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Legislative Update 2-11-19

February 10, 2019

Last Week

Funding for Supervision in Emergency Departments Reinstated: VAHHS, the Department of Mental Health and the Lamoille County Sheriff’s Department offered testimony earlier this week in the Senate Health and Welfare Committee on proposed budget cuts in the 2019 Budget Adjustment Act to funding for sheriffs in emergency departments. After hearing this testimony, the Senate Appropriations Committee reinstated the funding.  While reinstating the funding, the committee asked hospitals, sheriffs, designated agencies and peer support services to consult with the Department of Mental Health on recommendations that would continue funding support for emergency departments in a way that complies with federal regulations.  The recommendations are due on April.  This is a great opportunity to improve the support in our emergency departments, especially for our critical access hospitals.  If you have ideas or suggestions, please contact Devon Green at devon@vahhs.org.

Price Transparency and Surprise Billing: VAHHS and the Vermont Medical Society questioned the effectiveness of S.31, a bill that would add a number of disclosure requirements to the Patient’s Bill of Rights. While Senator Chris Pearson had earlier testified that he was introducing the bill to provide patients with greater simplicity, the bill actually requires a number of disclosures that may confuse the patient further while subjecting physicians and hospitals to greater liability. Patients would benefit more from targeted assistance, such as access to financial counseling. The bill would require:

  • Disclosure of whether a disputed bill will be sent to a collection agency—Vermont hospitals generally work with patients and try to determine if they are eligible for charity care or a monthly repayment program.  The hospital would not know from the outset whether the bill will be sent to the collection agency. 
  • Disclosure of financial conflicts of interest—The Stark Law or the Physician Self-Referral Ban is a healthcare fraud and abuse law that prohibits physicians from referring patients for certain designated health services, including inpatient and outpatient hospital services, paid for by Medicare to any entity in which they have a “financial relationship.” 
  • A price list for elective procedures and information on less expensive options if they are available—Hospitals produce the charge list right now as part of the Vermont Department of Health’s Hospital Report Cards for the top 20 procedures.  However, the charge list itself is confusing to patients.  The charge list price is often not the paid price once insurance or income level are taking into account.  Physicians don’t have all of this information and would be ill-equipped to discuss the exact cost to the individual patient.
  • The patient's right to be informed on facility fees— this billing process is being phased out by Medicare, is not currently practiced by Medicaid or commercial providers and would likely confuse patients rather than inform their decisions.

Next Week

Mental Health Data: VAHHS will be co-presenting with the Department of Mental Health on statewide mental health data to the Senate Health and Welfare Committee.

Tobacco 21: The Senate Health and Welfare Committee will also be taking up the Tobacco 21 legislation, which would increase the age requirement for purchasing tobacco products, including e-cigarettes, from 18 to 21 years of age.

Devon Green, Vice President of Government Relations