Transcript Highlights:

• <00:02:11.280> examination first which is outpatient examination first which is outpatient
• <00:03:09.952> [clears throat]<00:03:10.400> and outpatient [clears throat] and outpatient
• or, excuse me, an inpatient facility.
• where we say facility where we say facility means<00:52:09.920> a<00:52:10.240> hospital
• <00:54:58.160> in requires, are we adding facilities in requires, are we adding facilities

Bills: SF0023, SF0057

Keywords: mental health, involuntary hospitalization, examiners, public safety, Wyoming legislature, hospital pricing, healthcare transparency, public health, civil penalties, shoppable services, 916, all

Transcript Highlights:

• He is working with outpatient programs. He is happy, and he is living with me.
• In correctional facilities. Many people with anosognosia—where did I treat them?
• In correctional facilities, because that's where many of these folks end up, unfortunately.
• We tried desperately with Michaela Alioto-Pier to pass Laura's Law, assisted outpatient treatment, and
• This would specifically impact six SUD treatment facilities among more than 1,000 facilities that are

Keywords: 988, house, all

Summary: The hearing focused first on behavioral health, especially hard-to-treat serious mental illness through the lens of anosognosia, and the impact of potential federal Medi-Cal reductions under H.R. 1. A family member, Dawn Marie Anderson, described her son’s long cycle of psychosis, homelessness, arrests, jail-based stabilization, and repeated relapse when treatment ended, arguing that anosognosia is a symptom of illness rather than refusal of care. She and other witnesses urged more consistent, long-term treatment, family involvement, medication support, and stronger county and state coordination. County and provider representatives said the current system still relies too heavily on crisis response and leaves people with serious mental illness falling through gaps between managed care, county specialty care, housing, and justice systems. Testimony from the California Behavioral Health Association, Santa Barbara County Behavioral Health, and the County Behavioral Health Directors Association emphasized that people with anosognosia often cannot self-navigate care, making a “no wrong door” system essential. They said H.R. 1 could destabilize coverage and shift costs to counties, while existing private insurance coverage is inadequate for early psychosis and related services. Witnesses highlighted CalAIM, jail in-reach, assertive community treatment, mobile crisis, supportive housing, and LEAP-style family training as promising tools, but said counties still need more resources and that the state should strengthen both Medi-Cal and private insurance behavioral health coverage. A public commenter from Lake County said private insurers denied most claims, especially for unlicensed staff providing case management and mobile crisis services. The committee then heard an update on the Children and Youth Behavioral Health Initiative, including the virtual services platforms BrightLife Kids and Soluna and the CYBHI fee schedule program. DHCS reported strong growth in app registrations, coaching sessions, referrals, and positive user outcomes, and said the platforms are serving children and youth statewide, including many who had never previously accessed care. For the fee schedule, DHCS said 72% of school districts and 50 of 58 county offices of education are participating across six cohorts, with $9.6 million reimbursed to date and 41,556 students represented in claims. Members pressed the department on the program’s roughly $69.3 million administrative cost, the slow pace of reimbursement relative to the investment, and the late delivery of requested data. DHCS responded that many claims are still being submitted, most denials are correctable, and local implementation is still scaling up through technical assistance and capacity grants.

Transcript Highlights:

• I own an outpatient clinic in Burnet, Texas.
• Under the program, eligible hospitals and health centers can purchase outpatient prescription drugs at
• It's an outpatient.
• On outpatient medicines, they buy low, they sell high, and they keep the pricing spread, hopefully to
• Yeah, so it could be 10 or 15%, and that could be in either one of those facilities.

Bills: HB712, HB722, HB946, HB1687, HB1809, HB1899, HB2528, HB2583, HB2741, HB2750, HB3021, HB3150, HB3265, HB3658, HB3812, HB3960, HB4392, HB4432

Keywords: prostate cancer, health benefit plans, insurance coverage, cost sharing, preventive health care, auto insurance, total loss evaluation, disclosure, insurance materials, vehicle appraisal, HB 946, Texas Insurance Code, automobile insurance claims, oral release, written release, settlement agreement, claim release, property damage, bodily injury, psychological injury

Transcript Highlights:

• I'm also a congregate living facility owner.
• skilled nursing facilities where the quality of life will be different.
• I represent Congregate Living Health Facilities.
• Hi, I'm Miriam again with the Congregate Living Health Facilities.
• for the facilities?

Keywords: 988, house, all

Transcript Highlights:

• There are a couple of post-acute facilities, but other than that, we bring the voice of urban facilities
• and rural facilities.
• facility, or an urban facility, and then there is this supplemental payment.
• areas of the facility.
• For example, my facility has done better as far as a margin than some of the other facilities. within

Transcript Highlights:

• Facility, yeah.
• 40 orders a month for outpatient 40 orders a month for outpatient evaluations.<00:48:20.960>
• and the small facilities alike.
• and the small facilities alike.
• I guess the facilities weren’t proper.

Bills: SF0007, SF0008, SF0009, SF0010

Keywords: theft, penalties, larceny, criminal offense, felony, Wyoming, absconding, law enforcement, criminal justice, fentanyl, controlled substances, minors, drug distribution, enhanced penalties, mental health, detention, competency evaluation, treatment, contractual agreements, 916

Transcript Highlights:

• So this is to help a small rural health care facility provide senior services.
• <00:21:44.440> and our director of nursing facilities and our director of nursing facilities
• <00:22:17.000> open functional and keep the facilities open functional and keep the facilities
• home aspect of the hos of the facility home aspect of the hos of the facility and<00:23:00.679><
• If any of the rural facilities were to close, it would put more pressure on us.

Keywords: 1183, house

Transcript Highlights:

• Um, many of you have met with them in the past, and these are outpatient behavioral health providers.
• That happens quarterly for all the nursing facilities.
• That happens quarterly for all the nursing facilities.
• That happens quarterly for all the nursing facilities.
• That happens quarterly for all the nursing facilities.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board meeting began with a roll call and approval of the October 7 meeting minutes. The chair then reordered the agenda to hear the item on Medicaid reimbursement rates and network adequacy first because of scheduling issues. Dr. Steve Robertson of the Kentucky Dental Association was sworn in and testified at length about Kentucky’s dental Medicaid program, arguing that reimbursement rates are unsustainably low, have been largely flat for decades, and are often below the cost of providing care. He said Kentucky ranks near the bottom nationally in oral health, dental Medicaid rates are often 60% or less of commercial rates, and the program’s share of the Medicaid budget has effectively remained around 2% despite growth in enrollment and services. Dr. Robertson said the low rates are contributing to provider losses, rural access gaps, longer wait times, dental deserts, and greater use of emergency rooms for preventable dental problems. He cited examples of office costs exceeding reimbursement for basic procedures, noted that many dentists are small private businesses, and said the state is struggling to recruit and retain dentists because of low payment levels and high student debt. He also pointed to disparities with neighboring states and said recent increases in some oral surgery and cleaning codes were not enough to address the broader problem. His recommendations included completing the rebasing study, increasing dental reimbursement in the upcoming budget, tying future reviews to inflation and cost data, aligning benchmarks, and prioritizing preventive and restorative care to improve workforce stability and access. Board members asked about the size of the needed increase, the effect of private insurance on dental practice finances, and what a new dentist might expect to earn. Dr. Robertson said the association is working on an appropriations request and that private insurance pressures are part of the problem as well, since many plans are HMOs or PPOs with limited provider control over rates. He also said the association can no longer conduct reimbursement surveys because of FTC restrictions, but would try to obtain current ADA data. In response to questions about the future of the program, he warned that without significant changes it could become unsustainable and cited Ohio and Missouri as examples where higher reimbursement improved provider participation and access. The board then heard from Mr. Bowman of Baldwin Consulting, who discussed outpatient behavioral health providers, including ABA therapy and mental health/substance use disorder services. He said these providers face similar issues of rising costs, flat reimbursement, and access problems. He reviewed Kentucky’s network adequacy standards, including travel-time standards, 30-day appointment limits, and newer federal requirements that will require services within 10 business days by 2029. He said wait times for outpatient behavioral health, especially children’s services and ABA, have grown substantially, sometimes to more than a year, and emphasized that the Medicaid department must enforce these standards.

Transcript Highlights:

• care facilities and so forth.
• The Honorable Judge Robert Lata has hearings once a month for assisted outpatient treatment.
• Someone will not be mandated to assisted outpatient treatment because of their economic situation.
• No one will be unjustly committed to outpatient treatment.
• But this is dealing with mental health and assisted outpatient treatment options.

Keywords: 996, all

Transcript Highlights:

• risk and we'll work with that facility risk and we'll work with that facility to<00:33:08.399>
• So if they are a facility and they do ambulatory outpatient same-day care procedures, but if it’s under
• So if they are a facility and they do ambulatory outpatient same-day care procedures, but if it’s under
• So if they are a facility and they do ambulatory outpatient same-day care procedures, but if it’s under
• So if they are a facility and they do ambulatory outpatient same-day care procedures, but if it’s under

Keywords: 928, house, all

Summary: The committee first handled organizational business, electing Representative Mark Pearson as chair for the coming term, appointing Representative Lucy Weber as clerk, and approving the November 22 minutes with abstentions from members who were absent. Members also noted excused absences for Senator Avard and Representative Jessica Lontine. After the vote, the committee moved to the DHHS commissioners’ update. DHHS associate commissioners Patricia Tilly and Chris Santinello described a process-improvement effort to improve transitions for youth moving from DCF care into adult developmental services and Medicaid. They said the old process was fragmented, dependent on personal relationships, and not sustainable, so staff from DCF, the Bureau of Family Assistance, Developmental Services, and public health used a Kaizen/Lean event to map the workflow, identify bottlenecks, clarify roles, and create a more consistent playbook. Members asked about IT support and whether the process would create new bureaucracy; DHHS said current systems are antiquated, especially DCF’s CWIS, but the goal is to streamline coordination, not add bureaucracy, and future systems like Granite Families may help with reminders and age-based ticklers. Several members praised the work, including a CASA volunteer who said the added attention has improved services for vulnerable youth. The committee then received the annual healthcare-associated infections update from Ctin Hansen of the Division of Public Health Services. Hansen reported that New Hampshire’s HAI program, created by statute, tracks infections in hospitals, ambulatory surgery centers, dialysis centers, and long-term care facilities. For 2023, hospitals reported fewer infections than predicted nationally, with 135 infections statewide and 174 C. diff infections also below national rates; hospital influenza vaccination was 89.9%. Ambulatory surgery centers reported low infection counts and an 80.1% staff flu vaccination rate; dialysis centers reported fewer infections overall than the prior year but higher local access-site infections, with staff vaccination at 52.6%; and long-term care facilities reported a 50.1% flu vaccination rate, up from 37.8%. Hansen also said the program conducted over 100 investigations, handled 84 antibiotic-resistant organism reports, completed 20 infection-prevention assessments, and operated on a budget of about $348,000 plus grant funding, including an Epidemiology Laboratory Capacity Grant that was later reduced.

Transcript Highlights:

• > civil engagement services outpatient civil engagement services outpatient civil commitments<
• But we need those facilities that we currently don't have.
• But we need those facilities that we currently don't have.
• But we need those facilities that we currently don't have.
• It supports both training facility.

Keywords: 1187, senate, all

Transcript Highlights:

• Um page four gives the breakdown by facility and, as also mentioned, the three areas that continue to
• Um page four gives the breakdown by facility and, as also mentioned, the three areas that continue to
• Um page four gives the breakdown by facility and, as also mentioned, the three areas that continue to
• acute care facility. acute care facility.
• So the first table on page 39, total outpatient primary care dentist rates per 100,000 population.

Keywords: 928, house, all

Summary: The committee first approved the draft minutes of its May 16, 2025 meeting, with one correction removing Representative Dry from the attendance list because she was present as a guest rather than an appointed member. The committee then received a Department of Health and Human Services update from Commissioner Lori Weaver, who focused on the rural health transformation grant process. She said the department has been gathering stakeholder input since July, issued a request for information on September 22, and is working toward an end-of-October draft and a November 3 deadline, with a grant writer request expected to go before Governor and Council at no cost to the state. The bulk of the meeting centered on federal changes affecting SNAP and Medicaid. Karen Heert explained that the federal law changes commonly referred to as the “Big Beautiful Bill” or HR1 will affect SNAP eligibility and state costs, including a shift in administrative cost sharing from 50/50 to 75/25 beginning in October 2026 and a possible state share of benefits if New Hampshire’s error rate is too high. She said the program affects about 43,000 households, that New Hampshire’s federal fiscal year 2024 error rate was 7.57% versus a national rate of 10.93%, and that the state must get below 6% to avoid liability. She also said DHS is preparing remediation steps, auditing cases, and seeking technology and staffing support, including a grant for automation and training. Henry Litman then described Medicaid changes under HB2 and the new federal law. He said New Hampshire returned to pre-pandemic eligibility verification rules on July 1, including a 10% income compatibility standard and reduced ex parte renewals, which has increased manual work and contributed to a drop in enrollment from about 185,000 in late June to about 178,000 in early September. He also reviewed new child premiums, pharmacy copays, Granite Advantage premiums, and possible Medicaid work requirements, noting that DHS is working with CMS on implementation details and may use a state plan option rather than an 1115 waiver because it would be less expensive and faster. Members asked several questions about the SNAP error-rate rules, the distinction between administrative and client errors, the effect of unpaid copays, and the timing and legal risk of the Medicaid work requirement; no votes were taken on those policy issues.

Transcript Highlights:

• The policy itself establishes a licensure requirement for outpatient substance abuse treatment facilities
• uh substance abuse treatment outpatient uh substance abuse treatment facilities<00:33:22.159> in<
• there's no such requirement facilities there's no such requirement for<00:48:42.880> outpatient
• c><00:48:43.440> treatment<00:48:43.880> facilities<00:48:44.480> and for outpatient
• treatment facilities and for outpatient treatment facilities and because<00:48:44.960> of<00:

Keywords: 928, house, all

Summary: Division 3 Finance held a work session to move through five bills before noon, noting one member’s early departure and adjusting the order of bills accordingly. The first item, HB 54, would allow some alternative treatment centers in the medical cannabis system to operate for profit. Members discussed a fiscal note showing a one-time $133,000 cost, which was described as a Division 1 budget item to be handled through HB 2 rather than directly in Division 3. After discussion about keeping Division 1 informed and the distinction between retaining a bill versus funding it, the committee voted unanimously to retain HB 54 for further finance work and conversion into HB 2. The committee then took up HB 547, concerning reimbursement to counties for enhanced FMAP funds during the COVID period. The chair summarized the issue as federal enhanced Medicaid matching funds that were received by the state before authority existed to pass them through to counties, creating a disputed amount owed to counties. County representatives said the money should have gone to counties and clarified the relevant time period, while the department did not take a position. The chair proposed retaining the bill and moving it into HB 2, with discussion of a possible four-year repayment structure in equal annual installments. The committee agreed to retain the bill for continued work in the budget process. During the HB 547 discussion, members also clarified the fiscal and accounting details, including that the fiscal note had not been widely available and that some figures in the note should be treated as county revenue rather than county expenditure. Testimony explained that the enhanced FMAP increased from 50 percent to 56.2 percent, and that the state’s and counties’ shares of claims were affected by the timing of the federal change and the later state authorization. The committee emphasized that the issue was complex and budget-dependent, and that retaining the bill would allow further negotiation and incorporation into HB 2 rather than immediate final action.

Transcript Highlights:

• The outpatient service has two providers.
• Placement limitations at the secure facilities.
• Community facilities. We have eight community facilities across Washington State.
• facility footprint.
• Sometimes it's directly from a secure facility.

Summary: The committee heard testimony on the effects of H.R. 1 on Washington’s Medicaid, developmental disability, long-term care, and food assistance systems, followed by a separate discussion of juvenile rehabilitation caseloads and placement capacity. DSHS officials said HR1 could affect home equity rules, immigration-related eligibility, work requirements for some expansion-population enrollees, and provider taxes, while also creating a future opportunity for a new 1915(c) waiver. Advocates and providers warned that any state response that cuts home and community-based services would worsen already thin provider networks, increase waiting lists, push more people into hospitals or out-of-state placements, and strain families and workers. A pediatric behavioral health expert and a supported living provider said Medicaid reimbursement is already too low and further reductions would threaten outpatient, residential, and inpatient services for people with intellectual and developmental disabilities and severe behavioral needs. The committee then turned to SNAP and the state food assistance program. DSHS said HR1 would tighten work requirements and exemptions, end some immigrant eligibility for the federal program, eliminate the SNAP education program, raise state administrative costs, and eventually require Washington to share in benefit costs based on its error rate. Officials estimated large numbers of residents could lose or see reduced benefits, with significant added state costs. Anti-hunger advocates, a food bank director, and a SNAP recipient described the program as essential for low-income families, seniors, and people with disabilities, and said the changes would increase paperwork, reduce benefits, and worsen food insecurity while also harming local food economies. Testimony emphasized that food banks cannot replace SNAP and that work requirements may be difficult to meet for caregivers, people with disabilities, and those facing child care or transportation barriers. In the juvenile justice portion, the Caseload Forecast Council presented the JR forecast, which is currently mostly flat through the end of the biennium but expected to grow modestly over the longer term. Members discussed how policy choices, including the 2019 JR-25 law, have increased lengths of stay for adult-sentenced youth in JR, while diversion and other reforms have affected regular JR trends. A court researcher explained the data available to help forecast admissions and noted ongoing efforts to improve data sharing with JR, AOC, and county systems, though staffing and system-lag issues limit how quickly data can be produced. Juvenile court administrators and DCYF officials described the community-based juvenile justice continuum, rising complexity in the JR population, overcrowding at Green Hill and placement constraints at Echo Glen and Harbor Heights, and the need for more flexible community transition and mental health capacity. No votes were taken.

Transcript Highlights:

• I own an outpatient clinic in Burnie, Texas.
• Use jeopardize this access and revenue, placing the survival of many rural facilities at risk.
• It's an outpatient.
• Uh, not only your facility, but also, more importantly, the patients that it serves.
• Yeah, so it could be 10 or 15%, and that could be in either one of those facilities.

Transcript Highlights:

• So I'm specifically referring to the inpatient one versus the outpatient base rate.
• So I'm specifically referring to the inpatient one versus the outpatient base rate.
• Is there any money in there for that new facility we're supposed to be building?
• Is there any money in there for that new facility we're supposed to be building?
• Listen, inside of our facilities, we have more drugs than we have on some of our streets.

Summary: The House convened with prayer, a moment of silence for former Senator Donnell C. Childers, the Pledge of Allegiance, and recognition of Officer Antonio Richardson as law enforcement officer of the day. A quorum was announced, the journal was approved, and the Speaker said the chamber would take up 11 budget conference reports, with debate and final votes on each report. The first report considered was HB 7031E, the tax package, followed by HB 501E, the state budget appropriations bill. On HB 7031E, Chair Duggan explained that the conference report included a range of tax reductions and tax-related changes, including sales tax holidays, property tax and homestead-related provisions, reductions in certain taxes and fees, and new exemptions or administrative clarifications. He said the package also added items such as sales tax relief for certain university construction projects, a tennis admissions exemption, and changes to agricultural property tax treatment, and that the amendment reduced state and local tax revenues by $272.2 million. Members questioned the bill about the child care tax credit reduction from three years to one, the homestead exemption provision for certain diplomats and foreign service personnel, the absence of gas tax relief and combined reporting, and the inclusion of firearm accessories and tennis tickets in sales tax holidays. After structured debate, the House adopted the conference report and passed HB 7031E by a vote of 88-11. The House then began the conference report on HB 501E, the $114.5 billion budget for fiscal year 2026-2027, which was described as below the prior year’s spending level and leaving more than $14 billion in reserves. Subcommittee chairs outlined major allocations across education, higher education, IT, health care, transportation and economic development, justice, state administration, and agriculture/natural resources. Highlights included increased FEFP funding and veteran teacher raises, full funding for Bright Futures, major IT modernization projects, Medicaid and behavioral health funding, transportation and local infrastructure spending, correctional and law enforcement investments, fire station and emergency response funding, and large environmental and water-quality appropriations. Members asked detailed questions about school voucher fraud oversight, scholarship funding, teacher raises, preeminence funding, ADAP changes, SNAP data tools and error rates, Medicaid rate changes, prison wastewater monitoring, and other budget items, but the transcript ends during the budget questions before final action on HB 501E is shown.

Transcript Highlights:

• We have fire alarm upgrades underway at our DSH Metro facility.
• or... 546 either brand-new behavioral health facilities or current facilities that are expanding a wing
• But those are the bed types, and then outpatient is more for like mental health outpatient-type services
• We do have six facilities in the state.
• We do have six facilities in the state right now, and that is six among more than a thousand SUD facilities

Keywords: 987, senate, all

Summary: The subcommittee heard updates from the Department of State Hospitals on its proposed 2026-27 budget, including a $3.2 billion total budget, patient-driven operating cost increases, savings in the IST solutions program, and progress in meeting the Stiavedi court-ordered 28-day treatment standard. DSH reported it has met court benchmarks, reduced the IST pending placement list from a pandemic high of 1,953 to about 250, and is now averaging about five days to initiate treatment. Members asked about the effects of Proposition 36 and SB 1323 on referrals, outside hospitalization costs, Medicare coverage, and whether IST solution funds were being overbudgeted; DSH said referrals are slightly down overall, outside medical costs are rising due to inflation and an aging population, and the IST savings reflect slower-than-expected activation of community programs rather than a service gap. The department also outlined proposed funding for electrical infrastructure upgrades at Napa and Patton, a feasibility study under SB 380 for transitional housing for the CONREP SVP program, and a dental services expansion at Metropolitan and Patton. The committee held those DSH items open after discussion. The Commission for Behavioral Health presented its role in overseeing the transition from MHSA to BHSA, including data, evaluation, transparency, grantmaking, and technical assistance. It described the new Innovation Partnership Fund, a statewide innovation grant program funded at up to $20 million annually for five years, with small and large grants, and said it had received strong interest ahead of the May 8 application deadline. Members asked about what qualifies as innovation, whether grants could be renewed, and how the state would ensure the program supports service delivery rather than general outreach or training. The commission also sought a liquidation deadline extension for up to $4.062 million in remaining Alcove Youth Drop-in Center funds so sites can finish implementation and Stanford can complete the final evaluation; that item was also held open. DHCS provided an overview of behavioral health policy changes under CalAIM and BH Connect, including peer support, mobile crisis, contingency management, traditional health care practices for tribal members, the access reform and outcomes incentive program, workforce investments, evidence-based practice expansion, IMD participation, transitional rent, and upcoming youth-focused guidance such as high-fidelity wraparound and activity funds. On BHSA implementation, DHCS said it is not tracking specific local program cuts, but is monitoring county plans and outcomes while noting that counties must still preserve Medi-Cal specialty mental health and DMC-ODS services. The department also discussed its H.R. 1 implementation strategy, including outreach, streamlined renewals, ex parte exemptions, and proposed clinic navigator and outreach funding to reduce Medi-Cal coverage loss, especially for people with behavioral health needs. In response to questions, DHCS said it has not produced a specific H.R. 1 impact estimate for county behavioral health populations, and later explained that counties can still use BHSA and other funding streams for prevention and early intervention while the state tracks impacts through integrated plans and new performance measures. The department also reported on BH-CHIP bond spending, saying it has awarded $5.8 billion for 437 infrastructure projects creating 546 new or expanded facilities and more than 9,553 residential beds, with tribal set-asides exceeding the original allotment.

Transcript Highlights:

• The larger institutions, the hospitals, and the hospital-owned facilities will be capped at two and a
• basis to fully fund the current and projected claims obligations of the outpatient So is it Mr.
• It says that or two percent of the hospital or hospital control and outpatient health care facilities
• Privileged by a hospital or outpatient health care facility shall be paid by that hospital or outpatient
• facility.

Keywords: 996, all

Transcript Highlights:

• So the reimbursement from insurers goes to a facility that hires CRNAs and other APRNs.
• This is for the facilities to get reimbursed enough so that they can hire more providers, which would
• Now that has been opened up to facilities, hospitals, any place can utilize all APRNs independent of
• What we see happening is cultures at specific facilities have not changed.
• So even though this is the law, facilities maintain the right to develop their own policy that may or

Keywords: 995, all

Summary: The committee held a hearing on several health care access and insurance-related bills, with most testimony focused on H.1136 to improve the prior authorization process. The Massachusetts Medical Society, Massachusetts Health and Hospital Association, Health Care for All, the Leukemia & Lymphoma Society, physicians, and hospital representatives all supported the bill, arguing that prior authorization delays care, increases administrative burden, contributes to clinician burnout, and can worsen patient outcomes. Witnesses described examples involving delayed cancer treatment, diabetes care, COPD medication, shingles pain treatment, and hospital discharge delays. They said the bill would preserve prior authorization but add guardrails such as longer validity periods, continuity-of-care protections, faster responses for urgent care, clearer lists of services requiring authorization, and more transparency and standardization. The committee also heard testimony on H.1142/S.783 regarding equitable reimbursement for certified registered nurse anesthetists (CRNAs), with Senator Lovely and CRNA advocates supporting parity with physician anesthesiologists. They said CRNAs provide the same services at the same standard of care, but private insurers sometimes reimburse them at lower rates than physicians, which they argued is inconsistent with federal and state policy and harms access. Senator Keenan testified in support of a bill addressing claim denials and appeals, saying insurers should provide clearer explanations, time to resubmit claims, and timely appeal responses. Dr. Lorraine Schratz supported H.1126 to align state patient disclosure requirements with federal No Surprises Act rules, and Dr. Michael Trimbley supported H.1120 to recognize direct primary care as not being insurance and to encourage primary care participation. The committee also heard testimony on H.1140/S.801 to remove barriers to patient care by updating insurance statutes to reflect nurse practitioners’ full practice authority, and on H.1168/S.A.18 to eliminate the PCP referral requirement for specialty gynecological care. Witnesses on those bills described delays and denials affecting autism diagnosis, nutrition coverage, and endometriosis care, and said the proposals would reduce unnecessary barriers and improve timely access. After testimony and a few member questions, the chair closed the hearing; no votes were taken during the session.

Transcript Highlights:

• The Texas Civil Commitment Office operates a treatment and supervision facility.
• That are committed to the facility, including assault on staff.
• Therapists coming in and I had 10 therapists while in that facility.
• Either it's a treatment facility or it's not. You can't have it both ways.
• It requires TDCJ to compile and report annually on a, uh, facility by facility basis, de-identified data