Senate bill S.126 would expand Green Mountain Care Board powers, require reference-based pricing and set timetable for global hospital budgets

The Vermont Senate committee heard a section-by-section read of S.126 on July 13 that would direct major changes to how hospitals and insurers are paid and how the state plans health care services.

Jen Carvey, Legislative Counsel in the Office of Legislative Council, told the committee the bill’s stated purpose is “to promote the transformation of Vermont’s health care system,” and that the legislation would pursue four goals: improve health outcomes and access, invest in primary and long-term care, stabilize providers and reduce premiums by managing total cost of care, and increase insurance coverage.

The bill would expand the duties of the Green Mountain Care Board (GMCB). New language added to the board’s duties would expressly authorize reference‑based pricing, global payments and global hospital budgets and require the board to develop methodologies for payment reform. Carvey told the committee the bill directs the board to begin implementing reference‑based pricing for hospitals “as soon as practicable, but not later than hospital fiscal year 2027.”

Nut graf: S.126 sets a timetable and new reporting requirements that, if enacted, would shift the state toward an all‑payer approach that starts with reference‑based pricing tied to Medicare rates, then moves to hospital global budgets and a statewide health care delivery plan. The bill also increases data reporting and oversight demands on hospitals and insurers and creates a new advisory committee and deadlines for agency reports.

Key provisions

Reference‑based pricing: The bill requires the GMCB to establish reference‑based prices for hospital items and services based on a percentage of the Medicare reimbursement rate for the same or similar service,…