Devon Green: House passes FY’25 budget

by Devon Green, VP of Government Relations, Vermont Association of Hospitals & Health Systems

I need to correct the record! Thank you to Rep. Scheu who wrote in to let me know that I got it wrong last week—House Appropriations always formally votes on the budget on the Monday after the money crossover deadline. They do a straw poll vote on Friday and then Joint Fiscal all weekend to finalize the budget for a formal vote on Monday. I appreciate the clarification—and, I’ll try to restrain myself from slipping in occasional errors to see who’s paying attention. 

With that, let’s dive into the budget details and everything else that happened last week:

Budget: The House passed the FY’25 Budget on Friday, appropriating $8.58 billion in total, including:

  • $9.9 million for rate increases at skilled nursing facilities
  • $3.55 million for a Psychiatric Residential Treatment Facility for Youth at the Brattleboro Retreat
  • $1 million towards hiring and other start-up costs for the Southwestern Vermont Medical Center’s psychiatric inpatient facility for youth and adolescents


Prior Authorizations and Administrative Simplification: The Senate Health and Welfare Committee heard a walkthrough of H.766, which aligns prior authorizations with Medicaid and claims edits with Medicare. The Health Care Advocate testified that the goals of the bill were sound, but raised concerns about whether aligning prior authorizations to Medicaid was a workable solution.

Telehealth: The Senate Finance Committee heard testimony on H.861, a bill that makes reimbursement parity for audio-visual telehealth permanent and requires reimbursement parity for audio-only telehealth. VAHHS testified that this bill is about equal reimbursement for equal work—a provider delivering clinically appropriate care should be compensated regardless of platform. VAHHS also testified that this bill increases patient access and choice. More providers will offer audio-only telehealth if fully compensated for it, saving patients on transportation costs and work leave. On Friday, the committee raised concerns about setting out provider reimbursement in law for commercial insurers. Testimony will continue this week.

Uncompensated Care: The Office of the Health Care Advocate presented to the House Health Care Committee on uncompensated care and implementation of Act 119, which goes into effect on July 1st for hospitals. Their presentation offers a good summary on the major provisions of the bill. The Health Care Advocate has letter and poster templates available for hospitals. The Health Care Advocate noted that they will be asking about implementation of Act 119 during the hospital budget process.