Green Mountain Care Board details hospital budget enforcement process amid UVM Health Network hearings

The Green Mountain Care Board (GMCB) is reinforcing its commitment to budget enforcement for Vermont hospitals, emphasizing the legal obligation for hospitals to operate within established budgets. During a recent meeting, board members outlined the structured process for budget enforcement, which is rooted in state statute and reinforced by board rules and policies.

Key to this enforcement is the requirement that each hospital must submit its budget by September 15 each year, with a written decision from the board following two weeks later. Hospitals are legally bound to adhere to these budgets, and the board has established a clear procedure for addressing any budgetary non-compliance.

The board's enforcement process allows hospitals to request adjustments if they anticipate exceeding their budgets. For instance, if a hospital experiences an influx of patients requiring urgent care, it can present its case to the board at any time during the fiscal year. However, if a hospital fails to comply and exceeds its budget without prior adjustment, the board will review the situation based on specific criteria, including the hospital's financial position and performance in previous years.

In a recent case involving the UVM Health Network, the board received actual financial data from the hospitals in early spring and initiated a review process. Following a series of communications, including a letter from UVM requesting an extension for providing necessary information, the board scheduled a hearing to discuss budget overages. This hearing took place on August 28, where the board and UVM addressed the budget issues in detail.

Despite the thorough process, UVM later contested the board's enforcement actions, claiming that the proceedings constituted a contested case, a claim the board rejected. The GMCB maintains that budget decisions are not contested cases, and the enforcement actions taken were consistent with established procedures.

As the board prepares to finalize its budget decisions by the statutory deadline of September 15, the ongoing discussions highlight the importance of transparency and adherence to established financial guidelines in Vermont's healthcare system. The GMCB's structured approach aims to ensure that hospitals remain accountable while providing necessary care to their communities.