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Draft Bill Would Let Green Mountain Care Board Order Insurer Rate Reductions to Protect Hospital Solvency
Summary
Legislative counsel told the Vermont Senate Health and Welfare Committee on May 7 that draft H.482 would permit the Green Mountain Care Board, after consulting the Department of Financial Regulation, to order a reduction in a domestic insurer’s reimbursement rates to one or more Vermont hospitals if that insurer faces an acute, immediate threat to solvency.
Legislative counsel told the Vermont Senate Health and Welfare Committee on May 7 that draft H.482 would permit the Green Mountain Care Board, after consulting the Department of Financial Regulation (DFR), to order a reduction in a domestic insurer’s reimbursement rates to one or more Vermont hospitals if that insurer faces an acute, immediate threat to solvency as indicated by its risk‑based capital metrics.
“Notwithstanding any provision of 3 VSA chapter 25 to the contrary ... the board's activities under this section shall not be considered to be in contested case,” counsel said while explaining the bill text and the alternate appeal path identified in the draft. The draft also says a final board action under the section may be appealed as set forth in “section 93 81 of this title.”
Nut graf: The proposal would create an extraordinary remedy the Green Mountain Care Board could use in coordination with DFR to address insurer solvency risks by adjusting hospital reimbursement flows. The draft includes process language intended to avoid a contested‑case administrative procedure and to preserve an appeal pathway described in statute.
The draft enumerates criteria for which hospitals could be subject to a rate reduction and requires the board to consider competing financial impacts on both the hospital and the insurer. It also requires the board to provide hospitals an opportunity to request relief from a rate‑reduction order. The counsel noted the bill allows the board to act until the insurer’s risk‑based capital exceeds the company action level risk‑based capital threshold defined in statute.
Committee members asked about notice and the opportunity for dialogue before an order is issued. Counsel said the draft does not specify the exact notice format or timing, and that those details would be up to the board to implement.
The draft also includes a provision to appoint independent observers with “experience and expertise relevant to the specific circumstances” when the board reviews individual hospital budgets; counsel said the language aims to allow flexibility to match observers’ expertise to the case at hand.
The committee did not vote on H.482 on May 7. Members said they would review the draft and return to the bill in a subsequent session.
Ending: The draft is under committee review; its contested‑case carve‑out, insurer solvency trigger, and hospital relief provisions were highlighted for further consideration.
