by Devon Green, Sr. Vice President of Policy & Strategy, VAHHS
Legislative Update
In addition to the joint meeting with the health care committees and hospitals that Mike highlighted in his column, here’s what else happened at the legislature last week:
Private Equity: The House Health Care Committee reviewed a new draft of H.583. The stated purpose of the bill is to regulate the bad actions of private equity in health care, but both drafts prohibit many other health care financial transactions.
The new draft contains the following:
- For the below prohibitions, no new licenses will be released after January 1, 2027, and all existing facilities must comply by January 1, 2029:
- Prohibits ownership of health care facilities by organizations funded through capital investments
- Prohibits ownership of a health care entity by any for-profit entity, with the exception of a professional corporation
- Prohibits sale-leaseback structures
- Only Vermont-licensed MDs, Dos, PAs, and APRNs may own a medical practice or employ other licensees, with exceptions, such as hospitals
- Regulates arrangements between medical practices and management services organizations
- Prohibits restrictive covenants
- Extensive reporting by health care entities of financial and ownership information
- Enforcement can be through private right of action
While there is no private equity ownership of Vermont’s hospitals, which are all non-profit, this bill as written will destabilize other parts of the health care system and services within hospitals, such as telehealth.
APRN and Patient Bill of Rights: VAHHS testified in favor of S.163, which will include Advanced Practice Registered Nurses in the Hospital Patient Bill of Rights and hospital licensure, providing them with admitting and discharging privileges if allowed by hospital policy. VAHHS shared that some VAHHS members had concerns, including issues around Medicare billing.
Board Governance: Under H.585, the governor would have the power to appoint at least two members of the public to the board of Blue Cross Blue Shield of Vermont. The Department of Financial Regulation testified in House Health Care that they would be open to having a nominating process similar to the Green Mountain Care Board’s with limiting criteria as opposed to a straight nomination from the governor. Blue Cross Blue Shield of Vermont did not support the policy, but requested that governor appointees be subjected to liability the same as a regular board member.
Site Neutral: Blue Cross Blue Shield of Vermont testified on H.585 in House Health Care that they supported site neutral billing while acknowledging the large financial impact to hospitals. The Committee expressed an interest in examining facility fees.
Rural Health Transformation Funding: The Joint Fiscal Committee heard from the Agency of Human Services on the federal Rural Health Transformation Funding. The budget, which is still under negotiation with CMS can be found here.
Prescription Drug Discount Bill: House Health Care unanimously passed H.577 out of committee. The bill, proposed by the State Treasurer’s Office, creates a prescription drug discount card program for Vermonters.
Vermont Association of Hospitals and Health Systems
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