Committee reviews comprehensive primary health care markup, limits data integration until 2027

Jen Kirby, Office of Legislative Council, presented a consolidated House markup on language changes to the comprehensive primary health care bill, saying the draft “integrate[s] all of the proposals from the senate” and highlights where the House and Senate differed.

The proposal includes a provision that "integration of these data types or a subset of them shall not begin prior to 01/01/2027" and requires a favorable vote of a majority of all voting members of the HIE steering committee before integrating clinical, claims or social-determinants data into the unified health data space.

Why it matters: the draft would alter how Vermont agencies and stakeholder groups share clinical, claims and social drivers of health data, affecting hospitals, insurers, providers and patients. The markup also adjusts advisory committee membership and reporting deadlines tied to hospital financing and incentive payments.

Kirby told the committee the draft is a synthesis: "what I did was integrate all of the proposals from the senate," and that changes are shown where House and Senate language diverged. The draft preserves a role for an HIE steering committee; under the new language integration must wait until at least Jan. 1, 2027, and then may proceed only after a majority vote of the committee and only for specific uses that the committee approves.

Committee participants raised concerns about who would see various types of data. One committee member said they were "very concerned about payers having access to clinical data" and added that allowing providers access to claims data raised separate legal and proprietary questions. Kirby summarized the compromise in the markup as limiting rapid access for payers and emphasizing protections for proprietary information relating to payers and providers.

The draft also makes changes to advisory and steering bodies. The advisory committee was expanded to 18 members by restoring a representative of advanced practice registered nurses, a licensed mental health professional in independent practice, and a representative of small business. The draft adds a Vermont steering committee for comprehensive primary health care with responsibilities to provide input on the statewide health care delivery strategic plan.

Committee members discussed whether to add occupational and physical therapists to advisory roles. One member noted the recent focus on long COVID and said occupational therapy is important to recovery.

The markup includes reporting requirements and timing changes: Kirby said the first statewide plan is targeted to Jan. 15, 2028, with recurring submissions on a three‑year cycle tied to December 1 reporting dates; she also noted that several monthly hospital reporting requirements are limited to hospital fiscal year 2026. The draft moves several reporting deadlines to Dec. 1 to align disparate deadlines. Kirby also said the agency (AHS) would report by Dec. 1 on how much of the $2,000,000 appropriated for hospital incentive payments had been obligated as of Nov. 15.

No formal vote or final adoption occurred during the session. Members agreed to meet informally—"the 3 of us are gonna go and meet with Jen," one committee member said—to go through the consolidated markup and consider additional proposals on accountable care organizations and other items before taking the language to the floor.

Next steps: staff and members plan further meetings to refine the draft before floor consideration later the same day, and the markup as discussed would require subsequent committee votes (including the HIE steering committee votes specified in the draft) before data integration could begin.