Legislative Update
by Devon Green, Sr. Vice President of Policy & Strategy, VAHHS
The Legislature is still moving full steam ahead—let’s dive into what happened last week:
Insurance Regulation and Site Neutrality: The Department of Financial regulation presented their bill, H.585 to the House Health Care Committee. The bill proposes to:
- Require at least two governor-appointed members of the public to sit on the board of Blue Cross Blue Shield of Vermont and have oversight of executive compensation
- Move from pure community rating (everyone pays the same premium) to limited age rating that can vary premiums up to 5%
- Expand access to association plans
- Increase the length of short-term health insurance
- Define high-dollar claims as anything over $25k
- Reinstate prior authorization for primary care providers associated with hospitals
- Implement site-neutral billing
- Grant authorization to pursue a state reinsurance program using federal pass-through funds
VAHHS testified against reinstating prior authorizations, noting that the committee should wait until the required 2027 report to make a decision on a newly implemented policy. VAHHS opposed site-neutral billing. Even using a conservative methodology, site neutral billing would have a $200M impact to hospitals. Furthermore, the proposal would limit much needed flexibility for the Green Mountain Care Board to implement reference-based pricing.
Green Mountain Care Board Bill: The Senate Health and Welfare Committee heard testimony on S.190, the Green Mountain Care Board’s bill. In its testimony, VAHHS offered to work with the Green Mountain Care Board on a clear process for reference-based pricing reporting and agreed to more standardized reporting of outsourced clinical services. VAHHS raised concerns that further requirements on outsourced services would prevent organizations that provide high quality care at lower costs from coming into Vermont or even from having Vermont hospitals coordinate with each other. Aida Avdic, MD from Brattleboro Memorial Hospital and Dr. Jay Mullen, MD MBA FACEP from BlueWater Health voiced similar concerns in their testimony. VAHHS is opposed to the Green Mountain Care Board’s proposal to audit and investigate hospitals when it could be helpful to the board. This is an incredibly vague standard for an intrusive process, and the Green Mountain Care Board already has subpoena powers, as well as broad authority to assign an independent observer through Act 49 of last year.
APRN and Hospital Patient Bill of Rights: The Vermont Nurse Practitioner Association testified in favor of allowing APRNs to be providers of record and have admitting and discharging privileges. The Office of Professional Regulation testified that APRNs are limited to their scope of practice and noted that they have prosecuted when APRNs have failed to collaborate when they are out of their scope of practice.
Immunization Legislation: The Senate Health and Welfare Committee heard the Vermont Department of Health present on H.545, immunization protections. VAHHS supports this bill.
Private Equity: The Vermont Medical Society raised concerns over H.583, which would impose several restrictions on health care transactions, even between non-profit organizations. They put forward alternative language that would provide corporate practice of medicine protections against hedge funds and private equity groups.
Banning Mandatory Overtime for Nurses: The Senate Committee on Economic Development, Housing, and General Affairs held an initial hearing on S.277, which would prohibit hospitals and long-term care facilities from requiring overtime for nurses except for emergency circumstances. The committee discussed the current workforce shortage and will have hospitals and long-term care facilities testify on the issue.
Expansion of Primary Care: The Agency of Human Services testified in support of the intent behind S.197 but asked that the bill align with rural health transformation goals.
2.2.2026. Vermont Association of Hospitals and Health Systems https://www.vahhs.org/
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