Lawrence Miller

Recent Posts

Blue Cross Blue Shield: Vermont Health Connect owes $6.2 million

MONTPELIER — Blue Cross Blue Shield of Vermont is seeking $6.2 million from the state for premiums the insurer did not receive and claims it paid out after the state had terminated individual insurance plans, according to the company and state officials. BCBS and the state are engaged in a reconciliation process to settle the books for health insurance plans sold on Vermont Health Connect, the state’s online health insurance exchange, during 2015. It is the second year that reconciliation is taking place. The state paid $1.6 million to settle the book of business in 2014. A public records request made by the Vermont Press Bureau seeking documents related to the 2015 reconciliation process was returned by the Department of Vermont Health Access, but all 125 pages had all relevant information related to the request redacted. Continue Reading →

Filed under: , , , , , ,

House votes to fund review of exchange

MONTPELIER — The Vermont House overwhelmingly voted to fund an independent review of Vermont Health Connect Wednesday, appeasing minority Republicans who have been clamoring for an in depth study to help determine the future of the online insurance marketplace. By a vote of 136 to 5, the House approved an amendment to an unrelated housing bill that appropriates $400,000 for the review. The House Appropriations Committee included language in the 2017 fiscal year state budget it has already passed calling for the study, but did not include funding — angering some Republicans. House Appropriations Committee Chairwoman Mitzi Johnson, D-South Hero, and House Health Care Committee Chairman Bill Lippert, D-Hinesburg, promised to find the funding. Johnson told her colleagues Wednesday that the promise was kept. Continue Reading →

Filed under: , , , , , , ,

Blue Cross seeks millions from Vermont Health Connect

MONTPELIER — Blue Cross Blue Shield of Vermont believes it is owed more than $5 million from Vermont Health Connect for unpaid insurance premiums and claims paid on plans that were terminated by the state in 2015. The insurance carrier is going through a reconciliation process with the state for the second straight year to settle its books for plans it sold through the state’s online health insurance marketplace. For plans sold in 2014, the state paid BCBS $1.6 million after the reconciliation process was complete. BCBS told state officials last month that it believes as much as $3.8 million is owed for unpaid premiums in 2015. Additionally, another $2.3 million is owed on claims it paid out for plans that were terminated by the state but not communicated to the company, according to Cory Gustafson, director of government and public relations at BCBS. Continue Reading →

Filed under: , , , , , ,

Shumlin administration to revise, rebid major AHS tech projects

MONTPELIER — The Shumlin administration is planning to scuttle existing plans for major technology upgrades slated for the Agency of Human Services and begin the process anew using solutions developed in other states. Administration officials say contract negotiations for work on Integrated Eligibility and some major work on the Medicaid Managed Information System Core are being stopped and revised requests for proposals will be issued. The decision came from AHS Secretary Hal Cohen and is supported by the governor’s office and the federal Centers for Medicare and Medicaid Services, according to Secretary of Administration Justin Johnson. “Since we released the Medicaid Management Information System (MMIS Core) and the Integrated Eligibility Solution (IE) RFP’s, the approach to these solutions has evolved significantly allowing us to be more strategic in building solutions that meet the needs of Vermonters, providers and staff,” Cohen wrote in an email to staff Wednesday afternoon announcing the decision. “This is our opportunity to reset. Continue Reading →

Filed under: , , , , ,

Exchange Backlog Returns Due To New Technical Problems

ast October, Gov. Peter Shumlin said his administration had finally eliminated the customer-service bottleneck that had long plagued Vermont Health Connect. The change-of-circumstance backlog has since returned, however, and the setback has further eroded confidence in the future of the online insurance exchange. On Oct. 1 of last year, Gov. Peter Shumlin summoned reporters to the Statehouse to celebrate a Vermont Health Connect milestone. Shumlin said his team had finally worked through the backlog of people waiting to have changes made to their policies. Continue Reading →

Filed under: , , , , , ,

Effort to bypass exchange for small business continues

MONTPELIER — The Shumlin administration and lawmakers are moving forward with efforts to scrap plans for the small business function on the state’s online health insurance marketplace. Under state law, small businesses are supposed to be enrolling employees through Vermont Health Connect, the state-based insurance exchange created under the federal Affordable Care Act. But the website, which launched in October 2013, has never included that online function, known as Small Business Health Options Program, or SHOP. As a result, small businesses have enrolled employees directly through the two insurance carriers offering health plans on the exchange — Blue Cross Blue Shield of Vermont and MVP Health Care. Rep. William Lippert, D-Hinesburg, the chairman of the House Health Care Committee, has introduced a bill to allow the state to seek a so-called 1332 waiver to allow small businesses to continue enrollment directly through the carriers. Continue Reading →

Filed under: , , , , , , ,

Outside Audit Finds Vermont Health Connect Out Of Federal Compliance

he first independent, external audit of Vermont Health Connect has arrived, and Virginia-based auditing firm says the state is out of compliance with federal regulations for state health insurance exchanges. There’s a term of art in accounting called a “adverse opinion.” It means an institution isn’t in compliance with generally accepted accounting principles, or that documents needed to prove compliance are either missing or inaccurate. (more…) Continue Reading →

Filed under: , , , , , , ,

Two years late: Is Vermont Health Connect Finally Ready?

MONTPELIER — Gov. Peter Shumlin had not even decided to run for the state’s top office when the federal Affordable Care Act was signed into law in March 2010, but the landmark legislation would soon begin to shape his governorship in ways he could not have imagined. Shumlin, who was sworn into office in January 2011, began his tenure as the state’s chief executive with a trademark swagger. Now as he approaches the end, having announced in June that he will not seek a fourth term, he is hoping to leave in place a working exchange that he has championed, but which has struggled for two years and one month to meet Vermonters’ expectations. The governor held a news conference Thursday to announce that the site should finally work today, Nov. 1, as the open enrollment period for 2016 health care plans begins. Continue Reading →

Filed under: , , , , , , ,

Shumlin administration expects ‘smooth sailing’ for open enrollment

MONTPELIER — A state official overseeing Vermont Health Connect said he expects mostly “smooth sailing” when Vermonters begin renewing health care plans on a newly automated system Nov. 1. Chief of Health Care Reform Lawrence Miller informed lawmakers in a memo sent Monday that the state’s online health insurance marketplace is primed to begin automated policy renewals during the open enrollment period that begins on Sunday and ends Jan. 31. The memo is part of a monthly report to lawmakers about progress on the exchange. Continue Reading →

Filed under: , , , , , , ,

Shumlin administration set to deploy new exchange function

MONTPELIER — State officials maintained cautious optimism throughout the summer that an automated enrollment process will be added to Vermont Health Connect by Thursday’s self-imposed deadline and are preparing to deploy it this weekend. Lawrence Miller, Gov. Peter Shumlin’s chief of health care reform, said officials expect the online health insurance marketplace to be taken offline Thursday night to allow the function to be deployed. The site is expected to remain offline through the weekend. Miller said the function has been in vigorous testing over the last several weeks and is on track to be deployed. The state’s contractor, Optum, has been testing code to ensure that it works for users when open enrollment begins on Nov. Continue Reading →

Filed under: , , , , , , ,