Bill > H0585

This bill proposes several health insurance reforms, including changes to the governance and executive compensation of nonprofit hospital service corporations, allowing for limited age rating in individual and small group health insurance markets, and expanding access to association health plans and short-term, limited-duration health insurance. It also defines "high-dollar claims" for claims editing purposes as those exceeding $25,000 per episode of care, limits the exemption for primary care providers from prior authorization requirements to independent providers only, and begins implementing site-neutral billing policies for physical therapy, occupational therapy, and athletic training services, meaning these services will be reimbursed at a uniform rate across all health plan contracts and fee schedules, expressed as a percentage of the Medicare rate, except for inpatient settings. Additionally, the state is authorized to seek a federal waiver to establish a reinsurance program, and new reporting requirements are introduced for health care sharing plans and arrangements to increase transparency.

Budget and Finance, Health and Social Services

https://legislature.vermont.gov/bill/status/2026/H.585