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Ways & Means advances S.63 narrowing Green Mountain Care Board duties, adds ACO fees
Summary
The committee voted to move S.63, a bill that narrows some Green Mountain Care Board (GMCB) regulatory duties, updates hospital budget timing and appeals language, and establishes fees for accountable care organization (ACO) certification and budget review.
The Ways & Means Committee voted to report S.63 favorably after hearing bill background and testimony on proposed changes to the Green Mountain Care Board—s (GMCB) duties and fee authority.
Jennifer Kirby of the Office of Legislative Counsel summarized the bill as narrowing several GMCB responsibilities, including removing the board—s statutory duty to review and approve the statewide health information technology plan and to approve certain Vermont Information Technology Leaders budgets. The bill also revises the statute that allocates the board—s regulatory costs (the bill-back formula), preserving a 40/60 state-to-industry split but changing the industry allocation to 36% hospitals and 24% insurers under the new formula.
Nolan Linewald of the Joint Fiscal Office described section 5, which establishes fees tied to GMCB oversight of accountable care organizations. The bill would set a $10,000 initial certification fee and $2,000 annual maintenance fee for ACOs; it also proposes a $125,000 fee for each ACO budget review when an ACO receives Medicaid or commercial payments. Linewald estimated the board might collect about $40,000 in ACO-related fees in fiscal 2026 and roughly $8,000 in later years, noting the $125,000 review fee would apply only if a Medicaid or commercial ACO required a budget review.
Jean Stetter, administrative services director at the Green Mountain Care Board, said the GMCB developed the fee amounts from historical hours and experience regulating 1Care Vermont. "If this does not get passed, we will be doing the work without getting fees, and that will be paid for by Vermonters," Stetter said, explaining the board's view that fees paid by non-Vermont-domiciled Medicare-only ACOs would reduce cost pressure on Vermont hospitals and insurers.
After questions from the committee, Representative Medlin moved the committee to find S.63 favorable as amended by the House Health Care Committee. The committee called the roll and voted to report S.63 favorably, 9-2.
The committee recorded the following roll-call votes: Brannigan (yes); Burkhart (yes); Feltes (yes); Higley (no); Polka (yes); Kimball (yes); Maslin (yes); Odey (yes); Wazersach (yes); Canfield (no); Kornheiser (yes).
