Vermont § 4098c - Covered services provided by naturopathic physicians

§ 4098c. Covered services provided by naturopathic physicians

• (a) A health insurance plan shall provide coverage for medically necessary health care
  services covered by the plan when provided by a naturopathic physician licensed in
  this State for treatment within the scope of practice described in 26 V.S.A. chapter 81 and shall recognize naturopathic physicians who practice primary care to be primary
  care physicians. (b) Health care services provided by naturopathic physicians may be subject to reasonable
  deductibles, co-payment and coinsurance amounts, and fee or benefit limits consistent
  with those applicable to other primary care physicians under the plan, as well as
  practice parameters, cost-effectiveness and clinical efficacy standards, and utilization
  review consistent with any applicable rules published by the Department of Financial
  Regulation. Any amounts, limits, standards, and review shall not function to direct
  treatment in a manner unfairly discriminative against naturopathic care, and collectively
  shall be not more restrictive than those applicable under the same plan to care or
  services provided by other primary care physicians, but may allow for the management
  of the benefit consistent with variations in practice patterns and treatment modalities
  among different types of health care professionals. (c) A health insurance plan may require that the naturopathic physician’s services be
  provided by a licensed naturopathic physician under contract with the insurer or shall
  be covered in a manner consistent with out-of-network provider reimbursement practices
  for primary care physicians; however, this shall not relieve a health insurance plan
  from compliance with the applicable network adequacy requirements adopted by the Commissioner
  by rule. (d) Nothing contained in this section shall be construed as impeding or preventing either
  the provision or the coverage of health care services by licensed naturopathic physicians,
  within the lawful scope of naturopathic practice, in hospital facilities on a staff
  or employee basis. (e) This section shall apply to Medicaid and any other public health care assistance program
  offered or administered by the State or by any subdivision or instrumentality of the
  State. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)