(a)The Office of the Health Care Advocate shall:
(1)Assist Vermonters with health insurance plan selection by providing information, referrals, and assistance to individuals about means of obtaining and paying for health insurance coverage and services. The Office shall accept referrals from the Vermont Health Benefit Exchange and Exchange navigators created pursuant to 33 V.S.A. chapter 18, subchapter 1, to assist individuals experiencing problems related to the Exchange.
(2)Assist Vermonters to understand their rights and responsibilities under health insurance plans.
(3)Provide information to the public, agencies, members of the General Assembly, and others about Vermonters’ problems and concerns regarding health insurance and access to health care, as well as recommendations for re
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(a) The Office of the Health Care Advocate shall:
(1) Assist Vermonters with health insurance plan selection by providing information, referrals, and assistance to individuals about means of obtaining and paying for health insurance coverage and services. The Office shall accept referrals from the Vermont Health Benefit Exchange and Exchange navigators created pursuant to 33 V.S.A. chapter 18, subchapter 1, to assist individuals experiencing problems related to the Exchange.
(2) Assist Vermonters to understand their rights and responsibilities under health insurance plans.
(3) Provide information to the public, agencies, members of the General Assembly, and others about Vermonters’ problems and concerns regarding health insurance and access to health care, as well as recommendations for resolving those problems and concerns.
(4) Identify, investigate, and resolve complaints, questions, and inquiries on behalf of individual Vermonters with respect to issues regarding health insurance or access to health care, and assist those Vermonters with filing and pursuing complaints and appeals.
(5) Provide consumer education to Vermonters regarding their rights and responsibilities under State and federal laws, rules, and regulations.
(6) Analyze and monitor the development and implementation of federal, State, and local laws, rules, and policies relating to health insurance and health care, with a special focus on patients’ rights and eligibility for State and federal health care programs.
(7) Ensure policymakers hear directly from Vermonters by facilitating public comment on health care-related laws, rules, processes, and policies.
(8) Suggest to the Green Mountain Care Board, the Department of Financial Regulation, and other entities in State government policies, procedures, or rules that protect and promote the interests of Vermonters in matters related to health insurance and access to health care.
(9) Collaborate with other health care- and health policy-related citizen and consumer organizations to promote affordable and accessible health care for Vermonters.
(10) Ensure that all Vermonters have timely access to the services provided by the Office.
(11) Submit to the Governor; the House Committees on Health Care, on Ways and Means, and on Appropriations; and the Senate Committees on Health and Welfare, on Finance, and on Appropriations, on or before January 15 of each year, a report on the activities, performance, and fiscal accounts of the Office during the preceding calendar year.
(b) The Office of the Health Care Advocate may:
(1) [Repealed.]
(2) Pursue administrative, judicial, and other remedies on behalf of any individual or group of individuals experiencing problems with health insurance or access to health care.
(3) Represent the interests of the people of the State of Vermont in matters involving health care and health insurance at the Green Mountain Care Board, the Department of Financial Regulation, or other State agencies.
(4) Adopt policies and procedures necessary to carry out the provisions of this chapter.
(5) Take any other action necessary to fulfill the purposes of this chapter.
(c) The Office of the Health Care Advocate shall be able to speak to Vermonters and on behalf of the interests of Vermonters in health care- and health insurance-related matters and to carry out all duties prescribed in this chapter without being subject to any retaliatory action; provided, however, that nothing in this subsection shall limit the authority of the Agency of Human Services to enforce the terms of the contract.
(d) Health care providers and health insurers shall cooperate with the Office of the Health Care Advocate by providing relevant records and information when an individual or the individual’s guardian or legal representative has authorized the Office to act on the individual’s behalf. A health care provider or health insurer may require the written consent of the individual or the individual’s guardian or legal representative prior to providing the records or information to the Office. (Added 2013, No. 79, § 35a, eff. Jan. 1, 2014; amended 2017, No. 85, § E.300.6, eff. June 28, 2017; 2017, No. 154 (Adj. Sess.), § 24, eff. May 21, 2018; 2019, No. 14, § 60, eff. April 30, 2019; 2025, No. 6, § 3, eff. July 1, 2025.)