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Insurers and hospitals warn of operational and federal risks as committee considers reference‑based pricing
Summary
Blue Cross, hospitals and union witnesses told the committee that reference‑based pricing could lower premiums under some settings but would be 'messy and expensive' to operationalize in the Qualified Health Plan market and might create federal‑compliance and rural hospital stability risks without careful implementation.
Witnesses from insurers, hospitals and unions told the committee that reference‑based pricing and the bill’s price‑reporting requirements could reduce premiums for some markets but carry operational, regulatory and federal‑compliance risks.
Courtney Harness of Blue Cross and Blue Shield of Vermont said moving reference‑based pricing into the Qualified Health Plan (QHP) market "would be expensive and messy," though the carrier said it trusts the care board to set technical rules. "If the Green Mountain Care Board said to you, you will not pay hospitals more than 250% of…
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