The bill H.611 proposes significant amendments to the laws governing the Department of Vermont Health Access, with a focus on enhancing prescription drug cost transparency, expanding Medicaid eligibility, and ensuring health insurance coverage for HIV prevention drugs. Key provisions include the definition of "health insurer" and the requirement for health insurers and the Department to annually compile and publicly disclose lists of prescription drugs that have experienced substantial price increases. Furthermore, the bill empowers the Office of the Attorney General to demand justifications from drug manufacturers for these price hikes.

In addition to these transparency measures, the bill raises the limit on prepaid burial arrangements for Medicaid eligibility from $10,000 to $15,000, pending federal approval. It also establishes a timeline for the Department to seek a state plan amendment to include doula services under Medicaid. Importantly, the bill mandates that, starting August 22, 2023, coverage for preventive services, including HIV prevention drugs, must be provided without cost-sharing requirements across Medicaid and other state-administered public health care programs, with certain exceptions. Coverage must include at least one FDA-approved drug in each category of pre-exposure and post-exposure prophylaxis, and cannot be denied based on the prescribing health care professional's type, provided they are acting within their authorized scope of practice.

Statutes affected:
As Introduced: 18-4635, 33-402, 33-1813, 33-2031
As Passed By the House -- Official: 18-4635, 33-402, 33-1813, 33-2031, 18-4682, 33-2072
As Passed By the House -- Unofficial: 18-4635, 18-4682, 33-402, 33-1813, 33-2031, 33-2072
As Passed by Both House and Senate -- Official: 18-4635, 33-402, 33-1813, 33-2031, 18-4682, 33-2072, 8-4077
As Passed by Both House and Senate -- Unofficial: 18-4635, 18-4682, 33-402, 33-1813, 33-2031, 33-2072, 8-4077