State Touts Improved IT, Customer Service At Vermont Health Connect

A couple weeks ago, administration officials delivered their final monthly report on Vermont Health Connect to the Legislature. The document strikes a triumphant tone. Vermont’s insurance exchange, the report says, is succeeding at long last.

Trinka Kerris the chief health advocate for Vermont. She oversees Vermont Legal Aid's Office of the Health Care Advocate, an independent office that works to resolve consumer complaints about Vermont Health Connect, other insurers, state programs, hospitals and providers. ...

“It’s only good when you compare it to what it used to be like,” Kerr says. “We still get calls from people who are really upset, really frustrated, really angry about problems that they’ve been trying to resolve for months.”

Just because Vermont Health Connect is better today than it was six months or a year ago, Kerr says, doesn’t mean it’s as good as it should be. The Legislature commissioned an independent review of Vermont Health Connect due at the end of the year.

“I guess I’d like to see the results of the study that’s being done to determine whether it is really worth sticking with the system,” Kerr says.

Federal Court Orders CMS To Fix Improvement Standard Education Effort

A federal district court agreed with beneficiary advocates that CMS hasn't done enough to implement a three-and-a-half-year old settlement agreement to halt a widespread, unofficial policy of cutting off Medicare coverage for certain services when beneficiaries stop improving. The court ordered the agency to provide more education about Medicare coverage of services for beneficiaries that may not be improving The Center for Medicare Advocacy and Vermont Legal Aid alleged the improvement standard was illegal, and CMS and the beneficiary advocates...

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UVM Health Network faces questions on health care costs

A member of the Green Mountain Care Board challenged the state’s largest hospital system to reduce prices without seeking more money from government programs. ...

Dr. Allan Ramsay on Wednesday told top officials from the UVM Health Network that blaming the so-called cost shift for high hospital prices is unfounded. ...

A representative of Vermont Legal Aid’s Office of the Health Care Advocate, which represents the public interest in the hospital budget process, was the first to question why the hospitals were blaming the “cost shift” for higher prices.

Law Line of Vermont executive retires

Thomas F. Garrett retired this week from the top post of the Legal Services Law Line of Vermont, where he had been the executive director since the Law Line formed in 1996. His last day on the job was Monday.

In that post, Garrett managed a staff of attorneys who provide free consultation, advice, intake, referral and education for-low income Vermonters primarily through the Vermont Law Help hotline. The hotline, a joint project of Vermont Legal Aid and Law Line, is funded in part by the Legal Services Corp.  ...

Sam Abel-Palmer, a former staff attorney at Vermont Legal Aid and the current Vermont Law Help hotline supervisor, will serve as Law Line’s interim executive director.

Back to drawing board for boarding house regs

Residents packed a public hearing Monday night and demanded the town do something about the proliferating problems at the growing number of boarding houses in town.

The Springfield Select Board had drawn up a draft zoning change that would require any establishment of a boarding or rooming house to get a zoning permit and follow several conditions. ...

Jacob Speidel, a lawyer with Vermont Legal Aid in Springfield, said there were unintentional consequences of the proposed zoning change, including making it more difficult for the elderly to either rent a room or rent out a room in their homes.

Originally published in the Rutland Herald (available by subscription)

MVP argues for 6.3 percent increase in insurance prices

MVP Health Care is asking state regulators to let it increase how much it charges Vermont Health Connect customers by an average of 6.3 percent next year.

Kaili Kuiper spoke on behalf of Vermont Legal Aid’s Office of the Health Care Advocate, which advocates for the public interest in these cases. She argued that the board should enforce the 3.7 percent increase its actuaries at Lewis and Ellis in Burlington recommended.

In her opening remarks, Kuiper referenced public comments from Wednesday and said health care costs are so high that they are “negatively impacting individuals, families, communities and small businesses in Vermont.”

“They described how health care costs are impeding their access to care, taking a huge chunk out of their budgets, and they’re asking what they will have to give up to afford future rate increases,” Kuiper said.

“Vermonters are living under a federal mandate that requires them to buy health insurance, yet they can’t simply shop around for a better deal because as individuals and small businesses, their only option is to purchase health insurance on the Vermont health exchange,” she said. ...

Kuiper countered that MVP must meet a burden of proof in order to raise prices 6.3 percent and said the insurer hasn’t met it. She said the Lewis and Ellis actuaries use a better methodology and the result of the methodology is more affordable for Vermonters.

State grant funds more legal services for Vermont seniors

Vermont received an  Administration for Community Living grant that will provide $178,500 each year for three years to expand legal services for at-risk older adults. The Model Approaches to Statewide Legal Assistance Systems demonstration grant is a cooperative grant between the Vermont Agency of Human Services’ Department of Disabilities, Aging and Independent Living (DAIL) and Vermont Legal Aid. The grants are designed to help states respond effectively to legal issues affecting seniors with significant social or economic needs.

In Vermont, the funding will be used to develop services specifically for seniors at the statewide legal hotline, Vermont Law Help, as well as to provide legal training, to do outreach, and to build and strengthen partnerships throughout the state with the court system, Adult Protective Services, the Office of Public Guardian, the Area Agencies on Aging, and others.

“As the number of older adults living in Vermont continues to grow, more and more seniors are calling to find help,” said Michael Benvenuto, Elder Law Project Director at Vermont Legal Aid. “Housing, health care, consumer, and financial issues along with elder abuse are critical areas of need that, if unresolved, can threaten the well-being of older adults as well as their ability to stay in their homes and communities. This grant will allow Vermont Legal Aid to expand our services and develop an integrated system for helping seniors statewide.”

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Report recommends lower price increase for MVP Health Care

...MVP requested an 8.8 percent increase in what it charges customers on Vermont Health Connect starting Jan. 1. Blue Cross Blue Shield of Vermont requested an 8.18 percent increase.

The board’s actuaries analyzed the requests and came out with an opinion Monday. The actuaries said MVP should be able to raise its prices only 3.7 percent and that Blue Cross’s prices should go up 8.24 percent instead of 8.18 percent. ...

Hearings on the insurance prices for Vermont Health Connect customers will be held in Montpelier at 9 a.m. July 20 for Blue Cross and 9 a.m. July 21 for MVP at the Green Mountain Care Board offices in City Center. Health care advocates at Vermont Legal Aid will testify on behalf of consumers.

VITL wants to give doctors easier access to medical records

Officials with the Vermont Information Technology Leaders (VITL) are talking with stakeholders about a policy change that would give doctors automatic access to patient records unless a patient objects.

The company’s signature program, VITL Access, gives doctors and other clinicians information about patients. Under current policy, patients must give doctors permission to view their records. ...

VITL is required to discuss the policy change with the Office of the Health Care Advocate at Vermont Legal Aid, and the American Civil Liberties Union of Vermont.

Allen Gilbert, the outgoing executive director of the ACLU of Vermont, said the organization has always favored an “opt-in” policy for VITL’s systems, because patients will be more likely to know what they’re agreeing to that way.

“We worry about the way the VITL system works even when someone does give consent because there’s no PIN number or code that’s needed to access someone’s records,” Gilbert said, comparing the system to an automated teller machine.

The Office of the Health Care Advocate shares the ACLU's concerns and agrees that Vermonters should be given the chance to choose to allow their records to be shared by "opting in," rather than having their records shared automatically unless they "opt out."

Insurer lawsuit accuses Green Mountain Care Board of overreach

[MVP] health insurance company is suing the Green Mountain Care Board for telling the company it could not raise prices on one plan by an average of 27.4 percent and questioning whether the company can afford to operate the plan in Vermont. ...

Kaili Kuiper, from Vermont Legal Aid’s Office of the Health Care Advocate, also argued on behalf of the board. She said her office usually advocates for consumers to have as much choice as possible, but health insurance is complicated.

“(In health insurance) consumers are forced to compare one plan to another and decide which plan is in their best interest,” Kuiper said. “I think it’s wonderful that Vermont has the Green Mountain Care Board to help Vermonters weigh those issues.” ...

“The actuaries don’t look at consumer interest,” Kuiper said. “When they say the rate is not excessive, they are discussing the cost of the insurer and whether it’s excessive only to the insurer.”