For the Week Ending May 5, 2012

The 2012 session of the Vermont General Assembly adjourned Saturday as lawmakers wrapped up their work for the biennium. Highlights of the session include a transportation budget to address last fall’s damage from Tropical Storm Irene, a plan to address the loss of the state hospital due to flooding in Waterbury, and the next steps in the establishment of a health care insurance purchasing exchange.

House and Senate conferees came to midweek agreements on the two health care bills still in play: a bill setting the guidelines for the exchange (H.559) and another to require public reporting of claims denial information and administrative expenses of insurance companies (S.200). Those conference committees were easily concluded as House members generally agreed with Senate changes to H.559 and Senators readily agreed with House changes to S.200.

In addition to the exchange guidelines, H.559 also contains provisions relating to the number of forms and notification timelines that insurers must use for prior authorization requirements, new limitations for prescription drug out-of-pocket costs, and additional authority for the Green Mountain Care Board relating to insurer rate review, hospital budgets and the certificate-of-need process.

Senators on the S.200 conference committee agreed to House amendments significantly expanding that bill beyond insurer reporting to include significant limitations on pharmacy benefit managers’ (PBM) ability to audit pharmacy compliance with their contract provisions, and a requirement that health plan’s directly reimburse ambulance services for their treatment of insured patients.

Other key health care bills approved in the 2012 session were a new mandate requiring insurance coverage for early childhood developmental disorders (S.223), insurance coverage for certain services delivered through telemedicine (H.37), and designation of naturopaths as primary care providers (S.209).

A bill intended to stem a falling childhood vaccination rate (S.199) became one of the most controversial bills of the session and the strong feelings engendered by the proposal dragged on into the waning hours of the session. The bill proposed removal of a “philosophical” exemption that allows parents to opt out of a state requirement that children be vaccinated before enrolling in public schools or day care programs. Although a religious exemption would have remained in place, the proposal to remove the philosophical opt out sparked a grassroots campaign to derail the measure. Even the governor ended up disagreeing with his own health care commissioner. Ultimately, the bill was watered down to add an educational component prior to the existing opt-outs before it gained enough votes to pass.  

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 webmail@bcbsvt.com.