Vermont H 245: An act relating to hospital and health network budgets

Bill Text

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VT LEG #379293 v.2
H.245 1
Introduced by Representatives Olson of Starksboro, Donahue of Northfield, 2
Harrison of Chittenden, Kleppner of Burlington, Logan of 3
Burlington, Masland of Thetford, and McCann of Montpelier 4
Referred to Committee on 5
Date: 6
Subject: Health; Green Mountain Care Board; health care facilities; health 7
networks; hospital budgets 8
Statement of purpose of bill as introduced: This bill proposes to expand the 9
Green Mountain Care Board’s hospital budget review authority to include the 10
option to review and approve health network budgets. It would direct the 11
Board to investigate the impact on the public good of eliminating or reducing a 12
hospital’s or health network’s monopoly or significant market power in a 13
health care sector and take actions necessary to promote the public good. The 14
bill would also give the Board additional authority to affect health system costs 15
through its hospital and health network budget processes. 16
An act relating to hospital and health network budgets 17
It is hereby enacted by the General Assembly of the State of Vermont: 18
Sec. 1. 18 V.S.A. § 9375 is amended to read: 19
§ 9375. DUTIES 20

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VT LEG #379293 v.2
(a) The Board shall execute its duties consistent with the principles 1
expressed in section 9371 of this title. 2
(b) The Board shall have the following duties: 3
* * * 4
(7) Review and establish hospital budgets for hospitals and health 5
networks pursuant to chapter 221, subchapter 7 of this title. 6
* * * 7
(16)(A) Investigate whether, in the event that a hospital or health 8
network maintains a horizontal or vertical monopoly or significant market 9
power in any health care sector in this State, the public good would be 10
promoted by eliminating or reducing the monopoly or significant market 11
power. If the investigation indicates that the public good would be promoted, 12
the Board shall take such actions that are within its authority as are necessary 13
or desirable to eliminate or reduce the monopoly or significant market power 14
and shall recommend to the General Assembly any legislation needed to 15
authorize actions that are outside the Board’s existing authority. 16
(B) The Board may contract with one or more outside entities as 17
needed to enable the Board to conduct an investigation pursuant to subdivision 18
(A) of this subdivision (16) and may assess the applicable hospital or health 19
network for the amount of the Board’s actual expenses incurred in conducting 20
the investigation. 21

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VT LEG #379293 v.2
* * * 1
Sec. 2. 18 V.S.A. § 9376 is amended to read: 2
§ 9376. PAYMENT AMOUNTS; METHODS 3
(a) It is the intent of the General Assembly to ensure payments to health 4
care professionals that are consistent with efficiency, economy, and quality of 5
care and; that will permit them to provide, on a solvent basis, effective and 6
efficient health services that are in the public interest; and that are affordable 7
and will reduce cost increase trends to an appropriate level within a reasonable 8
period of time. It is also the intent of the General Assembly to eliminate the 9
shift of costs between the payers of health services to ensure that the amount 10
paid to health care professionals is sufficient to enlist enough providers to 11
ensure that health services are available to all Vermonters and are distributed 12
equitably. 13
* * * 14
Sec. 3. 18 V.S.A. chapter 221, subchapter 7 is amended to read: 15
Subchapter 7. Hospital Budget Review 16
§ 9451. DEFINITIONS 17
As used in this subchapter: 18
(1) “Hospital” means a hospital licensed under chapter 43 of this title, 19
except a hospital that is conducted, maintained, or operated by the State of 20
Vermont. 21

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(2) “Volume” means the number of inpatient days of care or admissions 1
and the number of all inpatient and outpatient ancillary services rendered to 2
patients by a hospital. 3
(3) “Health network” means a system comprising two or more affiliated 4
hospitals, and may include other health care providers and facilities, that 5
deliver health care services in a coordinated manner using an integrated 6
financial and governance structure. 7
§ 9453. POWERS AND DUTIES 8
(a) The Board shall: 9
(1) adopt uniform formats that hospitals and health networks shall use to 10
report financial, scope-of-services, and utilization data and information; 11
(2) designate a data organization with which hospitals and health 12
networks shall file financial, scope-of-services, and utilization data and 13
information; and 14
(3) designate a data organization or organizations to process, analyze, 15
store, or retrieve data or information; and 16
(4) designate one accounting entity and methodology to construct 17
financials and budget submissions for all hospitals and health systems, unles