March 18, 2025

NEED TO KNOW

Legislature Passes Crossover, House Focuses on Budget

Last Friday was “crossover,” the date by which most bills have to be voted out of their committees of jurisdiction or will not advance this session.  It led to a flurry of activity on bills VMS is following, including those described below.  For a more detailed outline of bills VMS is tracking, see the talking points  here.  The House Appropriations Committee has until this Friday to make their state fiscal year 2026 funding recommendations – see the separate action alert below regarding funding for primary care for 2026.

  • A continued focus on health care costs and expanding the GMCB role. 
    • Following the recent news that Blue Cross Blue Shield of Vermont is again facing a multimillion dollar operating loss (see BCBSVT testimony here), the House Health Care Committee agreed on Friday with a GMCB request in H. 482 to allow the GMCB to reduce a health insurer’s reimbursement rates to one or more hospitals if the health insurer is at imminent risk of insolvency.   
    • In the same bill, the Committee also allows the Board to appoint an independent observer to oversee a hospital and its operations if the Board finds the hospital has made a material misrepresentation or is out of compliance with its budget and the Board believes that appointing an independent observer is in the public interest. 
    • Meanwhile, the Senate Health & Welfare Committee passed their committee bill, DR 25-0907, which will move hospitals reference-based pricing in the commercial market, set at a percentage of Medicare prices, to be determined by GMCB no later than 2027.  The bill also directs the GMCB to establish global budgets for at least one Vermont hospital by 2028 and all hospitals by 2030.  See VMS testimony on the bill here.
  • Taking up scope of practice.
    • The House Health Care Committee passed H. 237, a bill that would authorize prescribing by doctoral-level psychologists – see separate article asking for feedback below.
    • The Senate Health & Welfare Committee held a hearing on S. 64, a bill to allow optometrists to perform certain laser and surgical procedures.  The Committee only had limited time for testimony and heard briefly from OPR and the Board of Medical Practice.  Since the Committee did not pass the bill before crossover, it is unclear if the bill has a path forward this session. 
  • A balanced approach to data privacy.
    • The Senate Institutions Committee spent the past two weeks taking testimony on a bill that would add comprehensive data privacy requirements to many businesses that hold data on Vermonters.  VMS testified on behalf of a coalition of health care organizations asking for an exemption for HIPAA-covered entities, as they already follow extensive federal privacy requirements, and to eliminate a private right of action allowing citizen suits against businesses.  VMS also joined a commentary authored by the Chamber of Commerce expressing support for the version of a privacy bill put forward by Senator Chittenden in S. 93.  Ultimately, the Committee adopted Senator Chittenden’s language and addressed VMS’s concerns.  The bill will have many more stops before the end of session.  An analysis of the path forward for the privacy bill can be found here.

Take Action on the Primary Care Funding Cliff

Thank you for all of the messages you have already sent regarding primary care funding!

This Friday is the deadline for the House Appropriations Committee to complete their work on the SFY2026 Budget and we need to keep pushing to make sure that critical primary care bridge funding is included. If you have not already, please email this week to ask the Committee to address the gaps left by not joining AHEAD until 2027 by including in the SFY2026 budget one-time funding of $5.5 million for primary care programs funded by OneCare Vermont (CPR & PHM payments) and $4.5 million in state funds to continue Medicare-funded Blueprint for Health programs. In addition, the Governor’s proposed state budget currently does not include funding for the Blueprint’s 2-year expansion of embedded mental health supports or the DULCE program. Please explain how devastating any loss of funds for primary care services will be at this time. VMS has been highlighting this crisis through testimony and a press event last month. 

Please also remind lawmakers that this is the time to invest to train primary care physicians in Vermont!

  • Ask them to continue the existing Medical Student Incentive Scholarship Program that provides scholarships for up to 10 third- and fourth-year UVM medical students who commit to practicing primary care outside of Chittenden County
  • Ask them to support the Maple Mountain Consortium family medicine residency program - $4.06 million over 4 years in temporary support to launch a new primary care pipeline that will train 4 family medicine trainees per year starting in July 2026.

Please email the House Appropriations Committee before the end of this week:

rscheu@leg.state.vt.us; jharrison@leg.state.vt.us; tbluemle@leg.state.vt.us; edickinson@leg.state.vt.us; jkascenska@leg.state.vt.us; wlaroche@leg.state.vt.us; mmrowicki@leg.state.vt.us; mnigro@leg.state.vt.us; tsquirrell@leg.state.vt.us; tstevens@leg.state.vt.us; dyacovone@leg.state.vt.us; epedley@leg.state.vt.us.

Input Sought on Bill Authorizing Prescribing by Psychologists

H.237, a bill that would authorize prescribing by doctoral-level psychologists, passed unanimously out of the House Health Care Committee last week with significant amendments based on testimony from the Office of Professional Regulation.  As passed the Committee, in order to obtain a prescribing endorsement, a psychologist would be required to:

  • Hold a current license to practice psychology at the doctoral level in Vermont;
  • Complete a postdoctoral training program in psychopharmacology designated by the American Psychological Association, a didactic curriculum of at least 400 hours, described further here;
  • Complete at least 14-months of clinical rotations in not less than nine practice settings, to include psychiatry, pediatrics, geriatrics, family medicine, internal medicine, emergency medicine, obstetrics and gynecology, surgery, and one elective. OPR rule would further specify acceptable clinical settings for rotations;
  • Complete a national certifying exam, as determined by rule by OPR;
  • Have a collaborative practice agreement with an MD or DO who specializes in psychiatry;  
  • Not prescribe for patients under 18 years of age, over 80 years of age, or who are pregnant;
  • Be limited from prescribing specific drugs or for specific conditions, to be specified in rulemaking by OPR. 

The Committee felt that these amendments answered some of the concerns they heard in testimony from the Vermont Psychiatric Association and VMS.   The bill will go to the House Floor next week and will then move to the Senate Health & Welfare Committee for review and discussion.

Please send any feedback to Stephanie Winters at swinters@vtmd.org.

Congress’ Continuing Resolution Extends Medicare Telehealth Provisions

The Continuing Resolution that Congress passed to continue government funding through September 2025 includes a continuation of Medicare’s telehealth flexibilities, allowing health care professionals to continue to offer telehealth visits to Medicare patients regardless of where they are located.   The bill also continues funding for FQHCs and the national health service corp.   It did not avert a pay cut contained in the 2025 Medicare physician fee schedule or address PBM regulation, two items in a health care package that failed at the end of 2024.  For additional details on the implications of the continuing resolution for health care, see articles here and here.

MISC.

Mildred Reardon Medical Student Scholarship Open for Applications

Do you dream of becoming a Vermont doctor? 

The Vermont Medical Society’s Education and Research Foundation (VMSERF) is now accepting applications for the Mildred Reardon scholarship, which awards $10,000 to a University of Vermont Larner College of Medicine third year student committed to practicing medicine in Vermont.

The scholarship is made to a student interested in any specialty, with a preference for specialties in high need in Vermont.  The scholarship is tuition-linked and is paid directly to the College of Medicine towards tuition. Applications are due April 25, 2025.  Click here for more information and details on applying for the scholarship.

Act 111/Department Financial Regulation Guidance- Lunch and Learn – April 4

On April 4th from 12-1pm join the Director of Health Insurance Regulation at the Department of Financial Regulation, Sebastian Arduengo, for a walk through of the Act 111 DFR Guidance.  This guidance provides details for payers and practices regarding how to implement Act 111’s changes to prior authorization and other insurance practices.

View the guidance here.

Join the meeting:

Microsoft Teams - Join the meeting now
Meeting ID: 223 678 480 489 / Passcode: mA73fm7y

Dial in by phone - +1 802-828-7667,,963404137# 

Green Mountain Nursing & Rehabilitation - Physician Search

Green Mountain Nursing & Rehabilitation is looking for a physician and/or physicians to assist in the regulatory physician visits for our sub-acute admissions and long-term care residents whose primary care physicians within the community are not under the UVMMC umbrella.

Green Mountain Nursing & Rehabilitation is located in Fort Ethan Allen in Colchester VT. The commitment is roughly around 16 hrs per week. For more information, please contact Jennifer Combs-Wilber, LNHA at 802-655-1025 ext. 112 or email JCWilber@greenmountainnh.com.

EVENTS

Learning Collaboratives on In-Basket Reduction and Reducing Regulatory Burden

February 2025 – March 2025

AMA STEPS Forward® Innovation Academy is launching two new, six-month learning collaboratives on optimizing the in-basket to reduce work burden and rethinking how organizations apply regulatory rules to clinical practice. Each collaborative will convene dyads or triads of leadership representatives from multiple organizations to engage in a longitudinal shared learning experience. Limited space available. Learn more.

Navigating Workplace Violence: A Webinar Series on De-escalation Strategies for Healthcare Professionals

March 20, 2025

March 20th, 1:00 PM to 2:00 PM - "Workplace Violence Prevention: Focusing on What’s Most Important"

This session is led by Brendan Riley and is designed to provide professionals with advanced strategies to effectively address workplace risks and foster a safe, supportive environment. This webinar is crafted to address the challenges faced by all healthcare workers, offering insights that can benefit professionals across the entire spectrum of care.

Register here for either webinar.

The New England MGMA 2025 Annual Conference

April 24-25, 2025

Join the New England MGMA 2025 Annual Conference Tools for Today, Vision for Tomorrow: Navigating Challenges and Unlocking Po, an essential event for medical society professionals seeking to gain valuable insights, network with industry leaders, and stay ahead in the evolving healthcare landscape. This conference is hosted by Massachusetts/Rhode Island MGMA, New Hampshire/Vermont MGMA, and Maine MGMA.

The conference is offering an exciting mix of speakers and topics! Explore innovative approaches and practical tools designed to enhance patient care, streamline operations and drive business growth. Take part in interactive sessions and build your network with professionals dedicated to integrating innovation with healthcare priorities, ensuring a healthier future for all.

View the full schedule and register for the conference here.

For more information about offerings from UVM CMIE, visit here.

VTMD.ORG

Vermont Medical Society

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Montpelier, VT 05602

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