Vermont health care providers rally for prior authorization and step therapy reform in Vermont

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MONTPELIER — Health care providers and patient advocates gathered at a press conference last week to demonstrate their support for H.766, a bill aimed at reforming prior authorizations and step therapy in Vermont.

Devon Green, VP of Government Relations at the Vermont Association of Hospitals and Health Systems (VAHHS), noted the palpable passion among providers who eagerly shared their experiences with bureaucratic processes and their desire for immediate action.

The Senate Health and Welfare Committee continued to hear testimony on H.766, which aligns prior authorizations with Medicaid, expands patient protections for step therapy, and aligns claims edits with Medicare. The committee is scheduled to mark up the bill this week.

In other legislative developments:

  • VAHHS joined a health care association coalition in requesting an entity-level exemption from H.121, a state data privacy bill, citing concerns about separate data privacy requirements in addition to HIPAA.
  • The Senate Health and Welfare Committee heard about H.622, which bolsters Vermont’s EMS services through Medicaid reimbursement for treatment without transport, support for a statewide EMS plan, and training funds.
  • The Senate Government Operations Committee approved allocating $15,000 to study reference-based pricing options for state employee and teacher health insurance plans, with VAHHS emphasizing the need to consider this initiative in the context of current global budget and hospital transformation efforts.
  • The Green Mountain Care Board updated the House Health Care Committee on the hospital budget process and FY 2023 actuals, discussing factors contributing to rising costs and the appropriateness of using net patient services revenue as a measurement.
  • The Senate Health and Welfare Committee advanced H.847, a bill establishing peer support certification for individuals with lived experience in trauma, mental health, or substance use challenges to assist others in accessing resources and navigating systems.
  • The House Health Care Committee advanced S.109, directing the Office of Professional Regulation to conduct a sunrise review on regulating doulas, reimbursement, and health care coverage recommendations.

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