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Lawmakers send to Gov. Scott bill to curb insurance companies’ influence on health care

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Lawmakers send to Gov. Scott bill to curb insurance companies’ influence on health care


Vermont legislators passed a bill to streamline insurance requirements for health care and are urging Gov. Phil Scott to sign the bill into law.

The bill, H.766, will reduce administrative delays and remove barriers to care for Vermont patients, according to proponents. The University of Vermont Health Care Network, the state’s largest health care provider, has been pushing for the bill’s passage.

“We have reached a point where insurance companies can tell us what we can and can’t do, even in life-threatening emergencies, and the victims are always patients,” Dr. Katie Marvin, a family physician at Lamoille Health Partners, said in a statement.

Marvin took particular aim at the insurance company practice of requiring prior authorization for drugs and procedures, putting clinicians in the position of having to ask permission from insurance companies before a patient can receive services.

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“(Prior authorizations) lead to delays in care, lapses in medications and apathy in providers,” Marvin said. “This bill may change this, which is why I have supported H.766 through the legislative process and spoke to the Governor about it last week.”

Pediatrician: Insurance practices leading to a crisis for kids with asthma

The House passed the bill unanimously on March 13, while the Senate voted 25-2 in favor of the bill on April 26. The Senate added an amendment, approved by the House, which requires insurance companies to give patients access to at least one type of available asthma inhaler without prior authorization.

“Insurance practices are leading to a crisis in caring for kids with asthma right now,” Dr. Kristen Connolly, a pediatrician, said in a statement. “We have had to order multiple types of inhalers to supplement for the one type of inhaler patients actually need. We have heard of rationing and increases in ER visits. This is our health system now − here in Vermont. We can do better.”

More: Vermont health care providers blame prior authorization for compromising patient care

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The bill also ends a process where insurance companies could request patient records before paying for health care services that had been delivered.

“The increase in administrative burden required increasing our staffing to process the claims,” Dr. Julie Lin, an independent dermatologist in St. Albans, said in a statement. “There were also times that this policy meant we asked patients if they were willing to come back on two different days for certain services we could have delivered in one appointment so we could get timely payment by the insurance company. This added delays in care and inconvenience for patients. We know how long patients are waiting for dermatology services and this only made it worse.”

Legislators don’t buy insurance companies’ argument that costs will increase due to the bill

Rep. Alyssa Black, D-Essex, rejected the argument insurance companies have been making against the bill that it will drive up costs.

“Payers claim H.766 will lead to increased costs, but prior authorizations are almost always approved, serving only to delay care, and can drive up costs through incentivizing people to go to emergency departments when care is not approved, which is the most expensive location,” Black said in a statement. “Primary care spends less, orders fewer tests, fewer unnecessary labs, and provides the most economic, best bang for your buck.”

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Sen. Ginny Lyons, D-Chittenden Southeast, said the bill is a first step in decreasing the administrative burdens on practitioners.

“We all benefit when health care providers can get back to caring for patients, not paperwork,” Lyons said in a statement.

Contact Dan D’Ambrosio at 660-1841 or ddambrosi@gannett.com. Follow him on X @DanDambrosioVT.



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Vermont

Former Vermont Teddy Bear Clothing Companies Are Leaving Vermont

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Former Vermont Teddy Bear Clothing Companies Are Leaving Vermont


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  • Anne Wallace Allen ©️ Seven Days
  • Vermont Teddy Bear headquarters in Shelburne

The owner of the three clothing companies once owned by Vermont Teddy Bear is closing its Shelburne distribution center, putting 29 people out of work by June 5. But the stuffed-toy maker is staying put at its Shelburne location, officials emphasized Wednesday.

“We’re still here,” Katie Langrock, senior vice president of operations for Vermont Teddy Bear, said in an interview Wednesday. “You can continue to have the tours and make the bears.”  The complex, which is where most of the bears are manufactured, is a popular tourist destination and features a “hospital” where visitors can watch the bears being repaired.

Langrock said her job is to separate the companies after Vermont Teddy Bear’s stuffed animal operation was purchased by USA Brands of Indianapolis, Ind., the owner of Vermont Flannel.

Vermont Teddy Bear was created in 1981 when creator John Sortino started selling his hand-made bears from a cart on Church Street in Burlington. The pricey bears and other stuffed animals are still made mostly in Vermont and are guaranteed for life.

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Vermont Teddy Bear’s owner, the New York City-based Lionel Capital, sold the company April 4 to Ohio-based USA Brands. An affiliate of Lionel Capital , PJ Acquisitions, now owns the three clothing companies, called Pajamagram, Pajamajeans and The 1 For U.  Those clothes are made overseas and are distributed from a large warehouse next to Vermont Teddy Bear’s complex on Shelburne Road, Langrock said.

PJ Acquisitions said last week that it was unable to reach agreement on terms for a new lease at that warehouse, and announced the impending layoffs to the Vermont Department of Labor. It’s moving the distribution functions out of state, Langrock said.

Vermont Flannel Has a New Operator
A worker sewing clothing at Vermont Flannel

Vermont Flannel Has a New Operator

By Anne Wallace Allen

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Vermont Teddy Bear described the move in a letter last week to Matthew Lawless, the Shelburne town manager, saying the lease negotiations prevented PJ Acquisitions from giving employees more notice. The layoffs are scheduled to happen between Thursday and June 5, the company said.

Lawless said he had been working closely with the Vermont Department of Labor, which will provide job training and other services to the affected workers.

“Twenty-nine jobs is no small number for us here in this community,” Lawless said Wednesday. “I want to be the best neighbor I can in helping displaced workers. I made sure everyone was aware of the Shelburne food pantry, which has bus passes and lots of other good things.”

Lawless said he thinks the owner of the warehouse will find another tenant quickly.

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“There aren’t a lot of buildings like this in the Shelburne or the Burlington region,” he said.

Vermont Flannel and Vermont Teddy Bear employ 70 people in Vermont, CEO Joe Van Deman said in April. Deman’s company, USA Brands, bought Vermont Flannel from its Vermont owners in 2022. Van Deman said Vermont Flannel has six stores in Vermont and two in Maine, and plans to open another in Waterbury this month.

He and Matt Bigelow, the Ohio-based CEO of Vermont Teddy Bear, have been busy dispelling concerns about the future of the teddy bear maker. Bigelow noted Vermont Teddy Bear held a well-attended event on April 8, the day of the solar eclipse.

“With the success of the eclipse event, we’ll probably be looking at the possibility of doing more events and getting more people to campus,,” Bigelow said.



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Vermont secures waiver to participate in summer food assistance program

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Vermont secures waiver to participate in summer food assistance program


The state has secured a waiver allowing Vermont to participate in a new federal program that provides low-income families with extra money to spend on food over the summer.

Vermont almost didn’t participate in the U.S. Department of Agriculture’s “Summer EBT” program. Gov. Phil Scott’s administration initially opted out, saying they couldn’t afford the administrative upgrades needed to manage it. But officials later decided to try for a waiver, and this week received word that they had gotten it.

The Republican governor said during his weekly press conference Wednesday that he let out a sigh of relief when the state was notified yesterday that Vermont had been granted the flexibility it needed.

“I’m just thrilled that we were able to get through the bureaucratic nightmare that the feds had created and was going to prevent us from taking advantage of this program to help families and kids in Vermont,” he said.

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Eligible families will receive $120 per child to use through an EBT card — a debit card that can be used at qualified retailers, including grocery stores and farmer’s markets. The state estimates that 45,000 children could participate.

That benefit is dwarfed by the kind of cash assistance that families received during the pandemic. But Anore Horton, the executive director of Hunger Free Vermont, said it will still make a difference.

“We have so many families in Vermont who are working hard to take care of their kids. And every dollar is actually a huge deal for a lot of families right now,” she said.

Some families will be enrolled based on existing benefits, and will see the extra cash automatically added to their EBT card. The state will open an application portal in August for families who qualify based on their income but aren’t enrolled automatically. More information is available at summerebt.vermont.gov.

Have questions, comments or tips? Send us a message.

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Report reveals new details about crash involving Vermont trooper

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Report reveals new details about crash involving Vermont trooper


WATERBURY, Vt. (WCAX) – The Vermont state trooper who crashed into a fire truck was traveling between 79 and 86 mph at the point of impact– that’s according to a crash report obtained by WCAX News.

The report, conducted by state police, shows the cruiser driven by Cpl. Eric Vitali was going 88 mph just prior to crashing into a firetruck on March 8 on Interstate 89 in Bethel. Data from the vehicle shows brakes and steering were used, indicating that it’s unlikely Vitali lost consciousness prior to the crash.

Vitali’s state-issued cellphone and other devices showed no user activity leading up to the crash.

A warrant was issued to Verizon to track possible activity on Vitali’s personal cellphone.

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The crash report concluded that Vitali failed to see and react to the fire truck, despite emergency lights being activated and road flares behind the truck. Why Vitali didn’t avoid the truck remains under investigation.

State police say the roadway was dry at the time of the incident.

Vitali was on his way to a first-aid training at Waterbury’s state police headquarters when he crashed into the back of a Bethel Volunteer Fire Department tanker truck that was responding to another crash just north of the Bethel exit.

Vitali, a 19-year veteran of the state police, suffered a severe traumatic brain injury in the crash. He was airlifted to the Dartmouth-Hitchcock Medical Center in critical condition. He was the only person injured in the incident.

The Vermont Troopers’ Association– on behalf of Vitali’s family– says he has been moved to a rehab facility where he’s undergoing extensive cognitive and physical therapy.

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