Health Care

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Speaker: House to explore exchange options

VTHealthConnect

MONTPELIER — The House Health Care Committee will hold hearings next week to examine the state’s options for Vermont Health Connect as the exchange faces new challenges and unrest grows in the Legislature, according to House Speaker Shap Smith. The Shumlin administration revealed last week that a new backlog of exchange users waiting for changes to their accounts has emerged and includes more than 3,000 people. According to a Vermont Public Radio report, the Shumlin administration blamed the new backlog on a software upgrade that was not yet ready to be deployed. The administration reported last fall that it had dealt with a backlog of requested changes that at one time had numbered more than 10,000. Smith told the Vermont Press Bureau Tuesday the Shumlin administration needs to show quick progress on fixing the so-called change of circumstance function and reducing the backlog. Continue Reading →

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Vermont proposes all-payer health care model

Al Gobeille, right, discusses the all-payer model.

MONTPELIER — Vermont has taken the first step toward a radical change in the way health care providers are paid for their services. On Monday, state officials submitted a proposal to the federal government that would see doctors paid for the health outcomes of their patients, rather than for the services they provide. “I think anyone in the health care industry knows that fee-for-service results in duplication and inefficiency,” said Gov. Peter Shumlin, a statement he has made in one form or another during his five years in office. Rather than pay for every visit to the doctor’s office or every test a patient takes, the proposed all-payer model would allow Medicare, Medicaid and private insurers to pay health care providers based upon the heath outcomes of their patients. The Shumlin Administration submitted its proposal Monday to the federal Centers for Medicare and Medicaid Services, seeking permission to employ an all-payer model in Vermont for five years, beginning in January 2017 and continuing through December 2021. Continue Reading →

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Shumlin scraps Medicaid change after one day

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MONTPELIER — Gov. Peter Shumlin said Friday he will scrap a $4.9 million budget-savings initiative he proposed just one day earlier that would have changed Medicaid eligibility requirements for pregnant women. Shumlin, who delivered his final budget address to the Legislature Thursday, had planed to raise the income level at which pregnant women qualify for the Medicaid from 138 percent of the federal poverty level to 213 percent. That equates to about $16,000 and $25,000, respectively. Women who no longer qualified for Medicaid under the governor’s proposal would have been eligible for subsidized health plans on Vermont Health Connect, the state’s online health insurance marketplace. A change in state law would be required, however, to allow pregnant women to enroll in a health plan outside of the open enrollment period. Continue Reading →

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Shumlin seeks 3.1 percent boost in FY2017 budget, expansion of provider assessment

Gov. Peter Shumlin delivers the final budget address of his governorship inside the House chamber. (Times Argus/Jeb Wallace-Brodeur)

MONTPELIER — Gov. Peter Shumlin is looking to address a deficit in the state’s Medicaid program by expanding a tax on health care providers in the $1.537 billion 2017 fiscal year budget proposal he revealed Thursday. Shumlin, a Democrat who is not seeking re-election, delivered the final budget proposal of his tenure to lawmakers Thursday. His proposal, outlined in his 30-minute address inside the House Chamber, would boost spending by 3.1 percent over the current fiscal year — after mid-year adjustments are put in place. Shumlin touted his budget as responsible and necessary, noting he closed a projected $68 million gap between anticipated revenues and spending without the use of one-time funding for ongoing expenses for the first time since before the Great Recession. The 3.1 percent spending increase matches projected revenues, he said. Continue Reading →

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Exchange Backlog Returns Due To New Technical Problems

Chief of Health Care Reform Lawrence Miller (VPR/Taylor Dobbs)

ast October, Gov. Peter Shumlin said his administration had finally eliminated the customer-service bottleneck that had long plagued Vermont Health Connect. The change-of-circumstance backlog has since returned, however, and the setback has further eroded confidence in the future of the online insurance exchange. On Oct. 1 of last year, Gov. Peter Shumlin summoned reporters to the Statehouse to celebrate a Vermont Health Connect milestone. Shumlin said his team had finally worked through the backlog of people waiting to have changes made to their policies. Continue Reading →

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Trailing Bernie: Sanders surges again, as Clinton steps up attacks

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ew polling in the Democratic Party’s presidential primary shows Sen. Bernie Sanders leading rival Hillary Clinton in both Iowa and New Hampshire, prompting Clinton to step up her attacks. A Quinnipiac poll released Tuesday shows Sanders, the 74-year-old self-described democratic socialist, with a 49 percent to 44 percent edge over the former secretary of state and first lady among likely Democratic caucus-goers. It’s the first time Sanders has had a lead over Clinton in the poll. The same poll on Dec. 15 gave Clinton a 51 percent to 40 percent lead. Continue Reading →

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Shumlin won’t rule out new revenue for Medicaid

Gov. Peter Shumlin discusses the state's Medicaid program in an interview Monday, Jan. 11, 2016. (VPB/Neal Goswami)

MONTPELIER — Outgoing Democratic Gov. Peter Shumlin is not ruling out the possibility of raising new revenue to pay for the state’s Medicaid program when he delivers his annual budget address on Thursday. Shumlin, in an interview with the Rutland Herald and the Barre-Montpelier Times Argus Monday, promised to deliver a balanced budget for the 2017 fiscal year on Thursday. That means he must close a projected gap of $58.5 million that is largely driven by the Medicaid program. The Medicaid deficit in the upcoming fiscal year is projected to be about $53 million. That’s because the state expanded the program under the federal Affordable Care Act. Continue Reading →

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Effort to bypass exchange for small business continues

VTHealthConnect

MONTPELIER — The Shumlin administration and lawmakers are moving forward with efforts to scrap plans for the small business function on the state’s online health insurance marketplace. Under state law, small businesses are supposed to be enrolling employees through Vermont Health Connect, the state-based insurance exchange created under the federal Affordable Care Act. But the website, which launched in October 2013, has never included that online function, known as Small Business Health Options Program, or SHOP. As a result, small businesses have enrolled employees directly through the two insurance carriers offering health plans on the exchange — Blue Cross Blue Shield of Vermont and MVP Health Care. Rep. William Lippert, D-Hinesburg, the chairman of the House Health Care Committee, has introduced a bill to allow the state to seek a so-called 1332 waiver to allow small businesses to continue enrollment directly through the carriers. Continue Reading →

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New rules to fight opiate addiction

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BURLINGTON — The state is making an effort to tighten up the rules surrounding the prescription of opiates and expand the rules surrounding prescriptions to fight opiate addiction. On Tuesday, Gov. Peter Shumlin outlined rules intended to curb the prescription of drugs such as OxyContin in Vermont, while revealing a multi-state effort to expand the number of people who are allowed to prescribe drugs such as Suboxone for addicts who are seeking treatment. “In the fight against opiate addiction, Vermont has made incredible progress,” Shumlin said. “We still have much work to do. We are fighting this battle on two fronts: helping those already addicted get into treatment and recovery and stopping addiction from taking hold in the first place.”

Since his 2014 State of the State Address – which he devoted entirely to the state’s opiate epidemic – Shumlin has made the issue a cornerstone of his administration’s priorities. Continue Reading →

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Health care costs drive budget adjustment

Andy Pallito

MONTPELIER — Health care costs are are driving a proposed budget adjustment from the Governor’s Office to the tune of $70 million. The House Appropriations Committee spent Monday reviewing a proposal that would add an additional $88.9 million to the FY 2016 budget, with the lion’s share of the increase due to the state’s expansion of health care. Much of that will be covered by federal funding. “Of the 88.9 million, $70 million is for DVHA (Department of Vermont Health Access) or Medicaid,” said Andy Pallito, commissioner of the Department of Finance and Management. Since 2012, the state has made a concerted effort to provide health care for all Vermont residents. Continue Reading →

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