Vermont H 719: An act relating to hospital collaboration and state action immunity

Bill Text

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VT LEG #386114 v.1
H.719 1
Introduced by Representatives Canfield of Fair Haven, Bosch of Clarendon, 2
Casey of Hubbardton, Harvey of Castleton, Howard of Rutland 3
City, Howland of Rutland Town, Keyser of Rutland City, Labor 4
of Morgan, Maguire of Rutland City, Malay of Pittsford, 5
McCoy of Poultney, Morgan, M. of Milton, Morrissey of 6
Bennington, Pinsonault of Dorset, Pritchard of Pawlet, and 7
Taylor of Mendon 8
Referred to Committee on 9
Date: 10
Subject: Health; health care reform; hospitals; health systems; Agency of 11
Human Services; antitrust; state action immunity 12
Statement of purpose of bill as introduced: This bill proposes to allow 13
hospitals and health systems to collaborate on efforts that align with or further 14
Vermont’s health policy goals and to provide for sufficient State supervision of 15
the collaborations to qualify for state action immunity under federal and State 16
antitrust law. 17
An act relating to hospital collaboration and state action immunity 18

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VT LEG #386114 v.1
It is hereby enacted by the General Assembly of the State of Vermont: 1
Sec. 1. 18 V.S.A. § 9405d is added to read: 2
§ 9405d. HOSPITAL COLLABORATION; STATE ACTION IMMUNITY 3
(a) Intent. It is the intent of the General Assembly that hospital and health 4
system collaboration efforts that meet the requirements of this section be 5
afforded state action immunity under applicable federal and State laws. This 6
immunity is in addition to the hospital cost containment conduct afforded state 7
action immunity under subdivision 9456(d)(2) of this title. 8
(b) Qualifying conduct. Conduct undertaken by rural hospitals, community 9
hospitals, and health systems, or a combination of them, for the purposes of 10
cost containment, improved access to care, quality improvement, preservation 11
of rural or community hospitals, advancement of the State Health Care 12
Delivery Strategic Plan, once established, or enhancement of any existing 13
health care initiative in a manner that is consistent with the principles 14
expressed in section 9371 of this title shall be afforded state action immunity 15
from criminal and civil litigation under applicable federal and State antitrust 16
laws if the conduct meets all of the following conditions: 17
(1) the Secretary of Human Services authorizes the parties to explore 18
opportunities to collaborate to achieve one or more of the purposes set forth in 19
this subsection; 20

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VT LEG #386114 v.1
(2) the Secretary of Human Services deems any initiatives proposed by 1
the collaborating parties as a result of their authorized collaboration to be 2
consistent with the State’s health policy goals; 3
(3) the Secretary of Human Services approves each initiative proposed 4
by the parties prior to its implementation; and 5
(4) the Agency of Human Services actively supervises the parties’ 6
conduct throughout the collaboration and implementation of the approved 7
initiatives, as set forth in subsection (d) of this section. 8
(c) Information sharing. Hospitals and health systems participating in 9
discussions and collaborations approved under this section may share cost, 10
utilization, workforce, and quality data as necessary to achieve the purposes of 11
the collaboration. This information sharing shall not be deemed a violation of 12
federal or State antitrust law. 13
(d) Process for approval; State supervision. 14
(1) A hospital seeking to collaborate with another hospital or a health 15
system in a manner that the hospital determines may violate State or federal 16
antitrust law shall seek approval from the Secretary of Human Services prior to 17
engaging in such collaboration. Separate approval shall be required for the 18
parties to discuss and explore opportunities to work together to further the 19
State’s health policy goals, using the process set forth in subdivision (2) of this 20
subsection, and for implementation of any initiatives developed pursuant to 21

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VT LEG #386114 v.1
these discussions, using the process set forth in subdivision (3) of this 1
subsection. 2
(2)(A) A hospital interested in exploring potential collaboration with 3
one or more hospitals or health systems shall submit an application to the 4
Secretary of Human Services describing the proposed collaboration and 5
specifying the manner in which the proposed activity would further Vermont’s 6
health policy goals and achieve one or more of the purposes set forth in 7
subsection (b) of this section. 8
(B)(i) The Secretary shall review the proposed collaboration and may 9
request additional information from the applicant or request an informal 10
hearing, or both. 11
(ii) Within 30 days following receipt of the proposal, the Secretary 12
shall approve, approve with conditions, or reject the proposed collaboration. 13
Approval or approval with