Senate agrees to delay rollout of H.266 infusion drug price cap, approves house amendment 20-10

The Vermont Senate on Friday voted 20-10 to concur in the House proposal of amendment to H.266 — a bill that would limit hospital charges for certain outpatient infusion prescription drugs — adopting a further proposal of amendment that delays the measure’s full implementation until Jan. 1, 2026.

Senator from Chittenden, reporting for the Senate Health and Welfare Committee, said the measure targets high markups on drugs administered in outpatient and office infusion settings and offered a phased-in reference-based cap tied to the federal average sales price published by the Centers for Medicare & Medicaid Services. “Folks are paying almost $50,000 a year” for a family of four’s silver plan and “the maximum out-of-pocket expense … approaches $20,000,” the senator said in describing why the committee recommended action.

The bill as discussed would set a phase-in cap of 130% of Medicare’s average sales price for an interim period and then a 120% cap going forward on hospital claims for specified outpatient infusion drugs. The House proposal and the version debated on the floor also prohibit hospitals from…