[{"_1":2,"_123":-5,"_124":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,99,111],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6360142,"mediaKeyId","2175262-9a496e5013b2d4be66ad1babb505ea2e","parentId",2175262,"title","Representative Cortes outlines package: CON thresholds, transaction oversight, doulas, MAID scope and stronger advocate access to data","audioSeconds",773,"startMs",5193000,"endMs",5966000,"viewUrl","/Search/View?dp=1&key=2175262-9a496e5013b2d4be66ad1babb505ea2e&start=5193&end=5966","thumbnailUrl","https://assets.pipeline.soar.com/2175262-9a496e5013b2d4be66ad1babb505ea2e/thumbnail_5193000.jpg","articleUrl","/articles/6360142/Vermont/Representative-Cortes-outlines-package-CON-thresholds-transaction-oversight-doulas-MAID-scope-and-stronger-advocate-access-to-data","mediaUrl","https://secure.pipeline.soar.com/6360142-aed4e63d0fa9ec7484e099bffedb14c6/orig.mp4?Expires=1771188106&Signature=VutwZPNstIPrwozqLfkixK85I2R5ChevCdesDJcc1bWz2mmhHVx9MZBM4LIfbeULo0FCE7NFBD6oSoVqobG-wKeOUtBUSMS39QxPOReJ6RjgaskiVTnKvv10DNjhgAJQtRRgdMdj6hensRmaJSWK3vRSpBfMladwZoZ2DwAj2neaLnKAKT~Ha1LbLXEsGItumYXaw~8IWCE96D1AMKV4JGfWlaEtzn~0UMWZSrXJNelvxqkTZVWG09d4Joq17vNHSLddfhbIxmf5Y3fV9mTOHjQqgppn1MhxKWrFdbjxyzsERNk~p0ZCOlrYPmoKU7i0U3veUIZciNGpVAzYhtl6mg__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-01-31T07:55:05Z","article","Representative Cortes presented a set of bills addressing oversight, transactions and workforce in Vermont’s health system.

H96 would raise monetary thresholds that trigger the state’s certificate-of-need (CON) review, a change sponsors say would reduce regulatory burden for smaller projects and help new entrants such as freestanding birth centers. Cortes said stakeholders including hospitals and private providers participated in drafting the bill.

H71 is a longer measure that would establish state oversight of healthcare institution transactions and require review by the Green Mountain Care Board and enforcement authority for the Attorney General. Cortes said the bill is aimed at preventing potential harms when private-equity firms buy distressed hospitals or long-term care facilities and then change ownership or use in ways that could reduce local access to care.

H75 would expand existing medical aid-in-dying and COLST/DNR authority to permit naturopathic physicians (in addition to physicians, nurse practitioners and physician assistants) to perform certain authorization functions. Cortes said Vermont’s naturopathic doctors provide primary care in some communities and that the bill aligns authority with providers’ roles.

H80 would amend the Office of the Health Care Advocate’s access to information so the office can obtain timely data and documents it needs to represent consumers effectively, while preserving confidentiality protections for patient and proprietary information.

H79 would create a certification pathway for community-based perinatal doulas through the Office of Professional Regulation, adopting certification rather than full licensure and aiming to standardize training and protect vulnerable birthing populations.

Cortes emphasized the bills address current fiscal and access pressures in Vermont health care and said the committee will have time to examine technical detail and stakeholder testimony. No votes were taken.","mediaType","Video","parentTitle","House Healthcare - 2025-01-30 - 1:00 PM","oneSentenceSummary","Representative Cortes presented a package: raise certificate-of-need thresholds (H96); require oversight of health-entity transactions (H71); permit naturopathic doctors to authorize medical aid-in-dying and COLST/DNR (H75); expand data access for the Office of the Health Care Advocate (H80); and create certification for community doulas (H79).","taxTitle","Health Care, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",30956,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6360147,"Two bills: expanded coverage for fertility and gender-affirming care (H55) and a state medication stockpile (H56) presented",364,3817000,4181000,"/Search/View?dp=1&key=2175262-9a496e5013b2d4be66ad1babb505ea2e&start=3817&end=4181","https://assets.pipeline.soar.com/2175262-9a496e5013b2d4be66ad1babb505ea2e/thumbnail_3817000.jpg","/articles/6360147/Vermont/Two-bills-expanded-coverage-for-fertility-and-gender-affirming-care-H55-and-a-state-medication-stockpile-H56-presented","https://secure.pipeline.soar.com/6360147-4168afa2f8f1ca91339afab97b6efdc5/orig.mp4?Expires=1771188106&Signature=dLQebtrdbOwPdI8fzwN~SoVpZhkOIGwy5HcpNpKTaOQKlmLDuXPCT4RGneVjWrRNuOzCzSbzyt~qNvk3M9WlH8gP1dlGp9i0eYLijM3bCa-KFj7yEzBqHEKn50aYS7B4lYi0wCuHbw~f9gGlWevM73eGrdcYeXByBjiN2zlK0Srd7lapG02iqvdZv5zD50jPVVJarYZw0I705wxnyhI0Bh~nK~ISj4zTDSCY0UqQJ6QLVMoetW1a9Voi3vCL0yHzDk9y3Fe5gvxDxc2RYC8j7p5ek-BGoRtL4eZffv0MV0DFqi0GNZU7CbGN-Q1Q9JEIMJtm3Vyipd4Vhrc6SlTe3A__&Key-Pair-Id=KUT5TJCACFTXG","Representative Troy Hedrick presented two separate bills to the House Health Care Committee. H55 would expand private insurance and Medicaid coverage (Medicaid contingent on federal approval) for gender-affirming health care and fertility-related services and would prohibit certain insurance-imposed barriers, such as requirements for prolonged hormone therapy prior to surgery. The bill would exclude nonmedical costs (egg/sperm donors, surrogacy) and would require the Department of Financial Regulation to report annually on compliance and access.

Hedrick said the bill is designed to reduce barriers and promote equity for Vermonters seeking these services. \"Expanding coverage for these services supports health equity, affordability, and aligns Vermont laws with current best practices in health care,\" he told the committee.

H56 would require the Vermont Department of Health to establish and maintain an emergency stockpile of essential medications for reproductive and gender-affirming care — examples Hedrick cited included puberty blockers, hormone therapies, contraceptives and medications used for pregnancy termination. The stockpile would prioritize equitable distribution to rural and underserved communities, be managed with inventory-rotation protocols to avoid waste, and include annual reporting to the Legislature. The bill would not compel private pharmacies or providers to dispense from the stockpile and would not alter the legal access framework for these medications.

Hedrick said the stockpile is designed to address supply-chain disruptions and potential policy-driven shortages in other states or at the manufacturer level. He said funding details remain to be worked out and that the Department of Health would develop procurement and distribution rules.

Committee members acknowledged the policy rationale and noted the fiscal and implementation questions to be addressed when the bills are scheduled for testimony; no committee vote occurred at this meeting.","Representative Troy Hedrick presented H55 to expand insurance coverage for fertility services and gender-affirming care (with Medicaid inclusion contingent on federal approval) and H56 to establish a Department of Health stockpile of reproductive and gender-affirming medications for emergencies and supply interruptions.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6360152,"Rep. Ella Chapin files bill to allow freestanding birth centers, create facility licensing",270,3309000,3579000,"/Search/View?dp=1&key=2175262-9a496e5013b2d4be66ad1babb505ea2e&start=3309&end=3579","https://assets.pipeline.soar.com/2175262-9a496e5013b2d4be66ad1babb505ea2e/thumbnail_3309000.jpg","/articles/6360152/Vermont/Rep-Ella-Chapin-files-bill-to-allow-freestanding-birth-centers-create-facility-licensing","https://secure.pipeline.soar.com/6360152-4c6324790764c52db20f0315dd5413b1/orig.mp4?Expires=1771188106&Signature=LWvu23pevJsDJvbKD3MgkWprQf9AgJrsfHgN1TvlMcFwNIeOuXzT0IFc29ZgrbK3CUIkf6Rg0JI3-KDFXV~aswSf0NCUUvXs28lK6YcFSBqryQexZIXiMIA9BmmIXhK4Mtr1KFEgX~dle1LnY9r76E~xdPKbuXIT1sfDSEWJxb5o4ZN2pt2JblI7vJyvxC-vmSllU2snqK-gOLy0PSNrzHjaUpItHa3~xlzGVsiTnBboUyPOg0fPrZmZ1E2zC0NXJ3xH7dmhB56gJdRwv8sH8uPfBhb62X1V30QrBPU5m78Tn10w1hYgiuppLu1T-II6R1SIg69~N8p-m8ki1IGXPQ__&Key-Pair-Id=KUT5TJCACFTXG","Representative Ella Chapin, of East Montpelier, told the House Health Care Committee she is sponsoring H40, a bill to enable freestanding birth centers in Vermont by exempting such centers from the certificate-of-need process and by establishing a licensing framework for the facilities within the Department of Health.

Chapin defined a freestanding birth center as a non-hospital facility, typically midwife-run, that provides labor and delivery care for low-risk pregnancies and related prenatal and postpartum services. She said the bill would create an optional facility licensing path to ensure centers follow national best practices, without requiring any center to open.

Chapin argued the change would expand birthing options and lower costs. \"Birth centers also are now clearly cost — it's clear that they cost significantly less. And that means affordability for individuals and families,\" she said, noting that neighboring states such as New Hampshire and Massachusetts already have birth centers.

She described the bill as a way to retain and recruit midwives and offer alternative settings for low-risk births, particularly for people who find hospitals triggering or inaccessible. The sponsor said existing midwifery licensure and Medicaid coverage of midwifery services would remain in place; the bill would add a facility licensing process and remove a regulatory barrier (certificate of need) that has limited development of such centers.

Committee members deferred detailed questions to later testimony and accepted a fact sheet the sponsor left for the record. No vote was taken.","Representative Ella Chapin introduced H40 to exempt freestanding birth centers from certificate-of-need review and to create a Department of Health licensing structure for such facilities; the bill sponsor said the change would expand low-cost birth options and help retain midwives in Vermont.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6360157,"Committee reviews Act 167 hospital transformation work; sponsor proposes new planning division at Green Mountain Care Board",2886,52000,2938000,"/Search/View?dp=1&key=2175262-9a496e5013b2d4be66ad1babb505ea2e&start=52&end=2938","https://assets.pipeline.soar.com/2175262-9a496e5013b2d4be66ad1babb505ea2e/thumbnail_52000.jpg","/articles/6360157/Vermont/Committee-reviews-Act-167-hospital-transformation-work-sponsor-proposes-new-planning-division-at-Green-Mountain-Care-Board","https://secure.pipeline.soar.com/6360157-422f407c8c9f6dd2da1a498b3c3db600/orig.mp4?Expires=1771188106&Signature=ausoFvRPG4TaOko0OMhJW8iMenXilSqClqTm0tmOW72wtXePNqeoE8kzL2mvJICmO3Wvm9ZEnriPXYyJV5mQ33ryNSAGZ62630xr4mutKbWDuj-w21SQhSE6Ie1HpZiCdyfLZQIbsolnoR7XlwJJM3L4RnS5u18MHC0l7yJBEYTvQQ-K5rDPb~2cIelX0EvbqzgL9qvTm2coKNdoSiGaGdqYcdeedZI7E9eXpoDbHMrRa8zDphBR3vcBpUXfSEahIuM9Uw4BuZTqYx428CjHpsLLTNp8VkeRw5gw5W8ZO0UtDVA0IHqEa59YWFd~4De3shC-FzCrokQkEFG-PpaLqw__&Key-Pair-Id=KUT5TJCACFTXG","Jen Carby of the Office of Legislative Council summarized Act 167 of 2022 and subsequent amendments, telling the House Health Care Committee that the law directed development of proposals for a subsequent all-payer model, consideration of value-based and global payments, and a required hospital system transformation engagement process that produced a community report (contracted through Oliver Wyman).

Carby reviewed the major elements of section 1 (AHS-led proposal for a subsequent all-payer model and considerations for total cost of care targets, global payment models, health equity and participation by accountable-care organizations) and section 2 (a data-informed, community-inclusive engagement process to reduce inefficiencies, lower costs and preserve emergency capacity). She said the statute required reports (director of health care reform and the Green Mountain Care Board were to report by Jan. 15, 2023; AHS stakeholder update by March 15, 2023) and noted appropriations to support the work: $900,000 to AHS (FY2023) and $4,100,000 to the Green Mountain Care Board for contracting and consultants.

A bill sponsor who asked to present to the committee proposed creating a division of planning and evaluation at the Green Mountain Care Board to translate Act 167 findings into specific reforms and to enable the board to exercise budget oversight and rate-setting to restrain health spending growth. The sponsor summarized the objective as capturing the savings identified in Act 167 and shifting investments to strengthen community-based care. \"A small investment will yield huge benefits to the state of Vermont,\" the sponsor said, urging the committee to consider resourcing the board for strategic planning and implementation.

Committee members asked whether the proposal aligns with prior board work and how the new division would relate to existing budget-review functions. The sponsor said the division would work closely with the board’s budget oversight and analytic functions and offered to provide a longer version of the proposal and stakeholders list for testimony.

No formal action or vote occurred; members said they expect to request additional written materials and witnesses, including representatives from the Green Mountain Care Board, Agency of Human Services and consultants who produced the engagement report.","Legislative counsel summarized Act 167 requirements on all-payer models and hospital system transformation. A bill sponsor proposed establishing a planning and evaluation division at the Green Mountain Care Board to pursue savings and a statewide strategic plan for affordability and access.",{"_33":112,"_35":36,"_37":38,"_39":113,"_41":114,"_43":115,"_45":116,"_47":117,"_49":118,"_51":119,"_53":120,"_55":56,"_57":58,"_59":121,"_61":62,"_63":64,"_65":122,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6360162,"Lawmakers review Vermont telehealth law: consent, recording ban and payment parity",1782,901000,2683000,"/Search/View?dp=1&key=2175262-9a496e5013b2d4be66ad1babb505ea2e&start=901&end=2683","https://assets.pipeline.soar.com/2175262-9a496e5013b2d4be66ad1babb505ea2e/thumbnail_901000.jpg","/articles/6360162/Vermont/Lawmakers-review-Vermont-telehealth-law-consent-recording-ban-and-payment-parity","https://secure.pipeline.soar.com/6360162-ec54664bfd16bf051b83b9b7e870c050/orig.mp4?Expires=1771188106&Signature=cG0GcCwfQZFJ2eIc6-LbdDJ-skY4BbzLEcSoFzzc6AfkvQ0DU4Sh~WJ-Ixfk3Zng98LI-kQkjjScmYDfxJOmYbzMpU~WhPhlw-rxivJvSWWpMu7WYXbb-JrUux~EtO0qdEPY3QMz0JPv4znsML2ksSzTq5er0xhlAeH8c7I0cLrPSn6BRek6Lasi-l0lB4VfrZdxk66GJf9rrK-4CMRWEgnEAyPYLxHXXMInBO2HT-UkBiI5wVbJilG5rZvRfnJ8WOdak0Zul5dbuLxoZzJPFLqe9pyWHyjp8c3Ty8kCwXCAKNKHb4BWT0g2qG2KOTviC3-c3EjG2vH5Xu3ez8FiEA__&Key-Pair-Id=KUT5TJCACFTXG","Legislative counsel Jen Carby told the House Health Care Committee that Vermont law sets detailed rules for telehealth delivery and payment, including requirements for informed consent, limits on recordings, and recent changes requiring equal reimbursement for in-person, telemedicine and audio-only care.

Carby said the statutes define telemedicine as a live audio-video clinical encounter, and include other modalities such as audio-only telephone visits, store-and-forward transfers of images or data, and remote home monitoring. She noted that “the provider has to be licensed where the patient is physically located at the time the services are delivered,” a licensing rule that remains in place as telehealth expands.

The memorandum Carby reviewed requires clinicians to obtain and document patient informed consent (or document oral consent) before using telemedicine or store-and-forward, and to explain limitations, who else may be present, and privacy protections that comply with HIPAA. She also identified statutory exceptions to consent for medical emergencies and certain psychiatric examinations.

Carby told the committee that state law also bars recordings of telemedicine and audio-only consultations: “Under current law, neither the patient nor the provider can record their consultation,” she said, and she traced that prohibition to language added in 2017. At the same time, committee members and witnesses described how transcription and artificial-intelligence tools now can convert visits to text in real time and said the law may need updating to reflect current technology and patient needs.

Bob, a bill sponsor who addressed the committee about a bill on the committee’s wall, framed the proposed change as narrowly administrative: allowing a patient and provider to agree to record or transcribe an encounter so electronic systems can generate clinical notes. “Functionally, what it does is allows the electronic record system to more effectively record the notes and allows your physician to look at you while you're talking about what's wrong with you as opposed to typing,” Bob said.

Committee members raised privacy and equity concerns, noting patients sometimes want a family member present or a transcript for accessibility. Several members said they expect the committee to take public testimony before making statutory changes.

For now, the law treats clinical records (the provider’s chart) and audio/video recordings differently: providers must document visits in the medical record, but producing a separate audio or video file of the encounter is currently prohibited. Carby and multiple members recommended additional testimony to clarify whether modern transcription apps should be treated as recordings under the statute or as part of the medical record.

The committee did not take a vote; members said they will schedule testimony from technology vendors, clinicians and privacy advocates before deciding on any statutory changes.","The House Health Care Committee heard a statutory overview of Vermont's telehealth rules, including informed-consent requirements, a 2017 ban on patient/provider recordings, and recent reimbursement parity for telemedicine and audio-only visits. Committee members flagged new transcription and AI tools for further testimony.","actionData","errors"]

Article not found

Representative Cortes outlines package: CON thresholds, transaction oversight, doulas, MAID scope and stronger advocate access to data

Two bills: expanded coverage for fertility and gender-affirming care (H55) and a state medication stockpile (H56) presented

Rep. Ella Chapin files bill to allow freestanding birth centers, create facility licensing

Committee reviews Act 167 hospital transformation work; sponsor proposes new planning division at Green Mountain Care Board

Lawmakers review Vermont telehealth law: consent, recording ban and payment parity