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

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.