VT
Vermont House Bill H0815
Vermont 2025-2026 Regular Session
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Vermont 2025-2026 Regular Session

Vermont House Bill H0815

Introduced
1/29/26  

Caption

An act relating to health insurance and Medicaid reimbursement for certain health care services

Impact

This bill has the potential to significantly influence state health care policies, particularly by reinforcing protections for mental health service providers and enhancing access for patients. By limiting the ability of health insurers to decrease reimbursement rates, H0815 seeks to maintain a stable financial environment for providers, encouraging them to continue offering necessary services. Furthermore, it requires that health plans undertake comprehensive assessments prior to any policy changes, which is expected to prevent unintended consequences such as service access reductions or delayed treatment for patients in need.

Summary

House Bill H0815 seeks to modify health insurance and Medicaid reimbursement protocols for mental health services, impacting providers and patients across Vermont. The legislation aims to prevent health insurers from unilaterally reducing reimbursement rates for mental health services, ensuring that such adjustments cannot occur more than once per contract year for any given provider type. Additionally, it mandates that insurers engage in stakeholder consultation before implementing any changes to policies affecting mental health and substance use disorder services, thereby promoting transparency and accountability in the decision-making process.

Contention

While the bill is largely supported by mental health advocates who view it as a necessary safeguard against a historically underfunded area of healthcare, it may face opposition from some insurers concerned about the constraints imposed on their operational flexibility. Proponents argue that this legislation is essential for ensuring equitable treatment of mental health services comparable to physical health services. However, opposition may stem from fears that it could increase administrative bureaucracies and costs for insurers, affecting their ability to manage services efficiently.

Companion Bills

No companion bills found.

Previously Filed As

VT S3802

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

VT A4265

Requires Medicaid reimbursement rates for certain primary and mental health care services match reimbursement rates under Medicare.

VT SB1047

Health insurance; requiring reimbursement for certain health care services. Effective date.

VT SB1047

Health insurance; requiring reimbursement for certain health care services. Effective date.

VT SB1648

Medicaid; creating the Healthy Moms, Healthy Babies Act; requiring coverage and reimbursement of specified services; requiring certain reimbursement methodology. Effective date.

VT A3344

"Mental Health Access Act;" increases Medicaid reimbursement rates for certain evidence-based behavioral health services.

VT HB1401

Community health workers; provide for certification of by Health Department and for Medicaid reimbursement for services of.

VT S0793

Increases individual, group, and Medicaid insurance rates of reimbursement for ambulance and wheelchair van services to be equal to reimbursement rates provided by Medicare for the same medical services.

VT H5772

Increases individual, group, and Medicaid insurance rates of reimbursement for ambulance and wheelchair van services to be equal to reimbursement rates provided by Medicare for the same medical services.

VT HB154

Relating to Medicaid coverage and reimbursement for certain inpatient mental health services.

Similar Bills

No similar bills found.