Category Archives: Health Care

DVHA has new deputy commissioner

MONTPELIER — A new Department of Vermont Health Access deputy commissioner has been hired to help the state’s troubled exchange.

Lawrence Miller, Gov. Peter Shumlin’s chief of health care reform, said Wednesday that native Vermonter Bob Skowronski will take over the role. Former Deputy Commissioner Lindsey Tucker has been assigned to a new roll in DVHA, he said.

According to Lawrence, Skowronski has “spent his career in health care IT system work.” In recent years he has worked on exchanges in New York, Maryland, Washington, D.C., Rhode Island and Connecticut. He has also worked as Blue Cross Blue Shield in Vermont as director of data management.

Skowronski said Wednesday that his experience in working on exchanges has come from the carrier side in previous work with United Health Care.

“I would consider the carrier … as a customer of the exchange. So, I’ve seen the exchange from a different perspective. The processes are the same, just a different perspective,” he said.

Miller said Skowronski approached him about helping the state fix Vermont Health Connect, which continues to lack key functions.

“He sent me a letter a few weeks ago offering to help at a time in his career when he can step off the corporate track and give back to the community in a way that really takes advantage of his skills and experience,” Miller wrote in an email.

Skowronski said he was preoccupied with his work and only recently began to take not of the challenges in Vermont. When he took stock of the situation at Vermont Health Connect he wanted to help. He said his status as Six Sigma black belt will can help address the site’s shortcomings.

“A few weeks ago, a month ago, I started paying closer attention to news reports … and realized they were experiencing problems that I thought I could help solve,” he said.

Miller said he passed Skowronski’s interest in helping along to Agency of Human Services Secretary Harry Chen and DVHA Commissioner Mark Larson for interviews.

Skowronski, who began work on Tuesday, said he has spent his first two days listening and gauging the needs of stakeholders.

“Clearly Vermonters have had issues with the way Vermont Health Connect was implemented. What I want to start with is their perspective. I want to start with what’s important to Vermonters. I want to work with what’s important to carriers. I want to make sure we’re working closely with the vendors. I want to make sure we’re satisfying various regulators,” he said.

Optum report critical of state, CGI

Vermont’s top health care reform officials are planning a roundtable meeting with reporters this morning to discuss a report by Optum that is critical of both the state and CGI.

Included in the report:

Optum has concluded, based review of the VHC’s Program Management documentation and interviews with both SOV and contractor staff, that the project’s Program Management structure and processes contributed to SOV’s lack of project ownership and CGI’s lack of accountability. Additionally, project
management processes within the program, do not align with industry best practices and are insufficient or ineffective.

As a result CGI has not met its commitments in the contract and the project has not met the expectations of the SOV. The project team’s ability to deliver the remaining contractual requirements is a ‘High’ risk, and as such, immediate corrective action is required.

 

Read the report below:

Hoffer will audit Vermont Health Connect

MONTPELIER — State Auditor Doug Hoffer announced Monday that his office is planning to audit the state’s online health insurance marketplace as the Shumlin administration and its new lead contractor look to fix ongoing technical issues.

Hoffer informed interim Agency of Human Services Secretary Harry Chen in a letter dated Aug. 21 of the pending audit.

Vermont Health Connect, the insurance exchange mandated under the federal Affordable Care Act, has been troubled since its October 2013 launch. Thousands of users who need to change information, such as their address or marital status, must undergo a cumbersome manual process rather than the faster, automated way the website was expected to offer.

Additionally, small business employees are still not allowed to enroll through the website and must obtain insurance directly from carriers. That function is now expected to be available next year at the earliest.

Hoffer said Monday that his office will focus on whether the state has plans in place to correct the site’s shortcomings. A number of reports from various independent contractors have highlighted those shortcomings and provided recommendations on how to address them.

Doug Hoffer

Doug Hoffer

“All of them include a number of recommendations and some of them go back to last year. That’s good, in a way, because we can check and see if adjustments were made,” Hoffer said. “We said, ‘Let’s try to be positive and provide info to the administration, the Legislature and the various departments and see how well they’ve responded.”

Hoffer said his review will begin by late September. That will allow time for an ongoing federal review, conducted by the U.S. Department of Health and Human Services’ Office of Inspector General, to be completed. There will be “no overlap” between the state and federal reviews, he said.

“We certainly didn’t want to be in their shop at the same time the IG’s folks are there,” Hoffer said.

The state review will not include contracts awarded by the state or money spent on the exchange, according to Hoffer.

“It’s not about contracts at this point. Some of that ground has been pretty heavily plowed,” he said. “Clearly, everybody knows and these reports have documented, that there have been a lot of problems.”

The state audit will involve two to three employees from the auditor’s office and is expected to take months to complete.

“These things are complicated and take a long time. I have yet to see an audit take less than four months — six is more likely,” Hoffer said. “It’s my intention to really encourage folks to find a way to get this done during the [legislative] session. That might involve trimming the objectives to save time.”

Racine out at AHS

MONTPELIER – Agency of Human Services Secretary Doug Racine is being replaced, the Shumlin administration announced Tuesday, as challenges within the agency mount.

According to Shumlin administration officials, current Health Commissioner Harry Chen will replace Racine on an interim basis while a permanent replacement is sought.

“I appreciate Doug’s hard work over three and a half years to help Vermont’s most vulnerable,” Shumlin said in a release.

Doug Racine

Doug Racine

Shumlin touted the agency’s move to a data-driven, results-based planning strategy and a revamped mental health system under Racine’s tenure.

But the agency has faced significant challenges, too. Vermont Health Connect, the state’s online health insurance marketplace that is overseen by the agency’s Department of Vermont Health Access, has struggled and remains hobbled. And The Department for Children and Families has faced scathing criticism following the recent deaths of several children, allegedly at the hands of caregivers.

“This has been a tough job, but now is the right time to start with new leadership to take the Agency of Human Services forward,” Shumlin said. “I appreciate Dr. Chen’s willingness to get us started on that challenge.”

Harry Chen

Harry Chen

Chen is expected to remain as Interim Secretary of AHS through the end of the year. Deputy Commissioner of Health Tracy Dolan will head the Health Department in his absence.

A full story will appear in Wednesday’s editions of the Herald and Times Argus.

Milne admits past health, legal troubles

MONTPELIER — Republican gubernatorial candidate Scott Milne revealed in a statement to reporters Thursday that he was arrested three times in college and suffered a stroke in 2006.

The arrests, two for driving under the influence of alcohol and one for possession marijuana and cocaine, all resulted in convictions. Milne said in a telephone interview Thursday that the cases were “settled as expeditiously as possible without spending money on counsel.”

“I don’t think about them on a daily basis, but my presumption is they are part of the public record,” he said.

In 2006, Milne suffered an ischemic stroke caused by a blood clot in his brain. He said he has made a full recovery, suffers “very little residual effect,” and has been cleared by doctors to campaign and serve as governor.

“Basically, I have a little bit of numbness on one side of my buddy and that really is about it,” Milne said.

He gave credit for his recovery to his daughter who he said sought immediate medical attention when the stroke occurred.

Milne, who has yet to formally launch his campaign, said he wanted the information about his past to be out in the open. He said facts about his past “might be important and relevant” to supporters.

Scott Milne

Scott Milne

“I think we wanted to get it out. If we started to campaign earlier we would have sent it out a lot earlier,” he said. “It was a consideration when I was weighing whether or not to run.”

Milne, in the statement sent to reporters, said “Vermonters have a right to a governor who is upfront and transparent.” He promised transparency about his personal life as well as the “economic challenges and crisis of affordability we face as a state.”

Another exchange deadline to be missed

MONTPELIER — Change of circumstance functionality expected to go live this weekend on Vermont Health Connect will not be deployed as testing continues, according to Department of Vermont Health Access Commissioner Mark Larson.

The state’s vendor, CGI, was supposed to have the change of circumstance function live on the health insurance exchange website by May 21 based on an amendment to the original contract. But the state reached an agreement on a revised work plan to extend the deadline to June 8. Now there is a new delay.

“We’re making very good progress on the development of the functionality and we’re close with automated change of circumstance functionality, but have made the decision that it’s not ready to go this weekend into the live environment,” Larson said Friday.

When deployed, the upgrade will allow thousands of Vermonters to edit personal information online if mistakes were made during registration, or if they experienced a life-changing event such as marriage. A backlog of 10,000 requests has amassed since the site launched in October.

“It’s important to us to make sure that the functionality, when it’s ready to go, is ready to serve Vermonters well. So, we’re going to continue our work until we feel like it’s ready to serve Vermonters, and focus on the quality and thoroughness of our work at this point,” Larson said.

Rep. Michael Fisher

Rep. Michael Fisher

The delays are frustrating lawmakers, including House Health Committee Chairman Michael Fisher, D-Lincoln.

“I think this is a really serious problem and I think it’s really an unacceptable situation that we’re in right now. Ten thousand households, many of whom may have small inconsequential changes, a change of address or something, but many of these Vermonters are worried that they’re not going to be able to get the care that they need,” Fisher said.

Continued issues and delays with the exchange site could damage future health care reform efforts, he said.

“I just know that there’s a lot of worry out there and a lot of frustration and I have been hearing a lot of it,” Fisher said. “It really does impact people’s view of our ability to move forward on health care reform.”

Meanwhile, the state is negotiating with a new vendor to help the state deal with the backlog in change of circumstance requests. The backlog increased by about 2,000 requests in the last month or so.

The contract, details of which remain confidential as negotiations continue, was expected to be signed by the end of Friday, Larson said. It will provide additional workers to help users update their information.

“It will help in the ability to have the automated functionality be able to assist in the work of resolving the backlog of change of circumstance requests. It will make it faster, but it will not eliminate the work left to do in making sure that we respond to all of those Vermonters who have made requests,” he said.

State officials expect users will still want assistance in changing information once the functionality is deployed.

“We fully expect that there will be a lot of people who will continue to want assistance in that process and we’ll be able to be more efficient with that,” he said. “It’s still going to take a significant effort to respond to everybody.”

Larson said he would not provide a specific date when testing will be completed and the system can be upgraded. “I think we are hopeful that we will be able to deploy this functionality soon. Again, we really have made a significant amount of progress,” he said.

neal.goswami@timesargus.com

Another exchange deadline missed, but state extends timeframe

MONTPELIER — A function missing from Vermont’s online health insurance marketplace will not be added by today’s deadline, but state officials say they are giving the contractor additional time to complete the project before they look to impose penalties.

Under an amended contract signed in early April, tech giant CGI was required to deliver “change of circumstance” functionality by today. The upgrade would allow thousands of Vermonters to edit their personal information online if mistakes are made during registration, or if they experience a life-changing event such as marriage.

But progress remains slow, and the function remains in testing, according to Mark Larson, commissioner of the Department of Vermont Health Access.

“We will not have the change of circumstances functionality tomorrow,” Larson said Tuesday.

Mark Larson

Mark Larson

Vermont Health Connect, the state’s online health insurance marketplace required under the federal Affordable Care Act, launched in October with serious deficiencies. Users are still unable to edit their information, and small businesses must enroll directly with the state’s insurers because the website is not functional for them.

The ability for individuals to make online payments for premiums was added in early March. Prior to that, payment had to be mailed in by check.

Larson said the “change of circumstance” upgrade has been postponed, likely until June, because it is not ready to be integrated into the website.

“We’re not going to implement any new functionality until we’re sure that it’s ready and fully tested,” he said.

“After careful consideration and reflecting on what we’ve learned over the past few months … I expect that we will agree to push the expected delivery date for change of circumstance to June 8,” Larson said. “I think that is a more realistic time frame for the functionality to be completed the way we would expect to.”

The state is allowing the use of a provision in the $84 million contract with CGI that allows for a change in deadlines if both parties agree. Larson said he expects the formal agreement to be signed today, setting the new June 8 deadline.

The state, by agreeing to a change in date, is also pushing back when it can begin to collect on the financial penalties it is allowed to assess for late delivery, according to the contract. Under the contract, the state can take a 12.5 percent discount on the cost of the function.

CGI can “earn” back some pay, however, depending on how quickly it completes each task after a missed deadline. Completion within seven days will allow for a 50 percent reduction in the penalty. Completion within 14 days will allow CGI to earn back 25 percent of the penalty, and completion within 28 days will allow for a 10 percent reduction in the penalty.

Those penalties will not be available until after June 8, if the agreement between the state and CGI is signed.

“By agreeing to a change in date we agree that those penalties will be applied if the delivery is not accomplished on June 8,” Larson said. “The penalties are all triggered by the agreed-upon date.”

Larson said June 8, “is more realistic” for upgrading the site and adding change of circumstance.

“Vermonters have the appropriate expectation that that function be available to them, and I know that Vermonters are frustrated by that not being there today,” he said. “I share that frustration and have a responsibility (to develop) a plan that is most likely to be successful and I think the change is consistent with that.”

Larson said the state will look to assess financial penalties if the new date is not met.

“I believe that the plan to achieve success is more likely with the change of date,” he said. “We aren’t eliminating any of our ability to impose financial penalties. We reserve all of those rights in the contract.”

The amended contract, signed in April, also requires CGI to deliver the small business enrollment function by July 2. No changes have been made to that deadline.

“We are still evaluating that. We’ve made no change there, though,” Larson said. “That date still stands, right now.”

A spokeswoman for CGI did not respond to phone and email messages Tuesday.

State, CGI sign amended contract with new timeline and penalties

MONTPELIER — State officials and the contractor building Vermont Health Connect have signed off on a new agreement that sets a new schedule for launching missing functions and includes additional financial penalties for missed deadlines.

The amended contract with tech giant CGI was signed Tuesday by Department of Vermont Health Access Commissioner Mark Larson and Gregg Mossburg, a senior vice president with the firm.

Under the amended contract, CGI must deliver “change of circumstance” functionality by May 21. By July 2, small business functionality must be operational. Failure to deliver by those dates will result in new financial penalties on top of the $5 million in “liquidated damages” the state has already claimed for CGI’s incomplete work.

“We really were trying to define an achievable road map and pair it with payment provisions and financial accountability so that we have an achievable plan and one that preserves for the state accountability for the success of that plan,” Larson said Thursday.

Lawrence Miller

Lawrence Miller

Vermont Health Connect, the state’s online health insurance marketplace required under the federal Affordable Care Act, launched last October with serious deficiencies. Users are still unable to edit their information, and small businesses must enroll directly with the state’s two insurers because the website is not functional for them. The ability to make online payments for premiums was finally added in early March.

Secretary of Commerce Lawrence Miller, tapped by Gov. Peter Shumlin in January to assist the beleaguered exchange team, said the previous contract with CGI “contemplated getting through development by October and everything being neat and clean.”

But late last year, after reviewing the state’s options, Miller and others began negotiating with CGI on a new contract that would help complete the project. Despite calls by Republicans to dump CGI, state officials determined that developing a new path with CGI was the best solution.

“There was this sort of fundamental question after December of do we finish the project with CGI or do we find somebody else. It was really clear, talking to other organizations and folks who have done this before, that the disruption of change, trying to change contractors, greatly exceeded the risk of negotiating a revised agreement and a revised path to done,” Miller said.

Massachusetts and the federal government have opted to drop CGI in favor of other tech firms. Other states are working with their contractors to redefine tasks and goals.

“When I’ve talked to people around the country, they are doing a combination of amendments to contracts and replacement of vendors. Everybody’s taking a slightly different approach. We did not consult with other states on the specifics of this,” Miller said.

Both sides “were pretty well firm on what was important to them,” according to Miller, but main components of the negotiated amendment “were not in substantial conflict.”

“Both parties wanted to finish the work and both parties recognized that this would be done in stages now,” he said.

Continue reading

Small biz direct enrollment to last through 2015 open enrollment

MONTPELIER — The Shumlin administration told lawmakers Tuesday that small businesses will have the option to continue directly enrolling in health care insurance plans during the next open enrollment period slated for this fall.

Director of Health Care Reform Robin Lunge delivered the update to the Senate Finance Committee early Tuesday afternoon. Mark Larson, commissioner of the Department of Vermont Health Access, delivered the same message later to the House Health Care Committee.

“The good news that I have is that the feds have approved the ability for us to continue with direct enrollment moving forward through the 2015 open enrollment period for 2016 plans and our intention is to allow this as an additional option,” Lunge said.

Direct enrollment with the state’s two insurance carriers was a contingency plan offered by Gov. Peter Shumlin when the state’s federally mandated online insurance marketplace, Vermont Health Connect, failed to function properly at launch last October. Small businesses were able to bypass the exchange and deal directly with insurers.

Employees of small businesses with 50 or fewer employees are required by state statute to obtain health insurance through Vermont Health Connect. But the website still does not allow for online enrollment. Administration officials say they expect it to be working when the 2015 open enrollment period begins in October.

Larson said the direct enrollment option is in no way an indication that the exchange website will still not be fully functional by October. Rather, it provides Vermonters with additional ways to enroll in qualified health insurance plans, he said.

However, direct enrollment with insurance carriers provides a limited choice of insurance plans. Individual using the website can choose from 18 plans between the two carriers. Small business employees can only choose from four plans.

Larson said the Centers for Medicaid and Medicare, which has approved the state’s request to continue direct enrollment, “is mindful of employee choice.” Larson said conversations with insurers are taking place to try and expand options.

“They are very interested in making sure that employees have the greatest ability to have choice in their plans as possible. That will be one of the conversations that we have, is how to do direct enrollment so employees continue to have access to as many plans as possible through their employer.”

House Health Care Committee Chairman Rep. Michael Fisher, following Larson’s appearance, said he is happy the direct enrollment option will be preserved for the next enrollment period.

“I can’t tell you how many times I’ve heard that this piece of IT structure or that piece will be ready in time, and so I don’t have any confidence that anything is going to work until I see it working,” he said. “I think Vermonters are comfortable going through the carriers directly and I’m pleased that the administration moved to a place that is supporting that. So, I think that’s a good thing.”

neal.goswami@timesargus.com

Online payments go live on state exchange

MONTPELIER — The state’s online health insurance marketplace is now accepting payment online for premiums, the Shumlin administration announced Monday.

Individual Vermonters enrolling in insurance plans on Vermont Health Connect, the online marketplace mandated under the federal Affordable Care Act, can now pay for monthly premiums online, according to the Department of Vermont Health Access. The site underwent an upgrade over the weekend, officials said.

Small businesses will continue to enroll directly through the state’s two insurers — Blue Cross Blue Shield and MVP Health Care.

The payment system will now allow Vermonters to pay premiums with a debit card, credit card or direct deposit from a bank account in addition to paper checks.

“This is great news for all Vermonters using VHC to enroll in health plans. Paying online provides convenience for Vermonters, and we’re pleased this functionality is now up and running. Our focus over the next month is to continue to enroll Vermonters through VHC,” DVHA Commissioner Mark Larson said in a statement.

Administration officials said additional system upgrades over the weekend will allow VHC staff to better process applications and provide a better overall experience for users.

The addition of online payments comes months after the site launched last Oct. 1. At launch, the site experienced significant technological failures that prevented most users from selecting plans. Small businesses can still not enroll on the site and must do so directly through insurers.

GOP leaders seek federal investigation into exchange

MONTPELIER — Republican leaders in the Legislature are seeking a federal investigation into Vermont Health Connect based on an anonymous tip that a state contractor duped state officials last year.

House Minority Leader Don Turner of Milton and Senate Minority Leader Joe Benning of Caledonia County sent a letter Wednesday to Tristram Coffin, the U.S. Attorney for the District of Vermont, requesting the investigation. The request is based on “whistleblower allegations alleging a fraudulent software demonstration on July 26, 2013 by CGI Technologies & Solutions.”

Newsweek published an article earlier this month in which an anonymous source said a demonstration by CGI last July designed to show connectivity with the state’s online insurance marketplace with a federal data hub was faked.

The exchange site, for which CGI has an $84 million contract to build, is still not fully functional, the GOP leaders wrote in their letter.

“We believe the unexplained and extensive delay, coupled with evidence suggesting the company in charge of designing the system may have duped Vermont officials into incorrectly thinking that the software system was working and on schedule, constitutes sufficient legal and factual predicate to begin a federal investigation,” they wrote. “If true, such a fraud prevented state officials from performing proper contractual oversight, prevented corrective measures, and helped CGI retain its multi-million dollar contract with the state.”

Mark Larson, commissioner of the Department of Vermont Health Access, has maintained that the July demonstration did feature a live connection with the federal data hub.

Linda F. Odorisio, vice president of communications for CGI, said in an emailed statement Wednesday evening that the demonstration did connect the state site to the federal hub.

“CGI confirms that the demonstration conducted on July 26, 2013 included a live interface to the Federal Data Services Hub, with the real time sending and receiving of data,” she wrote.

DVHA reveals second privacy breach

MONTPELIER — A state official revealed a second privacy breach Tuesday involving users on the state’s online health exchange but said the minor incident was caused by human error and did not involve a technology breakdown.

Mark Larson, commissioner of the Department of Vermont Health Access, told the Health Care Oversight Committee Tuesday of the “privacy incident,” but said there was no “security breach.” Rather, a Vermont Health Connect representative made a human error, he said.

“This incident was isolated to two unique Vermont Health Connect users. It was a result of manual human customer service error and there was not a risk to other Vermont Health Connect users,” Larson said. “The issue has been investigated by Vermont Health Connect. We have made the appropriate reporting to CMS as we did in the other incident that was discussed prior.”

The privacy breach did not involve any outside intrusion into secure parts of the website or any type of hacking, Larson said.

The disclosure for the weekend incident was in stark contract to a first security breach revealed in November. Larson, when asked directly at a Nov. 5 House Health Care Committee hearing about security lapses, said no private information had been breached.

However, a records request made by the Associated Press revealed the department knew of a security breach about three weeks before Larson’s testimony to the House Health Care Committee. Larson’s vague answers to the committee earned a rare public rebuke from Gov. Peter Shumlin and House Speaker Shap Smith.

According to Larson, in the weekend incident a user called VHC to modify an application. The customer service representative attached information from another user with the exact same name to the caller’s file, he said.

Check the Wednesday editions of the Herald and Times Argus for the full story.

House Dems to get 7-4 edge on health care committee with reassigment of Republican

The balance of power in the House Committee on Health Care will shift in favor of Democrats next year when House Speaker Shap Smith drops a Republican from the 11-person panel and replaces him with a member of the ruling party.

Gone from the committee, Smith said late Friday evening, is Rep. John Mitchell, a Republican from Fairfax now headed to the House Committee on Education. Replacing him is incoming Democratic Rep. Kathy Hoyt, appointed by Gov. Peter Shumlin earlier this year to replace the seat vacated by Margaret Cheney.

House Speaker Shap Smith said the move is designed to make way for a newly minted lawmaker whose “breadth and depth of experience are critically important as we move forward with health care reform.”

House Minority Leader Don Turner, however, said the shake up amounts to partisan maneuvering designed to undermine the influence of the GOP as the Democratic supermajority prepares to face tough questions over the troubled roll out of the new health insurance exchange.

“I’m very concerned and I’m very disappointed,” Turner said late Friday evening. “I think Vermonters will see through this – that Democrats don’t like tough questions when it comes to health care, and that by taking away a person who is asking those like tough questions may make it easier for them.”

The personnel change comes during the middle of the two-year biennium, and isn’t the only reassignment Smith confirmed Friday. Rep. Patti Lewis, a Berlin Republican, will move from education to the House Committee on Government Operations. Incoming Democratic Rep. Marjorie Ryerson, who filled the Randolph seat opened up by the death of Larry Townsend, will be assigned to the House Committee on Energy and Natural Resources. Rep. Rebecca Ellis, a Waterbury Democrat, will take over as vice-chairwoman of energy and natural resources, a position formerly held by Cheney.

Hoyt, who lives in Norwich, has a long career in government that includes stints as secretary of administration under former Govs. Madeline Kunin and Howard Dean. She was a also a member of a three-person panel that spent more than a year examining ways to overhaul the state’s tax structure.

With his “direct appointment” of Hoyt in September, Shumlin bypassed the conventional nominating process in which the local party committee forwards three names to the governor’s desk. Hoyt’s predecessor left when she accepted Shumlin’s appointment to a seat on the three-person Public Service Board.

“(Hoyt) is someone who has seen state government from every angle, and her experience will be invaluable on that committee,” Smith said.

Turner said that if Smith wanted to find room for Hoyt on the committee, he could have done so without eroding what little representation the GOP has on a panel that will be dealing next year not only with the exchange, but with the seeds of a public financing system for the single-payer system Shumlin has said will come online by 2017.

“I think it’s wrong,” Turner said. “I just don’t like that we’re going to have only two Republicans on one of the most important committees in the House right now.”

Smith said the composition of the Health Care Committee during the last session wasn’t reflective of the partisan make-up of the body. The six Democrats, one Progressive, one Independent and three Republicans, Smith said, didn’t mirror the near super-majority status of his party.

“It’s 6-5 committee right now, and the balance is different than most of the other committees, and that plays a role in the decision,” Smith said. “And it’s not an easy decision.”

That narrow margin led to some very public setbacks last session for the committee’s Democratic chairman, who saw his committee go against him on at least one high-profile vote.

Rep. Mary Morrissey, who will be one of two Republicans left on the Health Care Committee, said the change “disrespects” the work that Mitchell and the committee have done over the first half of the session.

Turner said he appreciated that the speaker called him earlier this week to inform him of his plan, and that Smith was willing to work with Republicans in determining which of the three would be sent to the education committee.

Turner said he thinks Hoyt’s experience on the Blue Ribbon Tax Commission, the panel that worked in 2009 to try to reform the income and sales tax, is one of the reasons Smith wants her on health care.

“From my perspective, I think they’re trying to figure out how they’re going to do single-payer,” Turner said. “And being a former member of that commission, I’m sure she has a lot of information about taxation.”

Smith said Hoyt’s facility with the tax code is one reason among many she’ll be a good fit on the committee.

“Certainly it helps that she was on the Blue Ribbon Tax Commission,” Smith said. “But it really is the breadth and depth of her experience.”

Darcie Johnston, head of Vermonters for Health Care Freedom, which working to stymie progress toward single-payer, said the committee reassignments underscore the urgency of the opposition.

“This is a clearly partisan political move to rearrange the deck chairs to get the political result they want of moving single payer health care forward,” she said.

Documents spotlight state’s escalating fight with exchange contractor

In a sternly worded letter to a top executive at the technology firm hired to build Vermont’s new health insurance exchange, the Shumlin administration late last month served notice that it plans to withhold more than $5 million in payments as a result of CGI’s “failure” to meet key deadlines.

The Nov. 21 correspondence represents the first formal move by the state to impose the “liquidated damages” that CGI Technologies and Solutions could face for missing at least four “critical milestones.”

Larson_letter1

Larson_letter2

And it comes as the state seeks new bargaining power over the company on which it’s relying to fix the problems that will otherwise prevent Vermont from having a fully functioning exchange.

“What we’re focused on now is making sure we exercise the rights we have under the contract … and making sure Vermonters get what they were promised,” Mark Larson, commissioner of the Department of Vermont Health Access, said in a phone interview Tuesday. Continue reading

Some exchange bills to be mailed, online payment still unavailable

MONTPELIER — State officials said Monday that online functions to process premiums the health care plans selected by individuals and families on the state’s exchange will be deployed overnight for a Tuesday launch.

Online credit card payment is still not ready, however. That function will not launch until security testing is completed, according to Department of Vermont Health Access Commissioner Mark Larson.

Invoices will be mailed later this week to individuals and families who have selected plans through the exchange. Those bills will need to be paid by check no later than Jan. 7 for coverage beginning Jan. 1.

The deployment of premium processing function is set to begin at 5 p.m. on Monday. The Vermont Health Connect website will be unavailable for applications and plan selection during the deployment, according to officials. The site is expected to be down until late Tuesday morning.

Meanwhile, the payment function for small businesses remains in testing.

As a result, small businesses and their employees who have selected health coverage through VHC will have current coverage extended into 2014 at 2013 rates until the payment function for small businesses is operational, officials said. Deductibles and out of pocket costs on all extended plans will reset on Jan. 1. Any expenditures will be credited to employees’ new exchange plan in 2014 as long as the carrier remains the same.

About 1,400 small businesses who have signed up for health coverage through the website online, over the phone, with a navigator or through a paper application are affected. Those businesses employ about 13,400 people.

Small businesses that have already elected to extend 2013 coverage or directly enroll through an insurance carrier into an exchange plan, or small businesses that chose to have their carrier roll them into an exchange plan that most closely resembles their current coverage are not impacted.

Check Tuesday’s Herald and Times Argus for the full story.