Budget & Taxes

This bill establishes the state of Vermont's budget for fiscal year 2027, providing funding for all state agencies, departments, and government operations. It authorizes specific spending amounts for various government functions and defines key terms like operating expenses, personal services, and grants to clarify how funds can be used. The legislation limits the creation of new state positions to those explicitly authorized during the 2026 legislative session and requires that agency staffing levels match the appropriated funds unless otherwise specified. It also outlines procedures for accepting federal funds and addresses how to handle errors in the budget totals.

This bill requires Vermont hospitals and health insurers to adopt reference-based pricing for services, setting payment limits based on Medicare rates starting in 2027. It mandates hospitals to report all outsourced clinical services (like emergency medicine or radiology) in budget reviews, closing loopholes where outsourced revenue bypassed oversight. Hospitals must display pricing both as a percentage of Medicare rates and in dollars, and use unique identifiers for off-campus services. The goal is to ensure price transparency, apply cost controls across all hospital services, and prevent surprise bills for patients receiving outsourced care.