[{"_1":2,"_87":-5,"_88":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},"mediaId",6103009,"mediaKeyId","2802344-955579d11dc94da755bcb9494064a86d","parentId",2802344,"title","Senate panel reviews bill to expand Office of the Health Care Advocate’s role and access to information","audioSeconds",1430,"startMs",1704000,"endMs",3134000,"viewUrl","/Search/View?dp=1&key=2802344-955579d11dc94da755bcb9494064a86d&start=1704&end=3134","thumbnailUrl","https://assets.pipeline.soar.com/2802344-955579d11dc94da755bcb9494064a86d/thumbnail_1704000.jpg","articleUrl","/articles/6103009/Vermont/Senate-panel-reviews-bill-to-expand-Office-of-the-Health-Care-Advocates-role-and-access-to-information","mediaUrl","https://secure.pipeline.soar.com/6103009-766df8af4368015caced9e5ef107e496/orig.mp4?Expires=1771161748&Signature=cV6aywUCpysK3c~ys21Fw0fSZCufwL6qsl3G2c5HwEyBKBXTj-4V3LSSAq9oehU3B8gajp~ZDbNoq9xMDr4dwPAqsaYozB3apMVMz8xXP0ILuOLsV8~Mza7ENH4s7AJqAgFgzAy0wtpITxeLmh0YWXeAstsrb8i8VX4pYXkCLrUev~DL1rbwYI-Uo-5873a4CYDxIoyO0zMWLt7eau1B6xhft7O0ve55QTWna-mcOUGwre7jxnUECk30ehMuRQ303t~nSxeg8ykWd0g8f58-icT95HVwkjdhFrzRqBTj4vgoQx-XCH6bsn0wyI2fLjwEJsqdsoX6q87kVC~CJtM31g__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-03-28T00:32:57.383Z","article","Jen Harvey of the Office of Legislative Council walked the Senate Health and Welfare Committee through the House bill that updates and broadens the Office of the Health Care Advocate’s statutory role.

“So now we will walk through the bill,” Harvey said at the start of her presentation.

The measure revises Title 18 statutory language to expand the office’s focus beyond health insurance to a broader charge on access to health care and affordability. At the hearing Harvey and other participants described changes that would strengthen the office’s ability to participate in rate review, certificate-of-need (CON) proceedings, and state policymaking that affects health care access.

Why it matters: the Office of the Health Care Advocate assists Vermonters with insurance and access problems, files public comments in regulatory proceedings and may intervene in CON cases. The bill would codify and expand that role, clarify confidentiality rules for sensitive materials, and require state agencies to facilitate meaningful participation by the office in matters of significant state policy.

Key changes noted by Legislative Council

- Rate review questions: Under current law the office may submit suggested questions to the GMCB for its contracting actuary; the bill would allow the office to submit questions “with a substantial relationship to the rate filing and review criteria” that the board shall ask the insurer directly or through a contracting actuary.

- Certificate-of-need participation: If the Office of the Health Care Advocate or the long-term care ombudsman files a notice of intervention in a CON application, the bill would give the office the right to receive copies of materials related to the application. Legislative Council said proposals remain under discussion about whether the office should be able to question GMCB staff directly; regulators have signaled concerns about that narrower proposal and a deletion is expected.

- Broader statutory mission and duties: The bill expands statutory language to refer to Vermonters generally and to matters of both health insurance and access to health care. It would allow the office to pursue administrative, judicial and other remedies on behalf of individuals experiencing problems with health insurance or access to health care and to represent interests before the GMCB, the Department of Financial Regulation (DFR), and other state agencies.

- Confidentiality and consent: The bill reinforces that the office must maintain confidentiality for information received and acknowledges that certain agencies—most notably the Agency of Human Services when acting in a Medicaid capacity—may require written consent from an individual or their legal representative before releasing protected records.

- Agency duties and access: The bill states legislative intent that state agencies consult the office on matters of significant state health policy and obliges agencies to comply with reasonable requests for information and assistance; it also provides a path for the office to access confidential or proprietary information when appropriate, subject to legal limits and non-disclosure obligations.

- Conflicts of interest and reporting: The bill would require the office to report potential conflicts of interest to the Agency of Human Services (which holds the contract with the office) and clarifies that unpaid service on certain nonprofit boards is not a per se conflict.

- Effective date: The bill would take effect July 1.

What committee members asked and next steps

Committee members asked whether the changes require additional appropriation; Legislative Council and the presenter said much of the work is already being done by the office and that the bill primarily codifies existing practice. Harvey noted there are pending technical edits and that stakeholders (GMCB, DFR, AHS, Vermont Legal Aid) are continuing discussions about specific wording, including narrow deletions related to questioning board staff.

Toward the end of the session Harvey summarized the bill’s practical effect: “It’s gonna be a really powerful health care advocate. Okay. It's a great help.”

Committee staff said they will schedule further briefings with the Office of the Health Care Advocate, GMCB and other affected agencies; no committee vote was recorded in the transcript.

","mediaType","Video","parentTitle","Senate Health and Welfare - 2025-03-27 - 9:00AM","oneSentenceSummary","Legislative Council attorney Jen Harvey briefed the Senate Health and Welfare Committee on a House bill that would broaden the Office of the Health Care Advocate’s statutory authority to ask questions in rate reviews, access CON materials upon intervention, and represent Vermonters before multiple state agencies.","taxTitle","Health & Welfare, SENATE, Committees, Legislative , Vermont","taxId",38585,"location","Vermont","headline","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":72,"_73":56,"_74":56},6103015,"Senate committee reviews H.482 to give Green Mountain Care Board limited power to reduce hospital rates and appoint independent observer",853,590000,1443000,"/Search/View?dp=1&key=2802344-955579d11dc94da755bcb9494064a86d&start=590&end=1443","https://assets.pipeline.soar.com/2802344-955579d11dc94da755bcb9494064a86d/thumbnail_590000.jpg","/articles/6103015/Vermont/Senate-committee-reviews-H482-to-give-Green-Mountain-Care-Board-limited-power-to-reduce-hospital-rates-and-appoint-independent-observer","https://secure.pipeline.soar.com/6103015-6bb6ca6ca2de4816ac4c002ccc45892f/orig.mp4?Expires=1771161748&Signature=FcHtIZnDQHJ8uFWgwFPIJyFxtTG-EeSsIQi6lCMrPEos78xnbjGB2yP5MSEekX00JfifY1DD~v879K3D4ChoTabzwuT1sloJXeP~hJfzywMdUhSRSk8GYoC9sSKeDazDasA2fUMipDBalWGw61lX8yM2n-CixdonrJa-Pu-GIaUTxXlz82RU1kHLUw1oKRzZRf2fs2XCSldkWR0U01krf6pVEhRynF16m3Pg7AyoFeeiHLZvqouQmMxaEx2hqeQNf4FnSK9sbxSAcCyLthnPabQCP7ZrMXlmoPnRwd3v0WqHd1BP0N5CTRl4lQm~sSMUdNnE40k1YEwYNs8LnX59xA__&Key-Pair-Id=KUT5TJCACFTXG","Representative Black, reporting H.482 to the Senate Health and Welfare Committee on March 27, described the bill as a targeted, time-limited tool for regulators to protect the solvency of Vermont domiciled insurers while limiting harm to hospitals.

“I have been reading this bill for the last 2 weeks since you passed it out. Our committee has already started taking testimony on it. I am excited. I am grateful to all of you for the enormous amount of work that you put into this. And this is a fantastic road map of where we need to be,” Representative Black said.

The bill, as outlined by Ben Cardi of the Legislative Council, would give the Green Mountain Care Board (GMCB) authority in narrowly defined circumstances to reduce reimbursement rates paid by a Vermont-domiciled insurer to one or more Vermont hospitals or hospital networks. “We are on screen looking at h 4 82, which is an act relating to Green Mountain Care Board authority to adjust a hospital's reimbursement rates and for point a hospital observer,” Cardi said.

Why it matters: the measure is intended as a remedy if a Vermont-based insurer faces an acute threat to solvency as measured under the state’s risk-based capital triggers (statutory measures cited in Title 8). By statute the GMCB sets hospital budgets and reviews rates; H.482 would add a limited, conditional mechanism to adjust commercial reimbursement flows to preserve insurer solvency while capping downstream effects on hospitals.

Key provisions described at the hearing

- Triggers and scope: The bill lets the GMCB act only after consultation with the Commissioner of Financial Regulation and only if a domestic health insurer’s risk-based capital has reached a regulatory action level that poses an acute, immediate insolvency threat (language in the bill relies on Title 8 risk-based capital definitions). The authority applies to hospitals that meet specific financial criteria or to hospital networks that meet the criteria at the consolidated level.

- Eligibility criteria: A hospital would be eligible for a rate reduction only if it has more than 135 days cash on hand and had a positive operating margin in the prior fiscal year, or if it is part of a hospital network that at the consolidated level has more than 135 days cash on hand or a positive operating margin in the prior fiscal year.

- Limit on harm to hospitals: Any reduction ordered by the GMCB may be no greater than necessary to remediate the insurer solvency threat and may not reduce a hospital’s projected days cash on hand below 125 days.

- Independent observer: If the GMCB finds that a hospital materially misrepresented information or is materially noncompliant with an established budget, the board may appoint an independent observer to observe operations, obtain information, and report findings to the board. The observer would receive copies of materials related to the board’s review but is required to keep confidential and proprietary information confidential and to share observations with the GMCB and with the Office of the Health Care Advocate (subject to confidentiality rules). The GMCB may require the hospital to pay all or part of the observer’s costs.

- Budget-review authority: The bill would clarify that GMCB hospital budgets may reconcile significant revenue deviations in the previous fiscal year using a methodology established by the board, and would permit the board on its own initiative to adjust commercial insurance reimbursement rates during a hospital fiscal year to ensure the hospital operates within its established budget.

- Time limits and effective date: The independent observer authority would sunset on Jan. 1, 2030; the act would take effect on passage.

What supporters said at the hearing

Representative Black framed the bill as a “road map” and said the Legislature should give regulators tools they may need even if those tools are never used, because doing so signals accountability to Vermonters. Cardi emphasized the bill contains “very specific triggers” and is time-limited.

Committee process and next steps

Legislative Council and committee members said they will hear from the Green Mountain Care Board and the Department of Financial Regulation for technical input; Representative Black offered to provide the committee’s floor report. No committee vote or formal action on H.482 was recorded during the meeting. Committee members noted the House had heard testimony from the Green Mountain Care Board chair and the Vermont Association of Hospitals.

Background and context

Committee members referenced a voluntary mitigation proposal submitted by UVM Medical Center and the UVM Health Network to the GMCB and to Blue Cross Blue Shield of Vermont as an example of hospitals and insurers negotiating over revenue and investments in primary care. The bill’s authors said H.482 essentially codifies an emergency regulatory tool that regulators and stakeholders discussed during recent budget and rate negotiations.

The committee did not take a final vote; staff said additional briefings from regulators and stakeholders will be scheduled.

","Representative Black reported H.482 to the Senate Health and Welfare Committee on March 27, a bill giving the Green Mountain Care Board conditional authority to order reductions in hospital reimbursement rates and to appoint an independent observer when a Vermont insurer faces an acute solvency threat.","actionData","errors"]

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Senate panel reviews bill to expand Office of the Health Care Advocate’s role and access to information

Senate committee reviews H.482 to give Green Mountain Care Board limited power to reduce hospital rates and appoint independent observer