Transcript Highlights:

• The Department of Revenue, 103 KR205, amends a life expectancy table used when computing the value of

Keywords: 958, all

Summary: The subcommittee met on October 14, approved the minutes, and then took up a large group of staff-suggested amendments to multiple regulations. Those staff amendments were approved without objection and were described as technical changes needed to comply with KRS Chapter 13A and other governing law. The committee then moved out of order to consider Kentucky Board of Medical Licensure regulation 2011 KAR 9:270, which governs buprenorphine prescribing and related standards. Board representatives said the regulation has been updated over time since 2015 and that the current amendments are intended to streamline the rule, remove outdated federal references such as the X-waiver, narrow education requirements to addiction-related topics, and create exceptions for settings like emergency rooms and certain pain treatment situations. The agency amendment would also allow buprenorphine monoproduct for up to 30 days when a patient is transitioning from a full opioid agonist, and would add physicians certified in addiction medicine as eligible specialty consultants. Board officials said the regulation was developed through a two-year process with a work group, informal outreach to medical organizations, and multiple comment periods, and they argued the rule is working because overdose deaths have declined and provider numbers have increased. Several witnesses and committee members raised concerns that the regulation remains too restrictive. Senator Rocky Adams noted that major medical organizations had said the proposed language could restrict access and worsen overdose risk, and he questioned whether the committee was being asked to choose between conflicting expert views. Opponents, including a medical student, a recovery advocate, and Dr. Colleen Ryan of the Kentucky Society of Addiction Medicine, argued the rule is outdated, creates unnecessary barriers to buprenorphine treatment, and should be repealed or substantially revised to align with federal guidance and evidence-based care. They said rigid requirements can discourage treatment and that addiction should be treated like other chronic illnesses. No final vote on the medical licensure regulation is reflected in the transcript excerpt, and the discussion ended with the chair preparing to hear from additional opponents.

Transcript Highlights:

• So it's taking a picture of the system and then recreating it on a computer.

Transcript Highlights:

• And there's all sorts of computations that go in there.

Summary: The committee heard the May Revision presentation for the Assembly Budget Subcommittee on Education Finance, with public comment focused heavily on K-12 priorities such as universal school meals, kitchen infrastructure, food service and custodial support, youth leadership grants, Special Olympics funding, English learner support, universal pre-K, literacy investments, and concerns about community college funding shifts. Speakers also urged support for expanded learning, teacher recruitment and training, and maintaining or increasing funding for community colleges and student support programs. Finance and the LAO then reviewed the Proposition 98 outlook. Finance said the May Revision lowers the 2025-26 Prop. 98 guarantee to $114.6 billion, about $4.3 billion below January, due mainly to lower revenue estimates, with smaller effects from attendance and property tax changes. The administration also described rebenching for universal transitional kindergarten and a one-time rebench tied to Los Angeles fire-related property tax losses, along with changes to the Public School System Stabilization Account, deferrals, and updated COLA assumptions. The LAO said the budget relies too much on deferrals and one-time funds, creates a structural shortfall, and should instead align ongoing spending with the guarantee and preserve a reserve buffer. Members questioned the TK rebench and the shift of funding from community colleges to K-12, asking why it was being applied retroactively and how colleges would be held harmless. Finance said the changes align funding with where TK costs are being incurred and that reappropriation funding and other adjustments would offset impacts on community colleges. The LAO argued the historical split formula is outdated and should be abandoned in favor of budgeting around current priorities rather than fixed percentages. Members also raised concerns about draining the rainy day reserve and using deferrals, while the LAO said preserving reserves would better protect against future volatility. The committee then moved to specific K-12 and education proposals. Finance outlined May Revision changes including state operations adjustments for the Department of Education, technical trailer bill changes, a $100 million student teacher stipend program administered by Kern County, and updates to the charter school facility grant program. The LAO recommended rejecting the proposed increases for expanded learning, literacy coaches, and the student teacher stipend as currently structured, while supporting the minimum grant increase for expanded learning. Members expressed support for teacher recruitment efforts but questioned whether one-time funding can sustain ongoing programs and whether the student teacher stipend should be targeted to shortage areas or low-income communities.

Transcript Highlights:

• And as far as the centers that are necessary to provide the massive amounts of computations that go into

Keywords: 1187, senate, all

Transcript Highlights:

• certain electronic consumer data by a provider of an electronic communication service or a remote computing

Bills: HB24, HB45, HB15, HB35, HB38, HB47, HB318, HB349, HB554, HB1359, HB1373, HB1647, HB2254, HB2259, HB2853, HB3073, HB3088, HB353, HB355, HB786, HB762, HB705, HB932, HB849, HB 1160, HB 1119, HB1612, HB3041, HB713, HB3104, HB3970, HB3962, HB5061, HB4042, HB4115, HB4490, HB1731, HB1705, HB2607, HB3556, HB138, HB3689, HB1788, HB1887, HB1914, HB2402, HB2306, HB1809, HB2350, HB3000, HB3237, HB3326, HB3211, HB 1056, HB2081, HB2187, HB3092, HB3308, HB3526, HB3750, HB3527, HB4219, HB4230, HB4290, HB5238, HB4804, HB4749, HCR6, HCR12, HCR34, HCR50, HCR55, HCR58, HCR70, HCR71, HCR72, HCR74, HCR75, HCR78, HCR80, HCR93, HCR100, HCR107, HCR116, HCR117, HCR90, SB1806, SB783, SB1271, SB326, SB1637, SB769, SB897, SB1035, SB1706, SB1185, SB1194, SB384, SB1426, SB1468, SB1215, SB1066, SB599, SB1930, SB2065, SB767, SB1619, SB1738, HB1500, HB718, HB23, HB34, HB 119, HB 128, HB 130, HB132, HB2756, HB166, HB406, HB186, HB331, HB380, HB1583, HB1584, HB621, HB303, HB552, HB366, HB463, HB 1211, HB1327, HB1461, HB923, HB1760, HB2467, HB5333, HB1592, HB1576, HB1552, HB2018, HB3511, HB1781, HB2013, HB2340, HB2508, HB2970, HB865, HB2851, HB3385, HB3336, HB3309, HB 1127, HB 1232, HB1397, HB4236, HB4041, HB1965, HB2730, HB3698, HB3699, HB163, HB201, HB272, HB405, HB519, HB654, HB694, HB791, HB 1136, HB 1240, HB 1266, HB 1275, HB1437, HB1532, HB1675, HB1842, HB1868, HB1894, HB1943, HB1990, HB2029, HB2061, HB2286, HB2523, HB2622, HB2652, HB2692, HB2842, HB2885, HB3016, HB3096, HB3248, HB3255, HB3479, HB3611, HB3623, HB3803, HB3804, HB3805, HB3806, HB3810, HB3816, HB4129, HB4163, HB4187, HB4238, HB4454, HB4588, HB4643, HB4738, HB4739, HB4945, HB5015, HB5616, HB1749, HB1775, HB 118, HB1762, HB2520, HB24, HB45, HB15, HB35, HB38, HB47, HB318, HB349, HB554, HB1359, HB1373, HB1647, HB2254, HB2259, HB2853, HB3073, HB3088, HB353, HB355, HB786, HB762, HB705, HB932, HB849, HB 1160, HB 1119, HB1612, HB3041, HB713, HB3104, HB3970, HB3962, HB5061, HB4042, HB4115, HB4490, HB1731, HB1705, HB2607, HB3556, HB138, HB3689, HB1788, HB1887, HB1914, HB2402, HB2306, HB1809, HB2350, HB3000, HB3237, HB3326, HB3211, HB 1056, HB2081, HB2187, HB3092, HB3308, HB3526, HB3750, HB3527, HB4219, HB4230, HB4290, HB5238, HB4804, HB4749, HCR6, HCR12, HCR34, HCR50, HCR55, HCR58, HCR70, HCR71, HCR72, HCR74, HCR75, HCR78, HCR80, HCR93, HCR100, HCR107, HCR116, HCR117, HCR90

Keywords: zoning, public notice, local government, residential development, protests, peer support, first responders, mental health, confidentiality, emergency services, information network, health services, client referral, data privacy, disaster preparedness, accreditation, community services, sexual assault, victim rights, forensic examination

Transcript Highlights:

• find programs for landscapers, electricians, welders, surgery technicians, gunsmiths, accountants, computer

Bills: HF3220

Keywords: school safety, school security, emergency access, law enforcement access, master key box, secure key box, entry device, school grants, education finance, Department of Education, charter schools, school districts, cooperative units, appropriation cancellation, one-time appropriation, school safety plan, emergency preparedness, public safety, school building security, 1183

Transcript Highlights:

• updates Florida law to give law enforcement 45 days instead of 10 to return search words involving computers

Bills: HB 118, HB 388, HB 114, HB 205, HB 2789, HB 2791, HB 499, HB 2960, HB 3163, HB 3135, HB 2427, HB 1618, HB 1672, HB 1722, HB 1338, HB 787, HB 2618, HB 879, HB 1126, HB 4134, HB 3513, HB 718, HB 1536, HB 1445, HB 1640, HB 1893, HB 1734, HB 3229, HB 3306, HB 1276, HB 3272, HB 3276, HB 3516, HB 4145, HB 1585, HB 4810, HB 2989, HB 2558, HB 3014, HB 2742, HB 1695, HB 29, HB 125, HB 145, HB 171, HB 255, HB 50, HB 363, HB 116, HB 491, HB 1495, HB 368, HB 1285, HB 1905, HB 2002, HB 917, HB 2723, HB 2067, HB 1238, HB 745, HB 1188, HB 1606, HB 2003, HB 2147, HB 2355, HB 2546, HB 2495, HB 2818, HB 2249, HB 3228, HB 3240, HB 1507, HB 658, HB 1748, HB 1851, HB 1922, HB 2798, HB 107, HB 1587, HB 3684, HB 118, HB 388, HB 114, HB 205, HB 2789, HB 2791, HB 499, HB 2960, HB 3163, HB 3135, HB 2427, HB 1618, HB 1672, HB 1722, HB 1338, HB 787, HB 2618, HB 879, HB 1126, HB 4134, HB 3513, HB 718, HB 1536, HB 1445, HB 1640, HB 1893, HB 1734, HB 3229, HB 3306, HB 1276, HB 3272, HB 3276, HB 3516, HB 4145, HB 1585, HB 4810, HB 2989, HB 2558, HB 3014, HB 2742, HB 1695, HB 609, HB 630, HB 420, HB 767, HB 1708, HB 1404, HB 2457, HB 140, HB 227, HB 913, HB 2198, HB 2763, HB 1261, HB 1135, HB 1318, HB 2358, HB 2765, HB 2735, HB 3307, HB 1242, HB 2842, HB 333, HB 201, HB 694, HB 2415, HB 155, HB 272, HB 405, HB 519, HB 1136, HB 1275, HB 1437, HB 1532, HB 1675, HB 1868, HB 1888, HB 1990, HB 2286, HB 2523, HB 3129, HB 3251, HB 3354, HB 3479, HB 3803, HB 3804, HB 3805, HB 3806, HB 3887, HB 4163, HB 4238, HB 1240, HB 1842, HB 2029, HB 2622, HB 3255, HB 654, HB 4643, HB 4945, HB 3611, HB 3724, HB 3623, HB 3810, HB 4127, HCR 78, HCR 12, SB 767

Keywords: HB 388, HB388, coordination of benefits, COB questionnaire, health benefit plan, health insurance, insurance commissioner, Texas Department of Insurance, uniform form, primary payer, secondary payer, multiple coverage, dual coverage, Medicaid, CHIP, managed care, HMO, small employer health plan, school district health coverage, self-funded plan

Transcript Highlights:

• Anyone that can look at the TP file or the computer site can make a comment on that. Got it.

Bills: HB2065, HB2462, HB2621, HB3187, HB3539, HB3563, HB3726, HB4164, HB4207, HB4368, HB4706, HB4916, HB4950, HB4967, HB5177, HB4429, HB5597

Keywords: commercial vehicles, parking regulations, residential areas, local governance, land use, traffic safety, high occupancy vehicle lane, pregnant operators, transportation, parental rights, motor vehicle regulations, live video feed, state agency, transparency, public safety, regional transportation, mobility program, sales tax, public infrastructure, local government

Transcript Highlights:

• But I go home, and there's a bad outcome on my computer. So I go to the nursing board.

Bills: HB5141, HB4638, HB2264, HB2035, HB4813, HB4408, HB2684, HB1621, HB2300, HB216, HB3829, HB4466, HB1747, HB2284, HB3614, HB2587, HB3219, HB3318, HB5147, HB4014, HB216

Keywords: lease, state property, public purpose, Travis County, Health and Human Services, pharmaceutical initiative, drug distribution, healthcare services, generic drugs, advanced pharmaceuticals, cost savings, mental health, patient discharge, medical records, health care professionals, substance use, family involvement, chemical dependency, treatment facilities, minor admissions

Transcript Highlights:

• He loves computers and tech. Thanks for lending us your dad, and thanks for being here.

Summary: The House convened with prayer, the Pledge of Allegiance, and a quorum present, then adopted the special order report and moved into a series of budget-related bills. The chamber first took up HB 5011/SB 2506 on environmental resource management and natural resources funding, where Democrats argued the bill would reduce recurring support for the Resilient Florida program, the Florida Wildlife Corridor, invasive species removal, and other conservation efforts. Supporters said the change would shift money from recurring to nonrecurring funding so the Legislature could reassess priorities each year and rely more on private-sector stewardship. After a strike-all amendment and conference posture change, SB 2506 passed 97-12. HB 5013, reducing state-funded property reinsurance reserves, passed 108-0, and HB 5501, redirecting documentary stamp tax distributions from housing and transportation trust funds into general revenue, passed 82-26 after extended debate over its impact on affordable housing and transportation funding. The House also passed HB 5015 on state group insurance, which requires DMS to develop a formulary management system and was described as producing significant savings; members raised concerns about prescription access and implementation, but the bill passed 109-0. HB 5201 on state financial accounting and HB 5203 on the Capitol Center both passed unanimously, as did HB 5009, which creates a Florida Accountability Office and reorganizes audit functions. The chamber then passed HB 7031, a major sales tax reduction bill lowering the state sales tax rate and several related rates; supporters framed it as permanent relief for all Floridians, while opponents said property tax relief would be more meaningful and that the sales tax cut would also benefit tourists and out-of-state visitors. HB 7031 passed 112-0. The House then began consideration of HB 501, the proposed fiscal year 2025-26 budget, totaling $112.9 billion and emphasizing reduced recurring spending and large reserves. Subcommittee chairs outlined their budget silos: K-12 education at $20.6 billion with teacher raises, school hardening, literacy, transportation stipends, and security funding for Jewish day schools; health care at $47 billion with full Medicaid and KidCare funding, opioid settlement spending, mental health beds, and senior services; transportation/economic development at $18.5 billion; agriculture and natural resources at $5.8 billion with reduced Everglades spending but continued water, resiliency, and land management funding; higher education at $8.7 billion; state administration at $2.9 billion; justice at $7.3 billion; and IT at $529 million for Florida PALM, FX, and other systems. Members then began questioning the K-12 budget, focusing on FEFP funding, proration, voucher growth, stabilization dollars, mental health and school safety funding, and whether districts would be held harmless under the proposed allocations.

Transcript Highlights:

• It's in my computer. I didn't send it, but I will. We strongly oppose this measure.

Keywords: 910, house, all

Summary: The joint hearing opened with SB 1442, which would update the statute governing the Child and Adolescent Mental Health Division and clarify its role as the state Medicaid provider of intensive mental health services for children and adolescents with serious emotional disturbance. The Department of Health testified in strong support, saying the current statute is outdated and warning against any unfunded mandate because the division relies on federal funding and faces uncertainty about future resources. Written testimony from several organizations also supported the bill. The committees took no immediate action and said they would hold decision-making until later. The hearing then moved to SB 479 on ABLE savings accounts. The Hawaii State Council on Developmental Disabilities and the Hawaii Disability Rights Center supported the measure, arguing that ABLE accounts help people with disabilities save money without losing benefits and that the state needs more outreach and staffing to expand participation. A testifier with a disability said the bill would help people keep Social Security and housing stability. The chair indicated an intention to move the bill forward, and asked about funding; the discussion settled on a requested appropriation of about $75,000 for incentives. Next, SB 1245 on reimbursement of pharmacists drew broad support from the Hawaii Pharmacists Association, rural pharmacies, the Hawaii Primary Care Association, and others, who said the bill would improve access to care, especially on neighbor islands and in rural communities, and help pharmacies participate in 340B-related services. The Insurance Division and HMSA raised concerns about bill language, saying it could be read to cover pharmacists outside an insurer’s network and that the scope of reimbursable services needed clarification; the pharmacists’ association said the bill is intended to apply only to in-network pharmacists and should continue to reference existing scope-of-practice law. The hearing also took up SB 1279, which would allow pharmacists to authorize medications via telehealth under certain circumstances. The State Board of Pharmacy opposed the bill, citing patient safety, a pilot project with reported errors, concerns about controlled substances and unregulated technicians, and the view that in-person pharmacist services are safer and already available on the affected islands. Several pharmacies and health care groups supported the measure as a way to preserve 340B access and improve service on Lānaʻi and Molokaʻi, while some local pharmacies said they already provide in-person service and opposed remote dispensing. No votes were taken in the portion of the hearing provided.

Transcript Highlights:

• Part of one of the most heartbreaking assignments I had was supervising the forensic examiner, the computer

Keywords: 1183, house

Transcript Highlights:

• And it is even rarer to find a tech guy who not only understands computers, but understands people.
• And it is even rarer to find a tech guy who not only understands computers, but understands people.

Keywords: U.S. House of Representatives Floor Proceedings on Tuesday, June 24, 2025, 1012, house, all

Transcript Highlights:

• able to use it to help bring new economic development opportunities to Carbon County, like cloud computing
• able to use it to help bring new economic development opportunities to Carbon County, like cloud computing
• able to use it to help bring new economic development opportunities to Carbon County, like cloud computing

Keywords: 916, all

Transcript Highlights:

• This is hardly worth the cost of changing the programs in the judicial systems computers to reflect this
• This is hardly worth the cost of changing the programs in the judicial systems computers to reflect this
• This is hardly worth the cost of changing the programs in the judicial systems computers to reflect this

Keywords: 1187, senate, all

Transcript Highlights:

• I mean, thumb drives went into our central data computers by DOGE employees, people who had not been
• I mean, thumb drives went into our central data computers by DOGE employees, people who had not been
• I mean, thumb drives went into our central data computers by DOGE employees, people who had not been

Keywords: U.S. House of Representatives Floor Proceedings on Monday, December 1, 2025, 1012, house, all

Transcript Highlights:

• We've got computers in our pockets that can do all kinds of crazy stuff.

Keywords: 1184, house, all

Transcript Highlights:

• Um, uh, an act establishing pre-computing parole. Thank you.

Keywords: 995, all

Summary: The committee heard extensive testimony on several Judiciary bills, with the largest portion focused on S. 1178/H. 2052 to reduce mass incarceration and end life without parole. People incarcerated at MCI Framingham, MCI Norfolk, and NCCI Gardner described personal growth, rehabilitation, restorative justice work, family separation, and the belief that parole eligibility after long sentences would better reflect public safety and human development. Speakers emphasized that life without parole removes hope and can undermine rehabilitation, while supporters argued that many lifers are older, less likely to reoffend, and could contribute positively if given a chance at parole review. Committee members did not take votes during the hearing. The committee also heard testimony on S. 1139 to restore the statute of limitations for wrongful death claims involving tobacco use, with Sen. Keenan explaining that a recent SJC decision had cut off claims where the injured person did not sue within three years before death. He said the bill would restore families’ ability to seek redress in cases involving long-latency tobacco harms like COPD. Another major topic was S. 1205, which would add abusive litigation to the definition of coercive control in domestic violence law; Sen. Michael Moore said the bill would stop abusers from using repeated court filings to harass and financially burden survivors. The committee also took up S. 1114 on automatic record sealing, with Sen. Friedman and others arguing that the current petition-based process is slow, burdensome, and disproportionately harms people with criminal records, especially Black and Latino residents. Testimony also supported H. 1965/S. 1132 on compensation for wrongful conviction, with advocates and sponsors describing a faster administrative claims process, transitional support, and higher compensation without the current cap. Sen. Payano testified for S. 1241 to expand educational programming for incarcerated emerging adults, saying education reduces recidivism and improves reentry outcomes. A substantial portion of the hearing focused on S. 2522, an update to Massachusetts’ shield law for reproductive and gender-affirming care. Sen. Friedman, the Attorney General’s office, and DPH Commissioner Robbie Goldstein said the bill is needed to strengthen protections against out-of-state legal attacks, protect patient and provider data, clarify enforcement authority, and add a state-level EMTALA-style emergency care requirement. Committee members asked detailed questions about prescription labeling, the prescription monitoring program, attorney discipline, custody and full faith and credit issues, and whether the bill’s enforcement language could create unintended limits or conflicts. The Attorney General’s office said it would provide follow-up written testimony on several technical questions.

Transcript Highlights:

• It was Kirsten Dady, because the computer, I was kicked off a few times. Thank you, Kristen.

Keywords: 995, all

Summary: The Joint Committee on Public Health held a hearing on several vaccination-related bills, including proposals to eliminate non-medical or religious exemptions for school immunizations (notably H. 2554 and S. 1557), a bill to require or improve reporting and administration of immunization data and exemptions (described as the Community Immunity Act, S. 1618), and H. 2431, which would prohibit COVID-19, mRNA, or gene-altering vaccine requirements. The committee also heard testimony on H. 2463, which would classify funeral directors as public health workers for vaccine-priority purposes during emergencies. The chair reviewed testimony rules and repeatedly asked speakers to keep comments orderly and brief so the committee could hear as many people as possible. No votes were taken during the hearing. Testimony on H. 2554 and S. 1557 was sharply divided. Pediatricians, infectious disease specialists, public health advocates, and groups such as the Massachusetts Chapter of the American Academy of Pediatrics, Massachusetts Medical Society, March of Dimes, Massachusetts Families for Vaccines, and several parents supported eliminating religious exemptions, arguing that vaccination protects medically vulnerable children and adults, improves herd immunity, and helps prevent outbreaks of measles, pertussis, and other diseases. They cited local school data showing pockets of lower coverage and incomplete reporting, and several speakers referenced outbreaks in other states and the need for stronger, more consistent reporting and exemption management. Opponents argued the bills would infringe on religious freedom and parental rights, force families to choose between faith and education, and unfairly target a small number of families; some also said Massachusetts already has high vaccination rates and that the real issue is incomplete data or the gap population rather than religious exemptions. H. 2431 drew testimony from supporters who said COVID-era mandates caused job losses, privacy concerns, and harm, and that the bill would prevent future requirements for COVID, mRNA, or gene-altering vaccines in schools, workplaces, and public settings. Supporters described personal experiences with alleged vaccine injury or mandate-related hardship. H. 2463 was supported by the Massachusetts Funeral Directors Association, which argued funeral directors work in infection-facing settings and should be eligible for vaccine priority during public health emergencies. The hearing featured extensive public testimony but no committee action beyond hearing the bills and taking questions from members.

Transcript Highlights:

• Members and guests are prohibited from using computers, phones, or any type of electronic device.

Keywords: 926, house, all

Summary: The House took up S. 190, a health care cost-containment bill relating to the Green Mountain Care Board, reference-based pricing, and a study of a public employee health benefit authority. The House first suspended rules to take the bill from the notice calendar, then heard committee reports from Health Care, Ways and Means, and Appropriations. The Health Care committee chair described the bill as a strike-all amendment intended to carry out Act 68’s hospital reference-based pricing timeline, saying it would let the Green Mountain Care Board begin implementation for fiscal year 2027, expand reference-based pricing to qualified health plans and the Vermont Education Health Insurance program, and address hospital pricing transparency, outsourcing, and critical access hospital Medicare outpatient cost-sharing issues. Supporters argued the bill would lower insurance costs, help reduce property taxes, and improve hospital sustainability by reducing the need for hospitals to limit access as they approach revenue caps. The Ways and Means committee said the bill could reduce education spending by lowering health care costs for school employees and reported the bill favorably on a 7-4 vote. The Appropriations committee said it reviewed the bill and an amendment, and noted that much of the detailed language would be changed by the appropriations amendment; it also discussed a possible state innovation waiver under the Affordable Care Act. The Health Care committee reported its strike-all amendment favorably on a 10-0 vote. The bill’s provisions were described in detail, including requiring hospitals and insurers to express rates as a percentage of Medicare, setting a path toward national median hospital prices by 2030, limiting certain reimbursements for QHP and VHI plans, requiring a report on hospital outsourcing and provider tax impacts, and creating a public health system performance tool if funding is available. The speaker also noted that the bill would not affect critical access hospitals or Vermont’s Medicare-dependent hospital in the reimbursement cap provisions, and that critical access hospitals were already working with the Green Mountain Care Board on solutions to Medicare outpatient cost-sharing concerns.