Senate Health and Welfare committee agrees to compromise amendment to S.190 setting 225% cap on QHP hospital rates

The Senate Health and Welfare committee agreed on a compromise amendment to S.190 that would define an "actual hospital specific Medicare reimbursement rate" and set a 225% cap on commercial reimbursements to qualified health plans (QHPs), while directing hospitals to sequence rate reductions under oversight of the Green Mountain Care Board.

The amendment, introduced by legislative counsel during the committee meeting, adds a new section (9459) directing hospitals to first target reductions in rates charged to QHPs and then, if additional reductions are needed, to reduce rates that exceed 500% of the Medicare rate or otherwise the highest rates relative to Medicare. It also clarifies that a hospital seeking to raise commercial reimbursement rates for particular service lines must do so through the board's budget-order process under section…