The bill proposes amendments to the Certificate of Need (CON) requirements for health care facilities in Vermont, specifically increasing the monetary thresholds that trigger the need for a CON. This bill aims to streamline the process for health care facilities while ensuring that significant projects still undergo necessary oversight.

H.206 was reviewed in the Senate Health and Welfare Committee on April 27 by Chairwoman Lyons and Legal Counsel (see previous reports on this bill here). It was determined favorable after making changes in the Blueprint for Health regarding how much insurers and Vermont Medicaid should increase the amount paid per-person to medical homes for providing the additional resources necessary for delivery of comprehensive primary care services to Vermonters. 

On Tuesday, Julia Boles, Health Policy Advisor at Green Mountain Care Board (GMCB), presented a report regarding Prior Authorization (PA) to the Senate Health and Welfare Committee. She explained that “Prior Authorization” means the process used by a health plan to determine the medical necessity, medical appropriateness (or both) of otherwise covered drugs. It is also applied to medical procedures, medical tests, and other health care services. Prior authorization is a process by which a medical provider (or the patient, in some scenarios) must obtain approval from a patient's health plan before moving ahead with a particular treatment, procedure, or medication.

The Senate Health and Welfare Committee heard testimonies on Thursday from various entities concerning H.206. The bill relates to the duties of the Department Vermont Health Access (DVHA), which was initially created in the House Health Care Committee back in February. Subsequently, reviewed by the House Appropriations Committee and then passed House sent to the Senate.

The Health Equity Advisory Commission (HEAC) presented to a joint Committee meeting of the House Health Care and Senate Health and Welfare on Wednesday. The agenda included an overview of the HEAC responsibilities, a summary of the HEAC’s 2023 Annual Report, budget and fiscal proposals, and final notes and reflections. The Commission members include thirty representatives from various entities in Vermont. Rev. Mark Hughes is the Chair and represents Vermont Racial Justice Alliance. He and Kristen Murphy (Executive Director, Vermont Developmental Disabilities Council) presented the annual report to the committee, which included government equity, programmatic approach/framework, community engagement, legal and administrative support, policies and programs, funding, grants and training, and continuing education.

Robin Lunge and Jessica Holmes, members of the Green Mountain Care Board (GMCB) presented the history and overview of the GMCB to the House Appropriations Committee on Wednesday. Holmes introduced herself stating that she is an economist and has been a member of the Board for eight years. She explained how the uniqueness of health care justifies the extensive government oversight through laws and regulations. In most markets, transactions involve only a buyer and seller, but in health care there is the presence of third parties, including insurers as well as the role of government.

This week the Senate Health and Welfare Committee confirmed the appointments of a number of the Green Mountain Care Board (GMCB) members.

The House Health Care Committee took up H.206, which is entitled “An act relating to miscellaneous changes affecting the duties of the Department of Vermont Health Access,” on Thursday. Stephanie Winters of the Vermont Medical Society (VMS) shared the perspective of the VMS on Section 3 of the bill pertaining to the Vermont Prescription System (VPMS) and the use of the data in this important registry. She reiterated that “VMS was involved in the design of VPMS at its inception and has always been our position that the focus should be clinical improvement and coordination and not enforcement purposes.”

S.54 was introduced by Senators Cummings, Perchlik, Watson, and Wrenner with the intent of extending the separation between the individual and small group markets in Vermont Health Connect through plan year 2025.

The Green Mountain Care Board (GMCB) met with the House Appropriations Committee on Tuesday to present their budget for 2024. The new Chairman, Owen Foster, introduced the current Board, which includes Jessica Holmes, Robin Lunge, David Murman, Thom Walsh, and Susan Barrett.