[{"_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",6337279,"mediaKeyId","2273724-829145ba53d2f192b97da800ae18d538","parentId",2273724,"title","Senate committee hears bill to spend $1M to buy and abolish medical debt, bar reporting to credit bureaus","audioSeconds",3126,"startMs",152000,"endMs",3278000,"viewUrl","/Search/View?dp=1&key=2273724-829145ba53d2f192b97da800ae18d538&start=152&end=3278","thumbnailUrl","https://assets.pipeline.soar.com/2273724-829145ba53d2f192b97da800ae18d538/thumbnail_152000.jpg","articleUrl","/articles/6337279/Vermont/Senate-committee-hears-bill-to-spend-1M-to-buy-and-abolish-medical-debt-bar-reporting-to-credit-bureaus","mediaUrl","https://secure.pipeline.soar.com/6337279-0ffd880d19563c94d339b58d4d437378/orig.mp4?Expires=1775399106&Signature=RXlQThFFN-K4SqYUr~qjMfQuKuzWavz2gKEruFPN1aXxuLM~dUBkGq7AIaeYkrF1qtyOeqFwzgeL9jkhwmJmuX4DPsruITQ8fV3NVLUaFFzfChOvmoEvp7RFHbyKrMA7lavcXR9TVc1hdSMcBGoPfMPhEznTqkUJG4-DY7VcVkEGr6XVKqlj8vKC7kxJ3LN8G6iF7eeWI0Jemf4i8OcTK3sbAhbYPX8091xJen5DlR0~CRUvRRBtppZqHKdIXyfF2mivtLB7kDngxPxA2clAn8D2Au8k5xmFz-Bu0g6h4PnPIlhEAF1oeTJDeNAyGCzt4NJcagHT~7Xvlje7gkZrEw__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-02-12T14:05:55Z","article","Senate Health and Welfare opened its Feb. 12 hearing on S.27, legislation that would appropriate $1,000,000 to the state treasurer for contracting with a nonprofit to acquire and abolish qualifying medical debt for Vermonters and add a state prohibition on reporting medical debt to consumer credit agencies.

Jennifer Carvey of the Office of Legislative Counsel read the bill’s provisions for the committee: “This is S.27 … an act relating to medical debt relief and excluding medical debt from credit reports. It starts off with a section appropriating $1,000,000 to the state treasurer … for the purpose of contracting with a nonprofit entity to acquire and repay certain medical debts to be verified Vermont residents as set forth in this section.”

The bill sets two eligibility paths: a household income at or below 400 percent of the federal poverty level for the household size, or medical debt equal to 5 percent or more of household income, and requires that the patient account still shows an outstanding balance after routine collection efforts. The proposed contract would require the treasurer’s contractor to buy medical debt at fair market value from health care providers, abolish the debt with no tax consequences for the debtor, and coordinate with providers and collectors to ensure adverse information is removed from credit reports following purchase and abolition.

State Treasurer Mike Pieciak described how his office would administer the contract and the funding source. “For the record, Mike Pieciak, state treasurer,” he told the committee. He said the $1,000,000 could be taken from an existing trust the treasurer has held to redeem general obligation debt prior to maturity and that his office would manage the procurement, oversight and invoicing for any nonprofit contractor the treasurer selects.

Treasury and bill supporters described the nonprofit RIP Medical Debt (referenced in testimony as the organization working in many states) as the likely vendor; witnesses said that nonprofit typically negotiates with hospitals, purchases older unpaid accounts, then cancels the debt and notifies patients. Treasury staff and witnesses said the contractor usually charges about 10 percent of the purchase as an administrative fee and that organizations running similar programs report roughly a 100:1 ratio of face value eliminated per dollar spent.

Advocates framed the bill as relief for financial stress and access to care. Brittany Davis of the Leukemia & Lymphoma Society told the committee that the cost of treating serious illnesses can be catastrophic and that national polling supports state action; she urged passage of the bill. “When patients can’t afford their medical treatment, how do outcomes improve?” she said in testimony supporting S.27.

A representative of PRA Group, a publicly traded purchaser of consumer receivables, cautioned the committee that the statutory definition of “medical debt” in Vermont law is broad and could unintentionally encompass nonmedical balances when those balances are carried on the same credit card account as a medical charge. Francie Whalen of PRA urged the committee to consider the Consumer Financial Protection Bureau’s definition — which ties the debt to an entity whose primary business is providing medical services — as a narrower alternative for statutory language.

Committee members asked detailed questions about how eligibility would be verified, how hospitals would be approached, when money would change hands and how notices to individuals would be handled. Treasury staff said the contractor would typically receive a hospital’s debt file, perform a “soft” credit inquiry and income checks to identify eligible individuals, make an offer to purchase a block of accounts, and invoice the state for the purchase plus administrative fees; the treasurer’s office would pay invoices from its trust fund and the contractor would handle sending notices to affected Vermonters.

Witnesses offered program-scale estimates. Treasury staff and proponents cited an estimate that roughly 60,000 Vermonters would qualify under the bill’s criteria and that approximately $100 million of Vermont medical debt could fall into the eligible age-and-size window (roughly 18 months to seven years old and meeting the income or 5 percent-of-income test). The bill proposes a one‑time appropriation; testimony noted the $1,000,000 figure could be adjusted later depending on negotiations and participation by hospitals.

Several speakers urged that Vermont adopt a statutory prohibition on reporting medical debt even if federal rules change. Carvey told the committee the bill would add a prohibition to the relevant patient financial assistance chapter and a separate amendment that would bar large health care facilities and medical‑debt collectors from furnishing medical‑debt information to credit reporting agencies. Committee counsel said the state provision would mirror recent federal action but preserve the prohibition if federal enforcement were to be weakened.

Senators and witnesses also discussed potential concerns: whether hospitals would record payments as unrestricted income, whether any recovered funds could be redirected to patient assistance, and how donations or hospital decisions to forgive debt without sale would be handled. PRA Group flagged the need for a clear statutory definition to avoid unintentionally insulating non‑medical consumer debt from reporting rules.

No formal committee vote occurred during the hearing; the bill is at the committee’s initial review stage and the treasurer’s office and legal counsel told senators they would continue to consult with providers and stakeholders as the committee drafts any final language.

The committee heard additional supportive testimony from patient‑advocacy groups and from the treasurer’s office; it also received written materials from other states that have implemented similar state‑level programs and from national consumer‑finance regulators.

If the committee advances S.27, the statute would: appropriate $1,000,000 for a treasurer contract to purchase and abolish qualifying medical debt; add a state prohibition on reporting medical debt to credit bureaus; and permit large hospital facilities to sell medical debt only to a 501(c)(3) organization for the purpose of abolition. A treasurer‑administered contract and a procurement process would be required before any funds are spent.

Senate Health and Welfare did not adopt or reject the bill at the Feb. 12 session; committee members said they would continue to gather information on procurement, eligibility verification and provider participation in the weeks ahead.

","mediaType","Video","parentTitle","Senate Health and Welfare - 2025-02-12- 9:05AM","oneSentenceSummary","Senate Health and Welfare opened its Feb. 12 hearing on S.27, legislation that would appropriate $1,000,000 to the state treasurer for contracting with a nonprofit to acquire and abolish qualifying medical debt for Vermonters and add a state prohibition on reporting medical debt to consumer credit agencies.","taxTitle","Health & Welfare, SENATE, Committees, Legislative , Vermont","taxId",38585,"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},6337261,"Pharmacy association thanks committee, reiterates pharmacists’ role in maintaining access",120,10136000,10256000,"/Search/View?dp=1&key=2273724-829145ba53d2f192b97da800ae18d538&start=10136&end=10256","https://assets.pipeline.soar.com/2273724-829145ba53d2f192b97da800ae18d538/thumbnail_10136000.jpg","/articles/6337261/Vermont/Pharmacy-association-thanks-committee-reiterates-pharmacists-role-in-maintaining-access","https://secure.pipeline.soar.com/6337261-c9d9ae7b34bef11aa05c045f11bb9420/orig.mp4?Expires=1775399106&Signature=VuSl9QHLr7aIwR3Q8V4TIaqHZr4yrWSkLAdRZtcSIfBO3pY~tCT9xGzB~vbadqtYi8ntHkSLrVnBT9RwN7HP5JMINOtYJgtHH6RVsaIs5eyymAkRipypu~p3ISfcOADwsIrap1zPCqpmjZxagF7UgJbBouKboV30CyYpRMQNho0-e2ydABHPkx8YaYtS6E9xTl-Nlp7xPBCoMpYYvvnkkcF77yWY5HkkDpVB6nKtCX~kFQuIbP61fzRxQwA2GWElCZyW~nKx~RcFYmIY751pEuZGalaOAUuupxeyGsjLR~Zb8cluws2JIaC8m1etYGXfUM9ZQ~eC3stSvWMvcWoIHg__&Key-Pair-Id=KUT5TJCACFTXG","Mike Tutel, representing the Vermont Association of Chain Drug Stores, offered brief testimony to reaffirm the pharmacy sector’s commitment to patient access and to thank the committee for prior legislative support.

Tutel identified workforce and economic pressures in community pharmacy and said his organization is working with the State Board of Pharmacy and the Office of Professional Regulation on practice expansions and regulatory matters to enable pharmacists to provide more direct patient care.

“We are working very closely with the board of pharmacy and OPR,” Tutel said. “Both Carrie and deputy Hibbert are an asset to the professions and state. We’re very excited with the work that’s being done.”

Senators responded positively and said pharmacist practice expansion could improve access and the delivery of services such as immunizations, medication management and other community‑based care; no bill action was taken at the hearing.","The Vermont Association of Chain Drug Stores told senators it supports expanded pharmacist patient care and thanked the committee for prior support; association leaders said pharmacies face challenging conditions and promised continued work to preserve access.",{"_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},6337265,"Early‑childhood centers and agriculture agencies urge $500K for farm‑to‑school and local food incentive grants",773,9381000,10154000,"/Search/View?dp=1&key=2273724-829145ba53d2f192b97da800ae18d538&start=9381&end=10154","https://assets.pipeline.soar.com/2273724-829145ba53d2f192b97da800ae18d538/thumbnail_9381000.jpg","/articles/6337265/Vermont/Earlychildhood-centers-and-agriculture-agencies-urge-500K-for-farmtoschool-and-local-food-incentive-grants","https://secure.pipeline.soar.com/6337265-437500a84614bdb21fc4b711b1f6b82e/orig.mp4?Expires=1775399106&Signature=d2zm5jyiAFVQ0tSl-r4jCooiudQAX18RLTjcVmfxvsH4y1PATBJQcenuxyu~d066CJ~7g70f~70vDHM7QEY7xLOveCSNHeBo3iKWnaO6zDeK2v5ZVu4rONlv069XAJ0C1fxrjx8ZDJAxNzidcFuZM0mllYdvw6DSdYln0Z9Wd2Hcs-8s6-WMsqjrBoqBADdrtcVY0P6DylKIzkKt37-Mt5mASlGKG54KNixU1EkUgi8bWUYvR5niDTR0-OQF37fmmsLuCq6sShlG~r9SSwTfE8q~-eZBMyyQSdRszhARaEj4vkwzRASotkWEKU-ApF7yzQORwmxZN616Ueh45XUxhw__&Key-Pair-Id=KUT5TJCACFTXG","Commissioner Mark Levine and Agency of Agriculture staff briefed the committee on farm‑to‑school and early‑childhood programs that bring local food and nutrition education into child care and school settings.

Levine emphasized the connection between early nutrition and brain development and said that child care programs are increasingly important sites for healthy meals because many children receive most of their daily calories in childcare. “These programs support high‑quality childcare, nutrition security and access to educational opportunities for children,” he told the committee.

Gina Clithero of the Agency of Agriculture described a state grant program that uses Rosen/McLaughlin Act funds and other appropriations to provide competitive grants to schools and early‑childhood programs; the agency currently awards roughly $500,000 per year to support farm‑to‑school and early‑childhood initiatives, she said. The grants can be used for school and center gardens, educator training, food preservation equipment and to buy local products such as meat, honey and maple syrup.

Beth Traver Adolphus, executive director of Oak Hill Children’s Center in Pownal, told senators how a grant allowed her center to build raised beds, involve children and families in planting and harvesting, offer hands‑on cooking activities (hummus, smoothies, pesto pizza), and buy local meat and syrup. She described children who refused certain foods until they helped grow or prepare them and an instance where a preschool group consumed a head of broccoli they had dissected and sampled after a garden lesson.

Traver Adolphus asked the committee to support a base appropriation of $500,000 for the Farm to School and Early Childhood grant program and level funding of $500,000 for the Local Food Incentive Program for schools. She told senators those modest investments support long‑term nutrition education, strengthen community ties to local farms and help child care providers supply nutritious meals to families that are food‑insecure.

Agency staff said they can supply details about grant application processes and eligibility directly to legislators and that the grants are intended to be broadly accessible, including to small rural programs with limited operating margins.

Senators thanked witnesses and indicated they would consider the funding request as part of budget discussions.","Providers and the Agency of Agriculture told the committee that farm‑to‑school and early‑childhood grants support nutrition, child development and local farmers; an early‑childhood director described gardens, cooking activities and harvest events that increased children’s willingness to try new foods.",{"_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},6337269,"Vermont Program for Quality in Health Care outlines statewide projects: patient safety reviews, primary‑care pilots and suicide‑care training",2301,6647000,8948000,"/Search/View?dp=1&key=2273724-829145ba53d2f192b97da800ae18d538&start=6647&end=8948","https://assets.pipeline.soar.com/2273724-829145ba53d2f192b97da800ae18d538/thumbnail_6647000.jpg","/articles/6337269/Vermont/Vermont-Program-for-Quality-in-Health-Care-outlines-statewide-projects-patient-safety-reviews-primarycare-pilots-and-suicidecare-training","https://secure.pipeline.soar.com/6337269-97e1facae74e276dc3801ed6ecb46217/orig.mp4?Expires=1775399106&Signature=IEs3ZBPq4HvaD2~o2I8KtaC1wZ9Vzqy9GtoGm7kRG2Gu7v1AuRzmK2zRvDyEZpn5dwJIWMaIil0bCaPDtq5unS6Mso3HiV6~y6~KZwblDMvjvtd9rHFamXExuVhe~xjJjoKGe1Vpz~jJRrcVksuqmBFht4vPeW03ImK1P3qPbc75U98E1AjlqKDkvZItZbb1k8zH4EaPu7dNkCa4CXfsVttWZeVBSDnzdDI7bx4lCy-4It6xI~bKNu4WQFVVF~ytfvZiOp~88HozVDOTQ8Dnu2VZVQkgECL1NmeVCf5mUfYCrbdNRmAPU8VGc7W4~9tMX12~CT1kVGSR85SuIN1bGg__&Key-Pair-Id=KUT5TJCACFTXG","Hillary Wolffley, executive director of the Vermont Program for Quality in Health Care (VPQHC), told the Senate Health and Welfare committee that VPQHC is the state’s independent, non‑regulatory quality organization and is positioned to support statewide measurement and improvement activities that complement access and cost initiatives.

“We improve healthcare quality in Vermont by studying the system and making it work better,” Wolffley said, describing VPQHC’s role as a neutral convener that runs multi‑site quality programs and produces public reports. She said VPQHC receives a mix of funding — bill‑back fees under 18 V.S.A. §9416, state contracts, federal grants, private contracts and philanthropy — and that bill‑back fees make up a minority of the organization’s budget.

VPQHC staff described three programs in depth: a hospital patient‑safety review and follow‑up process, a primary‑care pilot that tracked social‑needs screening and community health worker interventions, and a suicide‑care training initiative for clinicians.

Patrice Knapp described the Patient Safety Surveillance and Improvement System (PSSIS), a subcontract with the Vermont Department of Health that receives serious‑reportable event reports from hospitals, reviews root‑cause analyses, coaches hospitals on corrective action plans and conducts site visits to validate implementation. Knapp said PSSIS has increased hospital engagement in peer learning; the most frequent reports are hospital‑acquired pressure injuries, and the program focuses on action plans that go beyond retraining and emphasize system changes.

RANDALL Messier described VPQHC’s primary‑care work, including a Pilot at several pediatric clinics that implemented screening for health‑related social needs and deployed community health workers to connect families to resources. The pilot measured clinical, operational and financial outcomes and showed higher engagement and lower per‑event cost when community health workers helped avoid emergency transport and ER visits.

VPQHC also reported progress on training clinicians in Collaborative Assessment and Management of Suicidality (CAMS). The CAMS project trained more than 400 clinicians statewide, established a community of practice with quarterly consultation, and created a directory of trained clinicians to improve referral pathways.

Wolffley said VPQHC will produce a five‑year strategic plan and urged the legislature to include quality measurement and clinical outcomes in any broader health system reform work. She emphasized VPQHC’s ability to convene hospitals, primary‑care practices and independent providers to run multi‑site quality improvement initiatives and to produce data that policymakers can use to assess the consequences of access and cost changes.

Senators thanked VPQHC for the briefing and asked staff to identify specific ways the nonprofit could support statutory reform, data collection and the Green Mountain Care Board’s oversight roles.","VPQHC updated the Senate committee on a range of statewide, non‑regulatory quality improvement projects: a hospital serious‑event review program, primary‑care social‑needs pilots and a state‑wide rollout of suicide‑care training (CAMS). Leaders said the nonprofit’s statewide reach and convening role make it a ready partner for reform work.",{"_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},6337274,"Audit expert: UVM Health Network’s finances readable but policy needs clearer goals; outside hospitals drag metrics",3460,3233000,6693000,"/Search/View?dp=1&key=2273724-829145ba53d2f192b97da800ae18d538&start=3233&end=6693","https://assets.pipeline.soar.com/2273724-829145ba53d2f192b97da800ae18d538/thumbnail_3233000.jpg","/articles/6337274/Vermont/Audit-expert-UVM-Health-Networks-finances-readable-but-policy-needs-clearer-goals-outside-hospitals-drag-metrics","https://secure.pipeline.soar.com/6337274-a9b09ea88d328e10ed5883644b0493e2/orig.mp4?Expires=1775399106&Signature=f4AW1fabAfqL~l9tD2-SPQ8gLi8NjyOkWU~NlkGG8BYYXwdVa0CqTLBFoOj4OuoZrbiCtOvBVlQO5Y4gXyq16mDuPKSZgWhnbNgVT5qo5xFhpdbStcpS9dUu1CE2p0Ph4rVamquQH27KJwsEHo~icjANqxZnJH7Qzig2JWUN6IzBOv7-hLGdbVcirA0XVsJKIdKtHrltZA1KurLLTGxLh4apxyFS3SgQtQik1Krfcc1gGloTthXi53nUWMwfNXp8FAyhN~ea9209rqt-OfFREkQawO0YFsbj1UkosW2iZ--IJU-tTGRCEiW87vC9TmRPolucgd4tzSLgVmH2W936Ew__&Key-Pair-Id=KUT5TJCACFTXG","Nancy Kane, professor emerita at the Harvard T.H. Chan School of Public Health, briefed the Senate Health and Welfare committee and asked legislators to define the policy questions they want answered before ordering new audits of hospital systems.

Kane said audited financial statements and a standard set of financial metrics — profitability (operating and total margins), liquidity (days cash on hand and absolute cash and investments), solvency (long‑term debt as a share of capitalization and debt‑service coverage) and capital adequacy (capital spending relative to depreciation and average age of plant) — can give a credible, audited picture of a system’s finances. But she cautioned an audit’s value depends on the questions policymakers want answered and noted that many operational efficiency questions require cost accounting data rather than external financial statements.

“What financial data is very helpful for is looking at financial implications of any rate decision,” Kane said. “It helps identify financially advantaged or very wealthy systems versus sustainable systems versus distressed systems. It does not tell you whether the health system is efficient or not.”

Kane presented a peer comparison of the University of Vermont Health Network (UVMHN) and several Northeast academic medical systems, showing how payer mix, cash and investments, debt burden and capital spending affect ratios. She said UVMHN’s operating margin and days‑cash figures fall in the range of peer hospitals; the full consolidated network’s results are weaker when recent New York hospital affiliates are included in the consolidated statements.

Using UVMHN as an example, Kane said the UVM Medical Center — viewed as a standalone hospital in the financial filings — performs differently than the consolidated health network. “In almost every metric, the medical center, if it was standalone, does better than the system, except the days cash on hand,” Kane said. “That’s because the parent has half the days cash on hand. It redistributes it.” Kane also said the consolidated network’s debt service coverage and profitability are lower when affiliates outside Vermont are consolidated into the results, and that the network’s capital expenditures per depreciation had recently risen after a period of lower spending.

Kane urged the committee to ensure it has staff or contracted expertise that can interpret hospital financials for policymaking and cautioned against “going down a rabbit hole” asking auditors for operational details that will not directly help set policy. “I think what you’re looking for is someone who can understand the data and interpret the data,” she said. She recommended the Green Mountain Care Board or the committee hire financial analysts who can translate audited data into policy‑relevant findings and noted a state‑level policy program should decide “what’s affordable” and how to weigh capital investment, clinical services and strategic choices such as out‑of‑state affiliations.

Kane told senators that audited financial statements are credible and useful for fiscal policy and for creditors, and that timeliness — annual audits with quarterly unaudited statements — should inform expectations about how quickly the state can analyze changes. She also pointed to specific indicators senators could use, including days cash on hand, debt‑to‑capital ratios, debt‑service coverage and capital spending relative to depreciation, to determine whether a system is sustainable or in distress.

Committee senators thanked Kane for the overview and said they expect to use financial metrics and independent analysis in drafting oversight and reform proposals; they also asked for further follow‑up and technical assistance from her as the panel refines legislative options.","Harvard professor Nancy Kane told the Senate Health and Welfare committee that audited financial statements and peer comparisons can answer many policy questions but an audit alone is not a substitute for clear policy objectives and financial literacy at the state level.","actionData","errors"]

Article not found

Senate committee hears bill to spend $1M to buy and abolish medical debt, bar reporting to credit bureaus

Pharmacy association thanks committee, reiterates pharmacists’ role in maintaining access

Early‑childhood centers and agriculture agencies urge $500K for farm‑to‑school and local food incentive grants

Vermont Program for Quality in Health Care outlines statewide projects: patient safety reviews, primary‑care pilots and suicide‑care training

Audit expert: UVM Health Network’s finances readable but policy needs clearer goals; outside hospitals drag metrics