Health Care Board: Walk-in Care Clinics Don't Need State Approval

Apr 29, 2014

The Green Mountain Care Board ruled Tuesday that a New Hampshire-based group of emergency room doctors does not have to get state permission to open walk-in health care centers in five Vermont cities and towns.

The group, called ClearChoiceMD, said it expects the urgent care centers to supplement the care now offered by hospital emergency departments. They said their facilities would relieve the pressure on overcrowded hospital E.R.s, and would be less costly. The centers would be located in Brattleboro, Burlington, St. Albans, Barre and Rutland.

Under Vermont state law, health care providers who deliver more complex care than that normally offered in doctors’ offices have to get state approval, called a Certificate of Need. The proposal by ClearChoice does not trigger the CON requirement, the board ruled.

In the past, the issue of urgent care centers has roiled the Vermont system because they were seen as financial competitors for local hospital emergency rooms. The most striking case arose in 2000 when Health South of Birmingham, Alabama, applied to open a walk in center in Burlington.

Fletcher Allen Health Care, Vermont’s only teaching hospital and the state’s largest provider, opposed the granting of a CON for the Health South proposal. The state rejected the CON request after a two-year campaign. The fear in that case was that the centers would be used for surgical procedures that would pose a threat to Fletcher Allen’s services.

Northwest Medical Center in St. Albans and Central Vermont Medical Center Hospital in Berlin have indicated they oppose the new walk-in centers for competitive reasons.

The GMC board ruled, however, that the services listed by ClearChoice extended no further than routine office care, including stitching of superficial wounds and other types of primary care. “No fixed or mobile CT, MRI or PET/CT services” would be available, the board said in its letter.