§ 9573. Medicaid advisory rate case

(a) On or before December 31 of each year, the Green Mountain Care Board shall review any all-inclusive population-based payment arrangement between the Department of Vermont Health Access and an accountable care organization for the following calendar year. The Board's review shall include the number of attributed lives, eligibility groups, covered services, elements of the per member, per month payment, and any other nonclaims payments. The Board's review may include deliberative sessions to the same extent permitted for insurance rate review under 8 V.S.A. § 4062.

(b) The review shall be nonbinding on the Agency of Human Services, and nothing in this section shall be construed to abrogate the designation of the Agency of Human Services as the single State agency as required by 42 C.F.R. § 431.10.

(c) The Board shall review the payment arrangement prior to the finalization of a contract between the Department and the accountable care organization and shall maintain the confidentiality of information as needed to preserve the parties' contract negotiations. The Board shall release its advisory opinion within 30 days following the finalization of the contract between the parties.

(d) The Department of Vermont Health Access shall provide the Board and its contractors with all data and information that the Board requests for its review within the time frame set forth by the Board. (Added 2017, No. 167 (Adj. Sess.), § 14, eff. May 22, 2018.)