Transcript Highlights:

• and skilled staff treatment programs and skilled staff ultimately<00:09:12.000><c> providing</c><00:
• </c><00:10:27.839><c> and</c> culturally sensitive programming and culturally sensitive programming and
• </c> 501c3 nonprofit that provides programs 501c3 nonprofit that provides programs and<00:41:10.760><
• It sounds like a really worthwhile program. It sounds like the need is there.
• These are not things that we can only answer within programs, but not across our services.

Bills: HF1380 , HF1166 , HF487 , HF1553 , HF1472 , HF258 , HF1911

Committee: House Human Services Finance and Policy

Keywords: psychiatric treatment, human services, mental health funding, per diem rate, Clay County, disability services, assistive technology, remote support, advocacy, training programs, HF487, Wellness in the Woods, Minnesota human services, grant funding, general fund appropriation, peer support, substance use recovery, addiction recovery, reentry services, reentry after incarceration

Transcript Highlights:

• So the issue here We have a lot of really good programs in Texas.
• So, our goal here is not to create any new programs, but rather simply educate and inform. our veterans
• about the many programs that already exist and that are very successful and that's what this bill would
• suicide prevention. program is that is our that is my number one priority to reduce veteran suicide
• The VA spends $571 million on veteran suicide. prevention program. $571 million in a problem has not

Bills: HB39 , HB227 , HB930 , HB 1078 , HB39 , HB227

Committee: House S/C on Defense & Veterans' Affairs

Keywords: highway designation, veteran recognition, commemorative, transportation, Brazoria County, Texas National Guard, combat duty, military activation, state requirements, emergency response, active combat duty, military service, Congressional action, Governor responsibilities, Congressional declaration, state law, conflict, armed forces, congressional approval, war declaration

Transcript Highlights:

• , and other public programs.
• </c> federal Medicaid drug rebate. federal Medicaid drug rebate.
• CMS estimated that point-of-sale rebates would cause a 15% decline in rebates.
• </c> would cause a 15% decline in rebates. would cause a 15% decline in rebates.
• </c><01:25:50.800><c> also</c><01:25:51.040><c> we</c> program needs our program, but also we program

Committee: House Health Finance and Policy

Transcript Highlights:

• administrative cost to apply these rebates per person instead of targeted rebates.
• We're often faced with the impression that we support rebates, but we didn't create rebates.
• , and other public programs.
• would cause a 15% decline in rebates would cause a 15% decline in rebates<00:56:47.920><c> rebates</
• rebates are the primary way that rebates rebates are the primary way that Healthcare<00:56:50.559><c

Committee: Senate Commerce and Consumer Protection

Transcript Highlights:

• , and other programs.
• choose the high-priced, high-rebate version to maximize the rebates that they receive.
• CMS estimated that point-of-sale rebates would cause a 15% decline in rebates.
• Rebates are the 15% decline in rebates.
• . of drug rebates.

Committee: Senate Health and Human Services

Transcript Highlights:

• In addition, the 340B program does not restrict manufacturers from offering commercial rebates to PBMs
• This program first came to my attention. experience in California with a 340B program.
• in exchange for this program.
• For our organization, I will note that our Association Health Plan does have a drug rebate program in
• Our drug rebate programs from our Association Health Plan help contain and provide predictable drug costs

Bills: HB2145 , HB1828 , HB2155 , HB2437

Committee: House Health Care & Wellness

Keywords: 340B drug pricing, healthcare access, patient rights, discounted medications, manufacturer limitations, health professions, plasma donation, physician substitutes, medical regulation, nursing titles, healthcare, regulation, professional standards, licensure, accreditation, opioid treatment, health services, fee authority, public health

Transcript Highlights:

• In addition, the 340B program does not restrict manufacturers from offering commercial rebates to PBMs
• in exchange for this program.
• For our organization, I will note that our Association Health Plan does have a drug rebate program in
• Our drug rebate programs from our Association Health Plan help contain and provide predictable drug costs
• fee programs.

Summary: The committee first heard House Bill 2437, which would put the Department of Health’s authority to accredit opioid treatment programs into statute and allow the department to set a fee to cover the cost of those services. The prime sponsor and DOH said the bill would preserve a service that is especially important to tribal and rural providers and would be self-sustaining rather than supported by the general fund. Members asked about the relationship between DOH and HCA and whether the bill would duplicate existing authority; staff and the department said DOH already performs the accrediting role and the bill mainly formalizes that authority and fee-setting power. Public testimony on the bill was then closed. The committee then held an extensive work session on the federal 340B drug pricing program and later opened public testimony on House Bill 2145, which would prohibit manufacturers, distributors, and third-party logistics providers from restricting 340B drug acquisition or delivery and from requiring claims or utilization data as a condition of access. Committee staff and NCSL gave background on how 340B works, recent growth in the program, contract pharmacy issues, and state efforts in other jurisdictions. Testimony on HB 2145 was sharply divided: hospitals, community health centers, tribal representatives, contract pharmacies, and labor groups said the bill would protect safety-net providers, rural access, HIV and behavioral health services, and tribal programs from manufacturer restrictions; business groups, pharmaceutical companies, and employer coalitions argued the program has expanded beyond its original intent, lacks transparency, shifts costs to employers and taxpayers, and should be addressed through federal reform instead. No vote was taken in the excerpt. Finally, the committee heard House Bill 2155, which would bar non-human entities from using nursing titles such as RN, APRN, or LPN or otherwise implying they are licensed nurses. The prime sponsor said the bill is intended to protect patients from being misled by AI systems and to preserve transparency and public safety as health care technology expands. The Washington State Nurses Association testified in support, saying AI can be useful but should not replace nurses or be presented as a licensed professional. A member asked about enforcement and liability, and staff said they would follow up on those details.

Transcript Highlights:

• We also have a capital grant program.
• existing programs.
• I want to get a rebate. I guess there's up to $500,000 for rebate.
• Madam Chair, Senator, the concern I have is that, you know, if I am able to use a rebate program and
• assistance program, the threshold for the rebate program is 15% emissions reductions.

Committee: Senate Senate Conservation

Summary: The committee heard House Bill 153, a proposal focused on industrial decarbonization and manufacturing. The bill would create a voluntary, market-based framework with three main parts: an Environmental Product Declaration program to help manufacturers measure and certify product carbon footprints, an industrial carbon reduction incentive and capital grant program to support lower-carbon production, and a rebate program to encourage purchase of low-carbon construction materials. Supporters said the bill would reduce emissions, strengthen supply chains, create jobs, and help New Mexico attract and grow low-carbon manufacturing. Members raised concerns about the anti-donation clause, whether the program would actually benefit New Mexico companies, the availability of in-state supply, the cost to the state, and whether a sunset should be added. Sponsors and agency representatives responded that the programs are voluntary, would be implemented through rules with performance and verification requirements, and are backed by a finite appropriation and reporting requirements. They also said the bill is intended to build both supply and demand, with examples cited such as low-carbon cement and engineered wood projects that could reduce emissions and create jobs. After discussion, the committee moved to a vote on House Bill 153. The motion to do pass was approved, with Senator Scott voting no and several members excused. House Bill 254, which had also been on the agenda, was not heard because the committee was called to the floor.

Transcript Highlights:

• What's our cost to provide a rebate aggregation service or rebate administration service?
• them rebate alligators.
• Years ago, in the '90s, they created the Medicaid Drug Rebate Program.
• After the creation of the Medicaid Drug Rebate Program, they instituted the 340B program, which was an
• extension of the Medicaid rebate program and extended those best-in-class discounts to hospitals, federally

Committee: Senate Insurance

Summary: The Senate Insurance Committee met on May 13, 2026, adopted the May 6 minutes, and then took up several bills dealing with pharmacy benefit managers, prescription access, behavioral health coverage, and Citizens Property Insurance. HB 938, as amended, was the main PBM reform measure. After the committee adopted a large amendment set that narrowed the bill, members heard extensive testimony in support from Mark Bloom, Justin Joseph of Capital Rx, and Kathy Ue of Pontchartrain Cancer Center, all emphasizing transparency, pass-through pricing, reverse auctions, and patient access. Supporters described savings from reverse auctions and administrative models, while the cancer center testified that PBM-owned specialty pharmacy requirements can delay cancer medications and create financial hardship. The committee reported HB 938 favorably with amendments. The committee also heard HB 1154, which prohibits prior authorization for certain generic medications prescribed by qualified physicians, with a $250 cap discussed as a safeguard against higher-cost generics. The bill was supported by representatives from Ochsner Health and the Louisiana State Medical Society and was reported favorably. HB 909, which requires commercial coverage for behavioral health crisis services, was amended to clarify the insurers covered and then reported favorably with support from the Office of Behavioral Health and several outside groups. Testimony on HB 909 focused on reducing emergency room and law enforcement burdens and expanding crisis response capacity across the state. HB 1187, dealing with excess emergency assessment funds from Louisiana Citizens Property Insurance Corporation, was explained by the Insurance Commissioner as a way to transfer remaining Katrina-era assessment funds to the Fortified Roof Program. The committee reported the bill favorably. Finally, SB 511 and SB 512 were deferred and converted into a study resolution approach because there was not yet consensus on the underlying issue. The meeting then adjourned.

Transcript Highlights:

• What's our cost to provide a rebate aggregation service or rebate administration service?
• them rebate alligators.
• Years ago, in the '90s, they created the Medicaid Drug Rebate Program.
• After the creation of the Medicaid Drug Rebate Program, they instituted the 340B program, which was an
• extension of the Medicaid rebate program and extended those best-in-class discounts to hospitals, federally

Bills: SB511 , SB512 , HB591 , HB909 , HB938 , HB1154 , HB1187

Committee: Senate Insurance

Keywords: automobile repairs, insurance transparency, repair shop liability, non-OEM parts, policyholder rights, automobile insurance, appraisal process, insurance policyholders, dispute resolution, claim valuation, behavioral health, crisis services, mental health care, insurance coverage, healthcare access, pharmacy benefit managers, reimbursement standards, local pharmacies, drug pricing, regulation

Transcript Highlights:

• It's a 10-year rebate period and Right now, there are about 22 cities under this program.
• This is a 30-year rebate period.
• of rebates.
• The center hotel tax rebate program to the City of South Padre Island.
• The rebate period ends in 2043.

Bills: SB1071 , SB1444 , SB1483 , SB1556 , SB1703 , SB1756 , SB1854 , SB2036 , SB2133 , SB2297 , SB2622 , SB2779 , SB2955 , SB2979

Committee: Senate Economic Development

Transcript Highlights:

• It also runs our certificate of public need program, our COPN program.
• our rebates have to be prioritized to supporting these rebates, and I'll talk about the rebate dynamic
• So the decrease in the rebate funding really noticeable and impactful in this program.
• That's cost to the program.
• That's cost to the program.

Committee: House Health and Human Services

Transcript Highlights:

• Similar to many of our other programs, like the Community Energy Efficiency Programs or Sustainable Building
• existing programs.
• I want to get a rebate. I guess there's up to 500 000 for a rebate.
• I mean, we are offering a rebate program, but I still don't understand how, because when you are looking
• Assistance Program, the threshold for the rebate program is 15 emissions reductions.

Committee: Senate Senate Conservation

Transcript Highlights:

• Pharmacy rebates increased $47.0 million, resulting in net cost $72.2 million.
• They may increase a particular rebate.
• They may increase a particular rebate.
• , rebate programs.
• , rebate programs.

Committee: All LEGISLATIVE JOINT AUDITING

Summary: The committee first approved the June 5 minutes, then received and adopted the Executive Committee report, which noted adoption of prior minutes, staff updates on audits and special reports scheduled for the standing committees and full Legislative Joint Auditing Committee, and no other business. The Counties and Municipalities report focused on delinquent private water and sewer audits and municipal accounting compliance: turnback funds were reinstated for 40 of 43 entities after required reports were filed, three entities remained ineligible, several audits remained delinquent, and the committee approved escrow of 50% of Fargo’s turnback and gave officials from another town 60 days to reach compliance. The committee also reviewed numerous current and deferred reports, with many referred to prosecuting attorneys, the Attorney General, or the Governmental Bonding Board. The Education report covered 79 school audit reports, including 56 with no findings and 23 with findings. Officials from several school districts, two charter schools, and the Department of Education attended to answer questions about repeat findings. Eleven reports were referred to prosecutors and the Attorney General, two were also certified to the Governmental Bonding Board, Blytheville School District’s report was deferred, and 78 reports were filed. The committee also adopted the state agencies comprehensive financial report, which identified issues including an unauthorized payroll disbursement and insufficient collateral at the Department of Parks, Heritage, and Tourism and missing accounting entries at the Treasurer’s office; seven reports were filed and two deferred to September. Members then considered the Annual Comprehensive Financial Report and Single Audit report, which had been deferred previously but were adopted without further questions. A special report on the Employee Benefits Division’s health plans drew extensive discussion. The report found no findings but showed the state employee plan’s fund balance increased while the public school employee plan’s fund balance declined, with rising claims and pharmacy costs offset partly by higher rebates. Members questioned whether the audit addressed legal compliance, the sharp increase in claims, administrative costs, GLP-1 drug spending, and possible deductible changes. Agency officials said the audit was primarily financial, not a provider-level compliance review, and explained that inflation, utilization, rebates, and contract negotiations were driving costs; they also said outside consultants were used on the Blue Cross Blue Shield RFP at a cost of about $240,000. On motion, the committee voted to hold the report over one month for further review. Finally, the committee reviewed a Legislative Audit report on case transfers in the 19th West Judicial District Circuit Court. The review examined random assignment and transfers among divisions, found that 1,673 of 9,351 open cases had at least one transfer, and identified some transfers lacking documentation or not matching the data, though several discrepancies had been corrected. Audit recommended strengthening documentation and electronic controls and considering incorporation of the prosecutor-confirmation policy into Administrative Order No. 2015-1. After no further questions, the committee adopted the report and adjourned, with the next meeting set for September 10-11.

Transcript Highlights:

• Amendment number 6 defines the term rebate.
• We use the rebates to lower costs for all enrollees.
• We use them rebates to lower costs for all enrollees.
• of another for a high rebate.
• of another for a high rebate.

Committee: House Insurance

Summary: The House Insurance Committee met on April 29 with a quorum present and took up several insurance and health care-related bills. SB 192, a dental reimbursement bill, was amended to allow dentists to opt in electronically to credit-card payment methods and to clarify applicability and effective date; it was reported as amended. SB 84 would require prostate cancer screening coverage for men over 40 under current clinical guidelines and prohibit cost-sharing; supporters from the American Cancer Society said Louisiana has a high incidence of prostate cancer and that out-of-pocket costs deter early screening. The committee adopted amendments and reported the bill as amended. SB 275, dealing with reimbursement and network participation for certified registered nurse anesthetists, drew support from nursing and hospital groups and was reported favorably. SB 169, a cleanup bill on biomarker testing, was also amended and reported. The committee spent substantial time on SB 401, which creates a temporary prescription drug affordability board to review pricing data on selected drugs and report findings to the legislature. Supporters said the board would improve transparency and help lawmakers understand drug pricing trends; opponents raised concerns about confidentiality, market effects, and the lack of a defined policy outcome beyond reporting. Amendments narrowed the scope, added confidentiality protections, and removed opposition cards, and the bill was reported as amended. SB 387, a major PBM reform bill tied to SB 401, would change PBM compensation, rebate handling, formulary practices, audits, and appeals, while excluding ERISA plans after discussion and amendment. Supporters argued it would curb spread pricing and other practices that raise costs, while opponents from the Pelican Institute and PCMA warned it would interfere with private contracts, reduce flexibility, and could raise premiums or disrupt city, school board, and small-group plans. After extensive debate and a roll call, SB 387 was reported with amendments by a 10-4 vote. The committee also considered SB 241, which requires certain insurance adjusters and public adjusters to include license numbers in written communications. After amendments limiting the requirement to individual licenses and removing one statutory reference, the bill was reported as amended. Throughout the meeting, members and witnesses repeatedly discussed the need for transparency in drug pricing and PBM practices, the role of ERISA and non-ERISA plans, and potential impacts on public employers and consumers.

Transcript Highlights:

• from the rebates, the drug rebates, which are a big part of what funds this program and is also a major
• So the rebates are actually a big part of what funds this program.
• we have from the Ryan White program and the funding we have from the rebates, the drug rebates, which
• So the rebates are actually a big part of what funds this program.
• And I'll add that it's the insurance program that enables the rebates to come.

Summary: The Appropriations Committee on Health and Human Services heard a presentation on the governor’s proposed fiscal year 2026-27 budget for the health and human services silo, which totals $48.5 billion. Agency leaders outlined major requests for AHCA, APD, DCF, DOEA, DOH, and the Department of Veterans’ Affairs, including behavioral health redesign, Medicaid rate changes, developmental disability services, child welfare and opioid programs, senior services, cancer research, public health initiatives, and veterans’ facility and technology needs. The committee also received an overview of the overall state budget, which was described as $117.4 billion, up 1.1% from the current year. AHCA’s presentation focused on $71.6 million for a Medicaid behavioral health redesign, including funding for residential treatment, a serious mental illness waiver, and higher inpatient psychiatric rates for youth, plus $7.1 million to raise private duty nursing reimbursement in fee-for-service Medicaid, $2.5 million for the background screening clearinghouse, and $124.4 million for the Health Care Connection System (FX). APD requested funding to continue moving people off the pre-enrollment list and to support developmental disability centers, a new forensic facility, an electronic health record system, and higher operating costs. DCF highlighted $81.9 million for eligibility and system integrity, $187.5 million for opioid prevention and treatment, $35.5 million for community-based care lead agencies, and $72.7 million to expand behavioral health bed capacity, including 474 new beds at state hospitals. DOEA sought additional funding for Alzheimer’s services, home care, and community care for the elderly. DOH emphasized $278 million for cancer research and innovation, $5 million for food and product safety testing, $5 million for the Florida FIRST blood-on-ambulance initiative, and $5.7 million for a public lab feasibility study. Veterans Affairs requested funds for facility improvements, cybersecurity, and medication management equipment. Members asked detailed questions about several items, especially the proposed changes to the AIDS Drug Assistance Program (ADAP), which would reduce eligibility and the number of people served. Senators and public witnesses criticized the lack of transparency and urged the department to pause the changes and work with stakeholders; the Surgeon General said the issue was driven by funding constraints and federal changes, not a legal barrier, and that the agency was exploring alternatives. Questions also addressed the Office of Minority Health and Health Equity, the Kids Care/CHIP expansion implementation, the cancer research funding structure, and the timeline and cost of the FX system. Public testimony focused heavily on ADAP, with speakers warning that thousands could lose medication access and calling for community involvement and a review of the program’s finances. The committee adjourned after the presentations and questions, with no votes taken on the budget items during this meeting.

Transcript Highlights:

• Currently, we serve program.
• </c> enrolled in both the Medicaid program enrolled in both the Medicaid program and<00:41:58.319><c>
• And that 600,000 Insurance Program.
• So for the hospital rate improvement program and the ambulance provider assessment program, those two
• So for the hospital rate improvement program and the ambulance provider assessment program, those two

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.

Transcript Highlights:

• funding we have from the rebates, the drug rebates, which are a big part of what funds this program
• So the rebates are actually a big part of what funds this program.
• we have from the Ryan White program and the funding we have from the rebates, the drug rebates, which
• So the rebates are actually a big part of what funds this program.
• And I’ll add that it’s the insurance program that enables the rebates to come.”

Committee: Senate Appropriations Committee on Health and Human Services

Summary: The Appropriations Committee on Health and Human Services heard presentations on the governor’s proposed fiscal year 2026-2027 budget for the health and human services agencies. Kendall Kelly outlined the overall HHS budget at $48.5 billion, with AHCA accounting for the largest share, and agency heads then highlighted major proposals for Medicaid behavioral health redesign, APD waiver enrollment and facility needs, DCF child welfare, opioid, and mental health investments, DOEA funding for Alzheimer’s, home care, and community services, DOH funding for cancer research, public health initiatives, and lab capacity, and VA funding for facility improvements, cybersecurity, and medication management. Several members praised specific proposals, including increased reimbursement for private duty nursing, Alzheimer’s supports, and the Florida FIRST blood-in-ambulance initiative. Senators also questioned the proposed changes to the AIDS Drug Assistance Program (ADAP), with the Surgeon General explaining that the department expects a reduction in covered patients from about 30,000 to about 20,000 because of funding pressures tied to rebates, federal changes, and premium tax credit issues. Public testimony strongly criticized the ADAP changes, citing lack of transparency and warning that many patients could lose access to medications. Other questions focused on the Office of Minority Health and Health Equity, DCF’s substance abuse and mental health data dashboard, Kids Care/CHIP expansion implementation, APD bed and facility planning, and the FX Medicaid technology project. DCF said about $7 million is set aside for the dashboard system, and AHCA said the governor’s budget includes $124.4 million for FX maintenance and continued module development, with $13.5 million to begin claims processing work. The committee did not take a substantive vote on the budget presentations and adjourned after questions and public testimony.

Transcript Highlights:

• Representative Craft continued by asking about the rebates and the $500,000 in rebates.
• Representative Craft asked whether the rebate would be one rebate and whether the business is already
• So, as they then we assess the rebate.
• It says the total amount of rebates may not exceed the amount of the appropriation.
• So, this could be a rebate utilized by several companies. And one last final comment, Mr.

Transcript Highlights:

• Amendment 6 defines the term rebate.
• You see it in the VA program. The federal government requires data.
• We use those rebates to lower costs for all enrollees.
• We use those rebates to lower costs for all enrollees.
• of another for a high rebate.

Committee: House Insurance