The bill S.190, which was vetoed by the Governor, aimed to implement significant reforms in Vermont's healthcare pricing structure through the Green Mountain Care Board (GMCB). It proposed that the GMCB utilize reference-based pricing to gradually align hospital prices with national median rates by 2030. Key provisions included requiring hospitals and health insurers to express rates as a percentage of Medicare starting January 1, 2028, and mandating public reporting of these prices. Additionally, the bill sought to cap payments from health insurers to Vermont hospitals for services provided to enrollees in qualified health benefit plans and school employee plans, while also directing hospitals to report on outsourced clinical services and their impacts on provider tax revenue.

The legislation also included provisions for the GMCB to pursue a federal waiver for a reinsurance program and sought to exempt the GMCB from negotiating with provider bargaining groups regarding reference-based pricing. It aimed to eliminate the requirement for administrative appeals processes before appealing GMCB decisions to the Vermont Supreme Court. Furthermore, the bill called for the GMCB to create a public tool for health system performance data and required critical access hospitals to disclose specific outpatient service charges in relation to Medicare rates.

Statutes affected:
As Introduced: 18-9376(e), 18-9376, 18-9482, 33-1951, 18-9373, 18-9409, 18-9381, 18-9453, 18-9411
As Passed By the Senate -- Official: 18-9376(e), 18-9376, 18-9482, 33-1951, 18-9373, 18-9409, 18-9381, 18-9453, 18-9411, 18-221
As Passed By the Senate -- Unofficial: 18-9376(e), 18-9376, 18-221, 18-9409, 18-9381, 18-9411
As Passed by Both House and Senate -- Official: 18-9376(e), 18-9376, 18-9482, 33-1951, 18-9373, 18-9409, 18-9381, 18-9453, 18-9411, 18-221
As Passed by Both House and Senate -- Unofficial: 18-9376(e), 18-9376, 18-9409, 18-9381, 18-9411