Transcript Highlights:

• payment, not out-of-network.
• Federal payment error analyses, for example, only assess whether or not the capitation payment was made
• Even when improper payments are identified, the findings are out of public view.
• Florida currently has a SNAP payment error rate of over 15 percent.
• It provides up to five annual payments of $3,500, up to a total of $17,500.

Bills: S0006 , S0026 , S0206 , S0532 , S0576 , S1012 , S1110 , S1178 , S1192 , S1758 , S1760 , S7046 , S7048

Committee: Senate Appropriations

Summary: The Appropriations Committee met and considered a large agenda of bills, reporting several measures favorably. Early action included SB 6, a settled claim bill involving the Department of Children and Families and the estate of Leila Estrada and Sapphire Williams, which was approved for $3.8 million. The committee also passed a cybersecurity internships bill creating a Department of Commerce program with Cyber Florida, and SB 532, which lets clerks of court retain the full amount of certain excess revenue and clarifies foreclosure-sale procedures. Veterans housing measures, CS for CS for SB 1602 and SB 1604, were approved to create a pilot program and a related trust fund for vacancy relief and risk mitigation for veteran housing. The committee also favorably reported SB 1110 on Medicaid and insurance coverage for orthotics and prosthetics, with emotional testimony from a student and family describing the high cost and importance of activity-specific prosthetics. Members also approved CS for CS for SB 1012 after adopting an amendment that removed inmate emergency and specialty medical service compensation provisions while retaining changes to the contractor-operated institutions inmate welfare trust fund. Another bill, CS for CS for SB 1614, was narrowed by a delete-all amendment to focus on limiting the use of excess fees for new building construction by local governments. All of these measures were reported favorably after brief debate, with some support testimony submitted in writing or waived. The most extensive discussion centered on CS for CS for SB 17, a major Medicaid and public assistance overhaul. The bill would create a Joint Legislative Committee on Medicaid Oversight, allow the Legislature to retain its own actuary, tighten Medicaid program oversight, update encounter-data reporting, set performance standards for managed care plans, revise pharmacy benefit manager rules, and require DCF to implement SNAP fraud-reduction and payment-accuracy reforms, including photo IDs on EBT cards and updated work requirements. It also would direct agencies to seek federal waivers for Medicaid work requirements for able-bodied adults and expanded behavioral health services. After lengthy questioning and testimony, the committee adopted amendments adding a transitional medical benefits glide path for people who gain employment and later lose Medicaid eligibility, and exempting hospice patients with six months or less to live. Supporters argued the bill would improve accountability, reduce fraud, and save money, while opponents warned it would create administrative burdens, increase paperwork, and cause eligible people to lose coverage or food assistance. The committee ultimately reported the bill favorably as amended.

Transcript Highlights:

• We make the payments this program.
• No cash payment goes to a provider. No cash payment goes to a household. household. household.
• That is bill payment component.
• Again, no payments made to folks. Again, no payments made to households.
• </c> higher than the 150 on the bill payment. higher than the 150 on the bill payment.

Bills: SB8

Committee: Joint Natural Resources & Energy

Keywords: utilities, public service commission, energy regulation, appointment, emergency declaration, tax increases, consumer protection

Transcript Highlights:

• </c> guaranteed annual payment per year. guaranteed annual payment per year.
• So, 20% of the payment is up front.
• Um, and so they they have those guaranteed<00:47:36.840><c> payments.
• Um, and as we guaranteed payments.
• </c> that they receive the financial payments that they receive the financial payments for<01:00:56.520

Summary: The meeting began with introductions and approval of the previous minutes, including a small amendment clarifying a note about “leakage” in a prior presentation. The committee then heard a presentation from Sarah Hall of the American Forest Foundation on the Family Forest Carbon Program, which she described as a voluntary carbon and forest management program for smaller landowners. She said the program provides annual payments and technical assistance, requires a forest management plan within two years, and is designed to support improved forest management while still allowing compatible uses such as recreation, hunting, and some harvesting. Hall emphasized that the program is intended as one tool among many and is not a fit for every property. She said most enrolled landowners did not previously have a forest management plan or work with a forester, and that the program helps bring “unengaged” landowners into active management. She also said the program is compatible with current use and other commitments on a case-by-case basis, and that landowners retain ownership of their land and timber rights while AFF holds the carbon rights for the contract term. She highlighted examples of landowners using the program to support taxes, family ownership, wildlife habitat, timber stand improvement, and continued recreational or business uses. Committee members asked about registry compliance in New Hampshire and the relationship between carbon markets and the program. Hall responded that AFF handles registry administration for landowners and would follow up on the specific registry count raised by a member. She explained that the program is funded through a mix of carbon market revenue, philanthropy, and grants, and that carbon credits are generated through landscape-level methodology and monitored using randomly selected plots compared with FIA data. She also noted that consulting foresters are key partners in the program and that AFF has paid more than $3 million to consultants nationwide.

Transcript Highlights:

• , the cost of transporting is what it is, no matter what the payment structure is.
• the cost of transporting is what it is, no matter what the payment structure is.
• </c> higher payout, the capitated payment higher payout, the capitated payment system,<00:22:52.880><
• So So what the the payment structure is.
• </c><00:34:51.119><c> or</c> were uh lacking in finan in payments or were uh lacking in finan in payments

Summary: The Budget Review Subcommittee on Health and Family Services met in person, approved the October 15 minutes, and began with a moment of silence following a Louisville UPS plane explosion that was described as a local tragedy affecting many families and first responders. The main presentation was an overview of Kentucky’s Medicaid non-emergency medical transportation (NMT) program from the Department for Medicaid Services and the Transportation Cabinet. Witnesses explained that NMT is a federally required Medicaid benefit, administered by the Transportation Cabinet under a risk-based capitated model, with eligibility limited to Medicaid members traveling to medically necessary, Medicaid-covered services and who lack access to other transportation. They also described exclusions, including certain KCHIP, QMB, and PACE members, and outlined the brokered regional structure, call center operations, scheduling rules, vehicle and driver oversight, complaint handling, and rider surveys. The presenters reported that NMT handled more than 3.1 million trips in state fiscal year 2024, with over 1.38 million trips already recorded in October, and said customer satisfaction surveys were high. They said the FY 2025-26 contract total is about $360.6 million, with monthly per-member capitation rates set by region through an actuarial process and approved by CMS. They emphasized that payments are tied to monthly Medicaid enrollment and that the state draws down federal funds for the exact amount paid, with no leftover balance. They also said most NMT use comes from adult day centers and rehabilitative care such as dialysis. Members questioned the witnesses about how quality metrics and contract standards are set, whether the state had explored alternatives such as Uber Health or other integrated models, and how utilization was calculated. The witnesses said contract requirements are developed collaboratively by Medicaid Services, the Transportation Cabinet, and other agencies, and that studies of other models generally found higher costs and lower approval ratings, with additional research on a hybrid model expected by the end of the year. They clarified that one figure reflected the share of Medicaid members with registered vehicles, while another reflected actual NMT users, and they defended the capitated structure as shifting financial risk to brokers rather than the state. Representative Fleming also raised concerns about oversight, reporting, and the apparent gap between budgeted and contracted amounts, asking whether any unused funds would return to general funds; the discussion ended before a final answer was given.

Transcript Highlights:

• First, it maintains the current payment rates for enteral nutrition products, ensuring that medically
• First, it maintains<00:14:52.639><c> the</c><00:14:52.959><c> current</c><00:14:53.199><c> payment</c
• the current payment rates for ental<00:14:54.639><c> nutrition</c><00:14:55.120><c> products,</c><00
• </c><00:15:52.519><c> methodology</c> developing a similar payment methodology developing a similar payment
• So, how would that be handled for losses due to non-payment to that agency? work?

Committee: House Human Services Finance and Policy

Transcript Highlights:

• And when you say disrupted, that means a total non-payment, a partial payment, cancelled?
• It represents, um, non-payments, partial payments, communication that agencies shouldn't seek reimbursement
• So, how many times a year do you experience partial payment or pauses?
• Chair, Senator, I can't speak to there being never any delays in payment from the federal government,
• Chair, Senator, I can't speak to there being never any delays in payment from the federal government,

Committee: Senate Finance

Transcript Highlights:

• With payment amounts based upon the ...
• </c> have required full restitution payment have required full restitution payment before<01:37:35.200
• If the subject's payment is withheld, the proposal also extends the agency's ability to withhold payment
• In this agency can withhold payment.
• </c> payment is withheld. payment is withheld.

Transcript Highlights:

• For instance, there are ways these caregivers can get monthly payments and they get assistance through
• are all aware like everyone's situation could be different as far as their ability to make their payments
• But if the payments are coming in, that begins immediately upon us opening the case with DFPS and entering
• that order. that set that obligation, and we would collect on that case and get those arrearage payments
• And we will collect those independently of those arrearage payments that were owed under the other court

Bills: HB26 , HB140 , HB141 , HB142 , HB215 , HB26 , HB140 , HB141 , HB142 , HB215

Committee: House Human Services

Keywords: Medicaid, nutrition support, maternal health, chronic conditions, pilot program, DFPS, Department of Family and Protective Services, child protective services, child abuse investigations, child neglect, child exploitation, advisory committee, Family and Protective Services Council, council abolition, foster care, due process, investigative procedures, child welfare, parental rights, family preservation services

Transcript Highlights:

• </c><01:42:20.440><c> as</c> goes to alternate compliance payments as goes to alternate compliance payments
• </c><01:42:27.560><c> because</c> Alternate compliance payments because Alternate compliance payments
• </c><01:42:47.840><c> varies</c> Alternative compliance payments varies Alternative compliance payments
• </c><01:43:42.639><c> for</c> the alternate compliance payments for the alternate compliance payments
• </c> that the alternate compliance payments that the alternate compliance payments is<01:44:49.040><c

Committee: House Science, Technology and Energy

Transcript Highlights:

• So we've been very deliberate with CMS that what we're calling the transformative payments for rural
• These requirements, in addition to because they are to support payments that are related to increases
• Our contracted actuaries develop a rate range that constitutes a reasonable range of payment rates.
• It's incomprehensible that new lower payments have put us back about 30 years.
• I just want to really thank you for your comments and your efforts to reinstate Prop. 56 payment for

Summary: The Assembly Budget Subcommittee on Health held a May Revision hearing covering several health-related budget proposals and broader concerns about the state’s budget structure. The Chair opened by praising some May Revision changes, such as added health IT funding, county administration support tied to Medi-Cal changes, a delay in Medi-Cal cuts for some lawfully present immigrants, and additional support for Covered California subsidies, while criticizing proposed increases in Medi-Cal premiums, changes to senior eligibility, the lack of a Medi-Cal dental solution, and other reductions affecting counties, mobile crisis units, workforce incentives, and physician shortages. The Legislative Analyst’s Office said the state’s budget condition remains weak despite progress on the structural deficit, and the Department of Finance said the May Revision uses a mix of reductions, reforms, revenue proposals, and fund shifts to cut out-year deficits. The committee first heard Department of State Hospitals proposals, including adjustments to county bed billing authority, contract exemption language for online clinical/pharmacy subscriptions, reversion of unspent funds, a revised Metro Central Utility Plant replacement project, electronic health record implementation, and workforce development funded partly through Behavioral Health Services Act resources. DSH also described savings and realignments in incompetent-to-stand-trial and conditional release programs, including extending the independent placement panel program and shifting funds to support additional bed capacity and a mental health rehab center. Members asked about the use of BHSA funds for workforce programs, and the department said the proposal would replace General Fund support with BHSA reimbursements. The Emergency Medical Services Authority proposed funding for statewide behavioral health crisis response guidance and for enterprise system development, and the Department of Managed Health Care proposed modernization of its complaint system and claims-settlement data system to improve oversight and comply with AB 3275. The largest discussion centered on the administration’s BHSA spending plan under Proposition 1, including state-directed prevention, workforce, and other uses, plus General Fund offsets for existing programs. The LAO questioned whether some proposed offsets fit Proposition 1’s non-supplant and eligible-use requirements, while the administration argued the uses were consistent with the measure and that the state-directed share can be adjusted annually. The Commission for Behavioral Health’s proposals drew the most public and member concern. The administration proposed cutting the commission’s Innovation Partnership Fund from $20 million to $10 million and reducing the Community Advocacy Program by $6.7 million, while redirecting BHSA dollars to other state purposes and direct services. Commissioners, advocates, and several members argued the cuts would weaken community voice, reduce support for underserved populations, and disrupt grants already in process; they also objected to using BHSA funds to backfill General Fund commitments. Public commenters, including youth, disability, behavioral health, LGBTQ, tribal, veteran, immigrant, and community-based organization representatives, overwhelmingly opposed the cuts and urged preservation of prevention, advocacy, mobile crisis, and innovation funding. No votes or final actions were taken during the hearing.

Transcript Highlights:

• For example, the average reimbursement payment to the Kirkland Fire Department took about nine months
• For example, the average reimbursement payment to the Kirkland Fire Department took about nine months
• For example, the average reimbursement payment to the Kirkland Fire Department took about nine months
• For more personnel inside the State Patrol to assist with the processing of those payments, and we're
• Total payments made under the program for any fiscal year may not...

Bills: HB2675 , HB2681 , HB2714 , HB2688 , HB2481 , HB2116 , HB1408

Committee: House Appropriations

Keywords: accounts, finance, business regulation, transparency, audits, cannabis, license fees, regulatory framework, revenue generation, legalization, HB 2714, caseload forecasting, food assistance, SNAP, Supplemental Nutrition Assistance Program, state food assistance, budget forecasting, caseload forecast council, caseload forecast supervisor, Washington State

Transcript Highlights:

• This bill simply allows a fair payment methodology when they go to an ASC.
• on how they get paid: the time of service, the physician payment, all the other things that go into
• You have the payment at time of service and all that, and that's your net cost.
• And yes, and I think that's where they're only looking at the ASC and the difference in the payments.
• McMakin, there would be a way for these individuals to receive payment. But I would really like Ms.

Bills: HB165 , HB175 , HB198 , HB272 , HB457 , HB488 , HB566 , HB603 , HB763 , HB902 , HB909 , HB971 , HB981 , HB1066 , HB1125 , HB1154 , HB1231

Committee: House Appropriations

Keywords: HB165, lottery proceeds, Lottery Proceeds Fund, Veterans Service Grant Fund, constitutional amendment, veterans, military veterans, veterans' benefits, veterans services, family support, state lottery, education funding, Minimum Foundation Program, problem gambling, compulsive gaming, state treasurer, ballot proposition, constitutional referendum, lottery revenue, Louisiana resident veterans

Transcript Highlights:

• The bill also makes it a crime for building contractors who have already received payment.
• Many people have been affected by this, not receiving payment back from procedures that they had.
• These payments often involve a third-party processor that charges a convenience fee for its services.
• Instead, they threaten to eliminate the very payment options that consumers prefer, the options that
• These payments often involve a third-party processor that charges a convenience fee for its services.

Transcript Highlights:

• </c> perpetually funded uh payments. perpetually funded uh payments.
• And by implementing a new payment model, a payment reform where we help offset those high fixed costs
• :01.440><c> model,</c><00:58:01.760><c> a</c> implementing a new payment model, a implementing a new
• payment model, a payment<00:58:02.240><c> reform</c><00:58:02.640><c> where</c><00:58:02.880><c> we</
• c><00:58:03.040><c> help</c><00:58:03.359><c> offset</c> payment reform where we help offset payment

Bills: HB0111 , HB0112 , HB0122

Committee: House Appropriations

Transcript Highlights:

• assistance payments program and explain a little bit more about why.
• Legislation passed that created a new cash balance. plan, the commitment to the legacy fund payments,
• regularly and actually paying some additional payments.
• You know, a 13th check would basically just be, you know, your monthly annuity payment.
• They're looking for a broader supplemental payment.

Committee: House Appropriations - S/C on Articles I, IV, & V

Transcript Highlights:

• The information includes charges of theft and making false claims for health care payments.
• is charged with making personal purchases with a government credit card, including rent and a down payment
• The information includes charges of theft and making false claims for health care payments.
• Defo Mabrat of Portland, who pleaded no contest last week to making a false claim for health care payment

Summary: Oregon Attorney General Dan Rayfield held a press event marking National Health Care Fraud Takedown Day to highlight the state’s Medicaid fraud enforcement work and announce four new criminal filings. He said the Oregon Department of Justice’s Medicaid Fraud Unit, which includes investigators, auditors, attorneys, data analysts, and a nurse investigator, has secured hundreds of convictions and settlements since 2010 and recently received additional staffing from the legislature. He framed the work as bipartisan and aimed at protecting vulnerable Oregonians, recovering taxpayer dollars, and deterring fraud. The announced cases involved alleged provider or vendor fraud rather than Medicaid recipients: Ed Morgan of Beaverton was charged in connection with housing assistance funds tied to a health-related social needs program; Linda Thomas and her company, Gateway of Willamette Valley, were charged with billing Medicaid for day support services not provided; and Amanda Thorne, a former Lane County employee, was charged with using a government credit card for personal purchases. Rayfield also noted recent progress in other cases, including a nurse who pleaded no contest to false billing and theft and was sentenced to jail, probation, and restitution, and a medical transportation company owner recently charged with billing for services not provided. In response to questions, Rayfield said Oregon staff attended a federal meeting on Medicaid fraud despite late notice and political tensions, emphasizing that fraud enforcement should remain bipartisan. He said the federal landscape is complicated by cuts to enforcement staff even as there is talk of increased enforcement, and that states have had to step up. He also said Oregon’s managed care system has not been a major barrier to investigations, which typically begin with complaints and are developed with partner agencies. No votes or formal legislative actions were taken at the event.

Transcript Highlights:

• of any benefits for which they have not received payment from the employer and the employee.
• Those payments get smoothed out over a 15-year period.
• Those payments get smoothed out over a 15-year period.
• So there could be a situation where multiple payments are running at the same time.
• This would cease the payment. All right, so that was a question.

Committee: House Retirement

Summary: The Retirement Committee heard several retirement-related bills and deferred two measures at the start: HB 26 and HB 993 were voluntarily deferred by the author. HB 31, by Rep. Eccles, would allow certain small municipalities to terminate participation in the municipal police employees’ retirement system and create a lower-cost “Plan C” option for small towns like Stirlington. After discussion about population and officer-count limits, the committee adopted amendments, heard concerns from the Municipal Police Employees’ Retirement System about remaining issues, and reported HB 31 as amended favorably. The committee also advanced HB 1134, which creates a backdrop-style retirement option for judges whose positions are abolished, and HB 24, which would allow retired teachers to return to work as one-year contract teachers without the current retirement contribution structure. TRSL testified that return-to-work policy is complex and that a broader Senate study-group proposal is also moving, but the committee reported HB 1134 and HB 24 favorably. HB 21, a technical correction to the Municipal Employees’ Retirement System law, was amended to remove a sunset problem that would be fixed in another bill and was reported favorably as amended. Later, the committee reported HB 1017 favorably, which limits former spouses’ claims to post-divorce earnable compensation in the Firefighters’ Retirement System, with testimony that the bill would reduce litigation over promotions and raises after divorce. HB 43, which would let certain LASERS members retire after 35 years of service at any age, drew testimony from LASERS about its cost and workforce effects but received no motion and was voluntarily deferred. HB 30 was also voluntarily deferred because its substance would be moved into another bill. The committee then took up two major municipal police bills. HB 45, after extensive negotiations among the author, the Louisiana Municipal Association, EMPERS, and the City of New Orleans, was substantially rewritten by amendment to address retention pay, out-of-state service credit purchases, survivor benefits for certain officers killed in the line of duty, COLA funding, and a reduction in the non-hazardous accrual rate. The committee adopted the amendments and reported HB 45 as amended favorably. HB 49, a related bill on municipal police and firefighter retirement issues, was also replaced by a substitute that changed opt-out procedures, revised partial dissolution rules, and preserved full dissolution liability; after testimony that the changes would save New Orleans and other cities significant money, the committee adopted the substitute and reported HB 49 as substituted favorably. The meeting ended with adjournment.

Transcript Highlights:

• On a 36-month loan at 36 percent, it takes 24 on-time payments for us to even recoup any principal on
• Again, it takes, at that 36 percent, two entire years of on-time payments...
• Again, it takes at that 36% two entire years of on-time payments for the company to even make the same
• This targets practices where payments vary depending on whether the patient or the patient's practice
• Such programs often manifest as variable payments, and practices meeting high vaccination benchmarks

Bills: SB1165 , SB1206 , SB1212 , SB1291 , SB1347 , SB1516 , SB1554 , SB1649 , SB1689 , SB1812

Committees: Senate Finance , Senate Senate Finance Committee of Reference

Keywords: vaccination, insurance reimbursement, healthcare, patient rights, public health, agricultural property, classification, property inspection, county assessor, property appeal, fertility preservation, health insurance, iatrogenic infertility, reproductive age, religious exemption, aircraft registration, aviation maintenance, tax exemption, capital investment, transportation

Transcript Highlights:

• I do believe we have some collectors that take monthly payments.
• And it talks about annual, semi-annual, or quarterly payments.
• I do believe we have some collectors that take monthly payments.
• ago and... ...installment payments.
• It's not having to come up with a new down payment. So, yeah, it's really what drives me.

Committees: House Local Government , House Local Government, Elections and Pensions

Transcript Highlights:

• used to increase Medicaid reimbursement for emergency ambulance transports by applying an add-on payment
• to the Medicaid fee-for-service payment schedule, to make Medicaid payments for services in lieu of
• The quality assurance fee is set based on the revenue needed to support the add-on payments for ambulance
• If there's a surplus in the fund, HCA is directed to recalculate the fee to match the add-on payments
• And second, it directs HCA to annually calculate the add-on payment for ambulance transport providers

Summary: The committee held a public hearing and briefing on several bills, with House Bill 2441, House Bill 2159, House Bill 2521, House Bill 2531, House Bill 2543, and House Bill 1607 discussed in that order after agenda changes. HB 2441 would expand reimbursement from the LEO retirement fund for survivors of law enforcement officers killed in the line of duty, covering Medicare Parts A and B premiums and retroactive health insurance premiums during the period before a death is officially determined to be work-related. Staff described a relatively small number of affected survivors and modest actuarial impacts, and the prime sponsor spoke emotionally in support. A representative from the L&I Board also testified that the board had studied the issue and endorsed the bill. HB 2159 would create the Pre-K Promise Account to receive philanthropic funds for ECEAP expansion. Staff explained ECEAP eligibility and the proposed non-appropriated account structure, noting Governor Ferguson’s budget included $34.5 million in non-appropriated authority for about 2,000 new school-day slots. Testimony was strongly supportive from Ballmer Group, DCYF, Head Start/ECEAP advocates, a Yakima provider, and the governor’s office, all emphasizing the public-private partnership, expanded access, and support for children furthest from opportunity. HB 2521 would remove the $18 cap on the State Patrol’s firearm background check fee and allow the fee to be set to cover total program costs. Staff said the fee could rise to about $33 per check based on current costs, and the State Patrol testified that the cap no longer matches actual expenses and threatens staffing and service levels. One member of the public opposed the bill, arguing the state system should be scrapped or capped and that consumers would face higher costs. HB 2531 would freeze the ambulance quality assurance fee at its July 4, 2025 level to comply with federal law and adjust Medicaid add-on payments accordingly; the Washington Ambulance Association strongly supported it as essential to preserving federal matching funds and improving wages and benefits. HB 2543 would update county clerk fees and modernize outdated references, with county officials supporting the changes as necessary to reflect current electronic-record practices. HB 1607, the Recycling Refund Act, drew the most extensive testimony. Staff described a 10-cent refund system for covered beverage containers, a producer responsibility organization, Ecology oversight, and fiscal impacts tied to program administration and lost tax revenue. Supporters, including environmental groups, youth advocates, Seattle Public Utilities, and some industry voices, argued the bill would reduce litter, increase recycling rates, support reuse systems, and complement the existing recycling reform law. Opponents from recycling haulers, grocers, beverage interests, counties, and solid waste providers argued it would function like a tax, raise consumer and retailer costs, duplicate or undermine curbside recycling and EPR, and create siting and implementation problems. No votes were taken on the bills in this transcript; the hearing concluded with public testimony and adjournment.