by Devon Green, VP of Government Relations, VAHHS
Leaves on the trees, the Corporate Cup Race, a budget passed by both chambers—normally, these are signs of the session ending, but we’ve still got a couple weeks to go. Here’s the latest:
Budget: As mentioned above, the House and Senate landed on the budget bill last week with H.493. It now goes to the governor’s desk. Included in the budget as one-time funding are items that were initially included in the failed Budget Adjustment Act. Overall, the budget includes $11 million in reconciliation payments for the Brattleboro Retreat, $10 million for health care stabilization grants, $4 million for the Medicaid global hospital payment program to cover tail-end claims and bring in additional hospitals. For health care reform work, there are six positions for the Green Mountain Care Board and $2.2 million for the Agency of Human Services to do transformation work. Finally, there is $1.25 million in funding for the Maple Mountain Family Residency Program, a new residency program on primary care in rural communities.
340B Protection Bill: While H.266 maintains its 340B protections, it has also evolved into a mechanism to address the Blue Cross Blue Shield of Vermont (BCBSVT) financial crisis. BCBSVT presented on Vermont’s high drug prices and pointed to Vermont’s prohibition on white bagging (when a patient's medication is dispensed by a specialty pharmacy and then shipped to the healthcare provider's office or facility for administration) as the culprit. After hearing VAHHS testimony about the quality and safety issues around white bagging, the House Health Care Committee landed on a proposal to keep the white bagging prohibition in place, but to cap outpatient infusion therapies at 120 percent average sales price. BCBSVT estimates that this will net them about $46M. The bill language released on Thursday exempts critical access hospitals. Capping drug prices will have a substantial impact on the remaining hospitals, and the committee will hear more testimony this week.
Health Care Reform Bill: The House Appropriations Committee passed out the funding portion of S.126 with resources for the Agency of Human Services to do transformation planning and three positions for the Green Mountain Care Board to implement reference-based pricing for 2027. Next stops for the bill will be the House Floor and then Senate.
Green Mountain Care Board Expansion of Powers: The Senate voted in support of H.482, which expands the Green Mountain Care Board’s authority to adjust rates for certain hospitals if Blue Cross Blue Shield of Vermont is near insolvency and to adjust reimbursement for any hospital that is not meeting their budget target at any point in the year. The bill also allows the Green Mountain Care Board to assign an independent monitor paid for by the hospital if a hospital materially misrepresents information to the Green Mountain Care Board or if a hospital is materially noncompliant with its budget. The bill goes to Third Reading in the Senate and then to the House Health Care Committee, which has already taken initial testimony.
Homework for Next Session: The House Commerce Committee is starting to work on its agenda for next year and considered H.160, which would create a right-to-repair for medical devices. If you have thoughts on this novel approach, please contact me at [email protected].