An act relating to reference-based pricing and the Green Mountain Care Board

Summary

The legislation directs the Green Mountain Care Board to set maximum payment amounts for hospital items and services based on a percentage of Medicare rates, to review those prices annually, and to post findings showing that lower prices translate into lower insurance premiums. It also brings revenue from outsourced clinical services—such as emergency medicine, anesthesiology, radiology, and laboratory services—into the Board’s budget limits and requires hospitals to bill insurers for those services, protecting patients from surprise medical bills. The bill gives the Board authority to audit hospitals and, if funding is available, to develop an interactive health‑system performance tool.

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