Bill > S0055

This bill directs the Green Mountain Care Board (GMCB), a state healthcare regulatory body in Vermont, to develop a comprehensive plan for implementing reference-based pricing (RBP) for hospital services. Reference-based pricing is a healthcare cost containment strategy where payment rates for medical services are set based on a benchmark, in this case, a percentage of Medicare rates. The plan must include a gradual implementation timeline covering all inpatient and outpatient hospital services across different health insurance plans and payer types, while ensuring compliance with federal law. The GMCB must provide detailed recommendations on initial benchmark rates, future rate adjustments, potential cost savings, methods to maintain care quality and access, protections against balance billing, impact assessments on hospitals, alignment with existing healthcare reform efforts, integration into current rate review processes, and resource needs for implementation. By February 1, 2026, the Board is required to submit its implementation plan to the state legislature's health and finance committees, along with a recommendation about potentially expanding reference-based pricing to non-hospital services. The bill would take effect immediately upon passage.

Health and Social Services

https://legislature.vermont.gov/bill/status/2026/S.55