Committee weighs site-neutral billing to equalize outpatient payments across settings

Supporters and regulators told a legislative panel on Thursday that ‘site‑neutral’ billing — charging the same reference‑based payment for certain outpatient services regardless of whether they are delivered in a hospital or in a community setting — could lower costs and shore up independent providers, while hospital representatives warned the change could imperil hospital finances.

The bill would direct the Green Mountain Care Board, working with the Department of Financial Regulation (DFR), to identify outpatient and ambulatory items and services that are safe and appropriate to deliver in lower‑cost, non‑hospital settings and to establish a single reference‑based price for each service. Jen Carvey, counsel to the committee, said the provision would apply only to selected outpatient services and would not authorize the board to set rates for Medicare or Medicaid enrollees.

Proponents said the change is intended to remove a perverse incentive that has developed as…