Health care providers urge Gov. Scott to sign H.766, which streamlines insurance approvals and makes it easier for Vermont patients to access medical care.
Vermont Business Magazine Health care clinicians from across Vermont applaud the Legislature for passing H.766, a bill that will reduce administrative delays in care and streamline insurance requirements.
Health care organizations, including the Vermont Medical Society, Vermont Academy of Family Physicians, American Academy of Pediatrics Vermont Chapter, Vermont Association of Hospital and Health Systems, Bi-State Primary Care, Vermont HealthFirst and University of Vermont Health Network support the important steps this bill takes in reducing insurance paperwork burdens for Vermont providers and in removing barriers to care for Vermont patients, and urge Governor Scott to sign the bill.
The passage of H.766 will alleviate the mounting administrative burden on primary care clinicians by exempting primary care from prior authorizations for imaging and procedures. This incremental measure will not only help Vermont patients access care with fewer delays but can also help address Vermont’s primary care shortage by helping to retain and even recruit PCPs and staff who work for primary care practices, including desperately needed nurses to the State.
“We have reached a point where insurance companies can tell us what we can and can’t do, even in life threatening emergencies, and the victims are always patients,” said Katie Marvin, M.D., a family physician at Lamoille Valley Health Partners. “PAs lead to delays in care, lapses in medications and apathy in providers. This bill may change this, which is why I have supported H. 766 through the legislative process and spoke to the Governor about it last week.”
The House unanimously passed this bill. “Payers claim H.766 will lead to increased costs, but prior authorizations are almost always approved, serving only to delay care, and can drive up costs through incentivizing people to go to emergency departments when care is not approved, which is the most expensive location." said leading sponsor of the bill, Rep. Alyssa Black, D-Essex. ”Primary care spends less, orders fewer tests, fewer unnecessary labs, and provides the most economic, best bang for your buck."
A critical addition to the bill made by the Senate and approved by the House today also requires insurance companies to give patients access to at least one type of available asthma inhaler without prior authorization.
“Insurance practices are leading to a crisis in caring for kids with asthma right now. We have had to order multiple types of inhalers to supplement for the one type of inhaler patients actually need,” said Pediatrician Kristen Connolly, MD, “We have heard of hacks to make covered inhalers act as HFA inhalers do; we have heard of rationing and increases in ER visits. This is our health system now—here in Vermont. We can do better.”
The bill also makes a number of other improvements to the health insurance paperwork system including ending a process where insurance companies could request patient records before paying for health care services that had been delivered.
Julie Lin, MD, an independent dermatologist in St. Albans shared how one insurance company policy that will now be prohibited by H. 766 impacted her small office: “The increase in administrative burden required increasing our staffing to process the claims. There were also times that this policy meant we asked patients if they were willing to come back on two different days for certain services we could have delivered in one appointment so we could get timely payment by the insurance company. This added delays in care and inconvenience for patients. We know how long patients are waiting for dermatology services and this only made it worse."
The Senate also shared bi-partisan, broad support for H.766. “Vermonters currently have difficulty accessing medical care and practitioners are frustrated by administrative barriers that put health care on hold,” said Senate sponsor Sen. Ginny Lyons, D-Chittenden Southeast. “This bill begins to decrease administrative burden for practitioners, who work every day in our local communities to keep Vermonters healthy. We all benefit when health care providers can get back to caring for patients, not paperwork.”
Source: Montpelier, VT (May 2, 2024)
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