Senate clears housekeeping changes to Green Mountain Care Board duties and ACO oversight
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Summary
S.63 makes technical and housekeeping changes to the Green Mountain Care Board’s duties, modifies budget allocation formulas and certification and fee rules for accountable care organizations (ACOs), and updates hospital budget-review provisions; the Senate ordered third reading after committee votes.
The Vermont Senate on March 20 ordered third reading of S.63, a bill of technical and housekeeping changes to the Green Mountain Care Board (GMCB).
What the bill does
Senator Douglas, reporting for the Senate Committee on Health and Welfare, described S.63 as removing several duties from the GMCB that the board requested be reassigned or eliminated as redundant in light of shifting health‑care structures. Key changes include removing GMCB responsibility to review and approve a statewide health information technology plan and VITAL’s annual budget, updating the GMCB’s allocation formula for board expenses, and streamlining certification and budget-review rules for accountable care organizations (ACOs).
Major provisions
- Eliminates GMCB duties to review/approve the statewide health information-technology plan and VITAL’s (Vermont Information Technology Leaders) annual budget and connectivity criteria, on the grounds those responsibilities better fit other entities. - Adjusts the GMCB cost allocation formula (commonly called the “build-back” formula) by removing an 8% allocation for ACOs and reallocating costs to hospitals and insurers; the state share remains unchanged. - Expands the scope of ACOs that must be certified and simplifies certification criteria; the board may adopt rules for a streamlined Medicare-only ACO certification process. - Establishes specific ACO fees: $10,000 initial certification, $2,000 renewal, and $125,000 for budget review where applicable. - Revises hospital budget-review provisions to allow certain psychiatric hospitals not run by the state to have a January–December fiscal year for reporting purposes while other hospitals remain on an October–September fiscal year; the Senate Health and Welfare amendment limited broader changes to section 7 pending further clarification.
Committee input and outcome
The Health and Welfare Committee (vote 5–0–0) and the Finance Committee (7–0–0) reported favorably; Health and Welfare noted testimony from GMCB staff and other stakeholders. The Senate adopted the committee recommendations and ordered third reading by voice vote. Some senators asked for clarification on whether psychiatric hospitals receiving public dollars would remain subject to budget review; the Health and Welfare chair said that would be clarified by third reading.
