House committee abandons medical pay parity bill

A late-session effort from the Senate to help level reimbursements between independent doctors and hospital-employed doctors has failed in the House.

The House Health Care Committee decided to remove the so-called pay parity language from a broader bill, H.29. Members said there was not enough time to take proper testimony and make a decision on the issue.

The Senate passed H.29 on May 5. That was the day the Legislature originally intended to adjourn.

The Senate's language would have required the Green Mountain Care Board to convene a working group. Its members would develop a plan to reduce pay disparities between independent doctors and those employed by academic medical centers by the "maximum achievable" amount in the next three years and report back to a joint legislative committee this year.

Another provision would have prohibited insurance companies from raising how much they reimburse physician practices specifically because a hospital buys the practice. That provision was similar to what the federal Medicare Payment Advisory Commission proposed in November.

"We were given no time to go through a deliberative process," said Rep. Bill Lippert, D-Hinesburg, the chair of House Health Care. "We received the Senate's proposals on the evening of the day before adjournment."

Lippert said Wednesday H.29 would not move forward. The pay parity language is out of the bill; other parts of the bill that the House Health Care Committee supported would need to be attached to another bill if they are to become law this year, he said.

The other parts of the bill would allow Medicare patients to get certain expense discounts, such as when they pay premiums up front, and would create parity between regulatory fees that Blue Cross Blue Shield of Vermont and MVP Health Care pay.

Lippert said the committee did not have enough time to come up with amendments to the bill and would not have been able to get the bill through the House anyway because Republicans were refusing to allow Democrats to suspend procedural rules.

The Legislature often suspends procedural rules at the end of a session to get final bills to passage. Lawmakers usually suspend rules that require waiting periods before holding floor votes or waiting periods for moving bills between the House and the Senate.

A rules suspension requires the backing of two-thirds of the House. The House Republican caucus, which is slightly more than one-third of that chamber, refused to allow rules suspensions unless Democrats agree to Gov. Phil Scott's plan for statewide teacher health insurance negotiations.

"I feel like I made a strong effort to simply try to take some testimony because without testimony you can't really respond" to the Senate's proposal, Lippert said.

"We made an attempt to try to find a proposal that would satisfy our committee members, none of whom were actually prepared to concur with the Senate proposals," he said.

Going forward, Lippert said they are looking to the Green Mountain Care Board to continue a working group it has already created and bring back an analysis of pay parity issues. A first meeting is scheduled for Wednesday.

Jessica Holmes, a member of the Green Mountain Care Board, told the House Health Care Committee on May 10 that she was excited to work on the issue and said she would move forward with the working group whether or not H.29 passed.

Amy Cooper, the executive director of HealthFirst, a group for independent doctors, said the late-session effort left little time for stakeholders to tell House members about how independent doctors are struggling and why H.29 could help them.

"There wasn't time for all the parties to really educate them on the history of this issue and the complications of it," Cooper said. "I don't necessarily think it's a bad decision."

Cooper said she hopes to have action on reducing pay disparities between independent doctors and hospital-employed doctors in 2018.


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