by Devon Green, Sr. Vice President of Policy & Strategy, VAHHS
In years past, legislators would have already decamped back to their hometowns to gear up for campaign season. While things aren’t over yet, the health care issues appear to be wrapping up rapidly.
Reference-Based Pricing: The House Health Care Committee advanced S.190, which puts the Green Mountain Care Board on track to begin reference-based pricing in FY 2027. In the version voted out, the Green Mountain Care Board may take up to 3.5% of commercial net patient revenue system-wide and apply it to the individual and small group market and teachers’ plans as reference-based pricing. The systemwide total of this amount is $54.6M. Earlier versions of the bill had reference based-pricing proposals ranging from $90M-$140M.
Critical Access Hospital (CAH) Medicare Cost Sharing: Also in S.190, the House removed the Senate’s prohibition of the Green Mountain Care Board addressing the CAH Medicare Cost Sharing issue in the budget. In response to a memo from CMS, they removed a requirement to bring all charges down to five times Medicare reimbursement. Instead, CAHs must report their charges that are over five times Medicare reimbursement and provide notice to patients.
PAs Performing First Certification of an Emergency Exam: H.573, which allows PAs to do first certification of an emergency examination for individuals in mental health crisis has stalled in the Senate Health and Welfare Committee.
Artificial Intelligence: H.814, which creates neurological rights and expands AI council membership to health and human services passed the Senate. The AI bill, H.816, requiring provider intervention and oversight for mental health treatment also passed the Senate.
Private Equity: The Senate Health and Welfare Committee advanced H.583, which prohibits the corporate practice of medicine and requires reporting of private equity ownership. The committee added a stakeholder process for reporting and delayed the reporting implementation date from July 1, 2026 to March 1, 2027.
Adult Protective Services: H.582, which brings the state law definition of neglect in line with federal law passed both chambers and is on its way to the governor’s desk.
Internationally Trained Physicians: Also on the way to the governor’s desk, S.142, which creates a pathway for internationally trained physicians.
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