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Agency of Human Services urges caution on AHEAD changes, seeks to preserve OneCare functions as S.126 moves forward
Summary
Agency of Human Services officials told a legislative committee they support parts of S.126 but are reassessing the AHEAD model after federal changes at CMMI, want to preserve OneCare's data and analytics functions, and said Medicaid already uses reference-based pricing under its 1115 waiver.
At a legislative committee hearing, Agency of Human Services officials said they are generally supportive of S.126 but cautioned the committee to reassess parts of the AHEAD model as federal priorities shift and to protect operational functions now provided by OneCare.
Monica Ogilby, the state Medicaid director, told the committee the agency has been "working really hard and really well with Green Mountain Care Board, Healthcare Advocate, other community partners" and that the state is "delighted to be here to be a resource for you." She said the federal Center for Medicare and Medicaid Innovation (CMMI) has recently signaled changes in emphasis and that the agency is taking time to determine what elements are right for Vermont.
The agency flagged two practical areas for lawmakers: maintaining critical OneCare functions and clarifying who may set reference-based pricing for non-hospital commercial services. Ogilby said OneCare performs "robust and…
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