Committee reviews amendment to expand Medicaid coverage for optometrists' advanced procedures

The Government Operations & Military Affairs committee reviewed a Medicaid-focused amendment that would expand coverage for certain optometry services and ask Vermont Health Access to seek federal approval.

Jen Carby of the Office of Legislative (legislative staff) told the committee the amendment “would require Vermont Medicaid to cover services within the scope of practice of an optometrist with the advanced therapeutic procedures specialty to the same extent [as if] delivered by a physician,” and would direct Vermont Health Access to seek a state plan amendment from the Centers for Medicare & Medicaid Services to take effect on 07/01/2028. Carby said Medicaid coverage would begin on the later of 07/01/2028 or CMS approval of the state plan amendment.

Committee members asked clarifying questions about how the change would be structured in the amendment and whether the remainder of the bill’s effective date language was correct as read. Carby noted the rest of the bill ‘‘would still take effect 07/01/2020’’ as stated in the posted language; the committee did not resolve that apparent inconsistency during the discussion.

Representative Stone and other members pressed on oversight: who would supervise optometrists who do not hold the expanded-scope certification. Carby said the Board of Medical Practice language in this version of the amendment applies only to the advanced therapeutic specialty; other optometry practice regulation would remain with the Board of Optometry. She added that the Board of Medical Practice’s composition is set by statute and that adding a specific optometrist position would require statutory change.

The committee paused the matter later in the meeting to take up H.841 (animal welfare); members agreed to return to the optometry language when time permits. No formal vote on the Medicaid-related amendment was recorded in the transcript.