A tense exchange between health care leaders on Monday punctuated the annual, multiday marathon hospital budget hearings before the Green Mountain Care Board.

The discourse focused on a letter from an independent health care liaison that described a “simmering and ongoing adversarial relationship” between the state’s largest hospital network and its largest health insurer.

The letter conveys Blue Cross Blue Shield Vermont’s claim that University of Vermont Health Network leaders allegedly threatened to drop patients on the carrier’s insurance plans to pressure the insurer to accept higher network charges in previous years. Network representatives disputed this characterization at the hearing.

Regulators also asked health network executives about revenue overages and profit margins at

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