H 411: An act relating to extending COVID-19 health care regulatory flexibility - Vermont

As Enacted → As Passed by Both House and Senate (Official) · 10 edits

MAJOR

This bill extends the expiration date of nearly all COVID-19 related health care regulatory flexibilities in Vermont by one year, from March 31, 2023 to March 31, 2024 (and April 1, 2023 to April 1, 2024 where applicable). The affected provisions cover hospital and facility licensing waivers, Green Mountain Care Board regulatory flexibility, provider enrollment and credentialing relaxations, emergency insurance rulemaking authority, buprenorphine prescription renewals without office visits, out-of-state professional licensure, telehealth requirement waivers, temporary physician licenses, and advance directive remote witnessing. Notably, the pharmacist authority to order and administer SARS-CoV tests was NOT extended and remains set to expire on March 31, 2023.

Scope change

The bill's scope remains the same - it continues to apply to health care regulatory flexibilities during and after the COVID-19 pandemic in Vermont. The only change is the temporal scope: all flexibility provisions are extended by one year. The pharmacist testing authority sunset was deliberately left unchanged at March 31, 2023.

TIMELINE

Secretary of Human Services authority to waive or permit variances from state rules governing health care and human service providers extended from March 31, 2023 to March 31, 2024.

Green Mountain Care Board authority to waive hospital budget review, certificates of need, health insurance rate review, and accountable care organization certification requirements extended from March 31, 2023 to March 31, 2024.

Relaxed provider enrollment requirements for Medicaid and relaxed credentialing requirements for health insurers extended from March 31, 2023 to March 31, 2024.

Department of Financial Regulation emergency rulemaking authority to expand COVID-19 insurance coverage and modify prescription drug deductibles extended from April 1, 2023 to March 31, 2024, with rules remaining in effect until April 1, 2024.

Authority for health care professionals to renew buprenorphine prescriptions without requiring an office visit extended from March 31, 2023 to March 31, 2024.

Deemed licensure for out-of-state health care professionals providing services in Vermont (as Medical Reserve Corps volunteers or facility staff) extended from March 31, 2023 to March 31, 2024.

Waiver of telehealth requirements including HIPAA-compliant connection mandates and patient representation requirements extended from March 31, 2023 to March 31, 2024.

Board of Medical Practice authority to issue temporary licenses to out-of-state physicians, physician assistants, and podiatrists extended from March 31, 2023 to March 31, 2024, with practice authorization through April 1, 2024.

Board of Medical Practice authority to waive physician assistant scope of practice and supervision documentation requirements extended from March 31, 2023 to March 31, 2024.

Validity period for advance directives executed with remote witnesses or remote explainers in nursing homes, residential care facilities, or hospitals extended from March 31, 2023 to March 31, 2024.

As Passed by Both House and Senate (Official) → As Passed by Both House and Senate (Unofficial) · 2 edits

MINOR

This diff compares the official and unofficial versions of Vermont H.411 (2023), which extends COVID-19 health care regulatory flexibility provisions through March 31, 2024. There are no substantive policy changes between the two versions. The differences are limited to formatting: the header style, page count (15 vs 14 pages), and the removal of introductory metadata (date, subject line, and statement of purpose) that appears only in the official version.

TECHNICAL

The official version includes a 'Date:' field, a 'Subject:' field, and a multi-line 'Statement of purpose of bill as introduced' paragraph. These are omitted in the unofficial version.

The header changed from 'BILL AS PASSED BY THE HOUSE AND SENATE' to 'AS PASSED BY HOUSE AND SENATE', and page count changed from 15 to 14 pages due to formatting differences.

As Passed By the House (Official) → As Enacted · 1 edit

MINOR

This diff reflects only a formatting transition from the House-passage version to the final enacted version of Vermont H.411 (2023). No substantive policy changes were made between the two versions. The bill extends multiple COVID-19 health care regulatory flexibilities through March 31, 2024, including compliance waivers for health care facilities, telehealth requirement relaxations, out-of-state professional licensure provisions, and buprenorphine prescription renewals.

TECHNICAL

The bill was reformatted from the House passage layout (with line numbers, page headers reading 'BILL AS PASSED BY THE HOUSE', and a statement of purpose paragraph) to the standard enacted legislative format (numbered as No. 4, with VT LEG tracking numbers and no statement of purpose). All substantive policy language, dates, and provisions remain identical between the two versions.

As Passed By the House (Unofficial) → As Passed By the House (Official) · 3 edits · Mar 24, 2023

MINOR

This diff represents the transition from the unofficial to the official version of Vermont House Bill 411, which extends COVID-19 health care regulatory flexibility provisions through March 31, 2024. No substantive policy changes were made between versions; all differences are formatting and presentation only.

TECHNICAL

Header changed from 'AS PASSED BY HOUSE' to 'BILL AS PASSED BY THE HOUSE' and page count updated from 14 to 15 pages.

Official version adds line numbers throughout the text and includes a statement of purpose section at the top summarizing the bill's intent.

The unofficial version's footer markings ('VT LEG #368222 v.1') were removed in the official version.

As Introduced → As Passed By the House (Unofficial) · 2 edits · Mar 24, 2023

MINOR

H.411 passed the Vermont House without substantive amendments. The only changes between the As Introduced and As Passed By the House versions are procedural: the header was updated to reflect the new status, the statement of purpose section was removed (standard when a bill advances), and the page count dropped from 15 to 14 due to formatting. All policy provisions remain identical.

TECHNICAL

The 'Statement of purpose of bill as introduced' section was removed, which is standard practice when a bill moves past the introduction stage.

Header changed from 'BILL AS INTRODUCED' to 'AS PASSED BY HOUSE' and the internal tracking number changed from VT LEG #367187 v.4 to VT LEG #368222 v.1, reflecting the new legislative status.

An act relating to extending COVID-19 health care regulatory flexibility

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