Transcript Highlights:

• as well as providers, ... ...but seeing sites going down as well as providers.
• So that was a couple of providers there.
• And then you see the providers there.
• Dental providers are highly trained clinicians. They should be seen as the overall provider team.
• And let the dentist and the dental provider community do what's best, provide them with supports and

Keywords: 962, all

Summary: The Care Management Meeting opened with a DSS update on the PCMH program. Staff reported the program remained steady at 124 practices, 553 sites, and 2,548 providers, with some month-to-month fluctuation driven by practice consolidation, retirements, and a few practices leaving the program because NCQA requirements were burdensome. Members asked about declining provider and site counts, member attribution trends, and whether PCMH practices overlap with behavioral health homes; DSS said attribution changes are largely due to members becoming ineligible, moving, or getting other insurance, and that PCMH and behavioral health homes are separate programs that coordinate informally. The committee also discussed why some smaller practices leave the program and whether the requirements could be made easier to support retention. The committee then resumed a detailed presentation on the Husky Dental program. The presenter described the dental benefit’s history, the importance of preventive oral health, workforce and consolidation pressures in dentistry, and the lack of interoperability between dental and medical records. Network data showed year-over-year declines in enrolled dental practitioners and service locations, with access gaps concentrated in rural and eastern parts of the state. Appointment availability surveys showed average waits of 38 days for adults and 23 days for children, but much longer waits at FQHCs than private fee-for-service practices. The presenter said Connecticut remains above the national median on CMS pediatric dental quality measures, though sealant rates remain a concern, and noted that preventive care is associated with lower per-member costs. Members raised concerns about provider participation, large practices dropping Medicaid, mobile dental care, and whether the public directory accurately reflects which dentists are actually accepting new patients. The presenter said the plan uses secret-shopper calls, tracks appointment availability, and has begun using place-of-service coding to better identify school-based dental care. She also noted a new MOU with 20 Head Start programs to share data and provide oral health literacy and navigation support. The final major topic was implementation planning for HR1. DSS said CMS guidance was expected in early June and proposed using upcoming meetings to cover medical frailty, communication strategy, and data integration/ex parte verification. Committee members urged the department to create a dashboard to track disenrollments and other impacts of HR1, to build a process for complaints and problem resolution, and to think through cost-sharing, caregiver verification, exemptions, and notices. Members also asked about using existing eligibility structures such as the working-disabled program as a model. The committee agreed to move the next meeting to June 10 by Zoom, with the agenda to be circulated in advance and any PCMH Plus quality data shared if available.

Transcript Highlights:

• If you could provide those examples, that would be super helpful.
• So I don't know, are we trying to mandate the housing providers provide it, or are we trying to allow
• to provide cooling.
• HB 2452 provides a practical and reasonable solution.
• HB 2452 provides a common-sense change to the manner in which a housing provider serves a rent increase

Bills: HB1974, HB2265, HB2452

Keywords: land bank, land banking authority, affordable housing, housing crisis, housing supply, public corporation, public housing authority, nonprofit housing, tax-foreclosed property, blight remediation, redevelopment, anti-displacement, equity, redlining, racial segregation, deed restriction, affordability covenant, property tax exemption, excise tax exemption, predevelopment

Transcript Highlights:

• providing care.
• c> family</c> providers providing care there's family providers providing care there's family or<00:52
• </c> or group family child care providers or group family child care providers they're<00:52:47.440><
• providers?
• , including child care providers.

Keywords: 1183, house

Transcript Highlights:

• Who's providing it?
• they named those providers.
• want to or are able to provide as well.
• that also provide rough.
• Uh, Project 10 Million is another program that we have where we are providing $10.7 billion to provide

Transcript Highlights:

• for fees, provide for suspension or revocation of licensure, provide for a stay of eligibility after
• license revocation, provide for license renewal or reinstatement, and provide for the difficult... .
• for fees, provide for suspension or revocation of licensure, provide for a stay of eligibility after
• license revocation, provide for license renewal or reinstatement, and provide for the difficult... .
• license revocation, provide for license renewal or reinstatement, and provide for the difficult...

Summary: The House convened with 70 members present, heard prayer and the Pledge of Allegiance, and approved the House Journal. The chamber then received committee reports noting that House Bills 489 through 493 had been printed and referred to the Judiciary, Rules and Administration Committee. Under resolutions and first reading, House Concurrent Resolution 21 was introduced to designate 2026 as the Year of Volunteerism and the America 250 in Idaho Service Challenge, with related commemorative activities for the nation’s 250th birthday; it was referred for printing. The House also introduced House Bills 494 through 498, covering background checks and related code updates, dentistry and denturist regulation, podiatry licensure and discipline, controlled substances scheduling and related technical changes, and authorization for legislative leaders to employ outside counsel in federal litigation. All five bills were referred to the Judiciary, Rules and Administration Committee for printing. During announcements, members welcomed teachers, IEA members, and several guests in the gallery, and noted a sound money talk, a balanced budget amendment informational hearing featuring Governor Ron DeSantis, and a pharmacy student reception. Committee meeting notices were also read for the coming days. The House then adjourned until 11 a.m. Tuesday, January 20, 2026.

Transcript Highlights:

• We've been a long-term, large provider, and we provide those services through subcontracting.
• accessible information to families, providing professional development and coaching to providers, and
• Participation in Early Achievers is mandatory for providers who accept state subsidy and for ECAP providers
• For a provider to be eligible for an award, at least 5% of the children served by the provider must be
• For a provider to be eligible for an award, at least 5% of the children served by the provider must be

Summary: The Early Learning & Human Services Committee held public hearings on several child care and disability-related bills. House Bill 2317 would exempt certain ECAP and Head Start programs from DCYF licensing when they operate part-day or school-day in public school buildings or on public school property. Staff and the prime sponsor said the bill would remove duplicative licensing barriers and help expand preschool seats, especially as Washington prepares to add more ECAP slots. Testifiers from Head Start, school-linked providers, and the Washington Federation of Independent Schools supported the bill, describing licensing delays, added costs, and lost classroom time; no one testified in opposition. The committee also heard House Bill 2099, which would expand ECAP access for military families with incomes up to Working Connections Child Care limits and adjust prioritization for families with deployed or single custodial military parents. The prime sponsor and multiple supporters, including retired military leaders, Head Start/ECAP advocates, ESD staff, and a military-community partnership, said military families face frequent moves, deployment-related strain, and child care shortages that affect readiness and family stability. Testifiers said the bill would help families access care without changing the program’s low-income focus or adding state cost. House Bill 2350 would require DSHS to notify residents, guardians, and family members when a residential habilitation center is found out of compliance with federal CMS requirements, and to provide follow-up notices on correction and enforcement actions. The sponsor said the bill responds to limited communication around recent noncompliance issues at Rainier School and would improve transparency; DSHS had requested a narrow amendment about how notice is provided to residents. Disability rights advocates strongly supported the bill, saying families need timely information to protect loved ones and make informed decisions. Finally, House Bill 2318 would let ECAP and Head Start children count toward the 5% subsidy participation threshold needed for Early Achievers quality improvement awards. Supporters said the current rule can discourage providers from enrolling ECAP children because it risks losing an award, even though ECAP already requires Early Achievers participation. The sponsor and testifiers described the bill as a small fix to reduce a funding disincentive for providers serving high-need children. The committee took no votes and adjourned after closing the hearings on all four bills.

Transcript Highlights:

• trade associations, to provide for standing and remedies, to provide for an effective date, and to provide
• , to provide for an effective date, and to provide for related matters. ...to provide for terms, to provide
• for hearing aids, to provide for a limited cooling-off period, to provide for application fees, to provide
• provide for exemptions, to provide for violations, prohibited acts, and civil penalties, to provide
• for social media platforms, to provide for violations, to provide for civil penalties, to provide for

Bills: HB387, HB673, HB947, HB975, HB1102, HB1228, HB1229, HCR66, SB102, SB165, SB280, SB291, SB326, SB521

Keywords: engineering, land surveying, construction, state fire marshal, plan review, security cameras, abandoned property, blighted structures, property management, digital assets, abandonment, custodian, escheatment, blockchain, cryptocurrency, unclaimed property, state treasurer, Department of Public Service, statutory entities, public administration

Transcript Highlights:

• provider eligibility, to provide for definitions, and to provide for related matters.
• This instrument provides relative to the investments of domestic insurers to provide for solvency, to
• , to provide for applicability, to provide for an effective date, and to provide for related matters.
• I'll provide one in a minute.
• , to provide for rulemaking authority, and to provide for related matters.

Summary: The House Insurance Committee met on April 15 and first considered HB 909, which would require commercial health insurance coverage for behavioral health crisis services. Representative Spell and Office of Behavioral Health interim assistant secretary Dr. Holly Howitt described the Louisiana crisis response system, the goal of reducing emergency room and 911 use, and the need to expand provider participation beyond Medicaid. A technical amendment and a stakeholder-driven amendment allowing insurers to require documentation of crisis, medical necessity, and follow-up plan were adopted, and the bill was reported as amended with support cards from several health care and local government entities. The committee then advanced HB 1151, which changes investment limits for domestic insurers, especially life insurers, by capping equity holdings and aligning the rules with solvency concerns. After questions about whether the bill would increase profits at consumers’ expense, the author and Department of Insurance staff explained it was intended to provide guardrails and keep insurers solvent; the bill was reported favorably. HB 1154, dealing with prior authorization for certain generic medications, also received technical and substantive amendments. The bill would generally eliminate prior authorization for non-opioid generics, with a $250 wholesale acquisition cost cap and physician-specialty exceptions; it was reported as amended after support testimony from the Louisiana Dermatological Society and other health groups. HB 869, which sought coverage for injectable drugs used for glucose control or weight loss, prompted extended debate over cost, obesity, and long-term savings. Several members raised concerns about premium increases and the large fiscal note, while the author argued the bill was preventive and could save money over time. Representative Jordan proposed a 25% coverage amendment, but the committee declined to take up the substantive amendment that day, and the bill was voluntarily deferred to the next meeting. Later, the committee reported HB 1196 favorably, clarifying that screening colonoscopies remain screening even if polyps are found, and HB 1176 favorably, restoring Medicare Advantage coverage for certain integrative cancer care services. The committee also heard HB 771, which would have changed Medicare coordination rules for retirees who return to state employment, but staff explained the issue is governed by federal CMS rules and preemption concerns; the bill was voluntarily deferred so the author could review the governing law. HB 751, dealing with term life insurance disclosures, was likewise voluntarily deferred after the author said more work was needed and noted concerns about existing law and consumer understanding. At the end of the meeting, the committee also deferred HB 920 and HB 1199 to the following week and briefly stood at ease before moving on to other business.

Transcript Highlights:

• dollars and backfill dollars to provide stability to all the Title X providers across the state.
• We’re reproductive health care providers, including abortion care providers.
• PACE providers in L.A.
• 300 providers.
• And I have, I think, provided it to Patrick, but I'm happy to provide copies also.

Keywords: 988, house, all

Transcript Highlights:

• new providers.
• In those instances, they provided a 20% reduction of principal interest for services provided to indigent
• Again, the contract for services provides an additional incentive for child care providers to increase
• To providers.
• We provide the financing that our.

Transcript Highlights:

• </c> months after finally finding a provider months after finally finding a provider you<00:09:08.399
• We have faith that the providers who are providing this care will continue to do so.
• </c> providers who provide gender affirming providers who provide gender affirming care<00:29:57.360>
• who provide this HHS about uh providers who provide this care.<00:30:11.360><c> It's</c><00:30:11.679
• :19.440><c> provide</c><00:30:19.760><c> this</c> threaten providers who provide this threaten providers

Keywords: 919, house, all

Summary: State lawmakers, the attorney general, advocates, and parents held a press event responding to Children’s Minnesota’s announcement that it would pause some gender-affirming care for minors. Speakers, including Rep. Lee Finke, Hannah Edwards of Transforming Families Minnesota, and Jess Braverman of Gender Justice, said the pause was driven by federal pressure and threats from the Trump administration and HHS, not by medical best practice. They emphasized that gender-affirming care remains legal in Minnesota under the state’s Human Rights Act, Trans Refuge law, and insurance protections, and argued that interrupting care harms trans youth and families, especially those who moved to Minnesota for protection. Testimony focused on the emotional and practical impact on families: loss of trust in providers, delays in treatment, travel and intake wait times, and the stress of having to scramble for continuity of care. Speakers described the care as evidence-based, medically necessary, and life-saving, and said the federal government was using coercion and misinformation to intimidate hospitals and doctors. The attorney general said his office and coalition partners are litigating related federal threats, including a separate RFK Jr. declaration and proposed federal rules, and that Minnesota officials are working to preserve access and enforce state protections. In response to questions, speakers said the state’s legal tools are strong but limited against federal action, so they are relying on court challenges and enforcement of existing state law. They said Children’s Minnesota had been specifically targeted by federal officials and that the hospital’s pause was tied to that pressure. No votes were taken; the event ended with a call for continued public and institutional support for trans youth and for Children’s to resume care as soon as possible.

Transcript Highlights:

• It provides some technical fixes to regulatory barriers.
• The final bill is Senate 769, an act providing continuity of care for mental health treatment.
• It increases length of stay, uses resources, and provides no value.
• the adequate training to provide this function.
• By incredible luck, I found the right provider, but my private insurance covered nothing.

Keywords: 995, all

Summary: The committee held a hearing on a large group of behavioral health and insurance-related bills. Topics included expanding access to mental health services by allowing physician assistants to authorize Section 12 emergency holds and be recognized as licensed mental health professionals (H. 1131/S. 773); improving coverage for community behavioral health centers so commercial insurance matches MassHealth’s bundled outpatient and crisis services (H. 1276/S. 703); eliminating cost sharing for certain behavioral health services (S. 718); extending detox and clinical stabilization coverage from 14 to 30 days and adding transitional support services (H. 1319/S. 772); requiring coverage for dual-diagnosis treatment in psychiatric facilities (H. 1277/S. 771); and preserving access to treatment for serious mental illness through coverage of coordinated specialty care and assertive community treatment (H. 1135/S. 709). The committee also heard bills on preventive behavioral health services for children (H. 1228/S. 802) and post-pregnancy mental health care, including postpartum depression and pregnancy loss-related care (H. 1314/S. 823).

Transcript Highlights:

• and benefit payments; providing distribution for the Soil and Water Conservation Commission; providing
• and benefit payments; providing distribution for the Soil and Water Conservation Commission; providing
• ; providing distribution for the Soil and Water Conservation Commission; providing reappropriation authority
• and benefit payments; providing distribution for the Soil and Water Conservation Commission; providing
• ; providing distribution for the Soil and Water Conservation Commission; providing reappropriation authority

Keywords: 989, all

Transcript Highlights:

• Changes may provide that opportunity.
• That could include providing a set of requirements for the administration to provide additional analysis
• Of course, the service providers employ people to actually provide the service, so we're talking about
• That has to be earned based on the quality of the service being provided by the service provider.
• to the provider community to get them involved in that provider directory, we're going to be looking

Keywords: 988, house, all

Transcript Highlights:

• and potential service providers.
• We're providing, at this point, doctor, you know, we're providing information to families.
• And, of course, the service providers employ people to actually provide the service.
• That has to be earned based on the quality of the service being provided by the service provider.
• Same thing for service providers. We're doing it right now in a service provider directory.

Summary: The Assembly Budget Subcommittee on Human Services held a hearing on developmental services, rehabilitation, and related supports, with no votes taken. The first major topic was the Master Plan for Developmental Services. Administration officials described a year-long, community-driven process that included a steering committee, work groups, and statewide engagement sessions, and said the final draft would be released that Friday with about 170 recommendations. The Department of Developmental Services said the plan would inform future work, but did not offer a detailed implementation roadmap. The LAO said the plan contains significant policy and budget implications, may require statutory changes, and needs further analysis to turn recommendations into actionable proposals. Advocates and regional center representatives urged the Legislature and administration to avoid letting the plan sit on a shelf, called for prioritization and ongoing stakeholder oversight, and emphasized the need to address equity, workforce, service coordination, and cross-system collaboration. The chair said he wanted to work with the LAO on trailer bill language and future reporting to create a clearer path forward. The second topic was the Office of Employment First and competitive integrated employment. Administration witnesses said California has ended subminimum wage under SB 639, but that moving people into competitive integrated employment remains a major priority. They described existing efforts such as DDS’s coordinated career pathways pilot, paid internships, job development services, benefits counseling, and DOR’s career counseling and referral services, along with pilot projects in San Diego and Orange County. The State Council on Developmental Disabilities and advocates argued that employment outcomes have remained stuck at roughly 15% and that a dedicated Employment First Office is needed to coordinate across agencies, align goals, and improve outcomes. The LAO recommended regular legislative oversight on people transitioning out of subminimum wage and asked for technical assistance on coordinated career pathways. The chair criticized the administration’s decision to effectively eliminate funding for the office, requested a detailed implementation timeline and quarterly transition reports, and said the committee would continue pressing for the office to be implemented. The final issue was respite services, utilization trends, and access. DDS reported that in-home respite use and spending have risen sharply over several years, with about 150,000 people using respite in 2023-24 and expenditures reaching about $1 billion. Officials said access depends on families knowing the service exists, service coordinators identifying need, and having enough providers, especially in rural and linguistically diverse communities. The San Diego Regional Center said utilization generally mirrors statewide trends, but access is stronger in some areas, such as Imperial County, where families often prefer family-directed or agency-supported models that allow them to hire trusted workers. Committee members emphasized the importance of respite for family health and caregiver well-being, asked whether service coordinators are asking practical questions about sleep and stress, and discussed the need for better identification of complex behavioral and medical needs. DDS said a standardized family support tool and updated IPP process are intended to improve consistency, transparency, and person-centered assessment for respite and related services.

Transcript Highlights:

• to provide for changes in legislative intent, to provide for definitions, to provide for compliance
• to provide for changes in legislative intent, to provide for definitions, to provide for compliance with
• , to provide for qualifications, and to provide for related matters.
• It provides relative to children in need of care, to provide for definitions, to provide for reporting
• provider, to provide for a mental health care provider, to provide for a minimum supply of post-exposure

Bills: SB57, SB405, HB62, HB193, HB203, HB222, HB246, HB420, HB475, HB486, HB574, HB584, HB815, HB949, HB1092, HB1214

Keywords: SB 57, Act 735, Act 463, nutrition, public health, food additives, artificial colors, banned chemicals, ingredient labeling, food labeling, FDA, food and beverage regulation, consumer disclosure, school nutrition, Louisiana Revised Statutes Title 40, Louisiana Revised Statutes Title 17, food manufacturers, food retailers, compliance, effective date delay

Transcript Highlights:

• , to provide for changes in legislative intent, to provide for definitions, to provide for compliance
• to provide for changes in legislative intent, to provide for definitions, to provide for compliance with
• for confidentiality, to provide for public records exception, to provide for effectiveness, and to provide
• It provides relative to children in need of care, to provide for definitions, to provide for reporting
• provider, to provide for a mental health care provider, to provide for a minimum supply of post-exposure

Summary: The committee heard a personal privilege update on HB 1227, which Representative DeWitt said would return next week as a proposed HCR for a two-year study of the three-doctor panel after discussions with Dr. Nia Colotta. Better Louisiana also presented its new Leadership Louisiana Health Fellows Program, describing it as a data-driven leadership initiative focused on health care workforce, rural access, chronic disease, and other system issues; members discussed whether the program could also help generate policy research, including on managed care organizations. The committee then considered SB 427 on anatomical gifts. After adopting technical amendments, Senator Presley and Dr. Jeff White explained that the bill would strengthen organ donation law by creating a decision registry that records both yes and no choices, clarifying the legal effect of refusal, and codifying ethical principles such as the dead donor rule. Questions focused on organ viability, registry procedures, minors, and a Monroe case involving a disputed donor designation. Supporters included LOPA and the Louisiana Conference of Catholic Bishops, and the bill was reported favorably. HB 946, dealing with hospital price transparency and compliance with federal pricing rules, drew extensive testimony. Representative Landry and a witness from Patient Rights Advocate described it as a consumer transparency measure, but the Louisiana Hospital Association opposed the bill’s state-level enforcement and debt-collection provisions. Landry offered an amendment removing the debt-collection and affirmative-defense language, but after debate the substitute failed on a 5-6 vote and the bill was voluntarily deferred. The committee also reported favorably on SB 109, which revises membership qualifications for the Louisiana Emergency Medical Services Commission; SCR 20, urging federal flexibility on Medicaid redetermination for elderly and disabled beneficiaries; SB 216, allowing coroners to rely on licensed practical nurses for medical pronouncements of death; and SB 45, exempting certain gratuitous hospice houses from licensure, with testimony from hospice house operators and supporters. Finally, HCR 71 by Representative Chasson sought an LDH study of how Louisiana’s law and guidance on pregnancy-related emergency medications is working in hospitals, urgent care, and retail settings. Supporters said providers are hesitant to use medications such as misoprostol because of stigma and uncertainty, while opponents from Louisiana Right to Life argued the resolution was unnecessary and could create controversy. The discussion centered on whether the study should be narrowed or made more objective, but no final action on the resolution was reached in the portion provided.

Transcript Highlights:

• Um, the concern is department just um provide comment on department just um provide comment on the<00
• unfortunately unscrupulous providers unfortunately unscrupulous providers when<00:04:22.479><c> they<
• So notifying the provider for 90 days."
• . provider. provider.
• . providers. providers.

Keywords: 919, house, all

Summary: House File 3542 was heard in committee and moved forward with a recommendation to be re-referred to the Children, Families, Finance, and Policy Committee. The bill would change current law so that the commissioners of Human Services and Children, Youth, and Families must disclose the existence of an investigation, rather than may disclose it, with the stated goal of increasing transparency to the public and legislature. Members and agency officials discussed concerns that mandatory disclosure could tip off subjects of investigations, especially in fraud cases, allowing them to destroy evidence, coordinate stories, or otherwise interfere. The Department of Human Services and the Inspector General said disclosure can compromise investigations and noted that providers are typically notified when payments are reduced, suspended, or withheld, though federal law can sometimes require delayed notice. Representative Pinto offered an A2 amendment to require disclosure within 30 days unless it would compromise an investigation, but it was rejected. Representative Hudson then offered an oral amendment stating that disclosure would be required if the commissioner has taken action to reduce, suspend, or withhold payments to the subject of the investigation. The chair waived the rule to allow the oral amendment, and it was adopted. Staff clarified that the bill would only require disclosure of the existence of an investigation, not underlying details, and would not address trade secret redactions. After the amendment, the committee approved the motion to re-refer the bill.

Transcript Highlights:

• ><c> um</c> of a provider [snorts] provider type um of a provider [snorts] provider type um program<00
• It applies to a provider type.
• It applies to a provider type.
• It applies to a provider type.
• If there's some remote providers, maybe. But the center uh look A legacy provider.

Keywords: 918, senate, all

Summary: The committees resumed discussion of amendments to a bill dealing with licensing moratoria, change-of-ownership rules, and related provider oversight issues. Amendment A8 would prevent a licensing moratorium for certain intermediate care service settings from blocking a new license when the change is due to a change of ownership, including temporary licenses and transitional licenses. Department of Human Services staff said they were still reviewing the language but explained the department’s concern was maintaining program integrity and ensuring owners go through full change-of-ownership review so the agency can see who owns a provider and check compliance history. Senators supporting the amendment argued it would keep legitimate businesses from being harmed by a moratorium and could help preserve providers when ownership changes or family members take over after a death. A8 was adopted on a roll call, with both committees voting in support. Amendment A9, also on the moratorium topic, would exempt a change of ownership from the moratorium so long as it does not increase license capacity or service scope. The department said it needed more analysis to avoid unintended consequences, but the amendment was added to the working bill. Amendment A10 proposed a more detailed, data-driven framework for the moratorium and included a provision about refunds after implementation; department staff said the language would add cost and would require technical assistance, while senators emphasized the need to address licensure backlogs and avoid making provider delays worse. A10 was approved by the committees, though not unanimously. Amendment A11 would have set standards for how the commissioner designates provider types or program areas as moderate or high risk, with added transparency criteria. The department said the commissioner already has that authority and raised concerns about federal requirements and the state’s corrective action plan, and Senator Hoffman withdrew the amendment. Amendment A12, offered by Senator Fateh, would preserve remote supports by removing bill language that repealed the service and would add safeguards for remote overnight supervision, including staffing ratios to ensure emergency response times can be met. Several senators supported keeping remote services as an important, cost-effective option amid workforce shortages, while the department said it had program integrity concerns and supported the governor’s proposal to remove the service. The committee nevertheless advanced A12, with members noting the need to balance safety and integrity with access to services.

Transcript Highlights:

• an option to states to direct payments to providers through managed care.
• Want to make sure providers are smart and they're using their funds to that.
• >> So there are other funding streams for Medicaid program has to provide to provide care to members
• provider taxes as that addresses provider taxes and freezes provider taxes as certain rates which CMS
• Any new provider taxes on a new new class of providers as crazy. Not tax something.