Senate panel reviews H.482 giving Green Mountain Care Board authority to cut hospital reimbursement rates and appoint independent observer

Senator Foster, chair of the Senate Health & Welfare Committee, opened the April 24 hearing on H.482, a bill that would allow the Green Mountain Care Board (GMCB) to reduce commercial reimbursement rates to one or more hospitals after consulting with the commissioner of the Department of Financial Regulation (DFR) if a domestic health insurer faces an acute and immediate threat to solvency.

The bill directs the GMCB to limit reductions to the amount necessary to remediate the insurer threat, and it sets eligibility and floor thresholds tied to hospitals' days cash on hand and operating margins. Under the draft language discussed, a hospital (or hospital network) would be eligible for a reduction only if it has more than 135 days cash on hand or had a positive operating margin in the previous fiscal year; and any ordered reduction could not lower a hospital or network’s projected days cash on hand below 125 days.

The proposal also expands the GMCB’s hospital budget-review authority. The bill would require hospital budgets to reconcile significant revenue deviations from prior years and would permit the GMCB to adjust insurance reimbursement rates during a hospital’s fiscal year to keep a hospital operating within the board-established budget. Separately, the bill would…