Transcript Highlights:

• THE NURSING FACILITY PAYMENT INCREASE HAD A TARGET DATE OF OCTOBER 1. THIS WAS INCLUDED.
• THE SAME OF THE SUPPLEMENTAL PAYMENTS FOR THE CANCER HOSPITALS ALL THESE SUPPLEMENTAL PAYMENTS ALSO HAVE
• THE CHILDREN SPECIALTY HOSPITAL SUPPLEMENTAL PAYMENTS ARE TO PAYMENTS HERE. ONE FOR GE.
• THE KICK PAYMENT WOULD BE BASED PAYMENT PLUS A PERCENTAGE OF COST THAT THE PLANS HAVE INCURRED FOR THOSE
• WE ARE STILL UNDER OUR UPPER PAYMENT LIMIT THAT IS NOT AN ISSUE OR CONCERN.

Transcript Highlights:

• One is on payments in managed care.
• The other two have to do with payments. Yeah, it's on the payment side, yeah.
• One is on payments in managed care.
• One's payments in fever service and one is payments or one is eligibility determinations. Patrick.
• The other two have to do with payments. Yeah, it's on the payment side, yeah.

Committee: House Budget

Summary: The House budget hearing focused on the Department of Social Services’ budget and a detailed briefing on how federal H.R. 1, referred to by the director as the “Big Beautiful Bill,” will affect Missouri’s SNAP and Medicaid programs. The director outlined the department’s divisions, current caseloads, staffing challenges, and the need to modernize eligibility systems and processes. Members repeatedly asked for breakdowns of enrollment, spending, provider rates, and the impact of federal changes on the department’s budget request. A major portion of the hearing covered H.R. 1’s new eligibility and integrity requirements. The department said SNAP work requirements will expand to groups previously exempt, certain noncitizen categories will lose eligibility, and utility deductions will be narrowed. For Medicaid, the bill requires work requirements for the adult expansion group, more frequent redeterminations, and shorter retroactive coverage periods. Members questioned how these changes interact with Missouri’s constitutional expansion language, and the director said the department’s view is that federal requirements must be followed under the supremacy clause, though she acknowledged the legal issue could ultimately be resolved by a court. The committee also discussed program integrity and error rates. The department said Missouri’s Medicaid PERM error rate was 35% in the last full review, with most errors tied to eligibility processing, and that H.R. 1 could create major financial penalties if error rates are not reduced by 2029. For SNAP, the department said the most recent federal error rate was 10.79%, with a current combined rate around 8.6%, and that future state cost-sharing could be substantial if the rate remains high. Members asked about the use of contractors, automation, and verification tools to reduce backlogs and improve accuracy. No votes were taken; the hearing was informational, and the chair said public testimony would not be taken that day.

Transcript Highlights:

• And again, this declining student enrollment payment.
• The bill aligns the scholarship payment installments from quarterly to monthly and aligns the payments
• , or a monthly payment, rather, they receive front-loaded monthly payments, and that money goes into
• I do have a question when it comes to the monthly payments.
• So they're the ones that are making the payments.

Committee: Senate Appropriations Committee on Pre-K - 12 Education

Summary: The committee first heard the proposed Pre-K-12 education budget for fiscal year 2025-26, totaling $34.7 billion. The chair highlighted major increases for the FEFP, including $29.6 billion for public schools and K-12 scholarships, a $984 million year-over-year increase, along with higher per-FTE funding, $4 billion for the Family Empowerment Scholarship, $431.4 million for VPK, funding for school safety, the Florida School for the Deaf and Blind, school hardening, Jewish day school security, and an education enrollment stabilization fund. With no public comment, the committee adopted a motion for staff technical corrections and then approved the budget proposal as a recommendation to the full Senate Appropriations Committee. The committee then considered SB 1402 on dropout retrieval programs. The bill expands eligibility so any individual who has withdrawn from high school may enroll in dropout retrieval services and clarifies how school grades are calculated for virtual instruction providers that offer those services. An amendment clarifying the grading calculation was adopted, and the committee reported the bill favorably. Next, the committee took up SPB 7030 on educational scholarship programs, a broad measure addressing school choice funding and administration. The bill would fund the Family Empowerment Scholarship as a separate categorical, expand the education stabilization fund, create fall and spring application windows, require a single scholarship application and more documentation, assign student IDs, standardize payment timing to monthly installments, require continued eligibility verification, and add Level 2 background checks for providers receiving state funds. Members raised questions about background-check enforcement, payment timing, data sharing, and the impact on homeschool and private-school families. Public testimony included support from school-choice advocates and concerns from private-school representatives about added regulatory burdens and deadlines. The committee adopted the bill as a committee bill and reported it favorably, with Senator Osgood voting no. Finally, the committee considered SB 508 on the Family Empowerment Scholarship Program, which requires private schools to disclose in writing what accommodations, modifications, and services they will provide to students with existing plans such as IEPs, EEPs, 504 plans, or ELL plans before enrollment. An amendment was adopted to require public schools to consult with private schools about equitable services. Testimony was mixed: supporters said the bill would give parents needed information for informed choice, while private-school representatives said the language could be burdensome and vague. The committee reported the bill favorably.

Transcript Highlights:

• We currently accept all forms of payment through check, the regular means, but we would like to offer
• Right, this is going to be an optional fee or an optional online payment for the Safe Drinking Water
• It is a cost applied to all of the card services as a convenience to process the payment.
• We process payments both in Louisiana and in several other states where very similar legislation has
• We're excited to offer the option and convenience of online payments for our constituents, and happy

Summary: The Senate Committee on Revenue and Fiscal Affairs met on May 28, 2026, approved the May 19 minutes, and then considered three third-party convenience fee schedules for online payments. The first was for the Department of Agriculture and Forestry, presented by Rebecca Dupree with Louisiana Interactive; members confirmed the online payment option would be voluntary and approved the fee schedule without objection. The second was for the Department of Health’s Safe Drinking Water Program, presented by Karen Benjamin, and generated extended discussion about a $2.50 flat fee plus a 2.5% card-processing charge, especially whether that charge would violate recently passed Senate Bill 254 regarding debit card surcharges. Senators Mizell, Lambert, and Luneau questioned the structure, and department representatives said they believed the fee was not a surcharge and that ACH payments would avoid the percentage charge; the committee approved the fee schedule but urged the department to review it for compliance with SB 254. The third fee schedule was for the Louisiana Office of State Fire Marshal, presented by Lindsay Savoy and Garrett Lee, covering online payments for the conveyance program and the Fire Emergency Training Academy. Senators again raised concerns about the 2.5% card charge in light of SB 254, and the presenters said they intended to comply with the new law and would discuss the issue further. The committee approved this fee schedule as well, with a similar reminder to consider the bill’s impact going forward. The meeting then adjourned.

Transcript Highlights:

• Why were these payments paid late?
• Why were these payments paid late?
• incentive-based payments.
• incentive-based payments.
• Value-based payments or other incentive-based payments, MCOs are not required to use to base their rate

Committee: Senate Senate Health and Human Services COR

Summary: The committee continued its fourth hearing on fraud, waste, and abuse involving Arizona’s Medicaid and behavioral health systems, with a major focus on Access/ALTCS eligibility, behavioral health licensing, and payment delays. Senator Shamp presented findings alleging large gaps in ABD Medicaid asset verification, including that only a portion of enrollees were checked and that many with substantial liquid assets remained on the program. She argued the state’s waiver and lack of asset limits created a compliance and fiscal risk, and urged referrals to law enforcement, tighter verification, and broader reforms. Heather Dukes, representing behavioral health and sober living operators, testified that ADHS and Access have become overly punitive toward licensed providers, often sending technical paperwork violations straight to enforcement instead of allowing correction plans, and that zoning and licensing delays are harming legitimate businesses. Reva Stewart testified that patient brokering and fraudulent recruitment of vulnerable people into behavioral health and sober living settings remain ongoing, especially through social media, and called for stronger accountability and enforcement against bad actors. ADHS Deputy Assistant Director Tiffany Slater said the department has received more than a thousand complaints about unlicensed sober living operations, which has diverted staff from routine oversight of licensed facilities. She said ADHS has expanded enforcement tools for sober living homes, is using a new licensing system to flag repeat bad actors, and is trying to make the application process easier, while acknowledging that inspections can tip off unlicensed operators. Access Director Virginia Roundtree described steps the agency has taken since the prior hearing, including daily staff huddles, live dashboards, added project management support, an external claims vendor, and an independent review of the Division of Fee-for-Service Management. She said Access is trying to balance fraud prevention with support for legitimate providers, and committed to follow up on a specific provider payment dispute by early the next week. Committee members repeatedly pressed Access and ADHS on delayed claims processing, prepayment review, and whether the current system is driving providers out of business. Roundtable testimony from Access staff described the new Provider Resolution Roundtables, which are intended to work with a small number of providers facing the most claims and authorization problems. Members questioned why claims are being denied or held for long periods, why some providers are still waiting on payments from 2023 and 2024, and whether the agency’s actions are sustainable. Access also explained the Targeted Investment Program, saying it is a federally approved Medicaid initiative with large dollar amounts still being paid out on a delayed schedule, and agreed to provide more information on provider participation and payment timing. No formal votes or committee actions were taken in the portion provided, but the chair indicated the committee would continue reviewing the issue and requested additional reports and follow-up information from Access and ADHS.

Transcript Highlights:

• One more interest payment was made right at the end, so there were two interest payments made in the
• So converting those borrower payments from the annual payments to the monthly payments is where we're
• So it looks like the smaller payments and smaller borrowers are the ones that are maintaining their payment
• to convert folks from the annual payment cycle to a monthly payment cycle and put out for bid a loan
• So they send out the invoices, collect the payments, and apply the payments to the loan.

Committee: House New Mexico Finance Authority Oversight Committee

Transcript Highlights:

• with other child care payments.
• payments on top of our prior reimbursement rates.
• rate levels while adhering to the cost of care plus regional payment structure.
• But we are generally making timely payments to providers. Dr.
• That is not making those payments within that 21-day window.

Transcript Highlights:

• </c> schedules or um or um create new payment schedules or um or um create new payment methodologies<
• </c> payment error rate exceeds 6%. payment error rate exceeds 6%.
• </c><00:36:05.280><c> error</c> currently in Kentucky our payment error currently in Kentucky our payment
• </c><00:37:51.680><c> The</c> impacting payment error rates. The impacting payment error rates.
• </c> we seen some increase in the payment we seen some increase in the payment error<00:38:12.800><c>

Summary: The committee first approved the minutes, then heard a lengthy presentation from the Department for Public Health on Kentucky’s rural health transformation plan and related budget questions. Commissioner John Langfeld said the state received a $212.9 million federal award, one of the larger awards nationally, and outlined five focus areas: maternal and infant health, integrated EMS/trauma response, behavioral health and substance use disorder, oral health, and chronic disease prevention with an emphasis on obesity and diabetes. He stressed that the effort is intended to be integrated, data-driven, and sustainable, and that the federal funds cannot be used for new construction, clinician salaries, research and development, EHR replacement, or to pay for currently billable services. He also said the program carries accountability requirements and that funds can be clawed back if milestones are not met. Members pressed for clarification on duplication with other budget requests, sustainability after the five-year funding period, and how success would be measured. Langfeld said he was not aware of any duplicate funding with the department’s additional budget requests and said the rural health funds were separate from those requests. He also said the program will be tracked through specific metrics and timelines, using both execution measures and outcome measures such as readmissions, with more rapid-cycle feedback to allow course correction. Representative Fleming raised concerns about possible overlap with navigator funding and asked for more detail on the budget breakdown; Langfeld said a detailed line-item budget had been prepared but was still awaiting final CMS approval before release, and that he would explore sharing more information once restrictions were lifted. The committee then heard from the Kentucky State Public Health Laboratory about a request for a new central lab expansion. The presenter described the current 35-year-old facility as outdated and constrained by aging infrastructure, obsolete equipment, deferred maintenance, and inadequate space, and said the lab performs critical work with no in-state alternative for many services, including newborn screening, select-agent and biosafety level 3 testing, animal necropsy for rabies, genetic sequencing, environmental and food safety testing, and response to emerging infectious diseases. The project is already in design phase C, expected to finish in mid-April, with construction funding sought at roughly $276 million on top of about $35 million already approved for design. Members asked about long-term operating costs, backup arrangements, and whether the current facility would remain in use; the presenter said the current lab would continue to be used by the department while other divisions move into vacated space, and that the lab has mutual-aid agreements with the Southeast Consortium and universities for contingency support. Finally, the Department for Community Based Services began its budget presentation on SNAP and relative caregiver issues. Commissioner Lisa Dennis and budget director Misty Sammons identified the governor’s recommended budget items tied to new federal requirements under HR1, including changes affecting payment error rates. The discussion was just beginning when the transcript ended.

Transcript Highlights:

• State directed payments, or SDPs, are provider payment arrangements through managed care.
• However, existing approved payments and those payments currently under review by CMS must phase down
• </c> enactment July 4, 2025 for new payments. enactment July 4, 2025 for new payments.
• 04.559><c> review</c><00:30:04.880><c> by</c> those payments currently under review by those payments
• HR1 limits CMS's payment errors.

Transcript Highlights:

• To be issued as a cost-of-care-plus payment increase.
• CDSS issues quarterly cost-of-care-plus payments to contractors so that they can make their timely payments
• And if we do, for example, have to make an early payment to make a... ...to make those payments.
• And if we do, for example, have to make an early payment to make sure that Cost of Care Plus payments
• So that first payment is for June.

Summary: The committee first heard May Revision child care and human services items. The Department of Child Support Services described two technical adjustments, which the analyst supported. The Department of Social Services then walked through child care proposals, including a reduction in federal and Proposition 64 funding absorbed through a shift from General Child Care to the Alternative Payment program, a 2.01% child care COLA, disaster-related infrastructure grants, a new administrative support cost structure for Alternative Payment agencies, the removal of prospective pay funding after a federal rule change, a reappropriation for existing infrastructure grants, and estimates of unspent child care funds. The Legislative Analyst’s Office recommended asking for more justification for shifting reductions to CAP, supported the COLA reduction but wanted consistency across programs, recommended removing prospective pay funding, opposed the administrative cost shift, and suggested further review of disaster grant alignment. Members pressed the administration on why more slots would be cut for the same savings, why the COLA was reduced, and whether the administrative percentage would grow over time. The administration said the changes were intended to avoid disrupting currently enrolled families, reflect point-in-time relinquishments and unspent funds, and stabilize contractor operations. Public commenters, including providers, advocates, and county representatives, urged full COLA funding, rejection of child care slot reductions, preservation of prospective pay, and continued investment in child care infrastructure and access. The subcommittee then recessed before moving to health items. In Part B, the Department of State Hospitals presented its May Revision proposals, including a central utility plant replacement project at Metropolitan State Hospital, funding for a continuum electronic health record system, reduced county bed billing authority to reflect phase-in of additional LPS beds, limited contract exemption authority for online clinical subscription services, reversion of prior-year unspent operating funds, and a workforce development proposal to use Behavioral Health Services Act funds instead of General Fund for training programs. The department said the EHR would modernize records and improve continuity of care, and that the contract exemption would prevent delays in essential clinical information services. No votes were taken in the excerpt provided.

Transcript Highlights:

• We tested grant payments, amendments.
• with payments made to 11 out of those 18 grantees, and we questioned almost $296,000 in those payments
• </c><00:13:37.160><c> made</c> and we found issues with payments made and we found issues with payments
• </c> after final payment was issued. after final payment was issued.
• </c> So, DHS can withhold or reduce payments So, DHS can withhold or reduce payments to<01:35:07.600>

Committee: House Fraud Prevention and State Agency Oversight Policy

Transcript Highlights:

• So, this is the first meeting, an organizational meeting today, regarding the future of payments and
• This is a special initiative commission to study the future of payments and sales transactions by credit
• So, this is the first meeting, an organizational meeting today, regarding the future of payments and
• This is a special initiative commission to study the future of payments and sales transactions by credit
• , credit card fees, mobile payments, buy now, pay later financing, and other aspects of the payments

Summary: The House and Senate chairs opened the first organizational meeting of the special initiative commission created by Chapter 238 of the Acts of 2024 to study the future of payments and sales transactions by credit card and the impacts on small businesses. They explained that no testimony would be taken at this meeting; instead, the commission would begin its work, introduce members, and prepare for future hearings and a final report with recommendations on credit cards and other payment methods. The chairs outlined the commission’s charge: to examine payment trends, cashless transactions, credit card fees, mobile payments, buy now, pay later financing, and the effects of section 28A of chapter 140D on small businesses. They said the commission would likely organize hearings around business and consumer impacts, the legal and regulatory landscape, and policy options such as transparency measures, reporting requirements, and possible limits. Members discussed the importance of hearing from retailers, restaurants, banks, small businesses, and possibly experts, and suggested considering cryptocurrency and whether hearings should be held outside the State House or include regional access. Several commissioners and stakeholders introduced themselves, including representatives from the Attorney General’s office, the House, the Executive Office of Economic Development, the Commissioner of Banks, retail and restaurant associations, a banking representative, and two small business owners. The chairs said interested parties could sign up to testify or receive notices, written testimony would be accepted, and the first hearing was tentatively set for April 8 in Gardner Auditorium. The meeting ended with a motion to close, which passed unanimously.

Transcript Highlights:

• </c><00:08:48.519><c> from</c> especially governmental payments from especially governmental payments
• </c><01:17:58.800><c> program</c> it's called a directed payments program it's called a directed payments
• ><c> through</c> quarterly supplemental payments through quarterly supplemental payments through the<
• </c> new or untested idea uh directed payment new or untested idea uh directed payment programs<01:19
• </c> this directed payment this directed payment program<01:36:20.000><c> um</c><01:36:20.199><c> I</

Committee: House Health Finance and Policy

Transcript Highlights:

• And then directed payments are ways that the state can direct payments Through the managed care system
• Directed payments.
• those payments more quickly.
• of disperse those payments more quickly.
• We are going to see pressure on state-directed payments.

Transcript Highlights:

• The payment error rate is not a measure of fraud.
• We did receive our final payment error rate for this year.
• So we do now know that our 2025 payment error rate is 9.89. Okay.
• That can lead to spikes in the payment error rate.
• So how are they involved in the payment error rate discussions?

Summary: The committee was called to order, the roll was taken, and the March 18 minutes were approved. Members then received several project and program updates, beginning with CHI St. Alexius’s behavioral health buildouts in Bismarck, Williston, and Grand Forks. St. Alexius reported that the Bismarck project remains on track for June 2027 completion, with demolition underway and final design work nearing completion. Williston reported construction is progressing, staffing recruitment is underway for psychiatrists and other staff, and an air handler replacement is creating a roughly $750,000 unbudgeted barrier that will slightly delay the timeline. Grand Forks reported its expansion is about 30% complete, with no major barriers beyond weather, and leaders said the project should be substantially complete in the first quarter of 2027. The Department of Health and Human Services then presented a series of budget and program updates. Donna Ockland explained several recent line-item transfers as technical corrections that net to zero and do not require new spending, then reviewed salaries, wages, and FTE counts, noting the department remains within its authorized staffing levels. Pat Rainer followed with an update on the Rural Health Transformation Program, saying 12 opportunities have been posted, 422 applications received, and $8.4 million obligated so far, with a goal of obligating the full $199 million by September. He described grants for workforce retention, rural rotations and housing, community gardens, school wellness, behavioral health promotion, safety net services, equipment, technology, EMS, and other initiatives, emphasizing that the program is intended to be transformational and tied to metrics. Members asked extensive questions about how rural eligibility is defined, how grants will support both rural facilities and hub hospitals, and how future years of funding will build on current awards. The committee also heard an update on certified community behavioral health clinics from Elena Zeller, who said North Dakota has been accepted as a demonstration state, implementation is underway in Williston, North Central/Minot, Fargo, and Dickinson, and care coordination and service counts are increasing. Rebecca Askins then reviewed SNAP payment error rates, saying the 2025 rate was finalized at 9.89%, with the state aiming to get below 6% through policy updates, training, data tools, and a quality assurance team. Members pressed her on the causes of the error rate, the role of the SPACES software system, and the need for accountability and improvements. Finally, Dirk Wilkie reported the state laboratory project reached substantial completion on June 12 and is on budget at about $69.95 million, though a service elevator had to be redesigned because it was too small for equipment.

Transcript Highlights:

• </c><00:28:46.799><c> as</c> follow the evidence, stop payments as follow the evidence, stop payments
• ><c> whenever</c><00:56:10.880><c> our</c> suspending payments um whenever our suspending payments um
• Those overlapping payments just years. Those overlapping payments just stopped. stopped. stopped.
• The US attorney and the OA payment.
• And so payments from being stopped.

Committee: House Fraud Prevention and State Agency Oversight Policy

Transcript Highlights:

• , can't make their car payment, utility payments, those types of things, USA Cares will step in if they
• ,</c> payment, can't make their car payment, payment, can't make their car payment, utility<00:25:20.000
• </c> utility payments, those types of things. utility payments, those types of things.
• They do not payments on their behalf.
• </c> the payments and those types of things. the payments and those types of things.

Committee: House Veterans, Military Affairs, & Public Protection

Transcript Highlights:

• Because, of course, I did check the actual payments.
• In cash and didn't adequately document those payments.
• two extra payments each year.
• a year to 26 payments a year.
• The October interest payment was...

Committee: All LEGISLATIVE JOINT AUDITING-COUNTIES AND MUNICIPALITIES

Summary: The committee began with approval of the prior meeting minutes and then received updates on delinquent private water and sewer reports. Staff reported that 19 of 43 original entities for the 2022 reporting year had had turnback reinstated, while 24 remained in escrow; for the 2023 reporting year, 59 of 64 entities had filed, leaving five still outstanding. The committee also heard that Adona had come into substantial compliance with municipal accounting law, and it voted to file that report and discontinue withholding turnback. It then voted to start the 60-day clock and file the report for Gum Springs after hearing repeated findings involving budgeting, disbursements, payroll, and Act 833 funds, with city officials saying they had begun correcting records and were seeking help from the Municipal League and a city attorney. Fargo was deferred because the mayor was absent due to illness. The committee next considered Denning, where staff described repeated and serious accounting problems over 2022-2024, including unauthorized payments, missing documentation, weak payroll controls, and improper handling of funds. The mayor and recorder-treasurer said prior records were disorganized and that they were now working with an attorney, CPA help, and new software; the committee voted to start the 60-day clock and file the report. Green Forest’s report, involving a fixed-asset listing issue after the mayor’s death, was filed. Several private water and sewer reports were either filed or deferred depending on whether responses had been received, and the committee announced its March meeting would be held in Room 149 because of renovations. The committee then reviewed a series of referred reports involving alleged financial irregularities. In Elaine, the fire chief’s questionable purchases were referred and filed. In Strong, staff described undeposited garbage-bag receipts, improper payments for private dumpster service and other expenditures, payroll tax penalties, and deficit fund balances; the mayor said controls had been improved, but the committee deferred the report to March. The Faulkner County Fair Association report found undocumented cash withdrawals, questionable disbursements, and inadequately documented cash payments to a carnival vendor; the committee filed it. Brooklyn’s report involved a fraudulent direct-deposit change, and Mineral Springs’ report involved transfers from the cemetery fund, employee loans, overpayments, and travel reimbursement issues; both were filed. Additional reports included Rondo, where the recorder-treasurer explained missing computers and fuel purchases tied to personal vehicles, and the committee filed the report; Waldo, where the mayor had been overpaid due to extra biweekly payments, which was filed; Columbia County, where a floodplain management contract lacked an authorizing ordinance, which was filed; and several private water-system reports, some filed and others deferred for lack of responses. Carlisle’s report showed large but improving misstatements in financial records, and the committee filed it after hearing that new software and training had reduced prior problems. Caddo Valley’s report prompted a lengthy discussion about CDs and interest recognition; staff explained that principal balances should be reflected as city assets and interest should be recorded when earned or reported by the bank, and the report was filed. Prairie County’s budget overrun and road-fund issues were discussed at length, with the judge explaining equipment and weather-related costs and staff clarifying the distinction between road funds and locally approved sales-tax uses; the report was filed. Finally, the committee deferred a Cross County Rural Water Association matter after learning it had not filed with Legislative Audit since 2002-2003 despite receiving significant state funding, and members expressed concern about the long gap in filings.

Transcript Highlights:

• Senator Friedman: So, upper payment limit gets the PBMs out of the picture, right?
• So, upper payment limit gets the PBMs out of the picture, right?
• I don't believe that the upper payment does get the PBMs out of the picture.
• So we'll adjust in that upper payment limit.
• So that is all factors that we look at. payment limit language.

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing on a broad set of health care bills focused on cost, market oversight, pharmaceutical access, transparency, hospital closures, and pharmacy access. Chairs John Lawn and Cindy Friedman opened by emphasizing recent health care reforms and the need for further action on the drug supply chain, PBMs, private equity, and affordability. The committee heard testimony on several measures, including a Betsy Lehman Center bill to make technical changes and create a permanent trust account for federal and private funding, and bills on hospital profits and fairness, hospital closures and health planning, pharmacy deserts, and health care market oversight and pharmaceutical access. No votes were taken during the hearing. On the hospital profits bill, physicians and labor advocates strongly supported capping hospital CEO compensation at 50 times the lowest-paid worker, requiring greater financial transparency, and directing penalties from high-margin public hospitals into a Medicaid reimbursement fund. Testifiers argued that executive pay is excessive while frontline staff and safety-net services are under strain. Committee members raised concerns about unintended consequences, including whether hospitals might shift workers to contract status or lose executive talent, and whether the bill would actually direct money to the safety net. Supporters responded that the measure is one piece of a larger effort and that the bill’s Medicaid reimbursement provisions would help underserved hospitals. Testimony on market oversight and pharmaceutical access centered on rising health care and drug costs, PBM practices, and the proposal to give the Health Policy Commission authority to set upper payment limits for certain drugs. Consumer advocates, disability advocates, an independent pharmacist, the Attorney General’s office, and others supported stronger oversight, citing premium increases, affordability problems, and the impact of high drug prices on patients and community pharmacies. Pharma and some industry witnesses opposed parts of the bill, warning that upper payment limits could disrupt access, create legal issues, and fail to address the broader supply chain. The committee also heard support for stronger hospital closure notice and public hearing requirements, and for a pharmacy deserts bill aimed at identifying and addressing closures like the one in Roxbury that affected thousands of patients.

Transcript Highlights:

• So, over that decade, we're looking at a lot of reduced payments.
• This will be based on their payment error rate.
• On slide nine, here is a brief overview of the SNAP payment error rate.
• Currently, on slide 10, our payment error rate is almost 15%.
• That contributed negatively to the payment error rate.

Committee: House Legislative Health & Human Services Committee