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Committee debates scope of authority over hospital networks; definition and regulatory gap highlighted
Summary
Members reviewed draft Section 6 defining hospital networks and allowing the Green Mountain Care Board to review network structure and financial operations but concluded the board lacks direct regulatory authority over networks without new enabling statutes.
Legislative committee members reviewed language in draft Section 6 that would let the Green Mountain Care Board review and evaluate the structure and financial operations of a hospital network, but they repeatedly emphasized that the board does not currently regulate hospital networks and would need new authority to take enforcement action.
The draft directs the board to consider whether network operations should be organized and operated out of a hospital rather than at the network level and whether a network’s existence serves the public interest and aligns with principles for health care reform and a future statewide health care delivery plan. The draft also authorizes the board to investigate financial operations of a network, including compensation of the network’s employees and executive leadership.
Committee discussion focused on two connected issues: (1) the statutory definition of “hospital network” in the draft — described as a system of two or more hospitals that deliver coordinated services and that derive 50% or more of operating revenue from Vermont hospitals while using an integrated financial and governance structure — and (2) the practical limits of the board’s authority. Several members observed the board can take action against individual hospitals under its existing authority but cannot directly regulate an entity it does not license or otherwise regulate. One committee member suggested introducing separate legislation to give the Green Mountain Care Board explicit authority over networks if that is the committee’s intent.
Despite the draft’s language permitting review and recommendation, committee members agreed that converting recommendations into enforceable actions against networks would require a larger, separate regulatory framework and statutory authorization. No formal votes or final decisions on regulatory authority over networks were recorded in the transcript.
The committee agreed to keep the network definition and the board’s review authority in the draft while acknowledging the gap between review/recommendation and direct regulatory control.
