Vermont H 320: An act relating to stabilizing Vermont’s rural hospitals

Bill Text

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H.320 1
Introduced by Representatives Labor of Morgan, Demar of Enosburgh, 2
Galfetti of Barre Town, Higley of Lowell, Maguire of Rutland 3
City, Morgan, L. of Milton, Morrissey of Bennington, Nelson of 4
Derby, North of Ferrisburgh, Page of Newport City, Pritchard 5
of Pawlet, and Tagliavia of Corinth 6
Referred to Committee on 7
Date: 8
Subject: Health; Green Mountain Care Board; hospitals; health insurance; 9
physicians 10
Statement of purpose of bill as introduced: This bill proposes to prohibit the 11
Green Mountain Care Board from implementing certain recommendations 12
contained in a consultant’s report on hospital transformation until at least July 13
1, 2026, while requiring the Board to move ahead with other 14
recommendations. The bill would direct the Board to collect data directly from 15
Vermont hospitals in order to establish goals and methodologies for hospital 16
system transformation that would stabilize small, rural hospitals and preserve 17
access to hospital services. The bill would require the Department of Vermont 18
Health Access and Department of Financial Regulation to explore 19
opportunities to expand the number of health insurers offering plans on the 20
Vermont Health Benefit Exchange. It would direct the Area Health Education 21

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Centers program to develop a plan for placing medical students, residents, and 1
fellows in clinical rotations at critical access hospitals and to consider 2
opportunities for using State scholarship and loan repayment programs to 3
encourage careers in rural medicine. The bill would also require the Green 4
Mountain Care Board to develop recommendations for compensating hospitals 5
for caring for patients who are awaiting transfer to another facility. 6
An act relating to stabilizing Vermont’s rural hospitals 7
It is hereby enacted by the General Assembly of the State of Vermont: 8
Sec. 1. GREEN MOUNTAIN CARE BOARD; HOSPITAL 9
TRANSFORMATION; MORATORIUM; REPORT 10
(a)(1) The Green Mountain Care Board shall not implement or pursue 11
implementation of any of the following recommendations from the 12
consultant’s report prepared for the Board pursuant to 2022 Acts and Resolves 13
No. 167, Sec. 2, prior to July 1, 2026: 14
(A) permit no further increases in commercial subsidization for 15
hospital financial shortfalls; 16
(B) refrain from licensing any further hospital-based outpatient 17
department units; 18

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(C) begin movement to reference-based pricing, ideally at 200 1
percent of Medicare or less for prospective payment system (PPS) hospitals; 2
and 3
(D) require all hospitals to use the same accounting agency and 4
method to construct hospital financials and budget submissions. 5
(2) The Green Mountain Care Board shall promptly pursue 6
implementation of the following recommendations from the same consultant’s 7
report: 8
(A) simplify and shorten the certificate of need process; and 9
(B) encourage freestanding diagnostic, ambulatory surgical, and birth 10
centers. 11
(b) The members and staff of the Green Mountain Care Board shall collect 12
financial and service-level data directly from Vermont hospitals in order to 13
establish appropriate goals and methodologies for hospital system 14
transformation that will stabilize small, rural hospitals and preserve access to 15
hospital services in communities across the State. The Board shall report these 16
goals and methodologies to the General Assembly on or before March 1, 2026. 17
Sec. 2. EXPANDED OPTIONS IN HEALTH INSURANCE MARKET; 18
REPORT 19
(a) The Department of Vermont Health Access, in collaboration with the 20
Department of Financial Regulation, shall explore opportunities to expand the 21

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number of health insurers that offer qualified health plans to individuals and 1
small groups on the Vermont Health Benefit Exchange beyond the two health 2
insurers currently participating. 3
(b) On or before January 15, 2026, the Department of Vermont Health 4
Access and the Department of Financial Regulation shall report to the House 5
Committee on Health Care and the Senate Committees on Health and Welfare 6
and on Finance its findings and recommendations for expanding the number of 7
health insurers offering qualified health plans in Vermont. 8
Sec. 3. AREA HEALTH EDUCATION CENTERS; MEDICAL 9
EDUCATION; RURAL HOSPITALS; REPORT 10
(a) The Area Health Education Centers program (AHEC) shall develop a 11
plan for placing medical students, residents, and fellows in clinical rotations at 12
critical access hospitals in Vermont in order to increase the supply of new 13
physicians interested in pursuing employment in rural hospital settings. AHEC 14
shall consider opportunities to use new or existing State scholarship and loan 15
repayment programs to encourage car