Lawmakers, insurer and Green Mountain Care Board debate H.266 cap on hospital drug payments

Lawmakers at a Vermont legislative committee hearing on H.266 heard testimony about a proposed 120% cap on hospital payments for certain drugs and related reporting requirements that supporters say would increase price transparency and could lower health-care costs.

Catherine O'Neil, director of prescription drug pricing at the Green Mountain Care Board, told the committee the board does not currently regulate prescription drug costs and said the board supports greater transparency. "Currently, the Green Mountain Care Board does not regulate prescription drug costs," O'Neil said. She described new budget guidance requiring hospitals to report more detail on revenue and expenses tied to the 340B program and specialty pharmacy lines, and said the bill would ask for still more detailed hospital reporting if enacted.

The proposal to cap hospital payments at 120% of the average sales price (ASP) for certain drugs prompted questions about savings and service impacts. A Blue Cross Blue Shield of Vermont…