Vermont is looking at changing how it classifies urgent care centers, with an eye toward forcing operators to file a certificate of need (CON) before starting construction projects. Right now, independent Vermont urgent care centers are viewed as physician offices, which are exempt from filing a CON. The state’s Office of the Health Care Advocate says it would be more correct to view them as “medical facilities,” which would trigger the need for them to apply for CONs, as hospitals already do. Rep. Bill Lippert, who supports the bill, claims the proposal is intended to ensure that regulators have the authority to mitigate “overbuilding” and related costs to the healthcare system. Rep. Doug Gate, an opponent of the bill, says it unfairly singles out independent walk-in clinics, which constitute a minority of urgent care centers in Vermont, compared with hospital-owned centers. The proposed bill reads, in part:

“New urgent care centers should be subject to CON review as should all facilities that offer same-day care and are not associated with Vermont hospitals or ongoing patient-practitioner relationships….For the purposes of this subchapter, ‘freestanding walk-in clinics’ are defined as medical facilities, including urgent care centers, that are not associated with a Vermont hospital or federally qualified health center, and where the primary source of revenue in Vermont comes from medical services, offered in person or remotely, which are scheduled less than 24 hours in advance and where there is not an intent to develop an ongoing care relationship between the patient and the medical practice.”

Urgent care professionals have already taken umbrage with the notion that urgent care centers do not seek to develop ongoing patient relationships. Further, while the proposal references “new centers” specifically, there is concern that it could be extended to include existing centers that would want to expand. Similarly, industry insiders say New England states tend to emulate each other, to the extent that if this rule takes hold in Vermont neighboring states could cite it as precedent to increase their regulation of urgent care centers.

New England May Be Headed Toward More Regulation of Urgent Care Industry
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