Transcript Highlights:

• all who wish to testify, there will be a strict limit of 2 minutes per witness during the testimony period
• Pharmacists should be able to freely inform patients about the lowest cost prescription options, and
• how the PBMs have designed our prescription drug system.
• When the PTs, uh, testified last session, they talked about this direct access period they have.
• people in as much as they can in that period.

Transcript Highlights:

• During the testimony period, the chair moves to correct the minutes for the meeting held on April 24,
• Pharmacists should be able to freely inform patients about the lowest cost prescription options.
• exactly how the PBMs have designed... our prescription drug system.
• have, and that they were getting... ...50% of their revenue through that period.
• And so they're really just getting people in as much as they can in that period.

Bills: HB854, HB 1052, HB1642, HB2076, HB3042, HB3695, HB3787, HB4062, HB4092, SB213, SB493, SB896, HB5519, HB4635

Keywords: insurance, replacement cost, homeowner's policy, renter's policy, condominium insurance, property damage, claims process, telemedicine, teledentistry, telehealth, health benefit plan, insurance coverage, out-of-state services, anxiety, pain management, contraceptive devices, women's health, medical procedures, healthcare, laboratory

Transcript Highlights:

• ><00:39:27.119> measur from actually the period that we measur from actually the period that we
• <02:06:13.360> of apparent within a very short period of apparent within a very short period
• <03:23:33.680> drug add the uh prescription drug add the uh prescription drug affordability
• to the 4-year period that they um up to the 4-year period that they renewed<03:33:19.279> at<
• think today to not cover prescription think today to not cover prescription drugs<03:34:36.080><

Keywords: 928, house, all

Summary: The House Finance Division Three work session on February 21, 2025 focused on the Division of Medicaid Services budget. The chair opened with procedural guidance, noting the division’s role is to make recommendations to the full Finance Committee, that the budget must be balanced, and that members should track possible amendments ahead of a March 26 target for House Bills 1 and 2. Members also discussed the importance of using official budget documents and online resources, and the chair said no motions would be taken at this session. A major early topic was concern over a five-point Medicaid policy document and the timing of House Bill 2. Representative Tarki objected that the document appeared to be an unofficial draft and argued that significant Medicaid policy changes should have been transmitted by February 15 under state law. He said the lack of an official, posted document raised transparency concerns because the changes could affect tens of thousands of residents. Committee leadership responded that the five-point document was a working document, that it would be posted online within minutes, and that House Bill 2 is often delayed while the Office of Legislative Services finalizes and formats the governor’s proposed trailer bill. DHHS Chief Financial Officer Nathan White and Medicaid Director Henry Litman then began the budget presentation. White said the committee would use the PowerPoint as the document of record, starting with the governor’s operating budget pages 885-893, and noted that Medicaid is the largest accounting area in the state budget. He said the governor’s budget reflects about $60 million in reductions within the Medicaid area, with Granite Advantage handled off-budget and another $10 million in reductions there, for roughly a $70 million difference overall. Members asked whether the comparison was being made against an efficiency budget or a prioritized-needs budget, and White said the department could look at it different ways. The presentation then outlined Medicaid’s role in New Hampshire: it provides health coverage, serves as the state’s direct interface with the federal Centers for Medicare & Medicaid Services, and helps finance related services such as long-term supports, school-based services, adult dental coverage, and re-entry programs for people leaving correctional settings. White also reviewed enrollment and program context, saying New Hampshire has about one in seven residents enrolled in Medicaid, making it the fourth smallest Medicaid program in the country by enrollment, and described recent efforts such as youth re-entry and the Medicaid unwind after the end of the federal continuous coverage period. He said the state had to process more than 238,000 redeterminations after the public health emergency and that the department tried to avoid unnecessary coverage loss during that transition.

Transcript Highlights:

• . >> WITH THE INTEREST A PERIOD OF TIME I WILL BE BRIEF.
• IN THE INTEREST A PERIOD OF TIME I WILL BE BRIEF.
• OUR FEAR IS, SHE TALKED ABOUT PRESCRIPTION AND I LOVE THAT WORD.
• OUR FEAR IS OVER PRESCRIPTION ON THE HUMAN QUALITY CONTROL SIDE. ON THE RECORD-KEEPING SIDE.
• THIS IS A REALLY PRESCRIPTIVE APPROACH THAT MATTERS TO ALL OF US.

Transcript Highlights:

• Um, one example, having prescriptions changed.
• Senator Rawlings. about the same period of time and I'm about the same period of time and I'm driving
• Um, one example, having<00:47:44.960> prescriptions<00:47:45.520> changed.
• I've been having prescriptions changed.
• clinics actually changed prescriptions clinics actually changed prescriptions that<00:47:50.640>

Keywords: 958, all

Summary: The Senate Standing Committee on Health Services met with a quorum and first moved through administrative regulations without comment. The committee then heard Senate Bill 56, sponsored by Senator Gerald Neal, which would require Medicaid and its managed care entities to treat non-opioid pain medications on equal footing with opioid analgesics by prohibiting more restrictive coverage controls, prior authorization, or step therapy for non-opioids. Neal argued the bill would improve access to safer pain treatment options and reduce the risk of opioid use disorder, and Billy O'Brien of Young People in Recovery testified in support, describing personal experiences where non-opioid options were difficult to obtain despite a desire to avoid opioids. After discussion, the bill received a motion and second and passed the committee on a 10-0 vote. The committee then took up Senate Bill 72, sponsored by Senator Don Douglas and presented with Greg Chaffin of Alliance Defending Freedom. Douglas described the bill as a provider recruitment and retention measure intended to protect health care workers from being compelled to act against their conscience and to address workforce shortages and pressure in health care settings. He said the bill would protect individual beliefs while maintaining professionalism. A large number of witnesses then testified, and the chair limited public comments to two minutes each because of the number of speakers and the controversy surrounding the bill. Most public testimony opposed SB 72. Speakers including representatives of the Kentucky Council of Churches, a psychologist, an ordained minister and nurse, a nurse practitioner, and an ACLU policy strategist argued the bill was overly broad, could allow refusals of care by a wide range of health care workers, and could delay or deny treatment, especially for vulnerable patients and in rural or emergency settings. Several cited concerns about discrimination, patient safety, and the lack of adequate protections for patients. One witness recounted the death of an 18-year-old pregnant patient as an example of the harm that can result from delayed care. The transcript ends during additional testimony on SB 72, before any committee vote or final action on that bill is shown.

Transcript Highlights:

• We have a bunch of other prescriptions in statute and section 683-103.
• We have a bunch of other prescriptions in statute and section 683-103.
• So I obviously, in trying to be prescriptive, that we want these prominently displayed, I wanted to be
• Would be the two-year grace period for the endorsement. And so I'll leave it there.
• And so I'll leave it there. would be the two-year grace period for the endorsement.

Summary: The Senate Education Pre-K-12 Committee met with a quorum and took up several bills. SB 420, by Senator Burgess, would require George Washington and Abraham Lincoln portraits to be prominently displayed in social studies classrooms and K-5 classrooms, with the Department of Education selecting the portraits. Supporters framed the bill as a patriotic and educational measure tied to the nation’s 250th anniversary, while senators raised concerns about exclusivity, precedent, local control, and whether the measure could be expanded politically. Burgess said the bill was intended to be nonpartisan, historically rooted, and not to affect curriculum, and he committed to seeking funding so it would not be an unfunded mandate. The committee reported SB 420 favorably. The committee then considered CS for SB 206, by Senator Harrell, which revises teacher preparation and training related to autism spectrum disorder. The strike-all amendment requires teacher preparation programs to include autism and other neurodevelopmental disabilities, requires ESE-certified teachers to complete an autism microcredential by August 1, 2027, creates an Autism Education Loan Forgiveness Program, authorizes salary supplements and stipends, and requires district professional development to include autism-specific training with local CARD centers. Senators asked about implementation timelines, grandfathering current teachers, and whether the endorsement requirement should include a grace period; Harrell said she was open to further discussion and wanted to make the bill workable. Public testimony was largely supportive, including from an Orange County Public Schools representative and a parent of a child with autism. The committee adopted the amendments and reported the bill favorably. Finally, the committee considered CS for SB 556, by Senator Berman, which allows students with disabilities to satisfy the high school physical education requirement by participating in Special Olympics for one year if included in the student’s IEP. An amendment also clarified that two years of marching band participation satisfies both PE and fine/performing arts credit requirements. Testimony supported the bill as an inclusive option that could reduce administrative burdens and give students more flexibility. The committee reported the bill favorably. The committee also voted to recommend confirmation of appointees in tabs 4 through 7, and then adjourned.

Transcript Highlights:

• We have a bunch of other prescriptions in statute in section 683-103.
• We we have a bunch of other prescriptions in statute and section 683-103.
• So I obviously, in trying to be prescriptive that we want these prominently displayed, I wanted to be
• A two-year period to gain the certification. Yes, I skipped over one. I asked for two years.
• Would be the two-year grace period for the endorsement. And so I'll leave it there.

Bills: S0206, S0420, S0556

Keywords: autism, autism spectrum disorder, ASD, special education, exceptional student education, ESE, teacher preparation, educator certification, micro-credential, loan forgiveness, student loan repayment, teacher stipend, salary supplement, professional development, inclusive education, developmental disabilities, Down syndrome, behavioral disabilities, school district compensation, collective bargaining

Summary: The committee first heard SB 420, which would require portraits of George Washington and Abraham Lincoln to be prominently displayed in classrooms used for social studies and in all K-5 classrooms, with the Department of Education selecting the portraits. Senator Burgess framed the bill as a patriotic and educational measure tied to America’s 250th anniversary, while Senator Davis raised concerns about exclusivity, political precedent, and state intrusion into local classroom decisions. Senator Osgood and others asked about sensitivity to diverse student populations and whether additional figures such as Harriet Tubman could also be displayed. Burgess said the bill would not prevent other displays, emphasized the two presidents’ historical significance, and committed to funding support so the mandate would not burden districts. The committee voted the bill favorably. The committee then took up CS/SB 206 on autism education and teacher preparation. Senator Harrell’s strike-all amendment required teacher preparation programs to include autism and other neurodevelopmental disabilities, required ESE-certified teachers to complete an autism microcredential, created an autism loan forgiveness program and salary supplement provisions, and directed district professional development to include autism-specific training with local CARD centers. A second amendment removed a proposed change to the legal definition of autism so that issue could be handled separately. Senators Davis and Osgood asked about implementation timelines, grandfathering current teachers, and how the bill would affect educators already working in autism classrooms; Harrell said he was open to further discussion and wanted to ensure flexibility while still requiring the credential. Public testimony included support from Orange County Public Schools, a parent of children with autism, and others. The committee adopted the amendments and reported the bill favorably. Finally, the committee heard CS/SB 556, which allows students with disabilities to satisfy the high school physical education requirement by participating in Special Olympics for one year if included in the student’s IEP. An amendment also clarified that two years of marching band satisfies both the PE credit and a fine or performing arts credit. Supporters said the bill expands inclusive options and reduces administrative burdens, and Senator Yarborough praised the change as giving students more flexibility. The committee adopted the amendment and reported the bill favorably. The committee also took up confirmation votes for appointments in tabs 4 through 7 and recommended all of them favorably by a single roll call vote.

Transcript Highlights:

• <00:09:59.519> periods.
• All of on special enrollment periods.
• > drug There are new prescription drug There are new prescription drug treatments,<00:10:18.160
• <00:34:09.679> starting period begins on November 1st. starting period begins on November
• Those are that is no period of time.

Keywords: 1187, senate, all

Transcript Highlights:

• testify, there will be a hard 2, time limit of 2 minutes per witness during the public testimony, period
• And basically requires that a license holder, um, take at least one hour per training period on state
• Is there a record for testifying most times in the shortest period of time? I don't know.
• So it, it makes financial sense for the hospital to fill those prescriptions out of your. Yes.
• Our vendor gets data and it tells us, uh, that a patient got a prescription, what the prescription is

Transcript Highlights:

• so we're not over 100-year period so we're not over stressing<00:04:02.200> the<00:04:02.360>
• of generic and biosimilar prescription of generic and biosimilar prescription Med<01:15:53.560><
• And I should say the Prescription Drug Price Transparency Act consists of various components.
• Prescription drug price transparency sounds great, right?
• Prescription drug price transparency sounds great, right?

Keywords: 1187, senate, all

Transcript Highlights:

• Is there some fear in doing this prescription?
• that prescription renewed.
• Prescriptions while you're on corrections would last on average a month.
• Once you're leaving, Though we can only provide a prescription up to 30 days.
• If you're leaving the corrections department, you should have a prescription.

Transcript Highlights:

• Kincart Jonsson: THANK YOU GOOD AFTERNOON , THANK YOU FOR ALLOWING ME TO PRESENT HB 697, THE PRESCRIPTION
• THE US BUYS 23% OF THE WORLDS PRESCRIPTION DRUGS BUT PAYS 62% OF THE WORLDWIDE COST.
• ACROSS FLORIDA FAMILIES ARE VIEWING THE STRAIN OF RISING PRESCRIPTION DRUG COSTS, THE PRICE ACT IS FOCUSED
• GENERICS MAKE UP 90% OF PRESCRIPTIONS PRESCRIBED WOULD ONLY REPRESENT 15 TO 20% OF SALES. 10% REALLY
• THE PRESCRIPTION DRUG SYSTEM OPERATES SORT OF LIKE THE MAFIA.

Transcript Highlights:

• We have a presentation today by the Medicare Advantage Prescription Drug Contracts and related marketing
• So the Medicare Advantage prescription drug plan allowed them to reinstate that pharmacy benefit.
• During that time period, after they have put out what they think, what they are proposing for methodological
• You've got your medical care and prescription drugs under the same contract with a single insurance carrier
• You've got your medical care and prescription drugs under the same contract with a single insurance carrier

Summary: The committee received an update from Grant Wallace on the rebid and possible decoupling of the state’s Medicare Advantage retiree coverage. He said the state is exploring splitting medical and pharmacy benefits for post-65 retirees, with UnitedHealthcare as the incumbent vendor, and that preliminary estimates suggested savings of about $100 to $200 per participant per month. He outlined the expected timeline for final CMS rate announcements in April 2026, with contract amendments likely to come before the committee in May or June after review by the EBD Advisory Commission and State Board of Finance. Representatives from Segal Consulting then reviewed the history and current structure of the Medicare Advantage prescription drug plan, explaining that the plan was adopted after a 2021 recommendation and launched in 2023 alongside the existing Med-Sup option. They said the Medicare Advantage option has produced substantial savings, including a lower monthly rate than the Med-Sup plan and about $40 million in savings from initial enrollment, while also restoring pharmacy benefits for some retirees. The presenters then explained recent federal changes under the Inflation Reduction Act, including major changes to Part D funding, the direct subsidy, and risk-score methodology, which they said have made risk adjustment much more important and are driving interest in separating medical and pharmacy contracts. In response to questions from senators, the presenters said the Medicare Advantage plan covers post-65 teacher and state employee retirees, including retirees from state agencies and K-12 public schools. They also explained that the new Part D structure has reduced out-of-pocket costs for members, with a $2,000 annual cap and lower average member spending to reach it, while shifting more cost to the plan. No votes were taken and no formal action was reported; the committee simply received the update and was told to expect further information after the April rate notice. The meeting adjourned with the committee scheduled to return on May 13.

Transcript Highlights:

• If you have questions about these columns and so regarding the prescription, this is the prescription
• , this is the regarding the prescription, this is the prescription<00:11:43.279> drug<00:11:43.519
• > monitoring<00:11:44.160> board prescription drug monitoring board prescription drug monitoring
• But um period. Don't quote me on that.
• five entities in a 5-year period. Okay. five entities in a 5-year period. Okay.

Keywords: 1189, house, all

Summary: The committee first accepted the minutes from the April 4 meeting, then moved to a discussion of potential audit topics and follow-up on prior performance audits. Christine Young, Director of Audits, and Jay Henry, performance audit supervisor, walked members through a spreadsheet showing the status of roughly 30 performance audit reports from the past 10 years, including the number of observations, whether agencies concurred, how many observations were fully addressed, and when each report was last updated. They explained that “fully addressed” only means the agency addressed the observations it agreed with, and that some reports include rejoinders when the audit office disagrees with an agency’s response. Members also discussed how some audits have been updated and others have not, including an example from the prescription drug monitoring program, which moved from the Board of Pharmacy/OPLC to HHS and was recently updated after staff contacted HHS. A major focus was the mental health workforce licensing audit, which was described as having little or no follow-up in the spreadsheet. Several members said this was especially concerning given the ongoing mental health crisis and argued that the committee should require a response. The committee agreed to start by sending letters to the chairs of the boards listed under that audit, asking the chair or designee to appear at the next meeting or respond in writing about what has been done and what remains unresolved. Members noted that the current process is voluntary and self-reported, which can lead to long delays or no response, especially for boards that meet only monthly and may have changed membership or leadership since the audit was issued. The committee also discussed other audit follow-up issues, including the liquor commission division of enforcement and licensing, which staff said was farther along than its percentage suggested, and a recently released human rights report that was not yet due for update. Members raised the possibility of using future budget reviews to ask agencies what they have done about old audit findings. In addition, the committee briefly discussed future audit topics, including a possible audit of local school districts related to special education, and staff explained that the statute allows the LBA to audit a limited number of non-state entities over a five-year period. The motion to authorize the chair and LBA to draft and send letters to the mental health workforce licensing boards passed by show of hands with one abstention. The next meeting was tentatively set for June 6 in State House 100, with staff to confirm the room and schedule.

Transcript Highlights:

• Clarifying section two that the mandatory minimum period of imprisonment with the possibility of parole
• <00:06:35.560> of the mandatory minimum period of the mandatory minimum period of imprisonment
• This defines compounded prescription drugs for the purposes of the state's workers' compensation law
• drugs by dispensing of prescription drugs by physician<00:15:41.440> to<00:15:41.560> 30
• drugs to be obtained prescription drugs to be obtained through<00:15:46.760> the<00:15:46.880

Bills: SB888, SB2479, SB2489, SB2519, SB2521, SB2527, SB2575, SB2591, SB2611, SB2665, SB2667, SB2695, SB2697, SB2713, SB2730, SB2751, SB2765, SB2795, SB2797, SB2806, SB2812, SB2818, SB2835, SB2849, SB2851, SB2896, SB2922, SB2970, SB2972, SB2973

Keywords: SB888, Hawaii, consumer protection, smart home security, smart household security device, home security camera, video doorbell, Ring, Nest, connected devices, internet of things, IoT, privacy, data privacy, law enforcement access, police requests, search warrant, judicial warrant, subpoena, emergency disclosure

Summary: The Judiciary Committee met in decision-making only session and took up a long list of Senate bills, mostly advancing them with either no amendments or committee amendments. Early measures included SB 888, which bars smart household security device operators from sharing user data with law enforcement without consent or a warrant, and SB 2479, which allows certain defendants to seek reduced sentences based on family violence, dating violence, or child abuse history; both were adopted, with SB 2479 amended for technical and procedural changes. The committee also adopted SB 2489 on invasive species provisions in Department of Agriculture and Biosecurity leases, SB 2519 on Law Enforcement Standards Board deadlines, SB 2521 and SB 2527 on CDL-related exemptions and training/policies for emergency personnel, and SB 2575 on firearm-related mandatory minimum penalties, which was amended to clarify scope and set a far-future effective date. Several transportation and public safety bills were also approved. SB 2591 created a Waikiki refuse-collection pilot program; SB 2611 expanded criminal trespass rules for school premises to weekends and holidays, though one member raised concerns about use of school property as a park; SB 2665 required driver-license renewal applicants with recent citations to complete a road-safety course, later narrowed to moving violations only; SB 2667 restricted towing vehicles from far-left lanes; SB 2695 clarified crosswalk duties; SB 2697 prohibited driving on shoulders except in limited cases; and SB 2812 required driver testing on dangers posed by larger vehicles, with court-ordered timing for re-examination. Most of these measures passed unanimously or with one or more members recording no votes or reservations, but they were still adopted. The committee also advanced SB 2713 on restricting certain pesticide use near elderly care facilities, SB 2730 on warrantless arrest and detention factors for petty misdemeanors and violations, SB 2765 on condominium foreclosure rental income, SB 2795 on flag display rights in housing associations with health and safety carve-outs, SB 2797 on gift card fraud, SB 2806 on real estate listing restrictions, SB 2818 on boating and ocean recreation penalties, SB 2835 on liquor licensing and education funding, SB 2849 on public meeting notice requirements, SB 2851 on a deafness designation for vehicle registration, SB 2896 lowering the commercial driving age to 18, SB 2922 on cooperative association definitions, SB 2970 on state contracting conflicts involving relatives, SB 2972 on temporary Oahu spearing restrictions for certain fish, and SB 2973 on banning jug-line fishing. A few bills drew objections over breadth or penalties, especially the boating and fishing measures, but the committee still adopted the recommendations. SB 2751 on workers’ compensation prescription drug rules was deferred indefinitely, and the meeting ended with the chair noting upcoming joint and committee meetings for the next day.

Transcript Highlights:

• so if you have from May 15th to period so if you have from May 15th to June<00:59:55.359> 1st
• say was the filing period U you don't<00:59:57.880> have<00:59:58.000> to<00:59:58.119
• You can't print it right on the cutline, so we're really getting rather prescriptive on it.
• You can't print it right on the cutline, so we're really getting rather prescriptive on it.
• You can't print it right on the cutline, so we're really getting rather prescriptive on it.

Keywords: 1187, senate, all

Transcript Highlights:

• And I, over my period of time, I've got 30 to 40 claims where the initial reasonable amount was zero.
• I’m here today to offer insight regarding warning labels on opioid prescriptions.
• This bill establishes the prescription drug purchasing pool.
• recommend permitting other nutritional support services on a case-by-case basis for a limited time period
• recommend permitting other nutritional support services on a case-by-case basis for a limited time period

Bills: HB136, HB451, SB425, SB466, SB905, SB1986, SB2311, SB2450, SB2805, SB2826, SB2919, SB3001

Keywords: Medicaid, lactation, healthcare, consultation, reimbursement, maternal health, infant care, commercial sexual exploitation, child sex trafficking, human trafficking, child welfare, foster care, DFPS, Department of Family and Protective Services, juvenile probation, risk assessment, needs assessment, trauma screening, child abuse prevention, exploitation screening

Summary: The committee met with a quorum and announced it would vote on pending bills at 10:30, with public testimony limited to two minutes. It first took up Senate Bill 905, a TDLR cleanup bill on licensing regulation of speech-language pathologists and audiologists. Senator Zafferini said the committee substitute would streamline advisory board consultation, remove obsolete provisional licenses, and allow any licensed physician to authorize hearing instruments for minors; the substitute was adopted and the bill left pending. The committee then heard House Bill 451, which would require universal screening for commercial sexual exploitation risk for children in DFPS conservatorship and youth under TJJD jurisdiction. The author and witnesses from Children at Risk, the Fort Bend Anti-Trafficking Collective, and Texas CASA supported the bill as a prevention tool with existing infrastructure and training; the committee adopted the substitute and left the bill pending. The committee next considered Senate Bill 466, which would clarify that families may request a fetal death certificate at any gestational age, while keeping existing filing requirements for physicians. A constituent father testified about losing his 11-week-old daughter and being told he could not obtain a certificate, which he said prevented funeral arrangements; the substitute was adopted and the bill left pending. Senate Bill 2311 followed, requiring residential treatment centers to have a written agreement with the school that will educate resident children before becoming operational. The author cited a local dispute where an RTC and school district lacked communication, and witnesses from Texas CASA and Disability Rights Texas supported clearer educational planning while suggesting the Education Code may need conforming changes; the bill was left pending. The committee then heard Senate Bill 2826, known as Alyssa’s Law, which would create a statewide education program on medical child abuse for medical students, health care professionals, and CPS caseworkers. The author and Sheriff Bill Weyburn described Alyssa’s case as involving repeated unnecessary surgeries and argued the bill would improve awareness and early identification, while several witnesses and members raised concerns about false accusations, impacts on medically fragile children, and the need for scientific, peer-reviewed training and safeguards. After extensive discussion, the chair left the bill pending. The committee also heard House Bill 136, which would add certified lactation consultants as Medicaid providers to expand breastfeeding support; witnesses from lactation and nutrition fields said the bill would improve access, maternal and infant health, and long-term savings, and the bill was left pending. Finally, the committee took up Senate Bill 2805, a surprise-billing/arbitration measure that would clarify provider identifiers and shift arbitration costs to the losing party. The author said the substitute was a legislative counsel draft with no substantive difference, and witnesses from the Texas Medical Association, Texas Society of Anesthesiologists, and U.S. Anesthesia Partners supported the bill as a modest improvement that would reduce administrative confusion and make arbitration fairer without weakening patient protections. Members discussed how arbitration costs affect settlement behavior and how to define the “winner” in close cases. The bill was heard but not voted out during this segment.

Transcript Highlights:

• Today's markup is about addressing the high cost of prescription drugs and abusive practices that keep
• They'll help make prescription drugs more affordable.
• Hopefully, transparency driving down the cost of prescription drugs.
• Because I want to take care of these prescriptive drug bills. Yes, thank you Mr. Chairman.
• First, we call up S-527 Prescription Pricing for People's Act 2025.

Bills: SB1040, SB1041, SB1095, SB1096, SB1097, SB527

Keywords: drug competition, product hopping, generic drugs, biosimilars, federal regulations, FTC Act, patent, biological products, healthcare access, affordable prescriptions, Medicare, Federal Trade Commission, sham petitions, competition, public health, unfair competition, healthcare, pharmaceutical, antitrust law, pay-for-delay

Summary: The meeting focused on addressing the high cost of prescription drugs and the abusive practices that contribute to elevated prices affecting American families. Several bills were presented, including proposals to end pay-for-delay deals and to enhance transparency in the operations of pharmacy benefit managers (PBMs). The discussion was notable for its emphasis on consumer protection and ensuring that cheaper generic drugs reach the market more effectively. Members expressed frustration over past attempts to pass similar legislation stalling in the Senate, leading to renewed efforts to push these bills forward.

Transcript Highlights:

• population of people with dementia, which is the second line there, the blue, over the same time period
• Prescription drugs are included in those data sets as well. It's made available in two ways.
• Prescription drug price transparency. Prescription drug price transparency.
• The Prescription Drug Affordability Board's work is really an extension of some of the prescription drug
• In ingesting data, the board conducts affordability reviews for selected prescription drugs.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• However, we were still more concerned with the mandate itself, how prescriptive it is, how inflexible
• However, we were still more concerned with the mandate itself, how prescriptive is, how inflexible it
• antipsychotic drugs and limits any step therapy protocols to no more than two distinct prescription
• Now, will this bill add some cost to prescription medicine? Of course it will.
• So I... ...reduced and will more than offset, I believe, the prescription drug price.

Bills: SB1052, SB1115, SB1118, SB1120, SB1121, SB1124, SB1171, SB1172, SB1174, SB1175, SB1214, SB1233, SB1235, SB1316, SB1345, SB1372, SB1399, SB1458, SB1494, SB1496, SB1564, SB1602, SB1621, SB1628, SB1630, SB1631, SB1668, SB1672, SB1814, SB1821

Keywords: assisted living, health care, hyperbaric oxygen therapy, physician orders, informed consent, AHCCCS, remote work, state agency, employment, public health, housing, zoning, middle housing, urban development, duplexes, triplexes, fourplexes, townhomes, historic preservation, radiation protection

Summary: The committee first heard Senate Bill 1121, which would prohibit hospitals from requiring lead aprons for cardiac catheterization staff when a radiation protection system is in place, while still allowing hospitals to require aprons outside the designated safety zone or when exposure levels warrant additional protection. An amendment added flexibility for radiation safety officers to require lead or other PPE if exposures approach occupational limits and removed expedited rulemaking language. Supporters, including the sponsor and interventional cardiologists, argued the devices reduce radiation and orthopedic injuries and improve recruitment and retention; hospital groups shifted to neutral after the amendment. The committee adopted the amendment and passed SB 1121 on a 9-2 vote. The committee then considered Senate Bill 1120, which would require hospitals performing cardiac catheterization procedures to equip at least 50% of those rooms with radiation protection systems by 2027. Supporters said the systems protect clinicians from radiation and long-term injury, while opponents, including hospital and radiology groups, argued the bill was overly prescriptive, could create a captive market, and might not fit all rooms or procedures. After adopting a children’s hospital exemption amendment, the committee passed SB 1120 on a 6-6 vote, with the chair breaking the tie in favor of the bill. Senate Bill 1118, an appropriation measure tied to the radiation protection system proposal, was also advanced after brief discussion, passing 6-5. The committee then took up Senate Bill 1214, which would create guardrails for non-FDA-approved stem cell and regenerative therapies, including provider standards, informed consent, advertising limits, reporting requirements, and a private right of action for violations. Supporters described it as a patient-protection and access bill, while testimony emphasized concerns about unregulated “bad actors” and patients traveling out of state for treatment. The committee adopted an amendment removing a reference to the National Law and passed SB 1214 on a 9-3 vote. The transcript then began discussion of SB 1630, which would create a Medicaid-funded home and community-based service benefit for adults with serious mental illness, with AHCCCS taking a neutral position and estimating a significant fiscal impact.