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Senate committee advances reference‑based pricing language, debates 250% cap for QHP hospital reimbursements
Summary
During markup of S.190 the Senate Health and Welfare Committee reviewed Green Mountain Care Board‑led reference‑based pricing changes and debated a proposed 250% cap on hospital reimbursements in the Qualified Health Plan market; hospitals warned of budget harm and the committee directed further budget‑process off‑ramps and reporting requirements.
The Senate Health and Welfare Committee reviewed a comprehensive amendment to S.190 that would require hospitals and health insurers to begin expressing certain provider rates as a percentage of Medicare and would limit hospital reimbursements in the Qualified Health Plan (QHP) market.
Jen Haring, legislative council, presented the amendment and the board’s approach, including a definition of the “Medicare adjusted base rate” and an applicability‑date approach that delays some requirements until the Green Mountain Care Board’s rule takes effect. Haring said the amendment would initially require hospitals and insurers to “begin expressing as a percentage of Medicare” the rates for items and services identified through a collaborative process between the board and representatives of Vermont hospitals.
Devin Green (Vermont Association of Hospitals and Health…
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