by Devon Green, VP of Government Relations, VAHHS
Ah, Town Meeting Week, an oasis amidst the legislative chaos where everyone empties the State House and goes home to participate in Town Meeting Day on Tuesday. It’s also a great opportunity to recharge before the firehose that is the policy bill crossover deadline next Friday. Speaking of firehoses, see below for all that happened last week:
Health Care Reform Bill: The Senate Health and Welfare’s health care reform proposal has finally gone from an outline to a bill. The bill takes into account VAHHS testimony and eliminates the audit requirement and oversight of hospital board strategic plans. It includes beginning implementation of reference-based pricing for FY 2026 hospital budgets and reference-based pricing for nonhospital services. It also requires all hospitals to be in global budgets by 2030 regardless of the AHEAD model and addresses administrative versus direct care compensation.
Certificate of Need: House Health Care Committee advanced H.96, which will increase the jurisdictional thresholds for Certificate of Need Review to the following:
- $10M for building
- $5M for replacement of equipment and NO threshold for equipment that has been fully depreciated
- $3M for new health care services
- $50M for conceptual development
The bill would take effect on July 1, 2025, but will also apply to existing CON applications if there are no interested parties. The committee decided not to exclude government-funded projects.
Freestanding Birth Centers: S.18, the freestanding birth center bill passed out of the Senate Health and Welfare Committee. VAHHS will continue working with the birth centers to make Medicaid funding more sustainable for all birthing services.
Green Mountain Care Board Independent Monitor—In a bit of last-minute scheduling, the House Health Care Committee heard testimony on a bill that was apparently written the previous night at the request of the Green Mountain Care Board. It allows the GMCB to appoint an independent monitor to oversee hospital operations, obtain information from the hospital, and report recommendations to the Board if the Board believes it’s in the public interest. The House Committee can insert this language into the Senate Health and Welfare’s health care reform bill after it crosses over or move it as a standalone bill.
340B Protection—House Health Care took testimony from VAHHS and Jonathan Reynolds from Rutland Regional Medical Center on H.266, a bill that protects the 340B program. The committee also heard testimony on H.202, which has reporting and disclosure requirements on 340B. In discussion on Friday the committee agreed to combine some reporting requirements from H.202 with the 340B protections in H.266. The committee will further discuss the reporting requirements during crossover week.
Workplace Violence Prevention—Nurses came forward with H.259, a bill that requires hospitals to make workplace violence prevention plans and carves workplace violence initiatives from GMCB hospital budget and CON oversight. VAHHS supports this effort and appreciates that the House Health Care Committee is taking up the bill.
Medical Debt Relief—Treasurer Pieciak’s bill, S.27, passed out of the Senate Health and Welfare Committee. The bill prohibits reporting medical debt to credit agencies and allows a nonprofit to buy medical debt on behalf of Vermonters.
Fraud Protection and Confidentiality of Contact Information: The Senate Health and Welfare Committee advanced S.28, a bill addressing false advertising and oversight by absentee medical professionals. VAHHS proposed creating confidentiality of contact information for nurses, pharmacists, physicians, and other licensed professionals.
Health Care Committee Budget Recommendations: The House Health Care Committee sent over its budget memo and spending priorities to the Appropriations Committee. VAHHS appreciates the committee supporting primary care initiatives during the gap between the All Payer Model ending and the AHEAD model.
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