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S 190VERMONTSession 2025-2026State BillVetoed by the governor

Did Not Advance

Vermont S.190 establishes hospital reference-based pricing, outsourcing oversight, and appeals procedures

Original title: An act relating to reference-based pricing and the Green Mountain Care Board

Last action · May 29, 2026: Senate Message: Vetoed by Governor June 16, 2026Sponsor: Virginia Lyons

Bill progressHistory & official text ↓

Introduced

Committee

Floor Vote

Passed

Law

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What This Bill Proposed

This bill sets requirements for Vermont hospitals and health insurers to implement through the Green Mountain Care Board, regulates hospital clinical outsourcing contracts, and repeals health care provider bargaining groups. It requires hospitals to express rates as a percentage of Medicare starting October 1, 2026, and establishes new audit and appeal procedures.

Why it matters

The measure alters how Vermont hospitals set and report rates for clinical services, requiring them to include outsourced revenue under regulatory caps and billing protections while creating new paths to appeal Board decisions.

Who It Would Have Affected

Groups the bill's text would have affected, as described in the record. Being affected is not a position for or against it.

Directly affected

Vermont hospitals

Hospitals must comply with reference-based pricing limits, include outsourced clinical service revenue in budget caps, obtain unique NPIs for off-campus locations, and pay for Board audits.

Directly affected

Health insurers

Insurers must express rates as a percentage of Medicare for contracts starting October 1, 2026, and work with the Board to ensure price decreases align with premium decreases.

Key Facts

You don't have to trust us. Each fact below is taken straight from the official document - click any one to see the exact passage, highlighted in the original.

Frequently Asked Questions

When must hospitals start expressing rates as a percentage of Medicare?

For provider contracts entered into on or after October 1, 2026, each hospital and health insurer must express rates for all items and services as a percentage of Medicare or another approved benchmark.

What happens to health care provider bargaining groups under this bill?

The bill repeals the authorizing language for health care provider bargaining groups under 18 V.S.A. § 9409.

Who can a person appeal a Green Mountain Care Board decision to?

A person aggrieved by a final action or order of the Board may appeal to the Supreme Court after exhausting all administrative appeals.

What else do you want to know?

News Coverage

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Votes, people, money & the original source

Where This Stands

This bill did not become law - Vetoed by the governor.

Procedural history

65 actions

May 29, 2026House
Senate Message: Vetoed by Governor June 16, 2026
May 29, 2026Senate
Governor vetoed bill on June 16, 2026
May 29, 2026Senate
Delivered to Governor on June 10, 2026
May 28, 2026House
Senate Message: House proposal of amendment concurred in
May 28, 2026Senate
Rules suspended & messaged to House forthwith, on motion of Senator Baruth
May 28, 2026SenateFloor
As passed by Senate and House

Show 59 earlier actions

May 28, 2026Senate
Roll Call, requested by Senator Collamore , Passed -- Needed 15 of 30 to Pass -- Yeas = 17, Nays = 13
May 28, 2026Senate
Roll Call, Requested by Sen. Collamore
May 28, 2026Senate
House proposal of amendment concurred in
May 28, 2026Senate
House proposal of amendment; text
May 28, 2026Senate
House proposal of amendment
May 27, 2026Senate
House proposal of amendment
May 27, 2026Senate
Entered on Notice Calendar
May 26, 2026Senate
House message: House passed bill in concurrence with proposal(s) of amendment
May 22, 2026House
Rules suspended and bill messaged forthwith to the Senate as moved by Rep. McCoy of Poultney
May 22, 2026HouseFloor
Read third time and passed in concurrence with proposal of amendment
May 22, 2026House
Rules suspended and bill placed in all remaining stages of passage as moved by Rep. McCoy of Poultney
May 22, 2026House
Third Reading ordered
May 22, 2026House
Which was agreed to on a Roll Call Passed -- Needed 66 of 131 to Pass -- Yeas = 87, Nays = 44
May 22, 2026House
Report of Committee on Health Care , as amended, agreed to
May 22, 2026House
Rep. McCoy of Poultney demanded yeas and nays
May 22, 2026House
Report of Committee on Health Care amended as recommended by Committee on Appropriations
May 22, 2026House
Rep. Dickinson of St. Albans Town recommended for the Committee on Appropriations
May 22, 2026House
Rep. Holcombe of Norwich recommended for the Committee on Ways and Means
May 22, 2026House
Rep. Black of Essex reported for the Committee on Health Care
May 22, 2026House
Read second time
May 22, 2026House
Rules suspended and taken up for immediate consideration as moved by Rep. McCoy of Poultney
May 22, 2026House
Notice Calendar: Favorable with Amendment
May 19, 2026HouseCommittee
Pending entry on Notice Calendar, referred to Committee on Appropriations per Rule 35(a)
May 12, 2026HouseCommittee
Referred to Committee on Ways and Means per Rule 35(a)
May 12, 2026House
Notice Calendar: Favorable with Amendment
Apr 2, 2026HouseIntroduced
Read first time and referred to the Committee on Health Care
Mar 31, 2026SenateFloor
Read 3rd time & passed on roll call, requested by Senator Weeks , Passed -- Needed 15 of 29 to Pass -- Yeas = 23, Nays = 6
Mar 31, 2026Senate
Roll Call, Requested by Sen. Weeks
Mar 31, 2026Senate
Pending third reading, bill amended as moved by Senator(s) Hardy
Mar 31, 2026Senate
New Business/Third Reading
Mar 27, 2026Senate
Title amended as recommended by Committee on Health and Welfare
Mar 27, 2026Senate
3rd reading ordered
Mar 27, 2026Senate
Recommendation of amendment by Committee on Health and Welfare , as amended, agreed to
Mar 27, 2026Senate
Recommendation of amendment by Committee on Health and Welfare amended as moved by Senator Lyons, Benson, Cummings, and Morley
Mar 27, 2026Senate
Recommendation of amendment by Committee on Health and Welfare amended as recommended by Committee on Appropriations
Mar 27, 2026Senate
Reported favorably by Senator Lyons for Committee on Appropriations with recommendation of amendment
Mar 27, 2026Senate
Read 2nd time, reported favorably with recommendation of amendment by Senator Lyons for Committee on Health and Welfare
Mar 27, 2026Senate
Recommendation of amendment to be offered by Senator(s) Lyons
Mar 27, 2026Senate
Favorable report with recommendation of amendment by Committee on Appropriations
Mar 27, 2026Senate
Favorable report with recommendation of amendment by Committee on Health and Welfare
Mar 27, 2026Senate
Unfinished Business/Second Reading
Mar 26, 2026Senate
Recommendation of amendment to be offered by Senator(s) Lyons
Mar 26, 2026Senate
Favorable report with recommendation of amendment by Committee on Appropriations
Mar 26, 2026Senate
Favorable report with recommendation of amendment by Committee on Health and Welfare
Mar 26, 2026Senate
Unfinished Business/Second Reading
Mar 25, 2026Senate
Recommendation of amendment to be offered by Senator(s) Lyons
Mar 25, 2026Senate
Favorable report with recommendation of amendment by Committee on Appropriations
Mar 25, 2026Senate
Favorable report with recommendation of amendment by Committee on Health and Welfare
Mar 25, 2026Senate
Second Reading
Mar 24, 2026Senate
Recommendation of amendment to be offered by Senator(s) Lyons
Mar 24, 2026Senate
Favorable report with recommendation of amendment by Committee on Appropriations
Mar 24, 2026Senate
Favorable report with recommendation of amendment by Committee on Health and Welfare
Mar 24, 2026Senate
Second Reading
Mar 24, 2026Senate
Entered on Notice Calendar
Mar 17, 2026SenateCommittee
Referred to Committee on Appropriations per Senate Rule 31
Mar 17, 2026Senate
Favorable report with recommendation of amendment by Committee on Health and Welfare
Mar 17, 2026Senate
Second Reading
Mar 17, 2026Senate
Entered on Notice Calendar
Jan 6, 2026SenateIntroduced
Read 1st time & referred to Committee on Health and Welfare

Version history

Only one version on file - nothing to compare yet. As later stages (committee substitute, engrossed, enrolled) are captured, the redline appears here.

View official text →

Lobbying Activity

No state lobbying filings in our records match this bill. Federal lobbying reports (LDA) cover Congress, so they are not listed on state bills.

Full breakdown

Who this bill affects and the strongest case for and against it, written only from the bill’s own text.

Discoveries

1 pattern noticed across the record

Patterns POLISCOPE noticed across the record. These are observations to investigate, not conclusions.

policy shift95% confidence

Expansion of Green Mountain Care Board Authority

The bill shifts regulatory oversight by folding outsourced clinical services into hospital budget caps and rate-setting authorities.

Green Mountain Care Board

Connected Entities

Supreme Court, Department of Financial Regulation, Green Mountain Care Board and 2 more

OrganizationSupreme Court“Court designated for appeals of final Green Mountain Care Board actions and orde”Map →

OrganizationDepartment of Financial Regulation“Collaborates with the Green Mountain Care Board to monitor the implementation of”Map →

OrganizationGreen Mountain Care Board“State board tasked with implementing reference-based pricing, conducting hospita”Map →

PersonCommissioner of Health“Publishes the statewide comparative hospital quality report.”Map →

OrganizationGeneral Assembly“The legislative body enacting the bill.”Map →

Sources

Open source document

legislature.vermont.gov

Analysis Score

0–100

Significance75
How much this matters to a regular citizen
Controversy60
Intensity of disagreement among stakeholders
Entertainment10
Compellingness for a non-policy-wonk reader
Buzz35
Current news / social attention level

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