by Devon Green, VP of Government Relations, VAHHS
A lot happened last week, so let’s dive in!
Expansion of Green Mountain Care Board Authority: The Senate Health and Welfare Committee heard testimony on H.482, a bill that would allow the Green Mountain Care Board to adjust reimbursement rates and assign an independent observer to hospitals under certain conditions. Blue Cross Blue Shield of Vermont (BCBSVT) laid out their financial difficulties and urged all health care organizations to support H.482. The Department of Financial Regulation underscored that no other insurance carrier is willing to take BCBSVT's book of business.
VAHHS discussed how using one part of a fragile health care system to support another could result in further financial instability, especially with federal cuts on the horizon. Judi Fox, President and CEO of Rutland Regional Medical Center (RRMC), testified on how reducing reimbursement rates and appointing an independent observer could conflict with financial covenants, resulting in having debts called in. Judi Fox also testified on RRMC’s willingness to pursue reference-based pricing. The committee supported providing the Green Mountain Care Board a tool to use under extenuating circumstances and urged the parties to get together to craft a solution.
Health Care Reform: The House Health Care Committee dug into S.126, the health care reform bill, hearing from the Department of Vermont Health Access (DVHA), Vermont Medical Society, BCBSVT, and VAHHS on how health care providers get reimbursed. VAHHS testimony included data comparing how Medicare payments per patient case differ with other states, including states using reference-based pricing. The committee noted that they will be focusing on this bill exclusively until the end of the session.
Certificate of Need: The Senate Health and Welfare Committee passed out H.96, the Certificate of Need reform bill with additional provisions to exempt state-funded projects and a technical correction to ensure equal application of the thresholds to ambulatory surgical centers.
Workplace Violence Prevention: The Senate Health and Welfare Committee advanced H.259, the workplace violence prevention bill. Although there was some discussion of the bill on the Senate floor at second reading, VAHHS anticipates the bill will pass the full Senate this week.
Legally Protected Health Care Activities: The House Health Care Committee passed S.28 in an 8-3 vote. In addition to prohibiting misleading communications and improper delegation of services, the bill also protects licensee contact information within the Public Records Act.
Transportation and Health Care: The Senate Transportation Committee and Senate Health and Welfare Committee held a joint hearing on transportation and health care. Michael Costa, President and CEO of Gifford Health Care, and Anthony Knox, Blueprint Project Manager, Randolph Health Service Area, shared compelling patient stories to underscore the link between transportation and healthy communities. VAHHS informed the committee that EMS is developing a five-year statewide plan slated to come out in December 2025. VAHHS’s recommendation was to develop transportation infrastructure and to have a process for non-emergency medical transportation. DVHA pointed out that there are no current Medicaid cuts to transportation on the table and that a lot of the limitations to the non-emergency medical transportation are due to federal requirements. The Vermont Public Transportation Association brought forward several recommendations for “braided” transportation services, such as:
- Expand pool of volunteer drivers
- Reduce barriers to sharing of transportation resources
- Fund additional volunteer coordinators
- Include check box on DMV forms
- Establish statewide community driver program
- Investigate mobile dialysis units
- Investigate mobile SUD treatment
- Establish a Public Transit Mobility Special Fund
Both committees expressed a commitment to improving transportation for health care.
Repeal of Prohibition on Holding Intoxicated Individuals in Correctional Facilities:
The House Human Services Committee heard from health care providers on S.36 and the issue of the prohibition of holding intoxicated individuals in correctional facilities, which is supposed to go into effect on July 1 of this year. Alison Davis, MD, Medical Director of the Emergency Department at RRMC underscored that a repeal was needed because the mere threat of an increase in intoxicated individuals coming to the emergency department creates stress and adds to burnout of health care providers. Liz Couto, Chair of the Emergency Nurses Association, testified that putting intoxicated individuals in emergency departments without a medical need increases the probability of workplace violence.