011, No. 135 (Adj. Sess.), § 1, eff. May 14, 2012; amended 2015, No. 173 (Adj. Sess.), § 3.)
§ 4752. Opioid addiction treatment system
(a) The Departments of Health and of Vermont Health Access shall establish by rule a regional system of opioid addiction treatment.
(b) The rules shall include the following requirements:
(1) Patients shall receive appropriate, comprehensive assessment and therapy from a physician or advanced practice registered nurse and from a licensed clinical professional with clinical experience in addiction treatment, including a psychiatrist, master's- or doctorate-level psychologist, mental health counselor, clinical social worker, or drug and alcohol abuse counselor.
(2) A medical assessment shall be conducted to determine whether pharmacological treatment, which may include methadone, buprenorphine, and other federally approved medications to treat opioid addiction, is medically appropriate.
(3) A routine medical assessment of the appropriateness for the patient of continued pharmacological treatment based on protocols designed to encourage cessation of pharmacological treatment as medically appropriate for the individual treatment needs of the patient.
(4) Controlled substances for use in federally approved pharmacological treatments for opioid addiction shall be dispensed only by:
(A) a treatment program authorized by the Department of Health; or
(B) a physician or advanced practice registered nurse who is not affiliated with an authorized treatment program but who meets federal requirements for use of controlled substances in the pharmacological treatment of opioid addiction.
(5) Comprehensive education and training requirements shall apply for health care providers, pharmacists, and the licensed clinical professionals listed in subdivision (1) of this subsection, including relevant aspects of therapy and pharmacological treatment.
(6) Patients shall abide by rules of conduct, violation of which may result in discharge from the treatment program, including:
(A) provisions requiring urinalysis at such times as the program may direct;
(B) restrictions on medication dispensing designed to prevent diversion of medications and to diminish the potential for patient relapse; and
(C) such other rules of conduct as a provider authorized to provide treatment under subdivision (4) of this subsection (b) may require.
(c) [Repealed.] (Added 2011, No. 135 (Adj. Sess.), § 1, eff. May 14, 2012; amended 2015, No. 173 (Adj. Sess.), § 3.)
§ 4753. Care coordination
Prescribing physicians and collaborating health care and addictions professionals may coordinate care for patients receiving medication-assisted treatment for substance use disorder, which may include monitoring adherence to treatment, coordinating access to recovery supports, and providing counseling, contingency management, and case management services. (Added 2015, No. 173 (Adj. Sess.), § 3.)
§ 4754. Limitation on prior authorization requirements
(a) A health insurance plan shall not require prior authorization for prescription drugs for a patient who is receiving medication-assisted treatment if the dosage prescribed is within the U.S. Food and Drug Administration's dosing recommendations.
(b) A health insurance plan shall not require prior authorization for all counseling and behavioral therapies associated with medication-assisted treatment for a patient who is receiving medication-assisted treatment. (Added 2019, No. 43, § 3, eff. Jan. 1, 2020.)