Committee hears bill to let Green Mountain Care Board appoint independent hospital monitor

A legislative committee heard draft language Feb. 28 to authorize the Green Mountain Care Board to appoint an independent monitor to oversee hospitals’ compliance with the board’s budget review and enforcement authority, Office of Legislative Council staff said.

The proposal would amend 18 V.S.A. § 9456, part of the Green Mountain Care Board’s hospital budget review statute, to add a new subdivision allowing the board, at its discretion, to appoint an independent monitor when the board believes doing so is in the public interest. The monitor could oversee operations, obtain information from the hospital — including records about the hospital’s participation in a hospital network — and report findings and recommendations to the board.

"This is a challenging time, especially when health-care affordability is in crisis and there is an insurer with insolvency issues and risks," Diane Wamper, director of legislative affairs for the Green Mountain Care Board, told the committee. "Green Mountain Care Board needs the authority in this language for a monitor."

Office of Legislative Council staff described the drafting details. The language would make the new authority a separate subdivision, specify that an independent monitor has the right to receive copies of all materials related to the board’s review under the statute, and state that the hospital must provide information requested by the monitor. The draft also says the monitor may share information with the board and with the Office of the Health Care Advocate in accordance with existing confidentiality rules (subdivision b(3)), but otherwise must not disclose confidential or proprietary information provided by the hospital.

The draft permits the board to require a hospital to pay for all or part of the independent monitor’s costs. The language presented would take effect on passage, according to the draft shown to the committee.

Committee members asked for clarification on several points. One member asked how "public interest" would be defined; Wamper said the board would need to work with the committee to clarify the term and that the board generally acts as the state regulator "on behalf of the state and in the public's interests." Another member asked whether the authority would sunset when current public-health emergencies subside; Wamper said no sunset is included in the presented language and the monitor authority could continue beyond the current crisis.

Jen Carvey, who presented the draft on behalf of the Office of Legislative Council, cautioned that the language shows what the bill would do but did not tie the measure to a specific precipitating event. Committee members and staff said the draft is intended either to stand alone as a committee bill or to be considered for inclusion in a forthcoming Senate bill addressing broader hospital issues.

The committee did not vote on the language at the Feb. 28 meeting. Members said the topic could be taken up after the town meeting recess or considered during the larger Senate bill discussions when the legislature returns.

Votes at a glance: none — draft language presented; no motion or vote was recorded.