Senate Health & Welfare reviews House amendment to H.266 that would cap hospital drug charges

The Vermont Senate Committee on Health & Welfare reviewed a House proposal of amendment to H.266 that would cap hospital charges for outpatient- or office-administered prescription drugs based on a percentage of the average sales price (ASP), including a temporary 30% cap for July–December 2025 and a 20% cap beginning Jan. 1, 2026, unless the Green Mountain Care Board establishes a different reference-based price.

Jan Carvey of the Office of Legislative Council summarized the amendment for the committee, saying the House version strikes out white-bagging provisions in H.266 and replaces the effective-date language with two sections that set caps on charges to health insurers. Carvey said the amendment would use an April 1, 2025 snapshot: for any drug for which a hospital charged a health insurer more than 20% of ASP on 04/01/2025, the charge would be capped at 20% ASP (moving to a permanent 20% cap after 2025), and for drugs where hospitals charged 20% ASP or less on that date, the hospitals would be capped at the percentage they were charging as of 04/01/2025. Average sales prices under the…