VT LEG #381851 v.1
S.126 – An act relating to health care payment and
delivery system reform
As recommended by the Senate Committee on Appropriations
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Bill Summary
he bill proposes to enact certain health care payment and delivery system reforms to promote the
transformation of Vermont’s health care system.
The bill as introduced by the Senate Committee on Health and Welfare included five new permanent
positions and an appropriation of $1.5 million to the Green Mountain Care Board (GMCB) and 2 new
limited-service positions and an appropriation of $1.78 million to the Agency of Human Services (AHS).
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The bill as recommended by the Senate Committee on Appropriations would remove the positions and
appropriations from the bill with the intention of adding them to the budget.
The bill would:
• Direct GMCB to implement reference-based pricing and establish standards for global hospital
budgets;
• Require hospitals to disclose more information regarding executive compensation;
• Require the Agency of Human Services (AHS), in collaboration with GMCB and the Department
of Financial Regulation (DFR), the Vermont Program for Quality in Health Care (VPQHC), the
Office of the Health Care Advocate (HCA), and an advisory committee (also created in the bill) to
develop an integrated Statewide Health Care Delivery Plan; and
• Require AHS to develop an integrated system of clinical and claims data.
Fiscal Impact
There are no appropriations in the bill as recommended by the Senate Committee on Appropriations.
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The Joint Fiscal Office (JFO) is a nonpartisan legislative office dedicated to producing unbiased fiscal analysis – this fiscal note is
meant to provide information for legislative consideration, not to provide policy recommendations.
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The fiscal note for the bill as introduced by the Senate Committee on Health and Welfare can be found here.
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March 20, 2025 Nolan Langweil, Principal Fiscal Analyst S.126 - An act relating to health care payment and delivery system reform 2
VT LEG #381851 v.1
Appendix: Resources
• Green Mountain Care Board – 2024 Reference-Based Pricing and Data Analysis Report, in
accordance with Act 113 of 2024, Sec. E.345.2. https://gmcboard.vermont.gov/Reference-Base-
Pricing
• Vermont State Auditor – Strategies to Control the Rising Costs of State Employee Health Care:
Investigative Report 21-07 (2021).
https://auditor.vermont.gov/sites/auditor/files/documents/20211110%20%20State%20Employee%
20Health%20Care%20Price%20Variation%20Report.pdf
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The bill as introduced is available here:
https://legislature.vermont.gov/Documents/2026/Docs/BILLS/S-0126/S-0126%20As%20Introduced.pdf
The full fiscal note history is available on the fiscal tab of the bill page on the General Assembly website and can be pulled up
through a bill number search on the JFO page.