VT S0190

Green Mountain Care Board must implement reference-based pricing for Vermont hospitals by fiscal year 2027, establishing maximum payment amounts and requiring contracts entered after October 1, 2026 to express rates as a percentage of Medicare

Hospitals must use unique National Provider Identifiers for off-campus departments (facilities more than 250 yards from main campus) and include pricing as a percentage of Medicare in public machine-readable price files

Revenue from outsourced clinical services (emergency medicine, anesthesiology, hospitalist services) must be included in hospital budget limits, subject to reference-based pricing, and counted toward provider tax assessments

Hospitals become responsible for billing insurance claims for all outsourced services delivered by out-of-network contracted providers, and hospital financial assistance policies must apply to outsourced services

Repeals authorization for health care provider bargaining groups, grants the Board authority to conduct hospital audits and investigations, and directs development of an interactive health system performance tool contingent on federal funding