by Devon Green, VP of Government Relations, Vermont Association of Hospitals & Health Systems As Vermont emerges from negative temperatures, things are heating up at the State House. See below for more details:
Unmerging Health Insurance Markets: The House Health Care Committee unanimously supported H. 35, which will continue to keep the small group and individual health insurance markets separate, as authorized in 2022, which takes advantage of the ACA premium subsidies and maintains lower prices for small group premiums.
Budget Adjustment Act: The House Health Care and Human Services Committees made their recommendations to House Appropriations on the Budget Adjustment Act for FY25, including:
- $4M in one-time funds for the Medicaid hospital global budget program to pay tail claims and bring more hospitals into global budgets
- $2M in health care transformation funding to pursue the feasibility phase of Act 167 undertaken by the Agency of Human Services
Prior Authorizations and Claims Edits: VAHHS testified in favor of H.31, a bill that makes corrections to Act 111 of 2024, the prior authorization and claims edits bill. H.31 specifies that the claims edits standards does not apply to out of state claims and clarifies that a primary care provider is a health care provider who is contracted and enrolled with the health plan as a primary care provider.
Electronic Health Records (EHR): The Senate Health and Welfare Committee, which has noted that the electronic medical records issue is a priority this year, listened to testimony from the Vermont Information Technology Leaders (VITL) about their role in EHR interoperability. The Green Mountain Care Board also testified on their relationship to Vermont’s all claims database, the Vermont Health Care Uniform Reporting and Evaluation System (VHCURES) and the Vermont Uniform Hospital Discharge Data System (VUHHDS).
Emergency Medical Services (EMS): The Vermont EMS Advisory Committee Chair testified in front of the Senate Health and Welfare committee on the current state of Vermont’s EMS system. A five-year plan is expected by December 2026 to help modernize and improve coordination of the system.
Green Mountain Care Board (GMCB): The GMCB testified in the Senate Health and Welfare committee about their role and next steps in Act 167. The GMCB suggested exploring the AHEAD model and reference-based pricing to address health care affordability.
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