Vermont 2025-2026 Regular Session Status: Enacted

H 482 — An act relating to Green Mountain Care Board authority to adjust a hospital’s reimbursement rates and to appoint a hospital observer

Last action — House message: Governor approved bill on June 5, 2025

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed House
  4. ✓
    Passed Senate
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced March 18, 2025. Enacted.

Signed by Governor Phil Scott (Republican) on June 05, 2025.

Prognosis

Advancing 50% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

What changed in the latest version

120 added · 109 removed

Plain-language change summary

The changes to Bill H.482 include the addition of a new section related to reimbursement adjustments for hospitals and modifications to existing language regarding the appointment of an independent hospital observer. This matters because it clarifies the processes and criteria for adjusting how hospitals are reimbursed, aiming to ensure financial stability in the healthcare system. Additionally, the ability to appoint an observer provides a mechanism for oversight, which may improve accountability and transparency in hospital operations.

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AS PASSED BY HOUSE H.482 Page 1 of 5 H.482 An act relating to Green Mountain Care Board authority to adjust a hospital’s reimbursement rates and to appoint a hospital observer It is hereby enacted by the General Assembly of the State of Vermont:
BILL AS PASSED BY THE HOUSE H.482 Page 1 of 6 H.482 Introduced by Committee on Health Care Date:
Subject:
Health;
hospitals;
health insurers;
Green Mountain Care Board;
hospital observer Statement of purpose of bill as introduced:
This bill proposes to authorize the Green Mountain Care Board to reduce a health insurer’s reimbursement rates to one or more hospitals if the health insurer is at imminent risk of insolvency.
The bill would permit the Board to reduce a hospital’s budget for the forthcoming fiscal year to account for the hospital’s budget overage in the previous fiscal year.
The bill would also allow the Board to appoint an independent observer to oversee a hospital and its operations if the Board finds the hospital has made a material misrepresentation or is out of compliance with its budget and the Board believes that appointing an independent observer is in the public interest.
An act relating to Green Mountain Care Board authority to adjust a hospital’s reimbursement rates and to appoint a hospital observer It is hereby enacted by the General Assembly of the State of Vermont:
§ 9384 is added to read:
§ 9384 is added to read:
§ 9384.
BILL AS PASSED BY THE HOUSE H.482 Page 2 of 6 § 9384.
§ 8304, the Board may order a reduction of the insurer’s reimbursement rates to one or more Vermont hospitals as set forth in subsection (c) of this section until such VT LEG #381918 v.1 AS PASSED BY HOUSE H.482 Page 2 of 5 time as the amount of the insurer’s risk-based capital exceeds the company action level risk-based capital threshold defined in 8 V.S.A.
§ 8304, the Board may order a reduction of the insurer’s reimbursement rates to one or more Vermont hospitals as set forth in subsection (c) of this section until such time as the amount of the insurer’s risk-based capital exceeds the company action level risk-based capital threshold defined in 8 V.S.A.
(A) the hospital has more than 135 days’ cash on hand and had a positive operating margin in the previous fiscal year;
BILL AS PASSED BY THE HOUSE H.482 Page 3 of 6 (A) the hospital has more than 135 days’ cash on hand and had a positive operating margin in the previous fiscal year;
§ 9456 is amended to read:
§ 9456 is amended to read:
* * * VT LEG #381918 v.1 AS PASSED BY HOUSE H.482 Page 3 of 5 (4) reflect budget performances for prior years reconcile any significant deviation in revenue during the previous fiscal year in excess of the budget established for the hospital pursuant to this section, using a methodology established by the Board;
* * * (4) reflect budget performances for prior years reconcile any significant deviation in revenue during the previous fiscal year in excess of the budget established for the hospital pursuant to this section, using a methodology established by the Board;
* * * (f)(1) The Board may, upon application, adjust a budget established under this section upon a showing of need based upon exceptional or unforeseen circumstances in accordance with the criteria and processes established under section 9405 of this title.
BILL AS PASSED BY THE HOUSE H.482 Page 4 of 6 * * * (f)(1) The Board may, upon application, adjust a budget established under this section upon a showing of need based upon exceptional or unforeseen circumstances in accordance with the criteria and processes established under section 9405 of this title.
As used in this VT LEG #381918 v.1 AS PASSED BY HOUSE H.482 Page 4 of 5 subsection, a rebuttable presumption of “control” is created if the entity, hospital, or other person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing 20 percent or more of the voting securities or membership interest or other governing interest of the hospital or other controlled entity.
As used in this subsection, a rebuttable presumption of “control” is created if the entity, hospital, or other person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing 20 percent or more of the voting BILL AS PASSED BY THE HOUSE H.482 Page 5 of 6 securities or membership interest or other governing interest of the hospital or other controlled entity.
The independent observer shall share information provided by the hospital with the Board and with the Office of the Health Care Advocate in accordance with subdivision (d)(3) of VT LEG #381918 v.1 AS PASSED BY HOUSE H.482 Page 5 of 5 this section but shall not otherwise disclose any confidential or proprietary information that the independent observer obtained from the hospital.
The independent observer shall share information provided by the hospital with the Board and with the Office of the Health Care Advocate in accordance with subdivision (d)(3) of this section but shall not otherwise disclose any confidential or proprietary information that the independent observer obtained from the hospital.
(C) The Board may order a hospital to pay for all or a portion of the costs of an independent observer appointed for the hospital pursuant to this subdivision (2).
BILL AS PASSED BY THE HOUSE H.482 Page 6 of 6 (C) The Board may order a hospital to pay for all or a portion of the costs of an independent observer appointed for the hospital pursuant to this subdivision (2).
§ 9456(g)(2) (authority to appoint independent hospital observer) is repealed on January 1, 2030.
§ 9456(g)(2) (authority to appoint independent hospital observer) is repealed on January 1, 2030.
VT LEG #381918 v.1
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How this bill changes current law

6 changes Share ↗

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

This act enhances the Green Mountain Care Board's authority to adjust hospital reimbursement rates and appoint an observer for hospitals under specific financial conditions.

  • The Green Mountain Care Board may reduce a domestic health insurer’s reimbursement rates to one or more Vermont hospitals if the insurer is facing an acute and immediate threat of insolvency.

    This change allows the GMCB to lower insurer reimbursement rates to hospitals in cases of insurer insolvency risk.

  • The GMCB may adjust a hospital’s commercial health insurance reimbursement rates at any time during the year to ensure that a hospital stays within its approved budget.

    This allows the GMCB to make reimbursement changes throughout the year based on budget compliance.

  • Upon finding that a hospital has made a material misrepresentation in information or documents it provided to GMCB, or is materially noncompliant with its approved budget, the GMCB may appoint an independent observer for the hospital.

    This enables the GMCB to oversee hospitals that have significant compliance issues.

  • The independent observer may monitor the hospital’s operations, obtain information from the hospital, and report findings and recommendations to the GMCB.

    This provision enables oversight of hospitals suspected of noncompliance.

  • The GMCB may order a hospital to pay for all or a portion of the costs of the observer.

    This allows the GMCB to pass the costs of oversight back to the hospital.

  • The GMCB’s authority to appoint a hospital observer is repealed on January 1, 2030.

    This sets a sunset clause for the observer appointment authority.

Amendments

2 amendments

Click Show changes on an amendment above to see how it modifies the bill.

Action History

  1. House message: Governor approved bill on June 5, 2025

  2. Signed by Governor on June 5, 2025

  3. Delivered to the Governor on May 30, 2025

  4. House message: House concurred in Senate proposal of amendment

  5. Senate proposal of amendment concurred in

  6. Action Calendar: Senate Proposal of Amendment

  7. Notice Calendar: Senate Proposal of Amendment

  8. Senate Message: Passed in concurrence with proposal of amendment

  9. Division of the Senate Y-16, N-12

  10. Read 3rd time & passed in concurrence with proposal of amendment

  11. New Business/Third Reading

  12. 3rd reading ordered

  13. Proposal of amendment by Committee on Health and Welfare agreed to

  14. Read 2nd time, reported favorably with proposal of amendment by Senator Cummings for Committee on Health and Welfare

  15. Favorable report with proposal of amendment by Committee on Health and Welfare

  16. Unfinished Business/Second Reading

  17. Favorable report with proposal of amendment by Committee on Health and Welfare

  18. Unfinished Business/Second Reading

  19. Favorable report with proposal of amendment by Committee on Health and Welfare

  20. New Business/Second Reading

  21. Favorable report with proposal of amendment by Committee on Health and Welfare

  22. Second Reading

  23. Entered on Notice Calendar

  24. Read 1st time & referred to Committee on Health and Welfare

  25. Rules suspended and bill messaged forthwith to the Senate as moved by Rep. McCoy of Poultney

  26. Read third time and passed

  27. Action Calendar: Third Reading

  28. Third Reading ordered

  29. Rep. Black of Essex spoke for the Committee on Health Care

  30. Read second time

  31. Action Calendar: Committee bill for second reading

  32. Notice Calendar: Committee bill for second reading

  33. Committee bill read the first time and placed on Notice Calendar of 3/19/2025

Sponsors

  • House Committee on Health Care · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 189 not signed on

Sponsors (1)

  • House Committee on Health Care

Co-sponsors (0)

None.

Not signed on (189)

189 members have not signed on to this bill.

Show all 189 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

public-safety healthcare health-insurance
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Frequently asked questions

Who sponsors H 482?
H 482 is sponsored by House Committee on Health Care.
What is the current status of H 482?
This bill has been enacted into law. Introduced March 18, 2025. Enacted.
Where can I track H 482?
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