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.
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.
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.
No hearings or votes scheduled.