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Vermont Legal Aid warns Senate panel that budget would eliminate Medicare Advocacy Project funding
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Summary
Jessie Weiss told the Senate Appropriations Committee that the governor's budget would eliminate the state appropriation for the Medicare Advocacy Project (MAP), risking staff layoffs and reduced services including a statewide helpline and a new immigrant guardianship program.
Jessie Weiss, interim executive director of Vermont Legal Aid, told the Senate Appropriations Committee on Feb. 11 that the governor's proposed budget would eliminate the state appropriation that funds the Medicare Advocacy Project, known as MAP, and urged the legislature to restore funding.
Weiss said VLA and its sister organization Legal Services Vermont provide the core of the state's free civil legal assistance and that MAP helps ensure dual-eligible Vermonters (eligible for both Medicare and Medicaid) get the Medicare coverage to which they are entitled. "The governor's proposed budget does not maintain level funding for Vermont Legal Aid. Specifically, it proposes eliminating the appropriation that funds Medicare Advocacy Project known as MAP," she said.
MAP appeals, Weiss said, recover wrongly billed Medicaid costs by shifting payment to Medicare where appropriate, returning federal dollars to the state and protecting access to home health and other services. "Since 2000, recovery for the state has exceeded what Vermont Legal Aid has received by roughly $3,400,000," Weiss said, citing long-term program recoveries.
Weiss cited a 2013 settlement in a case in which Medicare agreed to cover maintenance nursing and therapies for people with non-improving conditions, and she said MAP's work has been critical to securing proper Medicare coverage and avoiding unnecessary nursing-home stays.
She told the committee the governor's proposal to cut MAP funding was disclosed in House testimony and came as a surprise: VLA had been awarded a new five-year MAP contract in November after a competitive bid. When asked which department the contract is with, Weiss identified the Department of Vermont Health Access (DVHA).
Weiss listed factors that reduced recent recoveries and complicated appeals work: a COVID-related pause on recovery efforts, the Genesis bankruptcy affecting skilled nursing facilities (which froze more than $200,000 in potential recoveries), and additional appeals layers introduced by Medicare Advantage (Part C) plans. She outlined steps VLA proposed and is implementing to improve results, including better data collection with DVHA, provider education, a recent training for DVHA provider-relations staff, additional provider trainings and quarterly meetings to review data quality and progress.
Weiss said MAP was pursuing roughly $1.1 million in Medicaid recoveries at the time of her testimony and argued that the state had not met the statutory criteria required before the DVHA commissioner can end the contract. She cited "33 Vermont Statutes Annotated, section 6703" as the statutory authority that sets the conditions for terminating the contract. "Given the newly awarded contract, the lack of the commissioner's determination, and the level of expertise that is needed to do the work, the team of attorneys and paralegals assigned to MAP at VLA are experts in Medicare and Medicaid law," she said.
Weiss warned that without restored funding VLA would lose more than $525,000 in state fiscal year 2027, likely forcing staff layoffs and reducing VLA's ability to provide other services, including elder-law assistance. She also described related budget pressures: the AHS contract funding line (E300) has been level-funded for three straight years, squeezing the poverty law project, and the statewide helpline receives only $100,000 in state funding while operating costs exceed $900,000, producing longer callback waits.
Weiss also described a new immigrant minor guardianship program launched in February to help families prepare guardianship petitions in case parents are detained or deported. She said VLA has helped draft plans for more than 75 families and about 130 children and estimated the program's costs at roughly $150,000; most of that work currently relies on donations and volunteer attorney time.
Weiss urged the committee to restore MAP funding and offered to report back to the committee next January on VLA's progress.
The committee followed with questions about contract totals, staff numbers and office locations; Weiss said VLA has about 80 staff and offices in Montpelier, Rutland, Springfield and Burlington. The hearing record showed no committee vote on the budget at the conclusion of her testimony.
