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.”

Town: No violation on homeless shelter

After a review, town officials say Morristown did nothing wrong in denying the Patchworks Place committee’s proposal for a homeless shelter. 

On April 22, Morristown received a warning from Vermont Legal Aid — in considering a homeless shelter, keep in mind the federal Fair Housing Amendments Act. ...

The Fair Housing Act prohibits discrimination against individuals on the basis of race, color, religion, sex, national origin, familial status and disability. ...

In an interview with the News & Citizen, the attorney who sent the letter to Morristown — Marilyn Mahusky, who works with claims made to the Housing Discrimination Law Project — said that if nothing listed in the letter is allowed in the industrial zone, “denying the shelter may have been permissible. However, it still concerns me that some community members are opposed to a shelter based on who could be using it.”

During a public forum March 1, some residents made assumptions that people who are homeless or housed in shelters have issues with mental health or substance abuse, and so should not be welcomed in Morrisville. ...

“It sounded like the committee may have been pressured by the landlord to look for a different site, and that concerns me too,” Mahusky said.

Morristown zoning director Todd Thomas — who has been fighting with the state to gain control over dilapidated buildings — suggested that Mahusky was pressured by the state Agency of Commerce and Community Development to send the letter.

Mahusky denied that, saying the homeless shelter issues were brought to her attention by multiple people at the state community level who were concerned after reading things in the news and in public documents about the homeless shelter.

“No single person brought this issue to my attention,” she said. “And I basically sent the letter just to make sure that the town knows about its obligations to follow the fair housing act’s rules in siting the shelter. We were not pressured by the state, and I stand by my letter. I also forwarded my letter to some of the concerned departments.”

Medicare Rules for Home Health Care
Medicare home health coverage can be a crucial benefit for seniors who have just been discharged from the hospital or who struggle with a chronic condition and have difficulty leaving home. But taking advantage of this benefit can be a real challenge. ...

In some cases, patients’ services are cut off because their condition is not improving. But the rules have never demanded that a patient's condition improve, says Diane Omdahl, president of 65 Incorporated, a firm that helps seniors navigate Medicare. In 2011, Medicare beneficiaries filed a nationwide class action lawsuit claiming that providers were inappropriately applying an improvement standard and the 2013 settlement of that case clarified that patients should be able to get care to maintain their condition or even slow their decline.

Yet the misperception persists, says Michael Benvenuto, director of the elder-law project at Vermont Legal Aid, which represented the plaintiffs in the case.

Low-Income Advocate Chris Curtis Follows in His Father's Footsteps

On the wall of his Vermont Legal Aid office in Montpelier are two photos of his adoptive father. The late David W. Curtis — lawyer, one-term state legislator, defender general and Vermont Democratic Party chair — was widely revered as a champion of the disadvantaged. He died in 1999 at age 61 of complications from AIDS. The Vermont Democratic Party will honor him Friday night at the 17th annual David W. Curtis Leadership Awards dinner.

Chris Curtis tries to honor his father's legacy every day by carrying on his work. …

"My clients are very, very smart, very resilient. The system is often stacked up against them," Curtis said. "It's my job to help them tell their story."

Hate Crime Victim Fatuma Bulle Advocates for Refugee Women and Families

... But it's possible Muslim women wouldn't even know when they're being victimized, according to Rachel Batterson, director of Vermont Legal Aid's Housing Discrimination Law Project. "Most people don't come out to say, 'I don't want to rent to you because you're Muslim.' People are educated enough to know they're not supposed to say that, even if they're thinking it," Batterson said, noting that Muslim women who wear the head scarf, are black and have a foreign accent are among the most vulnerable.

Leahy Introduces Prescription Drug Bill in Congress

Sen. Patrick Leahy, D-Vt., is helping to shepherd a bill in the U.S. Senate that seeks to stop brand-name drug companies from stifling competition. ...

“Federal law requires generic competitors to prove that their low-cost alternative is equally safe and effective as the brand-name drug with which they wish to compete,” Leahy said in a statement.

“Unfortunately, some brand-name companies are preventing generic manufacturers from obtaining the samples they need to make the necessary comparison. ...

Leahy’s office cited several groups in Vermont that support his bill: the Vermont Area Agencies on Aging, Community of Vermont Elders, AARP Vermont, the Vermont Center for Independent Living, Vermont Legal Aid’s Office of the Health Care Advocate, and a generic drug manufacturer in St. Albans.

New laws enacted for drivers, social workers

This week, Gov. Peter Shumlin signed into law a bill that reduces the cost of pre-existing traffic fines and streamlines the path toward driver’s license restoration.

Christopher Curtis, staff attorney for Vermont Legal Aid and co-chair of the Governor’s Pathways from Poverty Council, celebrated the new law.

“This new law will give thousands of Vermonters a chance to get back on the road to economic opportunity safely, legally and affordably,” Curtis said. “The old system was a poverty trap. It traps low-income Vermonters in a spiraling cycle of ticket after ticket simply because they cannot afford to pay an initial fine. The system was broken. This law will help fix it.”

Nursing Home Firm Questioned

Vermont health care regulators fired a barrage of questions Thursday at representatives of a corporation that wants to add five nursing homes in the state to its nationwide portfolio of more than 500 facilities. ...

Jackie Majoros, director of the Long Term Care Ombudsman Project of Vermont Legal Aid, filed a last-minute letter urging the board to condition its approval of the deal on two years of follow-up reports by Genesis on staffing levels and patient care quality.

Majoros noted that the acquisitions would leave Genesis with control of 30 percent of Vermont’s nursing home beds and “a direct bearing on the lives of the more than 900 residents in its care.”

Genesis’ existing Vermont properties provide 13 to 29 minutes less than the state average of certified nursing assistant care, and residents in three of its four homes had higher than average weight loss and depressive symptoms, she wrote.

Majoros also expressed concern about what she characterized as Genesis’ “practice of denying access to individuals who have a psychosis or significant behavior issues.”

That could make it harder for patients with behavioral problems to find care and add to the burden at other nursing homes, she added.