Vermont Update 2-10-20

Paid Family Leave

By a single vote, the House failed to override Governor Phil Scott’s veto of the paid family leave bill. The Administration is promoting the voluntary expansion of a new state employees' paid leave program. Telemedicine

The House Health Care Committee heard overwhelming support from provider groups for H.723, a bill to require health insurance reimbursement for expanded telehealth services. The bill is aimed at what’s known as “store-and-forward” telemedicine services. Store and forward is “asynchronous communication” (meaning more like e-mail than like Skype) and generally used for provider-to-provider consultations.

SFY 2021 Medicaid Budget

Department of Vermont Health Access Commissioner Cory Gustafson appeared before several committees last week to present the department’s SFY2021 budget request. We are pleased to report the budget includes an increase for skilled home health services like nursing and physical therapy. Medicaid home health is a very small program—most people who are eligible for skilled home health are covered by Medicare. It’s important to note that the increase does not impact the Choices for Care program, which is part of the Department of Disability, Aging and Independent Living budget. In addition, revenue projections are relying on a significant increase in home health provider tax revenue. The home health provider tax is projected to generate 10 percent more revenue than budgeted in SFY2020. Home health agencies are asking the legislature for provider tax relief in SFY2021. 
 
The Senate Health and Welfare Committee began a review of its omnibus health care reform bill, S.290. The bill:

• Requires additional reporting, certification and budget requirements for OneCare Vermont, the state’s accountable care organization
• Directs hospitals to report certain rate increases to the Green Mountain CareBoard (GMCB)
• Requires GMCB approval for contracts between health insurance plans and providers;
• Requires the Agency of Human Services to report on a two-year budget and reporting cycle for OneCare Vermont
• Provides GMCB oversight of the designated mental health and specialized service agencies
• Requires that GMCB membership include a health care professional
• Requires the GMCB to begin exercising its rate-setting authority and establish site- neutral reimbursement; and
• Imposes limits on health insurance rate increases attributable to administrative expenses.

The committee will take testimony on the bill starting next week.

Nurse Educator Shortage

Last week, the House Commerce and Economic Development committee turned their attention to the nurse educator shortage, a long-standing issue that was recently highlighted in a health care workforce report drafted by a sub-committee of this year’s Rural Health Services Task Force. The report recommends a change to Vermont Board of Nursing rules that exclude experienced nurses who hold bachelor’s degrees (but not master’s degrees) from serving as nurse educators.

Older Vermonters Act

The House Committee on Human Services continued taking testimony this week on H. 611, the Older Vermonters Act. The bill is aimed at Vermonters who are age 60 and older. It would create protections and a framework of principles for programs and services aimed at that population. It is intended to align with the federal Older Americans Act, the Vermont State Plan on Aging and the Choices for Care program. The bill would also establish annual inflationary increases to reimbursement rates for Choices for Care home- and community-based services.