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Senate orders third reading of bill to require regular Medicaid rate studies for community‑based providers
Summary
H.13 would require the Agency of Human Services to establish a methodology and schedule for determining reasonable and adequate Medicaid payment rates for community‑based providers, require annual rate determinations and set an implementation report deadline of Jan. 15, 2026; the Senate ordered third reading after committee reports.
The Vermont Senate ordered third reading of H.13, a bill that would require the Agency of Human Services (AHS) to set and report on a methodology and schedule for Medicaid payment rates for community‑based service providers.
Senator Julek, reporting for the Senate Health and Welfare Committee, said the bill aims to make rate-setting more transparent and consistent so the legislature and providers share a common set of facts when reviewing rate requests. “This bill strives to do all of it,” Julek said, summarizing the bill’s goals to increase access, improve outcomes and contain costs by supporting community‑based care.
Key provisions described on the floor include adding definitions for community‑based services to the rate‑setting statutes, requiring the AHS secretary to determine rates that are reasonable and adequate to achieve required outcomes, mandating a schedule for rate studies at least every five years for each service type, requiring annual rate determinations and establishing an extraordinary relief process for providers at imminent risk of closure. The bill directs AHS to report to legislative committees by Jan. 15, 2026 on implementation, including its proposed schedule for rate studies and methodology.
Senate Appropriations reported no fiscal note requiring immediate AHS spending; appropriations committee members emphasized the bill requires AHS to set rates and processes but does not itself appropriate funds. The bill was reported out of Health and Welfare and Appropriations and the Senate ordered third reading.
