Legislative Update 2-10-20

VAHHS Legislative Update

Whew, what a week!  In the first veto override vote in over 10 years, the House failed to override the governor’s veto on paid family and medical leave by one vote.  Minimum wage landed on the governor’s desk on Tuesday.  He has five days to veto it, so we should hear news imminently.  It was also a busy week in the health care world, tackling telehealth, workforce and budgets, budgets, budgets.

Last Week

Telehealth: in House Health Care, Dr. Joshua White, the Chief Medical Officer at Gifford Medical Center, along with Sarah Chistolini and Natasha Withers from the University of Vermont Health Network, testified in support of H. 723, a bill that expands reimbursement for store-and-forward technology to all medically necessary services, such as e-consults and asynchronous communication in a patient’s home. Right now, reimbursement for store-and-forward is limited to dermatology and ophthalmology. The witnesses testified that expanding reimbursement for store-and-forward will give primary care providers and patients better access to specialists.

Workforce: The House Committee on Commerce and Economic Development heard from Paulette Thabault, director and professor at the Norwich School of Nursing, in support of the Office of Professional Regulation’s report on Obstacles to Recruitment and Retention of Qualified Nurse Educators.  Recommendations include creating flexibility around the current Masters-level education requirement for nurse educators. 

GMCB Budget: The Green Mountain Care Board presented its FY ’21 budget in House Health Care.  Unlike previous years, there are no proposed cuts. The Green Mountain Care Board highlighted its work with the All-Payer Model, Rural Health Services Task Force and health care work force. 

Medicaid Budget: DVHA presented its FY ’21 budget to House Health Care with a proposal to create $1.2 million in savings by allowing for a preferred prescription drug list for HIV/AIDS treatment. DVHA has done outreach to providers and to the HIV/AIDS community, and there appears to be support for the initiative.  Additional highlights include:

• $1.1 million Brattleboro Retreat Rate increase (annualized from budget adjustment changes agreed upon in the fall)
• $26.7 million reduction in Medicaid caseload and utilization
• $4.3 million in Health Information Technology (HIT) fund state savings through a reduction in duplication and increased federal dollars (this change will not impact the health information exchange)

Department of Mental Health Budget: The Department of Mental Health also presented their FY ‘21 budget in the House Health Care committee. Included in the budget proposal are:

• $1.1 million in Level 1 reimbursement for the Brattleboro Retreat and Rutland Regional Medical Center (annualized from previous budget adjustment changes)
• $1 million increase in Community Rehabilitation Treatment (CRT) services
• $3.9 million increase reflecting the annualization of new level 1 beds recently constructed at the Brattleboro Retreat
• $575,000 in suicide prevention initiatives, including expanding the suicide prevention lifeline and the Zero Suicide Initiative

Next Week

Budget Adjustment: The FY20 Budget Adjustment will be presented for the full House for a vote.  Changes to the FY20 budget include:

• $5 million decrease in Medicaid caseload
• $5.15 million in Delivery System Reform investments (these are one-time funds to assist OneCare with the transition to the All-Payer Model; the Senate removed $550,000 for Rise Vermont and that cut remains)
• $549,000 rate increase for the Brattleboro Retreat

Suicide Prevention: House Health Care will be listening to suicide prevention efforts.  The Department of Mental Health and the Vermont Department of Health have worked with OneCare to expand the Zero Suicide initiative, expand the suicide prevention hotline and reach out to isolated older Vermonters.

Prohibition on Referring Provider Penalty: The Senate Finance committee will be hearing testimony on S.309, a bill that prohibits insurers from shifting liability for out-of-network referrals to referring providers.