Vermont
LLC
Website link to register:
https://sos.vermont.gov/corporations
Naming conventions
Must not suggest affiliation with government or an illegal purpose. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” Professional services require “PLLC.”
Licensing Requirements
Members must hold licenses from the Vermont Board of Medical Practice. Malpractice insurance required. Facility compliance with Vermont Department of Health regulations mandatory.
Required documentation for medical practices
Articles of Organization, General Facility Compliance, Professional Licenses, Malpractice Insurance
Filing Fee: $125
Annual/Biennial Fee: $35
Additional Notes: Annual report due March 15.
Medicaid
Program Name: Green Mountain Care
Official Website: greenmountaincare.org
Legislation: Vermont does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices should ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
Vermont Medicaid, known as Green Mountain Care, provides health coverage to eligible low-income residents.
Notification Requirements
Notification strongly recommended for Medicaid patient clarity.
Provider Enrollment Requirements
Providers must enroll with Vermont Medicaid to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
CMS supports innovative care approaches for Medicaid frameworks.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS guidelines emphasize streamlined enrollments for ordering/referring providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state programs aimed at innovative care delivery.
State-Specific Notes
Collaboration opportunities exist with Vermont Medicaid for innovative primary care models.
Dispensing Medication
Board of Pharmacy Official Link: https://sos.vermont.gov/pharmacy/
State Licensing
Physicians must register with the Vermont Board of Pharmacy to dispense controlled substances.
Scope of Practice
Dispensing is allowed for both non-controlled and controlled substances within a physician’s scope of practice.
Inventory Management
Secure storage and accurate inventory tracking are mandatory for all dispensed medications.
Record-Keeping
Records must comply with Vermont state and federal HIPAA regulations.
Dispensing Standards
Labels must include patient name, dosage, prescribing physician, and detailed usage instructions.
Controlled Substances
DEA registration and reporting to Vermont’s PMP are mandatory for controlled substances.
Billing and Reimbursement
Physicians must comply with Vermont-specific billing practices and federal Stark Law requirements.
Federal Compliance
Adherence to FDA, DEA, and OSHA standards is required for dispensing medications.
State Pharmacy Laws
Physicians must adhere to Vermont Board of Pharmacy regulations for dispensing controlled substances.
Patient Consent
Informed patient consent must be obtained before dispensing medications.
Insurance and Liability
Physicians must ensure malpractice insurance includes coverage for medication dispensing activities.
Training Requirements
Continuing education for compliance with Vermont’s controlled substances laws is recommended.
Audits and Inspections
Inspections are conducted by the Vermont Board of Pharmacy to ensure compliance, with penalties for violations.