VermontS.1262025-2026 SessionSenateWALLET

An act relating to health care payment and delivery system reform

Sponsored By: Sponsor information unavailable

Signed by Governor

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Bill Overview

Analyzed Economic Effects

9 provisions identified: 4 benefits, 0 costs, 5 mixed.

Caps on hospital and doctor bills

The Board sets reference prices as the maximum hospitals and clinicians can accept, starting by hospital fiscal year 2027. Providers cannot bill you or your insurer above that amount. This does not apply to Medicare or Medicaid services. The Board can also set reasonable provider rates, review them each year, and must weigh local costs and needs. The Board can adopt payment-reform rules to make these changes work.

2026 hospital savings and telehealth grants

The state pushes at least a 2.5% drop in hospital spending for hospital fiscal year 2026. AHS awards first‑come, first‑served grants in FY2026 to hospitals that join cost‑saving work and expand telehealth. The law gives AHS $2.2 million for planning and payment model work and $2.0 million from the Health IT Fund for hospital grants. The Board gets $1,062,500 for staff and contracts and $150,000 from the Health IT Fund for data work. AHS reports proposed cuts by July 1, 2025 and gives monthly updates during hospital fiscal year 2026.

More reports to track health reform

AHS selects outcome measures tied to reform goals and reports monthly on the first day of each month from August 1, 2025 through January 1, 2027. The Board gives a reform update to lawmakers by February 15, 2026. Starting July 1, 2026, the Board’s annual report adds status on reference pricing and global budgets and their effects. AHS also studies keeping ACO‑built capabilities and reports by December 1, 2025.

Primary care group to improve access

The state creates a steering group to improve primary care access, payment, and quality. The Blueprint for Health director must call the first meeting by September 1, 2025. Members do not get per diem or travel pay.

Global hospital budgets roll out

Beginning no later than hospital fiscal year 2028, the Board starts global budgets for some non‑critical hospitals. By hospital fiscal year 2030, all Vermont hospitals move to global budgets if resources allow. A global budget sets a hospital’s total allowed revenue.

Statewide health plan and advisory group

AHS leads a statewide Health Care Delivery Strategic Plan in 2027. The plan sets cost‑of‑care and primary care spending goals and a phased timeline. AHS sends the plan to lawmakers by January 15, 2028 and updates it every three years starting December 1, 2030. An 18‑member advisory committee helps set affordability benchmarks and monitor the system. The Director of Health Care Reform coordinates work and files an annual update by February 15.

Stricter hospital budget reviews and timeline

Each year the Board sets hospital budgets by September 15 and issues decisions by October 1. Hospitals must use a fiscal year that starts October 1 and submit standardized budget data. The Board reviews budgets against use, cost targets, workforce, compensation, and public input. Hospitals must show how higher public payments or lower bad debt reduce what they need from non‑Medicaid payers. The law also clarifies which entities count as hospitals and networks.

Tougher checks on rates and contracts

The Board reviews insurance rate requests and now considers new payment methods like reference-based pricing while protecting insurer solvency. On request, providers and payers must give unredacted contracts to the Board or the Department of Financial Regulation. The Board can review hospital networks and their finances. The Board chair can issue subpoenas, with at least six business days to comply.

Unified health data with privacy votes

AHS works with the Health Information Exchange Steering Committee to build a Unified Health Data Space. No data integration can start before January 1, 2027. Any integration needs a majority vote and must be for approved uses, with strong privacy and security. AHS reports by January 15, 2026 and then each year starting January 15, 2027.

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Sponsors & Cosponsors

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 99 • No: 38

House vote • 5/21/2025

Which was agreed to on a Roll Call Passed -- Needed 69 of 137 to Pass -- Yeas = 99, Nays = 38

Yes: 99 • No: 38 • Other: 1

Actions Timeline

Senate Message: Signed by Governor June 12, 2025
6/13/2025House
Signed by Governor on June 12, 2025
6/13/2025Senate
Delivered to Governor on June 6, 2025
6/6/2025Senate
Senate Message: Report of Committee of Conference adopted
5/30/2025House
Rules suspended & ordered delivered to Governor forthwith, on motion of Senator Baruth
5/30/2025Senate
As passed by Senate and House
5/30/2025Senate
Committee of Conference report adopted
5/30/2025Senate
Committee of Conference report submitted by Senator Lyons for Committee, text
5/30/2025Senate
Rules suspended & taken up for immediate consideration, on motion of Senator Baruth
5/30/2025Senate
Committee of Conference report
5/30/2025Senate
Entered on Notice Calendar
5/30/2025Senate
House message: House adopted Conference Committee report
5/29/2025Senate
Rules suspended and bill messaged forthwith to the Senate as moved by Rep. McCoy of Poultney
5/29/2025House
Committee of Conference report adopted (Senate bill)
5/29/2025House
Rules suspended and taken up for immediate consideration as moved by Rep. McCoy of Poultney
5/29/2025House
Notice Calendar: Report of Committee of Conference
5/29/2025House
House message: House appointed Conference Committee members
5/23/2025Senate
Speaker appointed Reps. Black of Essex, McFaun of Barre Town, and Berbeco of Winooski as members of the Committee of Conference on the part of the House
5/23/2025House
Senate Message: House proposal of amendment not concurred in and Committee of Conference appointed
5/23/2025House
Rules suspended & messaged to House forthwith, on motion of Senator Baruth
5/22/2025Senate
Committee of Conference appointed: Senators Lyons, Gulick, and Douglass
5/22/2025Senate
House proposal of amendment not concurred in; Committee of Conference requested, on motion of Senator Lyons
5/22/2025Senate
House proposal of amendment; text
5/22/2025Senate
Rules suspended & taken up for immediate consideration, on motion of Senator Baruth
5/22/2025Senate
House proposal of amendment
5/22/2025Senate

Bill Text

As Enacted (ACT 68)
6/18/2025
PDF
As Passed by Both Chambers
6/3/2025
PDF
As Passed by Both Chambers (Unofficial)
6/3/2025
PDF
House Proposal of Amendment
5/22/2025
PDF
House Proposal of Amendment (Unofficial)
5/22/2025
PDF
As Passed by the Senate
3/31/2025
PDF
As Passed by the Senate (Unofficial)
3/31/2025
PDF
As Introduced
3/14/2025
PDF

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