The House Health Care Committee Friday received an extension of its “crossover” deadline that will allow it to continue working until Wednesday on a draft bill to implement the second phase of an ambitious plan to transform the state’s health care system.

The committee is developing a proposal that would:

• Streamline and facilitate enrollment in state-sponsored benefit plans including Catamount Health and VHAP;
• Codify in statute the heretofore voluntary and collaborative Blueprint for Health and create a new position in the department of health to coordinate the processes in the Blueprint;
• Require health insurer participation in the Blueprint by 2009 and create a regulatory structure to enforce the provisions on insurers;
• Create, for the first time, state regulation and oversight over insurer reimbursement for providers by requiring additional payments to providers for chronic care management and establishing a state survey of insurer provider reimbursements;
• Create a medical home pilot project for chronic disease management integration;
• Create a pilot project for community-based care coordination with the ultimate goal to replace insurer disease management programs;
• Create a pilot project around chronic care payments;
• Establish a one-year pilot program for funding health information technology through assessments on insurers and hospitals; and
• Change the way the Catamount Health state subsidy is calculated to place a greater financial burden on enrollees choosing a higher cost Catamount offering instead of the lowest cost option.

The committee also was considering a provision to allow providers to collectively bargain with insurers, but they appear to have backed away from that for now due to anti-trust obstacles.

Also in the House, a bill (H.229) making technical amendments to last year’s health care reform bill remains mired in the Ways and Means Committee as the committee ponders how to treat a proposed amendment to exempt part-time employees who have insurance coverage from an employer assessment. Seasonal employees were exempted previously by the Health Care Committee. The cost of each exemption is $400,000. The Catamount Health fund revenue projections would be reduced by $800,000 if the committee decides to exempt both seasonal and part-time employees.

In the Senate, the Health and Welfare Committee Friday afternoon was finalizing work on a bill (S.39) designating naturopaths as primary care providers and requiring health insurers to pay for their services. The committee also was considering adding a requirement that those reimbursements not be less than for traditional PCPs. An unrelated provision also was under consideration to require insurers to pay for PSA tests for prostate cancer screenings. The bill will be referred to the Senate Finance Committee after approval by Health and Welfare.

This week, much of the focus of legislative activity shifts from committee rooms to full sessions as both House and Senate consider the many bills voted out of committee at the crossover deadline. The House is scheduled to debate a controversial “death with dignity” bill this week that was patterned after a law already in place in Oregon. The patient choice and control at end of life proposal (H.44) would allow legal prescriptions to assist terminal patients to end their lives with legal prescriptions.

New Bills of Interest:

S.174 Introduced by Senator Kittell of Franklin District and others

This bill proposes to improve insurance reimbursements to health care professionals for chronic care and chronic care management to ensure that health professionals are adequately reimbursed for encouraging patients to manage their chronic illnesses.

S.182 Introduced by Senator Flanagan of Chittenden District and Senator White of Windham District

This bill proposes to provide access to Catamount Health for underinsured individuals and those employed by farms and small businesses.

For more information on legislative proposals, visit the Blue Cross and Blue Shield of Vermont website at www.bcbsvt.com or call Leigh Tofferi at (802) 223-6131 or Kathy Parry at (802) 371-3205. If you wish to discontinue receiving these updates or know of anyone else who would like to receive it, please call Kathy Parry or send an e-mail to parryk@bcbsvt.com