| 1 | 1 | | BILL AS INTRODUCED H.245 |
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| 2 | 2 | | 2025 Page 1 of 15 |
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| 5 | 5 | | VT LEG #379293 v.2 |
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| 6 | 6 | | H.245 1 |
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| 7 | 7 | | Introduced by Representatives Olson of Starksboro, Donahue of Northfield, 2 |
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| 8 | 8 | | Harrison of Chittenden, Kleppner of Burlington, Logan of 3 |
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| 9 | 9 | | Burlington, Masland of Thetford, and McCann of Montpelier 4 |
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| 10 | 10 | | Referred to Committee on 5 |
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| 11 | 11 | | Date: 6 |
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| 12 | 12 | | Subject: Health; Green Mountain Care Board; health care facilities; health 7 |
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| 13 | 13 | | networks; hospital budgets 8 |
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| 14 | 14 | | Statement of purpose of bill as introduced: This bill proposes to expand the 9 |
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| 15 | 15 | | Green Mountain Care Board’s hospital budget review authority to include the 10 |
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| 16 | 16 | | option to review and approve health network budgets. It would direct the 11 |
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| 17 | 17 | | Board to investigate the impact on the public good of eliminating or reducing a 12 |
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| 18 | 18 | | hospital’s or health network’s monopoly or significant market power in a 13 |
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| 19 | 19 | | health care sector and take actions necessary to promote the public good. The 14 |
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| 20 | 20 | | bill would also give the Board additional authority to affect health system costs 15 |
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| 21 | 21 | | through its hospital and health network budget processes. 16 |
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| 22 | 22 | | An act relating to hospital and health network budgets 17 |
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| 23 | 23 | | It is hereby enacted by the General Assembly of the State of Vermont: 18 |
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| 24 | 24 | | Sec. 1. 18 V.S.A. § 9375 is amended to read: 19 |
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| 25 | 25 | | § 9375. DUTIES 20 BILL AS INTRODUCED H.245 |
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| 26 | 26 | | 2025 Page 2 of 15 |
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| 27 | 27 | | |
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| 28 | 28 | | |
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| 29 | 29 | | VT LEG #379293 v.2 |
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| 30 | 30 | | (a) The Board shall execute its duties consistent with the principles 1 |
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| 31 | 31 | | expressed in section 9371 of this title. 2 |
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| 32 | 32 | | (b) The Board shall have the following duties: 3 |
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| 33 | 33 | | * * * 4 |
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| 34 | 34 | | (7) Review and establish hospital budgets for hospitals and health 5 |
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| 35 | 35 | | networks pursuant to chapter 221, subchapter 7 of this title. 6 |
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| 36 | 36 | | * * * 7 |
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| 37 | 37 | | (16)(A) Investigate whether, in the event that a hospital or health 8 |
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| 38 | 38 | | network maintains a horizontal or vertical monopoly or significant market 9 |
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| 39 | 39 | | power in any health care sector in this State, the public good would be 10 |
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| 40 | 40 | | promoted by eliminating or reducing the monopoly or significant market 11 |
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| 41 | 41 | | power. If the investigation indicates that the public good would be promoted, 12 |
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| 42 | 42 | | the Board shall take such actions that are within its authority as are necessary 13 |
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| 43 | 43 | | or desirable to eliminate or reduce the monopoly or significant market power 14 |
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| 44 | 44 | | and shall recommend to the General Assembly any legislation needed to 15 |
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| 45 | 45 | | authorize actions that are outside the Board’s existing authority. 16 |
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| 46 | 46 | | (B) The Board may contract with one or more outside entities as 17 |
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| 47 | 47 | | needed to enable the Board to conduct an investigation pursuant to subdivision 18 |
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| 48 | 48 | | (A) of this subdivision (16) and may assess the applicable hospital or health 19 |
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| 49 | 49 | | network for the amount of the Board’s actual expenses incurred in conducting 20 |
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| 50 | 50 | | the investigation. 21 BILL AS INTRODUCED H.245 |
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| 51 | 51 | | 2025 Page 3 of 15 |
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| 52 | 52 | | |
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| 53 | 53 | | |
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| 54 | 54 | | VT LEG #379293 v.2 |
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| 55 | 55 | | * * * 1 |
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| 56 | 56 | | Sec. 2. 18 V.S.A. § 9376 is amended to read: 2 |
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| 57 | 57 | | § 9376. PAYMENT AMOUNTS; METHODS 3 |
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| 58 | 58 | | (a) It is the intent of the General Assembly to ensure payments to health 4 |
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| 59 | 59 | | care professionals that are consistent with efficiency, economy, and quality of 5 |
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| 60 | 60 | | care and; that will permit them to provide, on a solvent basis, effective and 6 |
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| 61 | 61 | | efficient health services that are in the public interest; and that are affordable 7 |
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| 62 | 62 | | and will reduce cost increase trends to an appropriate level within a reasonable 8 |
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| 63 | 63 | | period of time. It is also the intent of the General Assembly to eliminate the 9 |
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| 64 | 64 | | shift of costs between the payers of health services to ensure that the amount 10 |
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| 65 | 65 | | paid to health care professionals is sufficient to enlist enough providers to 11 |
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| 66 | 66 | | ensure that health services are available to all Vermonters and are distributed 12 |
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| 67 | 67 | | equitably. 13 |
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| 68 | 68 | | * * * 14 |
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| 69 | 69 | | Sec. 3. 18 V.S.A. chapter 221, subchapter 7 is amended to read: 15 |
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| 70 | 70 | | Subchapter 7. Hospital Budget Review 16 |
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| 71 | 71 | | § 9451. DEFINITIONS 17 |
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| 72 | 72 | | As used in this subchapter: 18 |
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| 73 | 73 | | (1) “Hospital” means a hospital licensed under chapter 43 of this title, 19 |
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| 74 | 74 | | except a hospital that is conducted, maintained, or operated by the State of 20 |
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| 75 | 75 | | Vermont. 21 BILL AS INTRODUCED H.245 |
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| 77 | 77 | | |
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| 78 | 78 | | |
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| 79 | 79 | | VT LEG #379293 v.2 |
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| 80 | 80 | | (2) “Volume” means the number of inpatient days of care or admissions 1 |
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| 81 | 81 | | and the number of all inpatient and outpatient ancillary services rendered to 2 |
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| 82 | 82 | | patients by a hospital. 3 |
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| 83 | 83 | | (3) “Health network” means a system comprising two or more affiliated 4 |
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| 84 | 84 | | hospitals, and may include other health care providers and facilities, that 5 |
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| 85 | 85 | | deliver health care services in a coordinated manner using an integrated 6 |
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| 86 | 86 | | financial and governance structure. 7 |
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| 87 | 87 | | § 9453. POWERS AND DUTIES 8 |
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| 88 | 88 | | (a) The Board shall: 9 |
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| 89 | 89 | | (1) adopt uniform formats that hospitals and health networks shall use to 10 |
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| 90 | 90 | | report financial, scope-of-services, and utilization data and information; 11 |
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| 91 | 91 | | (2) designate a data organization with which hospitals and health 12 |
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| 92 | 92 | | networks shall file financial, scope-of-services, and utilization data and 13 |
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| 93 | 93 | | information; and 14 |
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| 94 | 94 | | (3) designate a data organization or organizations to process, analyze, 15 |
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| 95 | 95 | | store, or retrieve data or information; and 16 |
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| 96 | 96 | | (4) designate one accounting entity and methodology to construct 17 |
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| 97 | 97 | | financials and budget submissions for all hospitals and health systems, unless 18 |
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| 98 | 98 | | the Board determines that an equally effective and efficient entity and 19 |
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| 99 | 99 | | methodology is appropriate. 20 BILL AS INTRODUCED H.245 |
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| 101 | 101 | | |
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| 102 | 102 | | |
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| 103 | 103 | | VT LEG #379293 v.2 |
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| 104 | 104 | | (b) To effectuate the purposes of this subchapter, the Board may adopt 1 |
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| 105 | 105 | | rules under 3 V.S.A. chapter 25. 2 |
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| 106 | 106 | | § 9454. HOSPITALS AND HEALTH NETWORKS ; DUTIES 3 |
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| 107 | 107 | | (a) Hospitals and health networks shall file the following information at the 4 |
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| 108 | 108 | | time and place and in the manner established by the Board: 5 |
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| 109 | 109 | | (1) a budget for the forthcoming fiscal year; 6 |
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| 110 | 110 | | (2) financial information, including costs of operation, revenues, assets, 7 |
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| 111 | 111 | | liabilities, fund balances, other income, rates, charges, units of services, and 8 |
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| 112 | 112 | | wage and salary data; 9 |
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| 113 | 113 | | (3) scope-of-service and volume-of-service information, including 10 |
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| 114 | 114 | | inpatient services, outpatient services, and ancillary services by type of service 11 |
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| 115 | 115 | | provided; 12 |
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| 116 | 116 | | (4) utilization information; 13 |
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| 117 | 117 | | (5) new hospital or health network services and programs proposed for 14 |
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| 118 | 118 | | the forthcoming fiscal year; 15 |
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| 119 | 119 | | (6) known depreciation schedules on existing buildings, a four-year 16 |
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| 120 | 120 | | capital expenditure projection, and a one-year capital expenditure plan; and 17 |
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| 121 | 121 | | (7) such other information as the Board may require. 18 |
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| 122 | 122 | | (b) Hospitals and health networks shall adopt a fiscal year that shall begin 19 |
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| 123 | 123 | | on October 1. 20 BILL AS INTRODUCED H.245 |
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| 125 | 125 | | |
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| 126 | 126 | | |
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| 127 | 127 | | VT LEG #379293 v.2 |
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| 128 | 128 | | (c) Hospitals and health networks shall use the accounting entity and 1 |
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| 129 | 129 | | methodology designated by the Board pursuant to subdivision 9453(a)(4) of 2 |
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| 130 | 130 | | this chapter. 3 |
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| 131 | 131 | | § 9456. BUDGET REVIEW 4 |
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| 132 | 132 | | (a)(1) The Board shall conduct reviews of each hospital’s and, at the 5 |
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| 133 | 133 | | Board’s option, each health network’s proposed budget based on the 6 |
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| 134 | 134 | | information provided pursuant to this subchapter and in accordance with a 7 |
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| 135 | 135 | | schedule established by the Board. 8 |
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| 136 | 136 | | (2) The Board may, at its discretion and in the interest of controlling 9 |
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| 137 | 137 | | health system costs, establish methodologies for reviewing each hospital’s or 10 |
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| 138 | 138 | | health network’s budgets based on revenue, based on costs, or based on the 11 |
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| 139 | 139 | | setting of a global budget for the hospital or health network. 12 |
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| 140 | 140 | | (3) Pursuant to its rate setting authority under section 9376 of this title, 13 |
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| 141 | 141 | | the Board may establish reference-based pricing for hospitals or health 14 |
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| 142 | 142 | | networks, or both. Any such reference-based pricing may apply with respect 15 |
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| 143 | 143 | | to all public and private payers, to the extent permitted under federal law, or to 16 |
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| 144 | 144 | | one or more payer segments, such as State employees, municipal employees, 17 |
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| 145 | 145 | | or school employees, or a combination of these. The Board may determine a 18 |
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| 146 | 146 | | transition period for implementation of reference-based pricing to permit 19 |
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| 147 | 147 | | appropriate reductions, as determined by the Board, in hospital or health 20 |
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| 148 | 148 | | network costs to accompany implementation. 21 BILL AS INTRODUCED H.245 |
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| 150 | 150 | | |
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| 151 | 151 | | |
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| 152 | 152 | | VT LEG #379293 v.2 |
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| 153 | 153 | | (b) In conjunction with budget reviews, the Board shall: 1 |
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| 154 | 154 | | (1) review utilization information; 2 |
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| 155 | 155 | | (2) consider the Health Resource Allocation Plan identifying Vermont’s 3 |
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| 156 | 156 | | critical health needs, goods, services, and resources developed pursuant to 4 |
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| 157 | 157 | | section 9405 of this title; 5 |
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| 158 | 158 | | (3) consider the expenditure analysis for the previous year and the 6 |
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| 159 | 159 | | proposed expenditure analysis for the year under review; 7 |
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| 160 | 160 | | (4) consider any reports from professional review organizations; 8 |
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| 161 | 161 | | (5) solicit public comment on all aspects of hospital or health network 9 |
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| 162 | 162 | | costs and use and on the budgets proposed by individual hospitals and health 10 |
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| 163 | 163 | | networks; 11 |
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| 164 | 164 | | (6) meet with hospitals and health networks to review and discuss 12 |
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| 165 | 165 | | hospital budgets for the forthcoming fiscal year; 13 |
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| 166 | 166 | | (7) give public notice of the meetings with hospitals and health 14 |
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| 167 | 167 | | networks, and invite the public to attend and to comment on the proposed 15 |
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| 168 | 168 | | budgets; 16 |
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| 169 | 169 | | (8) consider the extent to which costs incurred by the hospital or health 17 |
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| 170 | 170 | | network in connection with services provided to Medicaid beneficiaries are 18 |
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| 171 | 171 | | being charged to non-Medicaid health benefit plans and other non-Medicaid 19 |
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| 172 | 172 | | payers; 20 BILL AS INTRODUCED H.245 |
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| 174 | 174 | | |
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| 175 | 175 | | |
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| 176 | 176 | | VT LEG #379293 v.2 |
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| 177 | 177 | | (9) require each hospital to file an analysis that reflects a reduction in 1 |
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| 178 | 178 | | net revenue needs from non-Medicaid payers equal to any anticipated increase 2 |
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| 179 | 179 | | in Medicaid, Medicare, or another public health care program reimbursements, 3 |
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| 180 | 180 | | and to any reduction in bad debt or charity care due to an increase in the 4 |
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| 181 | 181 | | number of insured individuals; 5 |
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| 182 | 182 | | (10) require each hospital and health network to provide information on 6 |
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| 183 | 183 | | administrative costs, as defined by the Board, including specific information 7 |
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| 184 | 184 | | on the amounts spent on marketing and advertising costs; 8 |
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| 185 | 185 | | (11) require each hospital and health network to create or maintain 9 |
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| 186 | 186 | | connectivity to the State’s Health Information Exchange Network in 10 |
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| 187 | 187 | | accordance with the criteria established by the Vermont Information 11 |
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| 188 | 188 | | Technology Leaders, Inc., pursuant to subsection 9352(i) of this title, provided 12 |
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| 189 | 189 | | that the Board shall not require a hospital or health network to create a level of 13 |
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| 190 | 190 | | connectivity that the State’s Exchange is unable to support; 14 |
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| 191 | 191 | | (12) review the hospital’s or health network’s investments in workforce 15 |
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| 192 | 192 | | development initiatives, including nursing workforce pipeline collaborations 16 |
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| 193 | 193 | | with nursing schools and compensation and other support for nurse preceptors; 17 |
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| 194 | 194 | | and 18 |
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| 195 | 195 | | (13) consider the salaries for the hospital’s or health network’s 19 |
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| 196 | 196 | | executive and clinical leadership and the hospital’s or health network’s salary 20 BILL AS INTRODUCED H.245 |
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| 198 | 198 | | |
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| 199 | 199 | | |
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| 200 | 200 | | VT LEG #379293 v.2 |
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| 201 | 201 | | spread, including a comparison of median salaries to the medians of northern 1 |
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| 202 | 202 | | New England states. 2 |
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| 203 | 203 | | (c) Individual hospital and health network budgets established under this 3 |
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| 204 | 204 | | section shall: 4 |
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| 205 | 205 | | (1) be consistent with the Health Resource Allocation Plan; 5 |
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| 206 | 206 | | (2) take into consideration national, regional, or in-state peer group 6 |
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| 207 | 207 | | norms, according to indicators, ratios, and statistics established by the Board; 7 |
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| 208 | 208 | | (3) promote efficient and economic operation of the hospital; 8 |
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| 209 | 209 | | (4) reflect budget performances for prior years; 9 |
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| 210 | 210 | | (5) include a finding that the analysis provided in subdivision (b)(9) of 10 |
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| 211 | 211 | | this section is a reasonable methodology for reflecting a reduction in net 11 |
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| 212 | 212 | | revenues for non-Medicaid payers reasonable reduction in commercial payer 12 |
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| 213 | 213 | | rates to reflect actual and anticipated increases in reimbursements from 13 |
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| 214 | 214 | | Medicaid, Medicare, and other public health care assistance programs; and 14 |
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| 215 | 215 | | (6) demonstrate that they support equal access to appropriate mental 15 |
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| 216 | 216 | | health care that meets standards of quality, access, and affordability equivalent 16 |
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| 217 | 217 | | to other components of health care as part of an integrated, holistic system of 17 |
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| 218 | 218 | | care. 18 |
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| 219 | 219 | | (d)(1) Annually, the Board shall establish a budget for each hospital and, at 19 |
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| 220 | 220 | | the Board’s option, for one or more health networks, on or before September 20 BILL AS INTRODUCED H.245 |
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| 222 | 222 | | |
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| 223 | 223 | | |
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| 224 | 224 | | VT LEG #379293 v.2 |
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| 225 | 225 | | 15, followed by a written decision by October 1. Each hospital and health 1 |
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| 226 | 226 | | network shall operate within the budget established under this section. 2 |
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| 227 | 227 | | (2)(A) It is the General Assembly’s intent that hospital and health 3 |
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| 228 | 228 | | network cost containment conduct is afforded state action immunity under 4 |
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| 229 | 229 | | applicable federal and State antitrust laws, if: 5 |
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| 230 | 230 | | (i) the Board requires or authorizes the conduct in any hospital or 6 |
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| 231 | 231 | | health network budget established by the Board under this section; 7 |
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| 232 | 232 | | (ii) the conduct is in accordance with standards and procedures 8 |
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| 233 | 233 | | prescribed by the Board; and 9 |
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| 234 | 234 | | (iii) the conduct is actively supervised by the Board. 10 |
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| 235 | 235 | | (B) A hospital’s or health network’s violation of the Board’s 11 |
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| 236 | 236 | | standards and procedures shall be subject to enforcement pursuant to 12 |
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| 237 | 237 | | subsection (h) of this section. 13 |
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| 238 | 238 | | (3)(A) The Office of the Health Care Advocate shall have the right to 14 |
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| 239 | 239 | | receive copies of all materials related to the hospital and health network budget 15 |
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| 240 | 240 | | review and may: 16 |
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| 241 | 241 | | (i) ask questions of employees of the Green Mountain Care Board 17 |
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| 242 | 242 | | related to the Board’s hospital or health network budget review; 18 |
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| 243 | 243 | | (ii) submit written questions to the Board that the Board will ask 19 |
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| 244 | 244 | | of hospitals and health networks in advance of any hearing held in conjunction 20 |
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| 245 | 245 | | with the Board’s hospital or health network review:; 21 BILL AS INTRODUCED H.245 |
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| 247 | 247 | | |
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| 248 | 248 | | |
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| 249 | 249 | | VT LEG #379293 v.2 |
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| 250 | 250 | | (iii) submit written comments for the Board’s consideration; and 1 |
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| 251 | 251 | | (iv) ask questions and provide testimony in any hearing held in 2 |
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| 252 | 252 | | conjunction with the Board’s hospital or health network budget review. 3 |
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| 253 | 253 | | (B) The Office of the Health Care Advocate shall not further disclose 4 |
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| 254 | 254 | | any confidential or proprietary information provided to the Office pursuant to 5 |
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| 255 | 255 | | this subdivision (3). 6 |
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| 256 | 256 | | (4) The Board may adopt rules to incorporate certificate of need 7 |
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| 257 | 257 | | determinations into the budget review process of a hospital or health network. 8 |
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| 258 | 258 | | The rules shall retain the jurisdictional thresholds and required criteria set forth 9 |
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| 259 | 259 | | in subchapter 5 of this chapter but may provide for a streamlined process that 10 |
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| 260 | 260 | | reduces costs for the Board or the applicant, or both. 11 |
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| 261 | 261 | | (e) The Board may establish a process to define, on an annual basis, criteria 12 |
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| 262 | 262 | | for hospitals and health networks to meet, such as utilization and inflation 13 |
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| 263 | 263 | | benchmarks. The Board may waive one or more of the review processes listed 14 |
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| 264 | 264 | | in subsection (b) of this section. 15 |
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| 265 | 265 | | (f)(1) The Board may, upon application, adjust a budget established under 16 |
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| 266 | 266 | | this section upon a showing of need based upon exceptional or unforeseen 17 |
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| 267 | 267 | | circumstances in accordance with the criteria and processes established under 18 |
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| 268 | 268 | | section 9405 of this title. 19 BILL AS INTRODUCED H.245 |
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| 270 | 270 | | |
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| 271 | 271 | | |
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| 272 | 272 | | VT LEG #379293 v.2 |
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| 273 | 273 | | (2) A hospital or health network shall not increase its rates in response 1 |
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| 274 | 274 | | to a revenue shortfall in the absence of exceptional circumstances, as 2 |
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| 275 | 275 | | determined and approved by the Board. 3 |
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| 276 | 276 | | (g) The Board may request, and a hospital or health network shall provide, 4 |
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| 277 | 277 | | information determined by the Board to be necessary to determine whether the 5 |
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| 278 | 278 | | hospital or health network is operating within a budget established under this 6 |
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| 279 | 279 | | section. For purposes of this subsection, subsection (h) of this section, and 7 |
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| 280 | 280 | | subdivision 9454(a)(7) of this title, the Board’s authority shall extend to an 8 |
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| 281 | 281 | | affiliated corporation or other person in the control of or controlled by the 9 |
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| 282 | 282 | | hospital or health network to the extent that such authority is necessary to carry 10 |
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| 283 | 283 | | out the purposes of this subsection, subsection (h) of this section, or 11 |
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| 284 | 284 | | subdivision 9454(a)(7) of this title. As used in this subsection, a rebuttable 12 |
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| 285 | 285 | | presumption of “control” is created if the entity, hospital, health network, or 13 |
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| 286 | 286 | | other person, directly or indirectly, owns, controls, holds with the power to 14 |
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| 287 | 287 | | vote, or holds proxies representing 20 percent or more of the voting securities 15 |
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| 288 | 288 | | or membership interest or other governing interest of the hospital, health 16 |
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| 289 | 289 | | network, or other controlled entity. 17 |
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| 290 | 290 | | (h)(1) If a hospital or health network violates a provision of this section, the 18 |
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| 291 | 291 | | Board may maintain an action in the Superior Court of the county in which the 19 |
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| 292 | 292 | | hospital is located or the health network is headquartered to enjoin, restrain, or 20 |
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| 293 | 293 | | prevent such violation. 21 BILL AS INTRODUCED H.245 |
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| 295 | 295 | | |
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| 296 | 296 | | |
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| 297 | 297 | | VT LEG #379293 v.2 |
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| 298 | 298 | | (2)(A)(i) After notice and an opportunity for hearing, the Board may 1 |
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| 299 | 299 | | impose on a person who knowingly violates a provision of this subchapter, or a 2 |
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| 300 | 300 | | rule adopted pursuant to this subchapter, a civil an administrative penalty of no 3 |
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| 301 | 301 | | not more than $40,000.00 $400,000.00, or in the case of a continuing violation, 4 |
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| 302 | 302 | | a civil an administrative penalty of no not more than $100,000.00 5 |
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| 303 | 303 | | $1,000,000.00 or one-tenth of one percent of the gross annual revenues of the 6 |
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| 304 | 304 | | hospital or health network, whichever is greater. This subdivision (2)(A)(i) 7 |
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| 305 | 305 | | shall not apply to violations of subsection (d) of this section caused by 8 |
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| 306 | 306 | | exceptional or unforeseen circumstances. 9 |
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| 307 | 307 | | (ii) After notice and an opportunity for hearing, the Board may 10 |
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| 308 | 308 | | order all or a portion of the amount of a penalty imposed pursuant to 11 |
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| 309 | 309 | | subdivision (i) of this subdivision (2)(A) to be withheld from the compensation 12 |
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| 310 | 310 | | of the hospital’s or health network’s executive officer or officers responsible 13 |
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| 311 | 311 | | for the violation and remitted to the Board in partial or complete satisfaction of 14 |
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| 312 | 312 | | the penalty, as applicable. 15 |
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| 313 | 313 | | (B)(i) The Board may order a hospital or health network to: 16 |
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| 314 | 314 | | (I)(aa) cease material violations of this subchapter or of a 17 |
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| 315 | 315 | | regulation or order issued pursuant to this subchapter; or 18 |
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| 316 | 316 | | (bb) cease operating contrary to the budget established for 19 |
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| 317 | 317 | | the hospital or health network under this section, provided such a deviation 20 |
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| 318 | 318 | | from the budget is material; and 21 BILL AS INTRODUCED H.245 |
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| 320 | 320 | | |
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| 321 | 321 | | |
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| 322 | 322 | | VT LEG #379293 v.2 |
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| 323 | 323 | | (II) take such corrective measures as are necessary to remediate 1 |
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| 324 | 324 | | the violation or deviation and to carry out the purposes of this subchapter. 2 |
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| 325 | 325 | | (ii) Orders issued under this subdivision (2)(B) shall be issued 3 |
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| 326 | 326 | | after notice and an opportunity to be heard, except where the Board finds that a 4 |
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| 327 | 327 | | hospital’s or health network’s financial or other emergency circumstances pose 5 |
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| 328 | 328 | | an immediate threat of harm to the public or to the financial condition of the 6 |
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| 329 | 329 | | hospital or health network. Where there is an immediate threat, the Board may 7 |
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| 330 | 330 | | issue orders under this subdivision (2)(B) without written or oral notice to the 8 |
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| 331 | 331 | | hospital or health network. Where an order is issued without notice, the 9 |
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| 332 | 332 | | hospital or health network shall be notified of the right to a hearing at the time 10 |
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| 333 | 333 | | the order is issued. The hearing shall be held within 30 days after receipt of 11 |
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| 334 | 334 | | the hospital’s or health network’s request for a hearing, and a decision shall be 12 |
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| 335 | 335 | | issued within 30 days after conclusion of the hearing. The Board may increase 13 |
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| 336 | 336 | | the time to hold the hearing or to render the decision for good cause shown. 14 |
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| 337 | 337 | | Hospitals and health networks may appeal any decision in this subsection to 15 |
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| 338 | 338 | | Superior Court. Appeal shall be on the record as developed by the Board in 16 |
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| 339 | 339 | | the administrative proceeding and the standard of review shall be as provided 17 |
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| 340 | 340 | | in 8 V.S.A. § 16. 18 |
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| 341 | 341 | | (C)(i) Notwithstanding any provision of 3 V.S.A. chapter 25 to the 19 |
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| 342 | 342 | | contrary, the Board may establish a process to reduce expenditures for a 20 |
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| 343 | 343 | | hospital or health network that violates its budget order. The process shall 21 BILL AS INTRODUCED H.245 |
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| 344 | 344 | | 2025 Page 15 of 15 |
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| 345 | 345 | | |
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| 346 | 346 | | |
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| 347 | 347 | | VT LEG #379293 v.2 |
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| 348 | 348 | | include notice and an opportunity to be heard and provide an opportunity for 1 |
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| 349 | 349 | | public comment. 2 |
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| 350 | 350 | | (ii) A hospital or health network that seeks to reduce expenditures 3 |
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| 351 | 351 | | for patient services in response to the Board’s budget violation order shall do 4 |
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| 352 | 352 | | so in accordance with a compliance plan approved by the Board. 5 |
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| 353 | 353 | | (3)(A) The Board shall require the officers and directors of a hospital or 6 |
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| 354 | 354 | | health network to file under oath, on a form and in a manner prescribed by the 7 |
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| 355 | 355 | | Board, any information designated by the Board and required pursuant to this 8 |
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| 356 | 356 | | subchapter. The authority granted to the Board under this subsection (h) is in 9 |
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| 357 | 357 | | addition to any other authority granted to the Board under law. 10 |
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| 358 | 358 | | (B) A person who knowingly makes a false statement under oath or 11 |
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| 359 | 359 | | who knowingly submits false information under oath to the Board or to a 12 |
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| 360 | 360 | | hearing officer appointed by the Board or who knowingly testifies falsely in 13 |
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| 361 | 361 | | any proceeding before the Board or a hearing officer appointed by the Board 14 |
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| 362 | 362 | | shall be guilty of perjury and punished as provided in 13 V.S.A. § 2901. 15 |
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| 363 | 363 | | * * * 16 |
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| 364 | 364 | | Sec. 4. EFFECTIVE DATE 17 |
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| 365 | 365 | | This act shall take effect on July 1, 2025 and Sec. 3 (amendments to 18 |
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| 366 | 366 | | hospital and health system budget review) shall apply beginning with hospital 19 |
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| 367 | 367 | | fiscal year 2027. 20 |
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