Vermont Home Health Care Monopoly Expected to Continue

TLC Nursing Associates, a nonmedical home care provider headquartered in Burlington, Vermont, is firmly entrenched in a catch-22 situation that bars it from providing home health care, stemming from an inability to obtain a license to do so, reports the Burlington Free Press.

The state of Vermont has stopped issuing licenses for new home health care providers, and the company can’t get Medicare certification to provide those services in surrounding states because it must first obtain certification in the state in which the business is headquartered—impossible, with the moratorium that’s expected to get extended. 

“TLC would like to provide home health care services, but it can’t because of a moratorium on applying for the certificate of need it must have from the state before offering such services. That moratorium, which expires in June, is almost certain now to be extended through 2017,” The Free Press Writes. “The state Senate has approved the extension, and the House Committee on Health Care signed off on it last week, sending it to the floor for a vote. Mohamed Basha, owner of TLC, and several of his key staff made the trip to Montpelier last week to argue against extending the moratorium, testifying in a small meeting room on the third floor of the Capitol building.”


In neighboring New Hampshire, where no CON requirements make for a more open market, there are 99 home health care providers for the state’s approximately 1 million residents, according to the manager of the Bureau of Licensing and Certification in the Department of Health and Human Services. 

Only about a third have Medicare or Medicaid certification, though, while the remaining 67 are private pay, says the article. 

“If I’m residing in Vermont and I need home health care and I’m told there are just these two companies, that’s a monopoly, that’s not giving me choice,” Rod Gagne, a licensing and evaluation coordinated for the state DHS, said to the Burlington Free Press. “What if I don’t like that service? I can’t choose somebody else. I’m sorry, it just doesn’t make any sense from a consumer’s perspective.”


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Written by Alyssa Gerace