House Health Care committee hears Green Mountain Care Board defend hospital budget enforcement, debates delivery plan, payment changes and public notice for cut

The Vermont House Committee on Health Care spent the morning of May 1 debating S.63 after testimony from Green Mountain Care Board Chair Owen Foster about the board’s enforcement of hospital budgets and a contentious enforcement order against the UVM Health Network.

Foster told the committee that the board enforces budgets under 18 V.S.A. §9456 and an established board rule and policy, that hospitals must operate within budgets set before Sept. 15 and that the board issued an enforcement order on Oct. 1 after a hearing. “Hospitals are statutorily and legally required to operate within that budget,” Foster said, summarizing the board’s approach and timeline: a May 30 notice to UVM, a July 2 response from the network, an Aug. 28 hearing and the October order. Foster said the board’s written decision found UVM Medical Center’s actual revenue “differed substantially” from its budget and cited an overage on the order of roughly $80 million.

The committee heard, and members repeatedly returned to, three linked questions: what process hospitals get to be heard in budget enforcement (Foster said hospitals had multiple opportunities and a right to hearings), how a statewide health‑care delivery plan should relate to the existing Health Resource Allocation Plan (HRAP), and whether the state should proceed toward reference‑based pricing and global hospital budgets and on what timetable.

Representative Donahue urged folding elements of HRAP into the proposed statewide health‑care delivery plan and then sunsetting HRAP once the delivery plan…