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Finance committee reports S.63 changing Green Mountain Care Board fees and oversight to full Senate
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Summary
The committee voted 7-0 to report S.63 favorably; the bill reallocates portions of the board’s fee assessments after the wind-down of a large ACO, adjusts hospital fiscal-year reporting and makes changes to ACO certification and budget-review fees.
The Vermont Senate Committee on Finance on March 18 voted unanimously (7-0) to report S.63 favorably to the full Senate. S.63 would change the Green Mountain Care Board’s regulatory duties and the board’s fee allocation following the wind-down of a large accountable care organization (ACO) and would adjust hospital fiscal-year timing for regulatory review.
Committee staff and agency witnesses described the bill as largely housekeeping that adapts statute to the current market after the closure of one large ACO and the expectation that most remaining ACOs would be Medicare-only arrangements. Under existing statute the board’s regulatory costs are apportioned 40% state, 28.8% hospitals, 23.2% insurers and 8% ACOs. The bill would remove most of the prior ACO allocation and redistribute funds so the new split would keep 40% state with approximately 36% hospitals and 24% insurers, reflecting the smaller ACO role going forward.
The measure also narrows the board’s budget-review authority to those ACOs receiving Medicaid or commercial payments, and it sets fees for ACO certification and reviews: an initial certification fee of $10,000, a $2,000 annual renewal/maintenance fee, and a $125,000 fee in the event a budget review is required. Committee witnesses said fees are intended to cover the board’s regulatory costs when review is required.
Other provisions in the committee amendment focus on hospital fiscal-year timing, including a separate allowance for psychiatric hospitals not operated mainly by the state, and strike previously proposed changes to hospital rate-review contest procedures (the committee amendment limited the changes to fiscal-year timing only). Committee members asked for clarification on which entities fall into insurer categories; Joint Fiscal Office and board staff explained that nonprofit hospital and medical service corporations (for example, some Blue Cross plans) are an insurer type under the statute and that fee allocations are tied to regulatory workload rather than solely to the size of an organization.
The committee recorded a roll call on the motion to report the bill favorably. The clerk called the roll in sequence and senators present voted in favor; the committee reported S.63 favorably as presented and prepared the bill for the next Senate steps.
