by Devon Green, VAHHS, Sr. Vice President of Policy & Strategy
Happy Town Meeting Week to all who celebrate! With all the legislators back in their hometowns, you can let them know how they’re doing when you see them at the transfer station or grocery store. Also, VAHHS will not have a Legislative Update next week, due to lack of legislative action.
Go out and participate in democracy on Tuesday!
Physician Assistants and First Certifications: A huge thank you to the House Health Care Committee, which advanced H.573, a bill that allows PAs to perform the initial determination that an involuntary patient in need of mental health treatment requires inpatient care. The bill seeks to reduce patient wait time for care and reflects the changes put into place by Act 123 of 2020. In addition to VAHHS testimony, Philip Schafer, PA, Emergency Medicine Physician Assistant, Grace Cottage Hospital, Trey Dobson, MD, Emergency Medical Physician, Dartmouth Health, and Liz Couto, BSN, RN, CEN, Chair, Director, ENA-Vermont also testified. The bill passed out of committee with a vote of yes from nine members and two members absent.
Role of APRNs in Hospital Care: The full Senate passed out S.163, which adds APRNs to the Hospital Patient Bill of Rights and provides for admitting privileges. The bill will not go over to the House.
Elimination or Reduction of Hospital Services: After hearing from the Agency of Human Services and the Green Mountain Care Board, the Senate Health and Welfare Committee appears poised with S.189, to require hospitals to notify their communities and policymakers about any possible elimination or reduction of hospital services.
Green Mountain Care Board: The Senate Health and Welfare Committee started to make decisions on S.190, the Green Mountain Care Board bill. Where they’ve landed so far:
- Aligning closer to federal law on the requirement that hospitals obtain a National Provider Identifier for “off-campus” entities by changing the implementation date to 10/1/27
- Requiring detailed reporting on outsourced services to better understand the impact to hospital budgets and the provider tax
- Taking VMS’s proposal to carve reference-based pricing out of the provider bargaining group process
The committee will tackle reference-based pricing next week.
Primary Care Expansion: As I am someone who loves idioms, Sen. Lyons noting that primary care was a “can getting too dented” made me laugh. The Senate Health and Welfare Committee heard from several stakeholders on S.197, which would provide substantial additional resources to primary care. While there was general support for the concept of improving primary care, the Vermont Businesses for Social Responsibility wanted to look at impacts after this year to understand savings. Insurers, including Blue Cross Blue Shield of Vermont, MVP, and Cigna asked for more details on quality outcomes and transparency of funding. The Health Care Advocate focused on more immediate tweaks that could improve primary care.
Site Neutral: The House Health Care Committee reviewed a new draft of H.585, which changes all outpatient services to applying site-neutral principles in negotiations regarding physical therapy services.
Right to Repair Medical Devices: VAHHS testified in support of H.160, a bill that ensures that third parties can repair medical devices without prohibitions from manufacturers.
Artificial Intelligence: The House Health Care Committee narrowed their suite of A.I. bills to a new draft of H.814, which includes intent language, additional members to the state’s Artificial Intelligence Advisory Council and a report due on January 15, 2027. They also heard from witnesses on H.816, which addresses A.I. in mental health.
Private Equity: House Health Care heard from the Health Care Advocate, HealthFirst on behalf of the Health Care Association Coalition and VAHHS on private equity restrictions in H.583. VAHHS continues to support the Health Care Association’s proposal on regulating the corporate practice of medicine.