VermontVermont proposal would set hospital prices and require patient notices
The vetoed proposal would set hospital price limits, let the Board limit payments for some health plans, and require approved notices for certain Medicare patients.
What it does
The Board would set maximum prices that Vermont hospitals must accept and work toward bringing hospital prices to national median levels by 2030.
For hospital fiscal year 2027, the Board could limit payments for people in certain health plans, and insurers would have to follow any limit it sets.
Hospitals and insurers would show some prices as a share of Medicare rates, while public tools would let people compare care prices and view health system performance.
The Board would gather information about hospital outsourcing, assess its effects on care, and recommend any needed changes to provider tax rules.
Critical access hospitals would identify certain high-priced outpatient services and post an approved notice explaining Medicare patients' costs and where to ask for help.
Argument forPatients could compare prices more easily, and yearly reviews may show whether lower hospital prices also lead to lower insurance premiums.
Argument againstHospitals could receive less from some health plans, which may strain facilities that rely on those payments to support care.
More detail
The Green Mountain Care Board would set maximum prices that Vermont hospitals must accept for care. The prices would cover items and services provided by Vermont hospitals. The Board would consult insurers, hospitals, health professionals, the Health Care Advocate, and the Agency of Human Services. The Board could also set minimum payments for care delivered outside hospitals by health professionals. The Board would begin setting hospital prices as soon as practicable, no later than hospital fiscal year 2027, and review them each year.
The Board could order limits on hospital payments for certain health plans, and insurers would have to follow any limit it sets. The limits would cover care in Vermont for people enrolled in qualified health benefit plans or health plans offered to school employees by a health benefit association. The Board could issue an order for hospital fiscal year 2027; payment limits would apply only if it sets them. Hospitals could not bill patients beyond the cost-sharing allowed by their plan. If a Board budget order requires further cuts, hospitals would reduce rates above 500 percent of Medicare first, or their highest rates if none exceed that level. Any payment limit would apply for hospital fiscal year 2027.
Hospitals and insurers would show certain prices as a share of Medicare rates, and the Board would maintain public tools for comparing prices and viewing health system performance. The price displays would cover items and services identified through a process involving the Board and Vermont hospital representatives. A separate identifier would be required for each qualifying off-campus hospital department. The Board would choose a different price benchmark if it decides one is appropriate. Hospitals could use their actual Medicare payments until the Board adopts a rule for calculating Medicare rates. The health system performance tool would be developed only if the Board receives enough funding from the federal government or another source. The price display rules would apply to provider contracts entered into, changed, or renewed on or after January 1, 2028. The separate identifier would be required on claims filed after October 1, 2027.
The Board would collect information about hospital outsourcing and report its findings and recommendations to legislative committees. The information would cover clinical services that hospitals outsource to outside organizations. The Board would consult hospitals and their contracted independent providers and assess how outsourcing affects access to and the quality and availability of care. The Board and the Agency of Human Services would also report on effects on provider tax revenue and recommend any needed changes to tax rules. The information request would be for hospital fiscal year 2027. The Board would report to legislative committees by January 15, 2027.
Critical access hospitals would identify certain high-priced outpatient services and post a Board-approved notice for Medicare patients. The notice would cover outpatient services priced at five or more times Medicare's allowed amount at critical access hospitals. The notice would explain that Medicare patients pay 20 percent of the hospital's charge for outpatient care, may be able to get care elsewhere at lower out-of-pocket cost, and can contact the hospital about financial help. Hospitals would need Board approval of the notice before posting it. Hospitals would complete these steps by September 1, 2026.
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Where it stands
- Introduced
- Passed 1st Chamber
- Passed 2nd Chamber
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- May 29Senate Message: Vetoed by Governor Phil Scott June 16, 2026Latest
- May 29Governor Phil Scott vetoed bill on June 16, 2026Major
- May 29Delivered to Governor on June 10, 2026To Governor
- May 28Senate Message: House proposal of amendment concurred inMinor
- Vote recorded Roll Call, requested by Senator Collamore, Passed -- Needed 15 of 30 to Pass -- Yeas = 17, Nays = 13. Result: pass.Upper
- May 28Rules suspended & messaged to House forthwith, on motion of Senator Baruth
- May 28As passed by Senate and HouseMajor
- May 28Roll Call, requested by Senator Collamore, Passed -- Needed 15 of 30 to Pass -- Yeas = 17, Nays = 13
- May 28Roll Call, Requested by Sen. Collamore
- May 28House proposal of amendment concurred inMinor
- May 28House proposal of amendment; textMinor
- May 28House proposal of amendmentMinor
- May 27House proposal of amendmentMinor
- May 27Entered on Notice Calendar
- May 26House message: House passed bill in concurrence with proposal(s) of amendment
- May 22Rules suspended and bill messaged forthwith to the Senate as moved by Rep. McCoy of Poultney
- Vote recorded Which was agreed to on a Roll Call Passed -- Needed 66 of 131 to Pass -- Yeas = 87, Nays = 44. Result: pass.Lower
- May 22Read third time and passed in concurrence with proposal of amendmentPassed 2nd Chamber
- May 22Rules suspended and bill placed in all remaining stages of passage as moved by Rep. McCoy of Poultney
- May 22Third Reading orderedMinor
- May 22Which was agreed to on a Roll Call Passed -- Needed 66 of 131 to Pass -- Yeas = 87, Nays = 44
- May 22Report of Committee on Health Care, as amended, agreed to
- May 22Rep. McCoy of Poultney demanded yeas and nays
- May 22Report of Committee on Health Care amended as recommended by Committee on Appropriations
- May 22Rep. Dickinson of St. Albans Town recommended for the Committee on Appropriations
- May 22Rep. Holcombe of Norwich recommended for the Committee on Ways and Means
- May 22Rep. Black of Essex reported for the Committee on Health Care
- May 22Read second timeMinor
- May 22Rules suspended and taken up for immediate consideration as moved by Rep. McCoy of Poultney
- May 22Notice Calendar: Favorable with Amendment
- May 19Pending entry on Notice Calendar, referred to Committee on Appropriations per Rule 35(a)
- May 12Referred to Committee on Ways and Means per Rule 35(a)
- May 12Notice Calendar: Favorable with Amendment
- Apr 2Read first time and referred to the Committee on Health CareMinor
- Mar 31Read 3rd time & passed on roll call, requested by Senator Weeks, Passed -- Needed 15 of 29 to Pass -- Yeas = 23, Nays = 6Passed 1st Chamber
- Vote recorded Read 3rd time & passed on roll call, requested by Senator Weeks, Passed -- Needed 15 of 29 to Pass -- Yeas = 23, Nays = 6. Result: pass.Upper
- Mar 31Roll Call, Requested by Sen. Weeks
- Mar 31Pending third reading, bill amended as moved by Senator(s) HardyMinor
- Mar 31New Business/Third ReadingMinor
- Mar 27Title amended as recommended by Committee on Health and Welfare
- Mar 273rd reading ordered
- Mar 27Recommendation of amendment by Committee on Health and Welfare, as amended, agreed to
- Mar 27Recommendation of amendment by Committee on Health and Welfare amended as moved by Senator Lyons, Benson, Cummings, and Morley
- Mar 27Recommendation of amendment by Committee on Health and Welfare amended as recommended by Committee on Appropriations
- Mar 27Reported favorably by Senator Lyons for Committee on Appropriations with recommendation of amendmentMinor
- Mar 27Read 2nd time, reported favorably with recommendation of amendment by Senator Lyons for Committee on Health and WelfareMinor
- Mar 27Recommendation of amendment to be offered by Senator(s) Lyons
- Mar 27Favorable report with recommendation of amendment by Committee on AppropriationsMinor
- Mar 27Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 27Unfinished Business/Second ReadingMinor
- Mar 26Recommendation of amendment to be offered by Senator(s) Lyons
- Mar 26Favorable report with recommendation of amendment by Committee on AppropriationsMinor
- Mar 26Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 26Unfinished Business/Second ReadingMinor
- Mar 25Recommendation of amendment to be offered by Senator(s) Lyons
- Mar 25Favorable report with recommendation of amendment by Committee on AppropriationsMinor
- Mar 25Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 25Second ReadingMinor
- Mar 24Recommendation of amendment to be offered by Senator(s) Lyons
- Mar 24Favorable report with recommendation of amendment by Committee on AppropriationsMinor
- Mar 24Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 24Second ReadingMinor
- Mar 24Entered on Notice Calendar
- Mar 17Referred to Committee on Appropriations per Senate Rule 31
- Mar 17Favorable report with recommendation of amendment by Committee on Health and WelfareMinor
- Mar 17Second ReadingMinor
- Mar 17Entered on Notice Calendar
- Jan 6Read 1st time & referred to Committee on Health and WelfareIntroduced
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