S.63 would require ACO certification, change hospital budget appeals and limit some board reviews, Green Mountain Care Board staff say

Representatives of the Green Mountain Care Board told the Health & Welfare Committee Feb. 27 that S.63, a board‑requested bill, would change how the board regulates accountable care organizations and how hospital budget enforcement matters are appealed.

Michelle Sawyer, director at the Green Mountain Care Board, said the proposal makes certification mandatory for all ACOs that operate in Vermont — including Medicare‑only, multistate entities — so the board can decertify ACOs that do not meet state requirements. “The idea is that there's no model specific language in how the board would regulate ACOs,” Sawyer said, explaining the proposal seeks to make regulation agnostic to whatever payment model Vermont uses next.

Under current practice, Sawyer said, ACOs that contract with Medicaid or commercial payers must already submit an annual budget review to the board; Medicare‑only ACOs…