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Committee amends S 63 to narrow some Green Mountain Care Board duties, add ACO certification fees and adjust hospital budget timing
Summary
The committee advanced an amendment to S 63 that removes certain Green Mountain Care Board duties over health IT plan approval, retools ACO oversight and certification fees, modifies hospital fiscal-year timing for some psychiatric hospitals, and set deadlines related to hospital budget orders; the amendment passed committee by roll call.
Senate Health & Welfare members considered and adopted an amendment to S 63 that revises the Green Mountain Care Board’s roles, establishes fees for accountable care organization (ACO) certification, streamlines parts of ACO budget review and adjusts hospital fiscal-year timing for certain psychiatric hospitals.
Key changes described in committee discussion included removing the board’s role in reviewing and approving the state’s health information technology plan while making the board a voting member of the steering committee; narrowing the board’s responsibilities for health IT plan approval and certain existing review duties; and removing references to advisory or technical groups that “do not currently exist,” according to committee counsel.
The bill change expands the Board’s oversight scope to include ACOs that receive Medicaid or commercial payments, requires Vermont ACOs to obtain and maintain certification, and authorizes the Board to adopt rules to streamline Medicare-only ACO certification. The draft language sets fees for ACO certification processes identified in discussion as a $10,000 initial certification fee, a $2,000 recertification fee and a $125,000 fee for in-depth budget review when an ACO receives Medicaid and commercial payments.
Section 6 preserves the October 1–September 30 fiscal year for general hospitals but allows certain psychiatric hospitals not maintained by the State to use a January 1–December 31 fiscal year; section 7 as amended focuses on timing for written decisions and the budget-order date (moved to December 15 and a written decision by December 31 for hospitals operating on a Jan.–Dec. fiscal year). The committee explained the amendment narrows contested-case and appeal language in order to conform timing across hospital budget processes.
Committee chair (unnamed in the transcript) moved the amendment (draft cited as draft 1.1) and a senator seconded. The committee proceeded to a roll-call on the amendment; senators recorded as voting “yes” during the roll call in the transcript include Senator Hartland, Senator Cummings, Senator Carlos, Senator Bullock, Senator Olivas, Senator Park, Senator Douglas, Senator Gulick and Senator Lyons. The amendment was approved on the committee record as amended and the bill was reported out of committee for further consideration.
Members said they had removed a section that had proven contentious to allow the remaining, noncontroversial parts of the bill to advance. Members also noted additional statutory cleanup would be required in the summer to reconcile multiple concurrent amendments to overlapping statutes.
Ending: The amended S 63 will move to the next legislative stage (committee reporting to the Senate and referral to Finance as discussed); members and staff noted the House may address remaining policy details and contested portions.
