Bill S.197 seeks to reform primary care in Vermont by establishing a universal primary care program that is accessible and affordable for all residents. The bill aims to enhance patient care experiences, improve population health, reduce healthcare costs, and support the well-being of healthcare providers. Key components include developing a framework for universal primary care, optimizing the existing Blueprint for Health, and exploring alternative healthcare approaches. It also requires health insurers to participate in the Blueprint for Health and mandates reporting on primary care spending, including establishing spending targets and transitioning funding mechanisms.

Significant amendments in the bill include changes to the definitions of health insurance plans and insurers, as well as the introduction of new payment models for primary care practices. The bill amends 8 V.S.A. § 4092(i) to improve communication between health insurers and covered individuals regarding pharmaceutical coverage. It mandates annual notifications of changes to pharmaceutical coverage and requires insurers to inform individuals at least 60 days prior to the removal of a drug from the formulary. This provision aims to enhance transparency and ensure individuals are adequately informed about their prescription drug coverage, allowing for better healthcare decision-making. The bill will take effect upon passage.

Statutes affected:
As Passed By the Senate -- Official: 18-13, 8-4092(i), 8-4092
As Passed By the Senate -- Unofficial: 18-13, 8-4092(i), 8-4092
As Passed by Both House and Senate -- Official: 18-13, 8-4092(i), 8-4092
As Passed by Both House and Senate -- Unofficial: 18-13, 8-4092(i), 8-4092