[{"_1":2,"_86":-5,"_87":-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],{"_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",6093174,"mediaKeyId","2848986-91b15350a70f0525736c017dc0eaa4fb","parentId",2848986,"title","Senate committee moves to refine Office of Health Care Advocate authority on rate reviews and certificate-of-need proceedings","audioSeconds",2121,"startMs",2000,"endMs",2123000,"viewUrl","/Search/View?dp=1&key=2848986-91b15350a70f0525736c017dc0eaa4fb&start=2&end=2123","thumbnailUrl","https://assets.pipeline.soar.com/2848986-91b15350a70f0525736c017dc0eaa4fb/thumbnail_2000.jpg","articleUrl","/articles/6093174/Vermont/Senate-committee-moves-to-refine-Office-of-Health-Care-Advocate-authority-on-rate-reviews-and-certificate-of-need-proceedings","mediaUrl","https://secure.pipeline.soar.com/6093174-6d5b0218dcd21150d95888aad6b54742/orig.mp4?Expires=1770742043&Signature=WNR61WOMrA4Oj5UyqunZiNvpNwMiswjBl8IfuStIn8dLgTKYjO09frrlPoQnLAosXtNtNJjPfKfeTBtfUlhCuK-2G-5x2ChVD1ydV0zXtoWB1x~yBq61rPpV775iQ4-n766IZTHriJPmrmUbZos826O5yq8E33E0rOvjieCrz57OQ~Omx3l3RUZw-RCyFp5W3~rGoJ0HFxXYVv6-BhmVt26aQRbMlVUMtHa0xLjLUdrATPhw2tLmODM52WnDh01Ck9PJF~T~aIZWAv7tZ9sBN8bC-FVs0HBFULzExu6CH2tTaodBwn~ENsHGzxwOm~sGWm~VAp-wkIUr0Ui6ZuXeXA__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-04-02T14:02:55Z","article","On April 2 the Senate Health and Welfare Committee took up H.80, legislation that would revise the statutory authority of the Office of the Health Care Advocate (HCA) to participate in rate reviews and certificate-of-need (CON) proceedings and to clarify confidentiality and consent requirements.

The proposed amendment, presented by Jen Harvey of the Office of Legislative Council, would remove language allowing an interested party to ask questions of Green Mountain Care Board (GMCB) employees in CON contested proceedings, preserve the HCA’s ability to submit written questions and comments and to provide testimony, and add a requirement that providers or insurers may require written consent from an individual or the individual’s guardian or legal representative before releasing records to the HCA.

The change to CON language came after stakeholders asked for compromise language. \"So we are looking at H.80 and act relating to the Office of Health Care Advocate,\" Jen Harvey said while outlining a straight‑all amendment showing stakeholder‑recommended edits in context.

Why it matters: The HCA represents Vermonters in disputes about access and affordability. The bill’s changes affect what records the HCA may obtain, how the HCA participates in contentious CON proceedings, and how state agencies must solicit the HCA’s input on significant health‑policy changes.

Key provisions discussed
- Rate review: The amendment clarifies that the HCA may submit written questions and receive materials in rate‑review dockets; the committee heard concerns about the compressed timelines for carriers to answer questions during consolidated board review. A representative from Blue Cross Blue Shield of Vermont noted the rate‑review schedule is \"a very compressed timeline,\" with about a two‑week turnaround to answer consolidated questions.
- CON proceedings: The draft would remove a provision that would have allowed an intervenor (the HCA or long‑term care ombudsman) to ask questions of GMCB employees; it would preserve the intervenor’s rights to receive docket materials, submit written questions and comments, and testify in hearings.
- Consent and confidentiality: The amendment would permit providers or insurers to require written consent from an individual or the individual’s guardian/legal representative before disclosing records to the HCA. The bill also tightens confidentiality language governing the HCA’s handling of individual‑level information and proprietary materials.
- Office scope and structure: The draft updates statutory language to reflect that the HCA’s work extends beyond insurance‑specific matters to broader health‑care access and affordability, allows for multiple directors, and includes language clarifying what constitutes a conflict of interest for HCA staff who serve without compensation on certain nonprofit boards.

Stakeholder perspectives
- Emily Brown, deputy commissioner of insurance at the Department of Financial Regulation, testified in support of the bill and said the proposed amendments generally reflect current practice between her department and the HCA. \"I view this as just really updating the statutory language to reflect what is actually in process,\" Brown said.
- Sarah Teachout of Blue Cross Blue Shield of Vermont said carriers and the GMCB currently receive a consolidated set of questions and that the short turnaround imposes time pressure. She expressed support for language requiring that questions must have a substantial relationship to rate‑review criteria and submissions.
- A staff attorney for the GMCB said the board values the HCA’s participation and supported clarifying the HCA’s access to confidential docket materials while retaining confidentiality obligations.
- The state health care advocate described the amendment as the product of negotiation and emphasized the long‑running working relationship between the HCA and state agencies.

Committee action and next steps
Committee members indicated broad agreement with the amendment language brought by legislative council. The committee directed staff to prepare a strike‑all amendment reflecting the agreed changes and scheduled a markup and vote on H.80 at the committee’s next available slot.

The bill as presented would take effect July 1; the committee did not finalize an effective‑date change during this discussion but instructed counsel to prepare the strike‑all amendment for formal consideration at markup.

Ending: The committee expects to consider the prepared amendment at an upcoming markup and vote after members review the text and any additional stakeholder input.","mediaType","Video","parentTitle","Senate Health and Welfare - 2025-04-02 - 10:00 AM","oneSentenceSummary","On April 2 the Senate Health and Welfare Committee took up H.80, legislation that would revise the statutory authority of the Office of the Health Care Advocate to participate in rate reviews and certificate-of-need proceedings and to clarify confidentiality and consent requirements.","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":79,"_47":80,"_49":81,"_51":82,"_53":83,"_55":56,"_57":58,"_59":84,"_61":62,"_63":64,"_65":85,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6093168,"Senate committee considers raising certificate‑of‑need thresholds, debating birth center exemptions and state‑project notice",0,2046000,"/Search/View?dp=1&key=2848986-91b15350a70f0525736c017dc0eaa4fb&start=2046&end=2046","https://assets.pipeline.soar.com/2848986-91b15350a70f0525736c017dc0eaa4fb/thumbnail_2046000.jpg","/articles/6093168/Vermont/Senate-committee-considers-raising-certificateofneed-thresholds-debating-birth-center-exemptions-and-stateproject-notice","https://secure.pipeline.soar.com/6093168-7123421b0d89890067a134344aa2edbc/orig.mp4?Expires=1770742043&Signature=RS8rUAhKAxPugTcptCCW7WcM0WK4wBE2850KaMMX3L6iG03fvf7H6lw9afjt8t2LNSjyj2i3WLAXcvoNPP0ETa8vyM1swgoKAbG3m2JTgAOd7EpE9wiU8e6w7JHSr-hV4wlH4YZ6TVQI31hyJRWweTj9yWaqKBqgKQFo-h7Uh1~M-2uAWGY9OkZEH8oHpwYuP4H2oH~7Tor8HfFBA9oIiJd89QVuPFIyWY2syGCLiN4pGdjeZmLNOio06vysLZG47~hWoIzXUBU5Qs9STYDSyje4illOJphij9b4X8dB4sx3ISR~iPUYXYSxPyguML~qCS1B0WZLrAK7kUEXMQQgCw__&Key-Pair-Id=KUT5TJCACFTXG","During the same session the committee shifted to H.96, which would change certificate‑of‑need (CON) monetary thresholds and related procedures.

Committee staff and Green Mountain Care Board (GMCB) representatives discussed combining hospital and nonhospital facility thresholds now that proposed monetary thresholds align, clarifying ambulatory surgical center treatment under the statute, and whether transfers of ownership or sale provisions should treat birth centers differently.

Why it matters: CON thresholds determine which projects must undergo state review for potential impacts on access, quality and cost. Changes alter when expansions, new facilities, or ownership transfers require GMCB review and public notice.

Details discussed
- Thresholds and consolidation: Committee members instructed staff to explore folding ambulatory surgical centers into the general facility categories rather than leaving them as a separate category; one figure mentioned for projects was a $10,000,000 threshold under discussion for certain projects.
- State projects exemption plus notice: The committee agreed in principle to add a statutory exemption for state projects but require the state to notify the GMCB when a state project would otherwise fall under CON review so the board (and interested parties) would have notice. Committee members also discussed notifying the Office of the Health Care Advocate but noted potential redundancy with existing communications.
- Birth centers and transfers of ownership: Members flagged concerns about carving out birth centers from CON requirements. Testimony noted there are different kinds of birth centers and that some are low‑revenue operations; committee members asked staff to return with refined language, possibly a standalone exemption for birth centers and a low‑risk definition suggested by the Office of Professional Regulation.
- Effective date and administration: The GMCB indicated it could implement changes on passage but warned that a flurry of administrative actions (withdrawals/resubmissions) might follow; the board said effective‑on‑passage was administratively feasible.

Concerns raised
- Private equity and consolidation: Several members expressed concern about private‑equity or investor groups acquiring health and child‑care facilities for profit and the possible effect on access and cost; the committee indicated they may pursue closer review of ownership transfers in future work.

Committee action and next steps
The committee instructed staff to: combine subsections where appropriate (folding ambulatory surgical center thresholds into the main facility thresholds), incorporate the ambulatory surgical center language into section 1, add a state‑project exemption that triggers notice to the GMCB, change the bill’s effective date to on passage, and return a draft amendment for markup and possible vote by Friday.

Ending: Committee members said they would review updated language and monitor related work in the House on private ownership and birth‑center definitions before finalizing the committee’s position.","On April 2 the Senate Health and Welfare Committee discussed H.96, a bill to raise monetary thresholds for certificate‑of‑need reviews, consolidate thresholds for ambulatory surgical centers and other facilities, and add an exemption plus notification for state projects; members asked staff to combine subsections and prepare a markup","actionData","errors"]

Article not found

Senate committee moves to refine Office of Health Care Advocate authority on rate reviews and certificate-of-need proceedings

Senate committee considers raising certificate‑of‑need thresholds, debating birth center exemptions and state‑project notice