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House passes bill delaying key claims-edit provisions of Act 111
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Summary
The House passed H.890 to push back most of the claims-edit implementation in Act 111 to Jan. 1, 2026, after committee testimony that payers and regulators need more time to align systems, contracts and payment policies.
The Vermont House on a voice vote passed H.890, an act delaying implementation of certain health insurance claims-editing requirements set out in Act 111.
Representative Black (Member from Essex), speaking for the House Committee on Health Care, told colleagues the timeline originally set for Jan. 1, 2025, was “unworkable” after conversations with payers and regulators. She said insurers need time to review claims systems, payment policies and provider and hospital contract terms and that a later effective date will allow “payers, providers, and the department of financial regulation to come together” to create alignment. “The new effective date for most of section 2 is January 1, 2026,” she said.
Black said the committee’s change keeps other parts of Act 111 on their original schedule, preserves provisions limiting prepayment review, and is supported by payers, providers and the administration. The committee recommended the bill ought to pass.
Madam Speaker ordered third reading and the bill passed by voice vote; the House then suspended the rules to message its action to the Senate forthwith.
Next steps: the House messaged passage to the Senate for its action.
