All Roll Calls
Yes: 99 • No: 38
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.
Advance notice before hospital service cuts
Hospitals proposing service cuts to meet a state-set budget must give at least 45 days’ notice. Notice goes to the Board, Agency of Human Services, Health Care Advocate, and legislators representing the hospital service area. Hospitals must explain the cut and address their community needs assessment and the statewide plan, once established. The Board may review the proposal, change the budget, or take other steps to preserve necessary care. These notice and review rules exclude services identified for change through the 2022 hospital transformation efforts.
Payment caps protect Vermont hospital patients
By hospital fiscal year 2027, the Green Mountain Care Board must set hospital payment caps based on Medicare rates or another benchmark. Hospitals must accept these prices as full payment, with no extra charges to patients or insurers; Medicare and Medicaid charges are excluded. The Board reviews hospital prices yearly, considering patient needs, local costs, and each hospital’s role. It also sets rates for providers, drug makers, and supply companies, with phase-ins and allowances for underserved areas. The Board may set prices and minimum payments outside hospitals, excluding Medicare and Medicaid services; providers may accept less from uninsured patients.
Vermont funds health payment reform staff
Beginning July 1, 2025, the Board may establish three permanent positions in fiscal year 2026 using existing vacant Executive Branch jobs. They cover payment-cap direction, payment-cap project management, and operations, procurement, and contract oversight. Fiscal year 2026 funding totals $1.0625 million, including $512,500 for staff: $205,000 from the General Fund and $307,500 from the Board’s Regulatory and Administrative Fund. Another $500,000 from the General Fund supports contracts, including payment-cap implementation. A further $50,000 from the General Fund supports quality work by the Vermont Program for Quality in Health Care.
Vermont funds statewide health care planning
The Agency of Human Services must prepare a statewide health care plan in 2027 and submit it by January 15, 2028. The plan sets yearly total-care cost targets, resource goals, and primary and preventive care spending targets; state agencies must assist. Updates are due every three years, by December 1 starting in 2030. An 18-member advisory committee sets affordability benchmarks, tracks system and population health, helps develop the plan, and advises state leaders. Beginning July 1, 2025, fiscal year 2026 General Fund support totals $2.2 million: $2 million for provider planning, $100,000 for quality and access measures and monitoring, and $100,000 for payment models.
Shared health data with privacy limits
Beginning June 12, 2025, the Agency must develop a shared health data system with the Health Information Exchange Steering Committee. The system must protect privacy and security, support data sharing, and give patients and providers rapid access. Integration of clinical, claims, social-needs, and other data cannot begin before January 1, 2027. A majority of all voting committee members must approve integration and its specific uses. Agency and provider access must follow data-use agreements, support the statewide plan once established, stay within approved uses, and protect proprietary information.
Closer oversight of Vermont hospital finances
Hospitals must provide information the Board requests to compare expenses and standardize budget data. The Board may investigate hospital network structures, finances, and employee and executive pay, and recommend changes that address conflicts with state health goals. Beginning June 12, 2025, it may share subpoenaed records with human services and insurance regulators when relevant to their work. Recipients must protect records exempt from public disclosure. Beginning July 1, 2025, the law provides $150,000 from the Health IT-Fund for fiscal year 2026 electronic budget-data standardization.
Contract privacy with state regulator access
Health care contracting entities may require providers to sign reasonable agreements keeping proposed contract terms confidential. But providers and contracting entities must give unredacted contracts to the Department of Financial Regulation or the Board when requested. This disclosure rule covers both proposed and signed contracts.
Hospital grants support required spending cuts
Beginning June 12, 2025, the Agency of Human Services must coordinate providers to reduce hospital spending at least 2.5% in hospital fiscal year 2026. It must supervise collaboration as needed for state-action protection under antitrust laws. The law provides $2 million from the Health IT-Fund for grants in state fiscal year 2026. Eligible hospitals must actively join transformation efforts; grants support partnerships, hospital cost reductions, and wider access, including telehealth. Grants are intended to go out first-come, first-served until funds run out, rather than provide household payments.
Vermont hospitals face new budget limits
Subject to available resources, the Board must start global budgets for at least one non-critical-access hospital by hospital fiscal year 2028. It must cover all Vermont hospitals by hospital fiscal year 2030, also subject to available resources. These budgets may include Medicare only as federal law allows, and must exclude Medicaid. Hospital budgets must reflect state-set prices and include meaningful variable payments and incentive plans, while limiting spending. Reviews examine network finances, leadership pay, salary comparisons, and administrative versus patient-care staffing, and follow statewide cost targets once established.
Sponsors & Cosponsors
Sponsors
There is no primary sponsor on record.
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
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
6/13/2025SenateSigned by Governor on June 12, 2025
6/13/2025SenateDelivered to Governor on June 6, 2025
6/6/2025SenateSenate Message: Report of Committee of Conference adopted
5/30/2025SenateRules suspended & ordered delivered to Governor forthwith, on motion of Senator Baruth
5/30/2025SenateAs passed by Senate and House
5/30/2025SenateCommittee of Conference report adopted
5/30/2025SenateCommittee of Conference report submitted by Senator Lyons for Committee, text
5/30/2025SenateRules suspended & taken up for immediate consideration, on motion of Senator Baruth
5/30/2025SenateCommittee of Conference report
5/30/2025SenateEntered on Notice Calendar
5/30/2025SenateHouse message: House adopted Conference Committee report
5/29/2025HouseRules suspended and bill messaged forthwith to the Senate as moved by Rep. McCoy of Poultney
5/29/2025HouseCommittee of Conference report adopted (Senate bill)
5/29/2025HouseRules suspended and taken up for immediate consideration as moved by Rep. McCoy of Poultney
5/29/2025HouseNotice Calendar: Report of Committee of Conference
5/29/2025HouseHouse message: House appointed Conference Committee members
5/23/2025HouseSpeaker 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
5/23/2025HouseSenate Message: House proposal of amendment not concurred in and Committee of Conference appointed
5/23/2025SenateRules suspended & messaged to House forthwith, on motion of Senator Baruth
5/22/2025SenateCommittee of Conference appointed: Senators Lyons, Gulick, and Douglass
5/22/2025SenateHouse proposal of amendment not concurred in; Committee of Conference requested, on motion of Senator Lyons
5/22/2025SenateHouse proposal of amendment; text
5/22/2025SenateRules suspended & taken up for immediate consideration, on motion of Senator Baruth
5/22/2025SenateHouse proposal of amendment
5/22/2025Senate
Bill Text
As Enacted (ACT 68)Opens in a new window
6/18/2025
As Passed by Both Chambers
6/3/2025
As Passed by Both Chambers (Unofficial)
6/3/2025
House Proposal of Amendment
5/22/2025
House Proposal of Amendment (Unofficial)
5/22/2025
As Passed by the Senate
3/31/2025
As Passed by the Senate (Unofficial)
3/31/2025
As Introduced
3/14/2025
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