Legislative Update 2-17-20

Two weeks ago, the legislature failed to override Governor Scott’s veto on paid family and medical leave. Last week, Governor Scott wielded his veto power yet again, this time on S.23, the minimum wage bill that would increase the hourly wage to $12.55 per hour by 2022. The Senate quickly overrode the governor’s veto with a 24-6 vote. The House has scheduled their override vote for this week. After falling one vote short on paid family and medical leave, it remains to be seen what the House will do with minimum wage.

Last Week

Physician assistant licensure: The PA licensure bill passed the Senate and will move on to the House next week.  The bill includes replacing physician supervision with a single practice agreement, and removing statutory liability to providers for oversight of PAs. Two amendments were added to the bill that do not change the practical effect of the bill, but clarify that physicians may still be held liable for their own conduct and clarifying the existing liability of nurse practitioners and PAs.

Implementation of health care reform: VAHHS testified in opposition of S.290, a bill that requires the Green Mountain Care Board to approve all provider contracts and attain site neutrality through rate setting; creates new reporting requirements for hospitals and OneCare Vermont; and ties OneCare Vermont’s salary increases to meeting quality and budget targets. VAHHS argued that Vermont’s hospitals need predictability to make the transition over to value-based care and that bills such as S.290 create instability for the entire health care system.

Prohibition on holding referring providers liable for out of pocket costs and surprise billing: VAHHS testified in the Senate Finance Committee on S.309, a bill that prohibits health insurers from shifting liability for out-of-pocket expenses to referring providers when they refer a patient out of network. This bill is a response to a policy Blue Cross Blue Shield of Vermont put into place that would allow Blue Cross Blue Shield to fine providers when they refer out of network. Several health care providers testified to the chilling effect this policy has on the provider-patient relationship. The bill also proposes to eliminate patients’ out-of-pocket exposure for nonemergency services delivered by out-of-network providers at in-network facilities, ensuring protection to patients for an issue that is happening in other areas of the country.

Flavored tobacco ban: Senate Health and Welfare voted out of committee a bill banning flavored tobacco products and e-liquids—including menthol flavoring—for purchase in Vermont. The committee held a spirited discussion on the merits for public health and the concerns of overregulation and effect on businesses before passing the bill unanimously out of committee. VAHHS expressed support for the bill via written testimony provided to the Senate Committee Chair. The bill will now head to the Senate Finance committee, where they will grapple with a potential $5.5 million in lost revenue in tobacco taxes due to the ban.

Stem cell products and medical tourism: Senate Health and Welfare took testimony on the medical and ethical concerns surrounding stem cell products and medical tourism.  The committee is considering a bill that would require providers of stem cell therapies not approved by the FDA to provide clear notice of this fact in their interactions with patients and in their advertising.  Stem cell products not approved by the FDA and stem cell medical tourism—where providers refer patients to off-shore facilities to receive treatment that would be illegal in the United States—offer procedures that are not backed by science and are potentially dangerous to consumers.  Dr. Daniel Weiss, Professor of Cell and Molecular Biology at UVM, testified on the differences between legitimate stem cell research and stem cell clinics that provide unsupported procedures. The Vermont Ethnics Network, Vermont Medical Society, Office of Professional Regulation, the Attorney General's Office and the Department of Health all provided testimony in support of the bill. The committee expects to take the bill up again early next week.

This Week

Fiscal Year 2021 Budget Letters: House committees will be finalizing letters to the Appropriations Committee on spending priorities. 

Interstate Nurse Licensure Compact: The Senate Health and Welfare committee is scheduled to vote out S.125, the bill that would authorize the interstate Nursing Licensure Compact.

Prohibition on holding referring providers liable for out of pocket costs and surprise billing:  The Senate Finance committee will be taking further testimony on this issue.