Transcript Highlights:

• First off, maintaining the NDPERS pilot period.
• Last session, we did have debate about lengthening the NDPERS pilot period.
• So when we look at the NDPERS pilot period, the NDPERS population is unique.
• When we look at the NDPERS pilot period, the NDPERS population is unique.
• within a policy, and grace periods, just to name a few.

Keywords: 908, all

Summary: The committee met to review the history and current treatment of North Dakota health insurance mandates, with presentations from Blue Cross Blue Shield of North Dakota, Sanford Health Plan, the Public Employees Retirement System (PERS), and the Insurance Department. The discussion focused on how mandates apply differently to fully insured, self-funded, ACA, Medicaid, and PERS plans; how the state’s benchmark plan and federal essential health benefits affect coverage; and how the existing process requires cost-benefit analysis and, for certain measures, a PERS pilot period before broader application. Presenters also reviewed the long list of existing state mandates, including provider, beneficiary, and coverage requirements, and noted that many were enacted decades ago and have not been revisited despite changes in medical evidence and treatment options. Witnesses from the carriers argued that mandates should be reviewed periodically because some are outdated, can create unintended costs, and may not align with current medical guidance. Examples cited included PSA screening, off-label drug coverage, prior authorization rules, step therapy, and cost-sharing provisions for mental health and substance use treatment. They emphasized that carriers often cover services without a mandate when supported by clinical evidence, and that mandates can shift costs to employers and employees, especially in the fully insured small-group market. They also suggested possible policy improvements such as clearer mandate definitions, better transparency around cost-benefit analyses, a regular 10-year review of mandates, and more timely submission of proposals through the interim process. PERS and the Insurance Department highlighted a recurring tension over what counts as a mandate and when a measure triggers the state’s defrayal obligation under federal law. PERS described its interim committee process, the April 1 deadline for fiscal-impact proposals, and the limited pilot program used for certain measures, noting that only a few bills have gone through the full pilot process. The Insurance Department explained that it views new benefit mandates through the lens of the ACA benchmark plan and essential health benefits, distinguishing true new benefits, such as infertility coverage, from changes to existing benefits, such as telehealth or insulin cost-sharing caps. No votes were taken on policy changes; the meeting was informational, with members asking questions about costs, applicability, transparency, and whether a periodic mandate review should be established.

Transcript Highlights:

• Senator, could you talk to us about the Canadian prescription drug importation program, a program that
• we've had on the books for a period of time, and we're continuing.
• In Proviso lines 742 to 755, it directs the Department of Corrections to purchase prescription drugs
• from the Canadian prescription drug importation program.
• And if we're not using it anymore, how are we going to get the prescription?

Keywords: 998, house, all

Transcript Highlights:

• You see, grandmother couldn't read the prescriptions on the bottles or the instructions on the prescription
• And so while she prescription bottles.
• A key provision also within House Bill 611 expanded diversion from a six-month period to a 12-month period
• A key provision also within House Bill 611 expanded diversion from a six-month period to a 12-month period
• that look like over a 10-year period? that look like over a 10-year period?

Keywords: Meeting Start: 00:00:00 Roll Call: 00:00:08 Agency Updates: 00:01:27 Truancy: 00:01:43, 958, all

Summary: The Juvenile Justice Oversight Council met on October 8, 2025, approved the minutes from the August 29 meeting, and then focused its agenda on truancy and chronic absenteeism. Chad Butler, director of pupil personnel for Meade County and president of the Kentucky Department of Pupil Personnel directors, said chronic absenteeism remains a major problem statewide, citing recent Kentucky rates around 28% to 30% and noting that schools are trying to identify best practices to get students back in class. He said causes appear to include post-COVID social-emotional distress and confusion about when students should stay home, and he described a local effort to use a Healthy Kids Clinic model to keep some students in school when possible. In response to questions, he said chronic absenteeism has only been tracked seriously in the last two to three years and that House Bill 611 appears to have increased the number of youth entering the court system for habitual truancy; AOC said it would provide county-by-county data and outcomes later in the meeting. The council then heard from John Tyson of Alabama, a former Mobile district attorney, who described the Helping Families Initiative as a school-community partnership designed to address truancy and related behavior issues without arrest. Tyson said Alabama defines chronic absence as missing 10% of the school year and emphasized that the program is preventive rather than punitive, using warning letters, family engagement, assessments, individualized intervention plans, and referrals to community services. He said the program has operated since 2003, now includes 20 district attorneys and 44 school systems, and served more than 95,000 students, 73,000 families, and 162,000 parents in the most recent year. Tyson reported that in Mobile County the program was associated with a 3.15% attendance improvement in 2023-24 and a 4% reduction in the issue in 2024-25, along with a 50% reduction in truancy and 58% reduction in chronic absenteeism, and he said the program produced a large return on investment. Tyson also stressed that student absenteeism wastes tax dollars and that better attendance improves educational outcomes and community safety. He described the program’s use of a case-management database, real-time data tracking, and more than 1,000 referral agencies, and said the model is intended to be replicated statewide. He closed with examples of students whose attendance and family circumstances required coordinated support rather than punishment, including a teen mother and a disruptive child, to illustrate his view that schools, courts, and social services should work together to address underlying needs and keep children in school.

Transcript Highlights:

• eligible individuals, Medicaid reimbursements to be limited to covered services, and subject to periodic
• It comes in periodically. ...because that settlement money doesn't come in in one fell swoop; it comes
• in periodically.
• Data from the January 26 pharmacy benefit utilization report show that for prescription drugs that did
• Data from the January 26 pharmacy benefit utilization report show that for prescription drugs that did

Bills: SB1041, SB1050, SB1131, SB1138, SB1249, SB1267, SB1272, SB1317, SB1461, SB1488, SB1504, SB1517, SB1523, SB1580, SB1582, SB1584, SB1585, SB1602, SB1630, SB1654, SB1672, SB1673, SB1718, SB1761, SB1819, SB1826, SB1827

Keywords: electronic monitoring, nursing care, assisted living, resident rights, privacy, consent, surveillance, veterans, lifetime pass, state parks, Arizona, access, disabled veterans, cardiac arrest, defibrillators, school safety, emergency response, CPR training, Arizona education funding, automated license plate readers

Summary: The committee first considered Senate Bill 1630, which would direct AHCCCS to seek federal approval for a home- and community-based services program for adults determined to be seriously mentally ill, with quarterly implementation updates, stakeholder input, and a cap on enrollment. The sponsor and advocates from Arizona Mad Moms argued the bill would create an assisted-living-style Medicaid option for the most disabled SMI individuals, improve continuity of care, and reduce state general fund costs by shifting some expenses to federal Medicaid funding. Access testified neutral, estimating a total fiscal impact of $27.7 million, including $5.83 million general fund, and explained the need for CMS approval. The committee adopted an amendment reducing the initial cap to 250 members, changing reporting frequency, and adjusting eligibility and expansion conditions, then passed SB 1630 as amended on a 10-0 vote. The committee next heard Senate Bill 1131, which originally required school districts and charter schools to adopt cardiac emergency response plans and appropriated $1 million for implementation. An amendment replaced the mandate with a reporting requirement on AED counts, CPR/AED-trained staff, and whether schools have a plan, while keeping a grant component for AEDs and prioritizing rural schools. The American Heart Association supported the amended approach as a way to gather baseline data and target resources, and members discussed AED training, school preparedness, and whether the funding should favor rural or high-population schools. The committee adopted the amendment and passed SB 1131 as amended on a 9-1 vote, with Senator Kuby voting no and several members explaining concerns about funding and priorities. The committee then took up Senate Bill 1582, which concerned the school safety interoperability fund. An amendment shifted the appropriation from the Department of Education to the Department of Administration and allocated funds to specific county sheriff offices for continuing operation and maintenance of existing interoperability systems, while narrowing the program to public safety agencies and school districts and requiring twice-yearly testing. Sheriffs, a county school superintendent, and the Arizona Sheriffs Association described the systems as useful for drills and real emergencies, improving communication between schools and first responders; one speaker noted the program had been used in drills and at least one live deployment. Some members questioned the audit findings, the focus on rural counties, and whether the program was a good use of funds, while supporters emphasized its value for school safety. The committee adopted the amendment and passed SB 1582 as amended on a 6-4 vote. Finally, the committee began hearing Senate Bill 1504, which would change retirement rules for Tier 2 and Tier 3 public safety personnel by allowing earlier normal retirement and shortening the COLA waiting period, with an amendment exempting the changes from the statutory pre-funding requirement. Supporters from firefighter and police groups said the bill would improve recruitment and retention and let employees receive earned benefits sooner, while city, county, and taxpayer representatives warned it would add substantial unfunded liabilities and undermine the 2016 pension reforms. Actuarial testimony estimated significant costs, including tens of millions in annual or upfront impacts depending on how the change is funded, and members debated whether the amendment would shift costs onto future taxpayers or simply spread them over time. The transcript ends during continued testimony and discussion on SB 1504, before a final vote is reached.

Transcript Highlights:

• Synthetic THC, THC period in any products and any beverages.
• Period. Okay? Thank you for your testimony. Remember, there are questions of this witness.
• When I was sent home, they messed up my prescription, and I did not think I could make it.
• VA prescription epidemic and a default VA prescription of opioids. has just, has done a number on us.
• Many of these drugs, many of these are dangerous drugs. prescriptions.

Bills: HB 28, SB 3

Keywords: hemp regulation, consumable products, cannabinoids, state health, youth protection, licensing fees, criminal offenses, HB28, public testimony, committee decorum, bill substitute, legislative process

Summary: The meeting featured significant discussions regarding HB28, where the chair outlined the plans to bring forward a substitute for the bill. The chair emphasized the importance of maintaining order and decorum during the proceedings. Members engaged in deliberations, and a number of public witnesses were invited to testify, thereby enriching the discussion around the bill. This interaction provided valuable insights into public sentiment regarding the issues at hand.

Transcript Highlights:

• It seeks to ensure that authorized care is accessible throughout the authorization period.
• During this period, the clinical need is clear.
• During this period, the clinical need is clear.
• It preserves flexibility across the full six-month authorization period, protecting a patient's right
• Going through those different core competencies in that 80-hour training period, then taking a test for

Keywords: 987, senate, all

Summary: The Senate Committee on Health met in Room 2100 and first established a quorum, then approved a six-bill consent calendar on a 6-0 vote, placing it on call. The committee then heard AB 2233, which would ensure that once applied behavior analysis services for autistic patients are authorized, families can use those approved hours across the authorization period rather than losing them to weekly utilization caps or scheduling barriers. The author and supporters, including behavior analysts and family advocates, said the bill would not expand benefits but would improve access to already authorized care; health plan and insurance representatives initially raised fraud and utilization-management concerns but said they would remove opposition after amendments preserving those safeguards. AB 2233 passed 7-0 and was placed on call. The committee next heard AB 96, which would remove the high school diploma or equivalent requirement for certification as a Medi-Cal peer support specialist. Supporters from county behavioral health, peer services, and local governments argued that lived experience, training, and certification standards—not a diploma—should determine eligibility, and that the change would help address workforce shortages and expand culturally competent peer support. One opposition witness from the California Consortium of Addiction Programs and Professionals testified against the bill, but the measure advanced on a 7-0 vote to Appropriations and was placed on call. The final major item was AB 1876, the Fair Care for All Act, which would codify federal non-discrimination protections in state law for health care coverage and services. Supporters said it would protect transgender, gender-diverse, and intersex patients from discriminatory coverage practices and preserve access to medically necessary care; opponents argued it would force coverage of gender-affirming interventions and reduce insurer safeguards. After debate over whether the bill expanded coverage, the author said it simply mirrored existing federal non-discrimination law. AB 1876 passed 7-1 and was re-referred to Judiciary, then placed on call. The committee later opened the roll to record absent members and concluded the meeting after all items were disposed of.

Transcript Highlights:

• Return us to undefined break periods with no real accountability.
• The issue with this law is it's prescriptive. You start at 6:00, your break time's at 10:00.
• The issue with this law is it's prescriptive. You start at 6:00, your break time's at 10:00.
• spring break travel period. spring break travel period.
• Thank you, ma'am. the period involved. Um, and have a the period involved.

Keywords: 919, house, all

Summary: House File 3732, the Department of Employment and Economic Development appropriations bill, was presented as a package of budget and policy changes from the Workforce, Labor, and Economic Development Committee. The author described it as a set of practical fixes, including changes to reporting requirements, repealing unused programs, recommendations from a Governor’s Workforce Development Board subcommittee on direct appropriations, and creation of an Office of Community Investment within DEED. Members also noted the bill had been revised after earlier floor debate and included a modified version of a previously contentious proposal. The first major floor debate centered on Amendment A12, offered by Representative Zeleznikar, which would create an exemption from meal and break requirements for certain 24-hour care settings such as disability group homes and home care. Supporters argued the current break law does not fit the realities of one-on-one or overnight care and could force providers into unsafe or impractical staffing models. Opponents, including Representatives Johnson and Pinto, said the amendment would weaken or repeal worker break protections and remove clear standards and remedies. After debate, the House took a roll call and the amendment failed on a 67-67 tie. A second amendment, A13 by Representative Tabke, proposed a $150,000 state aviation fund-backed loan fund to help TSA and other airport workers who had gone without pay during a federal shutdown, by backstopping bank loans for affected families. Tabke framed it as worker relief tied to the aviation system, while Representative Niska argued it was not a serious proposal, had not been vetted, and unfairly used state money to address a federal dispute. Debate on the amendment became highly partisan and included a point of order over personalities in debate before the Speaker ruled the point well taken and returned discussion to the amendment.

Transcript Highlights:

• No THC product should be sold in our Texas neighborhoods, period.
• It's worth asking whether that period played a role in the mental state of these individuals.
• This is the only thing that helps him, period. Okay. Thank you for your testimony.
• The VA prescription epidemic and default VA prescription of opioids has just done a number on us.
• Many of these drugs are dangerous drug interactions for multiple prescriptions.

Bills: SB 3, HB28, SB3

Keywords: flash flood, flood warning, outdoor warning siren, emergency alert, disaster preparedness, flood mitigation, Hill Country floods, Texas Water Development Board, municipalities, counties, local government mandate, public safety, grant program, backup power, weather siren, emergency management, flood-prone area, warning system, hemp regulation, consumable products

Transcript Highlights:

• <00:04:26.960> of to buprenorphine limited to a period of to buprenorphine limited to a period
• uh, anybody who has prescriptive uh, anybody who has prescriptive authority<00:08:13.360> had
• So we had one open comment period.
• full open comment period.
• be on it for a period a long period of be on it for a period a long period of time. time. time.

Keywords: 958, all

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

Transcript Highlights:

• Representative Chasson, have there been complaints on the prescription of these, or what precipitated
• Not on the prescriptions of it.
• So for instance, the prescription of a compound that mimics, Life and death.
• So we can see whether this is this alleged. postal prescriptions and access issues.
• , which was quick for us. ...which happened within an eight-week period, which was quick for us.

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

Transcript Highlights:

• 18.240> severe created in 2017 in response to a severe created in 2017 in response to a severe period
• instability<00:14:20.399> in<00:14:20.720> the<00:14:20.880> individual period
• of instability in the individual period of instability in the individual market. market. market.
• Is it going to be to subsidize prescriptions?
• what whatever the case prescriptions? what whatever the case may<00:28:03.120> be.

Keywords: 1183, house

Summary: The committee took up House File 3388, and an A1 amendment was adopted by voice vote. The bill, as amended, would direct the Department of Commerce to seek another federal waiver to continue Minnesota’s reinsurance program and preserve the assessment-and-tax-credit funding model adopted last session. Chair O’Driscoll said the measure is intended to give future legislators options before the current reinsurance structure ends, warning that without it individual-market premiums could rise substantially and more people could lose coverage. Testimony was largely supportive. Dan Andre of the Minnesota Council of Health Plans said reinsurance has been a success since 2018, has lowered premiums by covering a portion of high-cost claims, and helped subsidize care for more than 5,000 Minnesotans in 2024. Ann New Brindley of the Minnesota Business Partnership and Steven Rubis of the Health Plan Partnership of Minnesota also backed the bill, saying market stability is important amid the loss of federal premium tax credits and that continued reinsurance would help prevent further premium increases and cost shifting. Jonathan Carter of the Minnesota Chamber of Commerce likewise supported the bill, citing the program’s role in keeping Minnesota’s individual-market premiums among the lowest in the country. Members also discussed how the assessment and tax-credit mechanism works, with Chair O’Driscoll describing it as an assessment on plans followed by a tax credit against state liability. Representative Elkins questioned how insurers self-assess, and Representative Smith said the assessment model is preferable to a general-fund approach if the program continues. Representative Kaggel raised concerns about taxpayer costs and the broader health care system, while also saying the current system is unsustainable and in need of more fundamental change. The committee then renewed the motion to lay House File 3388, as amended, over for possible inclusion in an omnibus bill.

Transcript Highlights:

• They can't afford the outrageously high cost of prescription drugs.
• Negotiations for prescription drugs under Medicare.
• Including prescription drugs. We'll have that time, not in this particular reconciliation bill.
• Use to reduce the price of prescription drugs for seniors on Medicare? I urge its adoption.
• We've talked about the cost of prescription drugs. Well, child care is another big deal.

Transcript Highlights:

• <00:24:10.400> claims, possession or prescriptive claims, possession or prescriptive claims
• adverse possession and prescriptive adverse possession and prescriptive claims<00:25:43.960>
• prescriptive use.
• > is<00:36:55.000> and Easements by prescription, um, is and Easements by prescription,
• what, uh, prescription is. what, uh, prescription is.

Keywords: 1191, senate, all

Transcript Highlights:

• Get a prescription from a doctor outside of the TCUP program.
• It stays in your body for a longer period of time.
• Period.
• My clients do not sell THC or hemp to children, period.
• So your testimony is 0.3% or less, period?

Bills: SB5, SB11, SB12, SB 5, SB 11, SB 12

Keywords: hemp regulation, consumable products, cannabinoids, occupational licenses, criminal offenses, SB 11, Texas attorney general, election crimes, election law enforcement, criminal prosecution, Election Code, Government Code Chapter 402, local prosecutors, county attorney, district attorney, grand jury, probable cause reports, state election offenses, voter fraud, election integrity

Transcript Highlights:

• It's high risk, particularly because the incubation period is so long.
• Just last session, we were able to support bills that passed addressing coverage for prescription drugs
• We were able to support bills that passed addressing coverage for prescriptions. session, we were able
• drug costs and prescription drug manufacturers, hospital and health system costs for high-cost care,
• drug costs and prescription drug manufacturers, hospital and health system costs for high costs care

Keywords: 995, all

Summary: The Joint Committee on Public Health held an introductory informational hearing for the new session, with Chairs Marjorie Decker and Senator Michael Driscoll outlining the committee’s scope and emphasizing the impact of the federal landscape on Massachusetts public health. They noted the hearing would focus on testimony from agencies and advocates, with short testimony limits due to the hybrid format. No votes were taken; the meeting was for briefing and discussion of priorities. Commissioner Robbie Goldstein of the Department of Public Health described the department’s budget and federal funding, warning that recent CDC grant terminations could cut nearly $100 million and affect lab testing, surveillance, vaccines, and community engagement. He highlighted DPH priorities including racial equity, maternal health, substance use and child welfare coordination, emergency preparedness, data transparency, and public hospital quality. MassHealth Assistant Secretary Michael Levine discussed MassHealth’s role covering about 2 million residents and its priorities in health equity, behavioral health, primary care, member independence, and customer service, while noting the agency relies heavily on federal Medicaid dollars and would face major strain from federal cuts. Several advocacy and provider groups focused on reproductive health and maternal health. Planned Parenthood warned of threats to Title X, 340B savings, and other federal funding, and supported a bill to eliminate parental consent and judicial bypass for abortion care for young people. Reproductive Equity Now urged stronger shield-law protections and changes to Massachusetts’ later-abortion framework. Dr. Indyamaka Anugaka called for full implementation of the maternal health law, better reimbursement for doulas and midwives, stronger data collection, and support for full-spectrum pregnancy care coverage. The Health Policy Commission said new maternal health and primary care task forces would begin work soon. Mental health and health system access were also major themes. The Mass Medical Society urged action on vaccine hesitancy, removal of non-medical school vaccine exemptions, and primary care reform. The Massachusetts Association for Mental Health and the Children’s Mental Health Campaign opposed proposed cuts to DMH and substance use services, called for more school-based supports, and raised concerns about inpatient capacity, including a unit serving LGBTQ youth. The Massachusetts Nurses Association and 1199 SEIU warned that staffing shortages, low wages, workplace violence, hospital closures, and possible Medicaid cuts threaten patient care and the health care workforce. The Betsy Lehman Center also urged investment in automated patient-safety monitoring to reduce harm and costs.

Transcript Highlights:

• We also have a number of controlled substances violation cases where prescriptions are being billed to
• If we know there was a period forward.
• Um, you know, some time period. Time frame. Yeah. Yes, ma'am. Okay. Thank you, Dr. Schustster.
• >> Um you know, some some time period >> Um you know, some some time period >>
• dental health has had the longest period dental health has had the longest period of<01:30:36.320

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board reconvened and heard a presentation from the Attorney General’s Office Medicaid Fraud and Abuse Control unit. AG staff described the unit’s structure and work: it investigates and prosecutes Medicaid provider fraud, and also handles abuse, neglect, and exploitation cases involving vulnerable adults in facility settings when asked to assist. They said the office has prosecutors, detectives, auditors, and support staff, works with federal partners, Commonwealth’s attorneys, CHFS, DMS, OIG, and MCOs, and uses a hotline and referral line for complaints. They also explained the MCO referral process, including monthly meetings, stand-down lists, and review of referrals for a “credible allegation of fraud” before the AG office decides whether to open a criminal or civil investigation. The presentation focused heavily on current fraud trends. Staff said behavioral health is a major concern, along with participant-directed waiver services, medically assisted treatment, cash billing for services, controlled-substance billing, and vision and dental fraud. They gave examples such as duplicate time sheets for family caregivers, questionable Suboxone counseling and urine drug screening practices, and a prior optometry case involving false claims for children’s glasses. They also discussed CMS’s estimate that about 5% of Medicaid payments are improper, noted that most improper payments are at the fee-for-service level, and said there is no reliable overall fraud-rate estimate. They highlighted a sharp shift in behavioral health billing after the cabinet’s November 1, 2024 policy changes, saying individual psychotherapy spending dropped while group billing increased, suggesting providers may have moved billing to different codes. Members asked about the scale and timing of cases, how MCO referrals are screened, and whether the data reflected more people being served or just higher spending. The AG office said investigations can take years, with some federal cases still awaiting sentencing from 2018 and 2019 matters, and that they currently had nine individuals awaiting sentencing in federal court. They also reported 58 hotline reports during the referenced period, six cases opened from MCO referrals, and four additional MCO referrals not accepted for active cases. Several members raised concerns about home-based services and the risk of abuse or fraud when family members are reimbursed, and asked whether the process could be streamlined; the AG office said it had no immediate recommendations but would be willing to return with suggestions after further review.

Transcript Highlights:

• wish to testify, there will be a time limit of three minutes per witness during the public testimony period
• But at the same time, when there's a period of uncertainty, those inflated actuarial assumptions were
• However, over that period of time, we've seen that pharmacy spending has increased by...
• Over that period of time, we've seen that pharmacy spending has increased by about 29%.
• These averages are across the entire 2019 to 2024 period.

Keywords: 1184, house, all

Transcript Highlights:

• So, the bill already requires medical necessity and a prescription.
• So, the bill already requires medical necessity and a prescription.
• Anyone outside of the hospital period, so there's no time limit to how long someone can be considered
• Anyone outside of the hospital period, so there's no time limit to how long someone can be considered
• , Anyone outside of the hospital period, Anyone outside of the hospital period, so<00:42:13.600><

Bills: SB2433, SB2047, SB2425, SB3045, SB2761, SB3001, SB2852, SB2471

Keywords: condominium governance, education trust fund, unit owners, real estate, dispute resolution, financial obligations, community representation, pharmacy benefit managers, maximum allowable cost, transparency, drug pricing, insurance commissioner, contracting pharmacies, healthcare, substance use disorder, SUD, addiction treatment, behavioral health, mental health, rehabilitation

Summary: The committee heard testimony on SB 2433 SD1 relating to condominiums, which would direct the condominium education trust fund toward educational resources for unit owners and require the Real Estate Commission to ensure owners’ interests are represented in funded activities and related rulemaking. Supporters, including the Hawaii Real Estate Commission and a condominium owner advocate, said owners need a seat at the table in condo governance and education efforts. Committee discussion focused on whether the bill was necessary, with the Real Estate Commission indicating it could already use the trust fund for owner education and that owners are already considered stakeholders, though not through a specific commission seat. No vote was taken during the excerpted discussion. The committee then took up SB 2047 SD2 HD1 on pharmacy benefit managers, which would set requirements for maximum allowable cost reimbursement, allow reverse-and-rebill claims after successful appeals, and authorize fines for violations. The Insurance Division offered comments, the Hawaii Pharmacists Association supported the measure with amendments and suggested future PBM reform funding, and Kaiser Permanente requested a technical amendment. A committee question raised whether the staffing and resource request for implementation was too large for a bill focused only on MAC pricing, and the witness said he would provide more data to the next committee. No final action was shown. Next was SB 2425 SD2 HD1 on health insurance and substance use disorder treatment, requiring insurers to honor written assignments of benefits to SUD providers and prohibiting anti-assignment clauses. Supporters described patients being unable to access treatment because of high out-of-pocket costs and said direct payment would reduce harm for people in recovery. HMSA opposed the bill but said it would begin direct payments to non-participating SUD facilities effective March 27, while continuing to object to the assignment-of-benefits portion because of fraud and balance-billing concerns; the Hawaii Association of Health Plans also opposed. Members questioned HMSA about reimbursement mechanics and why the bill was needed if coverage policies were already changing. Finally, the committee heard SB 3045 SD1 HD1, which would require coverage of continuous glucose monitors and related supplies, including for Medicaid managed care, under certain conditions. DHS and the Insurance Division offered comments, while SHPDA, Hilo Benioff Medical Center Foundation, and others supported the bill, citing inconsistent access and a case in which a woman allegedly died after being denied a CGM. HMSA said it already covers medically necessary CGMs and had updated its policy in 2025 for type 1 and insulin-dependent patients, but it raised concerns about expanding mandated coverage to type 2 and gestational diabetes and about supply impacts. The committee also discussed whether the bill duplicated existing coverage standards and why it had been introduced repeatedly. No votes or final dispositions were included in the excerpt.

Transcript Highlights:

• Lena Green, a Delta soror in my district, got me to partner with a period poverty event in my district
• where we're fighting against period poverty.
• where we're fighting against period poverty.
• where we're fighting against period poverty.
• And goodbye to them over a very long period of time. It could be months, years.

Keywords: 993, senate, all

Summary: The Senate convened, approved the prior journal, and handled several motions to discharge and substitute identical Assembly or Senate bills, along with a number of amendments. The chamber also welcomed student visitors from the League of Women Voters’ Students of Albany program and a group of Staten Island titleholders, and later adopted previously approved resolutions honoring Dorothy E. Reid for her role in Brown v. Board of Education and recognizing Delta Sigma Theta Sorority, Inc. on Delta Day, with multiple senators speaking in support of both recognitions. The bulk of the floor session was devoted to third-reading votes on a large number of bills, most of which passed with broad support. Measures addressed public health, workers’ compensation, education, environmental conservation, insurance, labor, criminal procedure, domestic relations, tax, municipal authority, and correction law. Several bills were explained by sponsors as advancing stormwater management authority, labor-law transparency, public health protections, and stronger penalties for trafficking-related offenses; one bill on immunization in summer camps drew a defense from Senator Skoufis as a child-protection measure, while another on correction law passed with some Republican opposition. The chamber also took up a controversial public health/electronic health records bill by Senator Fernandez. Senator Martin questioned the bill at length about redacting certain categories of information, emergency access, provider obligations, and the impact on doctors’ ability to see complete medical histories. Fernandez said the bill was intended to protect patients from discrimination and to limit access to a small list of sensitive services, while also noting emergency exceptions and support from more than 200 health care providers. The debate remained focused on balancing privacy protections with concerns about continuity of care and record integrity.

Transcript Highlights:

• their prescriptions or obtain new prescriptions out of network. in Los Angeles and Ventura County, all
• their prescriptions or obtain new prescriptions out of network I don't know.
• And permit impacted members to refill their prescriptions or obtain new prescriptions out of network
• Prescriptions tend to be the first thing where there's challenges.
• Prescriptions tends to be the first thing where there's challenges.

Summary: The Assembly Health Committee held an informational hearing on the health impacts of wildfires and the effects on health care systems and access to care. The first panel focused on public health consequences, with testimony from UCLA and UCSF physicians, a community organizer, and an Altadena recovery leader. Witnesses described acute and long-term physical harms from wildfire smoke and ash, including asthma and COPD exacerbations, cardiovascular and stroke risks, pregnancy impacts, infection risk, and possible added hazards from lithium-ion battery fires. They also emphasized mental health effects such as anxiety, depression, PTSD, “firebrain,” and the need for psychological first aid, trauma-informed community networks, and youth-focused resilience programs. Community advocates stressed that Latine, Indigenous, undocumented, and Black communities face disproportionate harm because of language barriers, unsafe work conditions, lack of insurance, and exclusion from disaster aid, and they called for stronger language access, worker protections, permanent disaster relief, and better outreach. Committee members asked about air monitoring, masks, wind events, lithium-ion batteries, and how to reach communities with translation and emergency information. Panelists said AQI is useful but incomplete, that N95s help for smoke but P100 masks are needed for ash/asbestos exposure, and that communities should be warned to stay indoors and avoid windy dust-ups after fires. They also discussed the importance of building relationships during non-emergency periods, using text alerts and trusted community organizations, and providing culturally and linguistically appropriate information. Several members and witnesses highlighted the need for more research on long-term health effects, especially for people with chronic lung disease, workers who cannot stay indoors, and residents exposed to repeated disasters. The second panel addressed health care system response and access to care. DHCS and DMHC described emergency flexibilities used during the Southern California fires, including federal waivers, extended Medi-Cal renewal deadlines, reinstated coverage for some disenrolled members, suspension of prior authorization and prescription refill barriers, out-of-network access at in-network cost-sharing, and communication through websites, toll-free numbers, and social media. Hospital and community health center leaders described major operational strain: emergency room surges, canceled surgeries, dialysis disruptions, staff displacement, temporary housing needs, and financial losses. Huntington Health and AltaMed reported using incident command systems, temporary care spaces, bilingual and culturally tailored services, mobile clinics, infection control measures, and community health workers to keep care going. Members and witnesses also discussed the need for better disaster staffing pools, more flexible facility rules, stronger mental health coverage, child care planning, and statewide coordination for future emergencies; no formal votes were taken.