Vermont H 71: An act relating to prohibiting State contracts with for-profit correctional facilities

Bill Text

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VT LEG #378935 v.2
H.71 1
Introduced by Representatives Bluemle of Burlington, Cordes of Bristol, 2
Berbeco of Winooski, Black of Essex, Cina of Burlington, 3
Goldman of Rockingham, and Page of Newport City 4
Referred to Committee on 5
Date: 6
Subject: Health; health care facilities; Green Mountain Care Board; Attorney 7
General; health care entity transactions; corporate practice of 8
medicine 9
Statement of purpose of bill as introduced: This bill proposes to require health 10
care entities to provide notice to the Green Mountain Care Board and Attorney 11
General before entering into certain types of transactions and would direct the 12
Board, in consultation with the Attorney General, to review certain proposed 13
transactions and approve, approve with conditions, or disapprove them. The 14
bill would prohibit corporations from practicing medicine or otherwise 15
interfering with health care providers’ professional judgment and clinical 16
decision making. The bill would also require public reporting on ownership 17
and control of certain health care entities. 18
An act relating to health care entity transaction oversight and clinical 19
decision making 20

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VT LEG #378935 v.2
It is hereby enacted by the General Assembly of the State of Vermont: 1
Sec. 1. 18 V.S.A. chapter 226 is added to read: 2
CHAPTER 226. TRANSACTION OVERSIGHT AND CLINICAL 3
DECISION MAKING 4
Subchapter 1. General Provisions 5
§ 9521. DEFINITIONS 6
As used in this chapter: 7
(1) “Acquisition” means the direct or indirect purchase in any manner, 8
including by lease, transfer, exchange, option, receipt of a conveyance, 9
creation of a joint venture, or any other manner of purchase, such as by a 10
health care system, private equity group, hedge fund, publicly traded company, 11
real estate investment trust, management services organization, insurance 12
company, or a subsidiary of any of these entities, of a material amount of the 13
assets or operations of a health care entity. 14
(2) “Affiliate” means: 15
(A) a person who directly, indirectly, or through one or more 16
intermediaries, controls, is controlled by, or is under common control or 17
ownership of another person; 18
(B) a person whose business is operated under a lease, management, 19
or operating agreement by another entity, or a person substantially all of whose 20

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VT LEG #378935 v.2
property is operated under a management or operating agreement with that 1
other entity; 2
(C) an entity that operates the business or substantially all of the 3
property of another entity under a lease, management, or operating agreement; 4
or 5
(D) any out-of-state operations or corporate affiliate of an affiliate, as 6
defined in subdivision (A), (B), or (C) of this subdivision (2), including 7
significant equity investors, health care real estate investment trusts, and 8
management services organizations. 9
(3) “Change of control” means an arrangement in which any other 10
person acquires direct or indirect control over the operations of a health care 11
entity in whole or in substantial part. As used in this subdivision, 12
“arrangement” includes any agreement, association, partnership, joint venture, 13
management services agreement, professional services agreement, health care 14
staffing company agreement, or other arrangement that results in a change of 15
governance or control of a health care entity or a department, subdivision, or 16
subsidiary of a health care entity. 17
(4) “Control,” including “controlling,” “controlled by,” and “under 18
common control with,” means the direct or indirect power through ownership, 19
contractual agreement, or otherwise, to: 20

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VT LEG #378935 v.2
(A) vote more than 10 percent of any class of voting shares of a 1
health care entity; or 2
(B) direct the actions or policies of the specified entity. 3
(5) “Health care entity” means a health care provider, health care 4
facility, provider organization, pharmacy benefit manager as defined in section 5
3602 of this title, or health insurer as defined in section 9402 of this title that 6
offers a health insurance plan in this State. 7
(6) “Health care facility” has the same meaning as in section 9432 of 8
this title. 9
(7) “Health care provider” has the same meaning as in section 9402 of 10
this title. 11
(8) “Health care services” has the same meaning as in section 9481 of 12
this title and includes all of the following: 13
(A) inpatient, outpatient, habilitative, rehabilitative, dental, palliative, 14
therapeutic, supportive, nursing home, home health, mental health, and 15
substance use disorder services provided by a health care entity; 16
(B) pharmacy services, including drugs, devices, and medical 17
supplies; 18
(C) performance of functions to refer, arrange, and coordinate care; 19
(D) durable medical equipment, diagnostic e