VT H0245

Expands the Green Mountain Care Board's budget review authority to include health networks (systems of two or more affiliated hospitals), not just individual hospitals, with budget review provisions applying beginning with hospital fiscal year 2027

Requires the Board to investigate whether eliminating or reducing a hospital's or health network's monopoly or significant market power in any health care sector would benefit the public good, and to take action or recommend legislation accordingly

Authorizes the Board to establish reference-based pricing for hospitals or health networks that may apply to public and private payers, including State, municipal, and school employees

Increases maximum administrative penalties for budget violations from $40,000 to $400,000 for single violations and from $100,000 to $1,000,000 (or one-tenth of one percent of gross annual revenues) for continuing violations

Prohibits hospitals and health networks from increasing rates in response to revenue shortfalls without Board approval for exceptional circumstances, and allows the Board to withhold penalty amounts from executive compensation