Vermont H 815: An act relating to the installation of fireblocking in single-family dwellings

Bill Text

BILL AS INTRODUCED H.815
2026 Page 1 of 9

VT LEG #386147 v.1
H.815 1
Introduced by Representative Berbeco of Winooski 2
Referred to Committee on 3
Date: 4
Subject: Health; health insurance; Medicaid; mental health professionals; 5
Department of Financial Regulation; Department of Vermont Health 6
Access 7
Statement of purpose of bill as introduced: This bill proposes to limit the 8
extent to which health insurers may reduce reimbursement rates for mental 9
health services. It would also require health insurers and Vermont Medicaid to 10
provide notice and stakeholder engagement opportunities prior to 11
implementing any change to reimbursement methodology, billing policy, 12
coding alignment, supervised billing requirements, or service authorization 13
requirements affecting mental health, substance use disorder, or intellectual or 14
developmental disability services. 15
An act relating to health insurance and Medicaid reimbursement for certain 16
health care services 17

BILL AS INTRODUCED H.815
2026 Page 2 of 9

VT LEG #386147 v.1
It is hereby enacted by the General Assembly of the State of Vermont: 1
Sec. 1. 8 V.S.A. § 4072 is amended to read: 2
§ 4072. MENTAL HEALTH AND SUBSTANCE USE DISORDER 3
SERVICES 4
* * * 5
(c) A health insurance plan shall provide coverage for treatment of a mental 6
condition and shall: 7
(1) not establish any rate, term, or condition that places a greater burden 8
on a covered individual for access to treatment for a mental condition than for 9
access to treatment for other health conditions, including no greater co-10
payment for primary mental health care or services than the co-payment 11
applicable to care or services provided by a primary care provider under a 12
covered individual’s health insurance plan and no greater co-payment for 13
specialty mental health care or services than the co-payment applicable to care 14
or services provided by a specialist provider under a covered individual’s 15
health insurance plan; 16
(2) not exclude from its network or list of authorized providers any 17
licensed mental health or substance use disorder treatment provider located 18
within the geographic coverage area of the health insurance plan if the provider 19
is willing to meet the terms and conditions for participation established by the 20
health insurer; 21

BILL AS INTRODUCED H.815
2026 Page 3 of 9

VT LEG #386147 v.1
(3) not reduce the reimbursement rate for more than one mental health 1
code for the same mental health professional license type in any contract year 2
below the reimbursement rate provided for that code and license type in the 3
previous contract year; 4
(4) make any deductible or out-of-pocket limits required under a health 5
insurance plan comprehensive for coverage of both mental and physical health 6
conditions; and 7
(4)(5) if the health insurance plan provides prescription drug coverage, 8
ensure that at least one medication in each therapeutic class approved by the 9
U.S. Food and Drug Administration for the treatment of substance use 10
disorder, including for opioid use disorder, methadone, buprenorphine, and 11
naltrexone, is available on the lowest cost-sharing tier of the plan’s 12
prescription drug formulary. 13
* * * 14
Sec. 2. 18 V.S.A. § 9418h is added to read: 15
§ 9418h. MODIFICATIONS TO REIMBURSEMENT AND CODING 16
POLICIES FOR CERTAIN SERVICES AND PROVIDERS 17
(a) Notwithstanding any provision of this subchapter to the contrary, a 18
health plan shall not implement any change to reimbursement methodology, 19
billing policy, coding alignment, supervised billing requirements, or service 20

BILL AS INTRODUCED H.815
2026 Page 4 of 9

VT LEG #386147 v.1
authorization requirements affecting mental health, substance use disorder, or 1
intellectual or developmental disability services without first: 2
(1) publicly identifying whether the change is required by federal or 3
State law and, if so, citing the specific federal or State statute, regulation, or 4
rule that requires the change; 5
(2) publicly identifying which elements of the change, if any, are 6
discretionary policy choices; 7
(3) publishing the proposed policy language and billing guidance on its 8
website, and sending written notice directly to providers, including 9
independent mental health providers, designated and specialized service 10
agencies, relevant advocacy organizations, and representatives of individuals 11
and families of individuals who receive services that will be affected by the 12
change, and the Department of Financial Regulation, at least 90 days prior to 13
implementation; 14
(4) conducting at least one public stakeholder meeting and soliciting 15
public comments; and 16
(5) publishing on its website a written response describing the ways in 17
which stakeholder input and public comments were considered and 18
incorporated. 19
(b) Prior to implementing any reimbursement or coding policy change 20
described in subsection (a) of this section, the health plan shall: