Vermont S. 190, if passed as written, would fundamentally restructure emergency medicine, anesthesia, radiology, and other hospital-based specialties by eliminating the ability of independent, physician-led clinical groups to operate. 

This is not a narrow billing reform. S. 190 transfers control of ED professional billing, revenue, and rate setting from physicians to hospitals and state regulators. 

If enacted, S. 190 would: 

• Remove the ability of outsourced clinical clinicians to bill and submit claims independently under their own tax ID number.
• Transfer full control of professional billing, collections, and payer interactions to hospitals.
• Fold revenue from outsourced clinical services into hospital global budget, rate caps, and state assessments. 
• Force independent, hospital-based clinical groups to restructure, sell, or dissolve. 

For emergency and specialty physicians, this means loss of autonomy, permanent downward pressure on compensation, and hospital-controlled emergency medicine.

S. 190 is effectively designed to end physician-led care in Vermont.

Lawmakers must hear directly from the clinicians and healthcare professionals who understand what this means for emergency medicine, workforce stability, and patient access to care.

Take action today and contact your state legislators.