Among other things, the bill would direct the Agency of Human Service to develop a proposal for a public option for small businesses to use to purchase health coverage for their employees and require the Agency to propose a schedule of sliding-scale cost-sharing requirements for the Medicaid program. The bill would also require the Agency to recommend modifications to specialty care reimbursement rates and to report on potential changes to the structure of Vermont’s health insurance markets.

Among other things, the bill would direct the Agency of Human Service to develop a proposal for a public option for small businesses to use to purchase health coverage for their employees and require the Agency to propose a schedule of sliding-scale cost-sharing requirements for the Medicaid program. The bill would also require the Agency to recommend modifications to specialty care reimbursement rates and to report on potential changes to the structure of Vermont’s health insurance markets.

Amends the regulatory duties of the Green Mountain Care Board to include engaging in payment and delivery system reform, including developing and maintaining a method for evaluating systemwide performance and quality. Requires insurer participation in multipayer alternative payment models, global hospital budgets, reference-based pricing, site-neutral payments, and other strategies to promote equitable reimbursement. Also requires the office of the attorney general, in collaboration with the green mountain care board, to develop joint legislative proposals for appropriate review and approval of mergers, affiliations, and divestments involving hospitals, clinics, independent practices, long-term care facilities, and other health care providers located in Vermont by the office of the attorney general or the green mountain care board, or both.

Amends prior authorization requirements.

An act relating to pay parity and transparency in health care. This bill proposes to require the Green Mountain Care Board to review health care contacts and fee schedules between health plans and health care providers to increase transparency in health care. This bill would also increase primary care payments and spending and provide an exemption from prior authorization requirements. This bill also proposes to make certain temporary prohibitions on pharmacy benefit managers permanent.

An act relating to expanding eligibility for health insurance to all income-eligible adults regardless of immigration status

An act relating to expanding eligibility for health insurance to all income-eligible adults regardless of immigration status