Transcript Highlights:

• with emergency room claims rose 15%.
• Formulary management is used to manage which drugs are included in formulary in order to manage costs
• management approach to the formulary.
• claims process with regard to screenings or the claims process in general.
• It's those kinds of cases, but all of these claims are negligence claims.

Summary: The Budget Committee met with a quorum and took up several bills. HB 677, relating to state-covered fertility preservation for employees undergoing cancer treatment, was introduced as coverage for egg and sperm preservation for up to three years, with an estimated fiscal impact of about $813,000. After brief questions and no public testimony or amendments, the bill passed unanimously and was reported favorably. The committee then considered CS/HB 59, which would reform Florida’s wrongful incarceration compensation process by extending the filing deadline from 90 days to two years, removing the clean-hands requirement, and allowing exonerees to choose between the state compensation process and a civil lawsuit; it was supported by the City of Flagler Beach and passed unanimously. CS/HB 1313, which recreates the Resilient Florida Trust Fund in the Department of Environmental Protection before its scheduled termination in 2025, also passed unanimously after supportive testimony from advocacy groups. The committee received a lengthy presentation from the Department of Management Services on the State Group Insurance Program and the recent Revenue Estimating Conference. The presentation covered enrollment, revenues and expenditures, rising medical and pharmacy costs, emergency room utilization, GLP-1 drug spending, and options for tighter formulary and utilization management. Members asked about ER cost growth, GLP-1 coverage and copays, PBM oversight and potential conflicts, avoidable ER visits, cancer screening claims, dental and vision costs, specialty drug biosimilars, and possible savings from more restrictive pharmacy models. DMS said it would follow up on several questions and noted ongoing work on cancer coordination, preventive screening, biomarker testing, and a proposed member-facing benefits platform. The committee also heard extensive testimony on HB 301, which would raise sovereign immunity caps from $200,000 per person and $300,000 per incident to $1 million and $3 million, align limitations periods with private claims, and allow government entities to settle above the caps without a claims bill. Local governments, school-related entities, and county and city associations opposed the bill, warning of major fiscal impacts, higher insurance costs, and pressure on services; several speakers urged smaller increases or a tiered approach. Proponents, including families affected by catastrophic injury or death, argued the current caps are too low and the claims bill process is inefficient and unfair. After debate, the bill passed on a recorded vote, with some members voting no, and was reported favorably.

Transcript Highlights:

• the parties on a claim-by-claim basis.
• why that claim was denied.
• clean claim and pay it within 30 days, except as agreed in writing by the parties on a claim-by-claim
• Premara does not pend clean claims.
• Insurance companies are often incorrectly denying claims. We appeal the claim.

Summary: The Senate Health and Long-Term Care Committee heard testimony on several bills. SB 6159 would create a public hospital infrastructure account funded by a new annual coverage assessment on insurers and other businesses subject to the premium tax, and would allow public hospital districts and other public health entities to collaborate more freely and access capital financing for major construction or modernization projects. Senator Dhingra said the bill is intended to help public hospitals compete and modernize, especially amid federal Medicaid and ACA subsidy cuts. Supporters included UW Medicine, while hospital districts supported the general concept but said Section 2 could unintentionally narrow existing cooperative agreements with nonpublic entities. Health plans and insurers opposed the bill, arguing it would raise premiums, increase consolidation, and improperly sweep in property and casualty insurers and mutual companies; testimony also raised concerns about pass-through costs and retaliatory tax effects. The hearing on SB 6159 closed with 5 pro, 74 con, and 2 other sign-ins. The committee then heard SB 5845, which would modernize timely payment rules by requiring carriers and public employee plans to pay or deny all clean claims within 30 days, require prompt notice and a single request for additional information on incomplete claims, and impose interest or penalties for missed deadlines. Senator Slaughter said the bill would reduce uncertainty for providers and stabilize payments without increasing patient costs. Hospitals, physicians, and health systems strongly supported the measure, citing large volumes of late clean claims and examples of prolonged delays, including a Harborview claim that remained unpaid more than a year after billing. Health plans opposed the bill, saying the current 95% standard is workable, that they already meet high compliance rates, and that the bill could limit fraud, waste, and abuse review on high-dollar claims; they also sought more flexibility and additional time for responses. The hearing closed with 69 pro, 4 con, and 2 other sign-ins. The committee also heard SB 5916, which would prohibit health plans from disadvantaging non-opioid pain treatments relative to opioids in formularies and utilization management, and would require a Department of Health educational pamphlet on non-opioid alternatives. Senator Harris described the bill as a response to opioid deaths and a way to encourage safer pain treatment options. Patients, recovery advocates, and rare disease advocates testified in support, saying insurance barriers and step therapy often make non-opioid care harder to access and can push patients toward opioids. The Health Care Authority and an association of health plans opposed the bill, arguing it could reduce formulary flexibility, increase costs, and limit tools such as prior authorization and step therapy. The hearing closed with 8 pro, 1 con, and 2 other sign-ins. Finally, the committee heard SB 6102 and SB 6103, both sponsored by Senator Muzzall, and SB 6071. SB 6102 would align the ambulance transport quality assurance fee with federal rules after H.R. 1 barred new provider taxes, preserving the existing fee rate and adjusting the Medicaid add-on rate annually; the Washington Ambulance Association supported it, saying the program had improved wages and benefits for EMS workers. SB 6103 would make Medicaid payments for services provided by a rural emergency hospital subject to appropriation, creating a framework for East Adams Rural Health Care to convert to the new federal rural emergency hospital model; East Adams and the Washington State Hospital Association supported it as a way to preserve rural access. SB 6071 would shorten overpayment recovery timelines for all services to six months, or nine months for coordination-of-benefits cases, matching the shorter timelines already enacted for behavioral health services; providers and specialty associations supported the bill as a way to reduce destabilizing clawbacks, while the remaining testimony was still underway when the transcript ended.

Transcript Highlights:

• This month, EDD initiated its vendor contract for the integrated claims management system, which I'm
• management system project. ...the contract to complete the integrated claims management system project
• We also improved our website with step-by-step instructions to apply for and manage benefit claims in
• The effort known as the Integrated Claims Management System will make it easier to manage claims, share
• We're also continuing to make progress on a new document management system that speeds up claim processing

Keywords: 988, house, all

Transcript Highlights:

• This amendment is to allow L&I to hire additional claims managers.
• managers shouldn't have more than 141 claims each.
• Part of the problem, from my professional experience, is that L&I claims managers are overloaded.
• This amendment would also ask that those claims managers, as we increase the number of claims managers
• and other independent sources to say that they should have a more managed bill claim load.

Bills: HB2188 , HB2218 , HB2524 , HB2563

Committee: House Labor & Workplace Standards

Keywords: transparency, industrial insurance, insurance rate increases, financial disclosure, regulatory oversight, workers' compensation, medical care, healthcare access, employee rights, insurance coverage, security, regulation, employment standards, security guards, industry board, unemployment, electronic notices, compensation, digital communication, order processing

Transcript Highlights:

• This month, EDD initiated its vendor contract for the integrated claims management system, which I'm
• claim.
• We also improved our website with step-by-step instructions to apply for and manage benefit claims in
• The effort, known as the Integrated Claims Management System, will make it easier to manage claims, share
• We're also continuing to make progress on a new document management system that speeds up claim processing

Summary: The Budget Subcommittee on State Administration held an informational hearing on whether the Employment Development Department is ready for the next recession, with a focus on EDD Next, the department’s long-running technology modernization effort. The Legislative Analyst’s Office reviewed EDD’s major benefit programs, the history of prior modernization attempts, the current Integrated Claims Management System work, and the department’s remaining risks, including continued reliance on a COBOL-era mainframe and the challenge of adapting quickly to future federal or state policy changes during a downturn. The LAO also explained that most pandemic-era fraud was tied to temporary federal unemployment programs rather than California’s core UI system, and that the state’s UI loan repayment is not largely attributable to fraud. Members raised concerns about the cost of repeated modernization efforts, paper versus online claims, appeal overturn rates, WARN notices, and legislative oversight of the project. EDD’s panel said the department has made substantial customer-service and processing improvements, including online self-service tools, improved call center features, identity verification, fraud controls, language access upgrades, and a new document management system. Officials reported that as of early 2026, about 83% to 85% of claims across programs were being processed timely within two weeks, and said paid family leave delays in 2024 were tied to the transition into the disability insurance online platform and seasonal workload patterns. They also said EDD is working with the Department of Technology on EDD Next and that the project will proceed in phases, with paid family leave and disability insurance first and unemployment insurance later. Members pressed EDD on persistent paid family leave backlogs, the share of paper applications, response times for constituents, and whether the department tracks long-running cases and WARN notice trends. EDD said its service standard is generally immediate response through phone, chat, or callback tools, while more complex cases can take longer because the department may be waiting on claimants or medical providers. The department also said it tracks call outcomes and outstanding cases, and that it can provide additional data on WARN notices. No votes were taken, and the hearing ended with plans to continue discussing EDD Next and paid family leave at a later March 10 budget hearing.

Transcript Highlights:

• So that's the claim payments.
• Risk Management Division, Transportation, Facilities Management for the five different divisions.
• The number of claims shows how the claims have increased over the years in a 10-year period from FY13
• What's the artwork claims? Are we losing art? What happened? We have... ...27 artwork claims.
• I wonder what those claims are. You get the dollar amounts for the claims on the Rail Runner. Mr.

Transcript Highlights:

• I'd argue that much of the managing of care of the managed care organizations is managing their claims
• I'd argue that much of the managing of care of the managed care organizations is managing their claims
• A lot of what they say is managing care when I say it's managing their claims.
• </c> managing their claims. managing their claims.
• And we they're managing the claims.

Keywords: 918, senate, all

Summary: The interview focused on Senate File 3612, which the senator described as “patient-centered care” legislation for Minnesota’s Medicaid and MinnesotaCare programs. He said the bill would remove private insurers and HMOs from administering those public programs, replace them with a state contract for claims processing and administrative services, and shift care coordination directly to primary care clinics, counties, and nonprofits. He argued the current managed-care system creates churn, prior-authorization barriers, and fragmented care, and said providers should manage care rather than insurers. The senator repeatedly cited Connecticut as a model, saying that state moved away from managed care, improved primary care participation, and saved money. He also argued Minnesota’s current system lacks transparency and may be overpaying health plans, pointing to fraud concerns and a past example in which UCare returned money to the state after an overpayment. He said the bill would improve accountability, make fraud easier to detect, and could save taxpayers billions, though he emphasized his main goal was better care rather than savings. On support and prospects, he said the bill has backing from the governor and the American Cancer Society but currently only DFL co-authors. He said he does not expect it to become law this year because the fiscal note and details are still pending, and he does not expect insurance companies to support it. He added that he is open to discussion but sees the insurers as fundamentally opposed. The interview ended with him saying workers in insurance and claims processing should be treated fairly and offered retraining or dislocated-worker support if broader reforms reduce their roles.

Transcript Highlights:

• to evaluation of claims.
• to evaluation of claims.
• to encourage claims that might not otherwise be filed.
• So it's very managed.
• Members, vote your machines. 22 claims.

Bills: HR91 , HR92 , HR93 , HCR44 , HR84 , HR85 , HR86 , HR87 , HR88 , HR89 , HR90 , HCR42 , HCR43 , SCR21 , HB483 , HB484 , HB893 , HB1087 , HB1088 , HB1089 , HB1090 , HB1091 , HB1092 , HB1093 , HB1094 , HB1095 , HB1096 , HB1097 , HB1098 , HB1099 , HB1100 , HB1101 , HB1102 , HB1103 , HB1104 , HB1105 , HB1106 , HB1107 , HB1108 , HB1109 , HB1110 , HB1111 , HB1112 , HB1113 , HB1114 , HB1116 , HB1117 , HB1118 , HB1119 , HB1120 , HB1121 , HB1122 , HB1123 , HB1124 , HB1125 , HB1126 , HB1127 , HB1128 , HB1129 , HB1130 , HB1131 , HB1132 , HB1133 , HB1134 , HB1135 , HB1136 , HB1137 , HB1138 , HB1139 , HB1140 , HB1141 , HB1142 , HB1143 , HB1144 , HB1145 , HB1146 , HB1147 , HB1148 , HB1149 , HB1150 , HB1151 , HB1152 , HB1153 , HB1154 , HB1155 , HB1156 , HB1157 , HB1158 , HB1159 , HB1160 , HB1161 , HB1162 , HB1163 , HB1164 , HB1165 , HB1166 , HB1167 , HB1168 , HB1169 , HB1170 , HB1171 , HB1172 , HB1173 , HB1174 , HB1175 , HB1176 , HB1177 , HB1178 , HB1179 , HB1180 , HB1181 , HB1182 , HB1183 , HB1184 , HB1185 , HB1186 , HB1187 , HB1188 , HB1189 , HB1190 , HB1191 , HB1192 , HB1193 , HB1194 , HB1195 , HB1196 , HB1197 , HB1198 , HB1199 , HB1200 , HB1201 , HB1202 , HB1203 , HB1204 , HB1205 , HB1206 , HB1207 , HB1208 , HB1209 , HB1210 , HB1211 , HB1212 , HB1213 , HB1214 , HB1215 , HB1216 , HB1217 , HB1218 , HB1219 , HB1220 , HB1221 , HB1222 , HB1223 , HB1224 , HB1225 , HB1226 , HB1227 , HB1228 , HB1229 , HB1230 , HB1231 , SB1 , SB54 , SB82 , SB87 , SB92 , SB93 , SB99 , SB104 , SB113 , SB114 , SB115 , SB123 , SB129 , SB133 , SB161 , SB162 , SB224 , SB236 , SB275 , SB280 , SB289 , SB305 , SB310 , SB325 , SB330 , SB339 , SB350 , SB359 , SB382 , SB410 , SB412 , HCR10 , HB54 , HB55 , HB67 , HB73 , HB125 , HB133 , HB158 , HB168 , HB169 , HB191 , HB195 , HB205 , HB225 , HB245 , HB280 , HB283 , HB296 , HB319 , HB325 , HB339 , HB399 , HB407 , HB448 , HB482 , HB550 , HB591 , HB821 , HB826 , HB992 , HB995 , HB1085 , HB1086 , HR15 , HR20 , HCR14 , HCR6 , HCR19 , HB861 , HB889 , HB904 , HB907 , HB908 , HB929 , HB1009 , HB13 , HB23 , HB25 , HB32 , HB41 , HB90 , HB120 , HB121 , HB122 , HB127 , HB138 , HB139 , HB141 , HB179 , HB187 , HB213 , HB247 , HB286 , HB332 , HB344 , HB357 , HB367 , HB370 , HB462 , HB505 , HB527 , HB537 , HB605 , HB680 , HB681 , HB725 , HB780 , HB782 , HB847 , HB892 , HB911 , HB916 , HB1012 , HB81 , HB134 , HB154 , HB163 , HB170 , HB194 , HB217 , HB220 , HB254 , HB259 , HB290 , HB308 , HB311 , HB360 , HB382 , HB401 , HB410 , HB417 , HB463 , HB575 , HB592 , HB718 , HB723 , HB750 , HB755 , HB776 , HB812 , HB844 , HB882 , HB888 , HB961 , HB966 , HB980 , HB228 , HB289 , HB735 , HB796 , HB284 , HB301 , HB722 , HB468 , HB546 , HB746 , HB842 , HB923 , HB46 , HB166 , HB349 , HB352 , HB436 , HB588 , HB140 , HB429 , HB827 , HB953 , HB901 , HB9 , HB52 , HB58 , HB193 , HB400 , HB570 , HB577 , HB582 , HB733 , HB747 , HB868 , HB952

Keywords: Tulane University, education, research, economic impact, healthcare, Louisiana, condolences, memorial, community service, faith, legacy, centenarian, tribute, honor, longevity, philanthropy, youth leadership, fundraising, nonprofits, physical therapy

Summary: The House convened with a quorum, opened with prayer and the pledge, and then spent much of the day on personal privileges and resolutions recognizing groups and individuals. Members honored Physical Therapy Day at the Capitol, Tulane Day at the Capitol, and Landscape Architecture Month/Day, and also recognized the Liftoff Louisiana team for its work on an FAA advanced air mobility pilot program. The chamber also observed a moment of silence for former Representative Gene Durgey and adopted several condolence resolutions. The House then took up a long series of introductions and committee reports on bills, with many measures referred to committees and several resolutions adopted without objection. Among the more notable floor actions, the House adopted resolutions for Tulane University, physical therapy, landscape architecture, and the Liftoff Louisiana team, while other resolutions expressing condolences or commending individuals were either adopted or laid over. The chamber also received a large number of House and Senate bills on second reading for referral, covering topics such as education, health care, insurance, transportation, criminal justice, natural resources, taxation, and government administration. During floor consideration of bills, the House passed a number of measures, including a government clean-up bill removing inactive boards and commissions, an oyster tagging measure for alternative cultivation, a naloxone immunity bill, and a Secretary of State fee bill that drew some opposition but passed. Other bills approved included legislation on auto glass insurance practices, reckless driving at speeds over 100 mph, retirement system changes and cost-of-living adjustments, and several local crime prevention or improvement district measures. Some bills were amended or temporarily returned to the calendar for correction, including a firefighter retirement board governance bill, while most final passages were accompanied by motions to table reconsideration and, in some cases, requests for co-authors.

Transcript Highlights:

• I also talked about bringing on an external claims vendor to help... ...bringing on an external claims
• vendor to help process claims.
• Moving on to work on claims from January, February, March of 2024.
• the different portals that they have to submit claims through.
• Core operational metrics are needed to manage health plans.

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:

• The second, RAIL 025, authorizes the Department of Labor and Industries to hire more claims managers
• This amendment is to allow L&I to hire additional claims managers.
• managers shouldn't have more than 141 claims each.
• This amendment would also ask that those claims managers, as we increase the number of claims managers
• and other independent sources to say that they should have a more manageable claim load.

Summary: The Labor and Workplace Standards Committee met to consider four bills, though House Bill 2563 was removed from consideration before action. HB 2188 would require L&I to publish more information about workers’ compensation premium rates and actuarial rate-setting. Members described it as a transparency measure, and it passed the committee 8-0 with one excused. The committee then took up HB 2218, dealing with access to medical care in the workers’ compensation system. The proposed substitute made several changes to provider-network rules, rural access standards, utilization review timelines, and continued treatment after claim closure. Representative Schmidt’s amendment to add more claims managers was adopted, while earlier amendments on inducement and treatment language were withdrawn. The substitute bill passed 6-2 with one excused, with supporters emphasizing rural access and faster care, and opponents raising concerns about the fiscal note and some inducement-related language. HB 2524 would create a State Security Guards Industry Standards Board to set minimum employment standards for security guards and allow enforcement by L&I and, in the original bill, a private right of action. Amendment 236, making technical changes and delaying the board’s first meeting, was adopted, while Amendment 237 to remove the private right of action failed. The amended substitute passed 5-3 with one excused. Supporters said it would improve training, stability, and worker protections, while opponents cited cost concerns and argued it could interfere with existing compensation and bargaining arrangements.

Transcript Highlights:

• Bringing on an external claims vendor to help process claims was an important piece to help us get through
• the backlog of claims, and so that took a little bit of time.
• Resubmitted and then the claims are getting paid, right?
• Core operational metrics are needed to manage health plans.
• Core operational metrics are needed to manage health plans.

Committee: Senate Health and Human Services

Keywords: 1182, all

Transcript Highlights:

• Managers from DCS told us they sometimes find out about unreported insurance claims through other channels
• With the average claim bringing in around $7,300 toward past due child support, each additional claim
• Managers from DCS told us they sometimes find out about unreported insurance claims through other channels
• With the average claim bringing in around $7,300 towards past due child support, each additional claim
• and then audit a sample of claims to make sure all eligible claims were reported as required.

Committee: Joint JLARC I-900 Subcommittee for SAO Performance Audits

Summary: At the June 4, 2025 JLARC I-900 Subcommittee hearing, the State Auditor’s Office presented a performance audit on Washington’s child support insurance intercept law. The audit reviewed the mandatory reporting system for insurance claims tied to past-due child support, noting that collections increased after the law took effect in 2022, but that some eligible claims still are not being reported. Auditors said DCS learns about roughly 1 in 10 claims through other channels, and that insurers may miss reporting because they are unaware of the law, make administrative errors, or misunderstand the $500 threshold and timing requirements. The audit recommended that the Office of the Insurance Commissioner help educate insurers by adding information to its website and sharing insurer contact contacts with DCS, and also recommended that the Legislature amend the law to create monitoring and enforcement authority. The auditor said neither DCS nor OIC currently has authority to monitor compliance or take action against noncompliant insurers, though other states use insurance regulators or market conduct exams for this purpose. Committee members asked about possible coordinated enforcement between DSHS and OIC, which the auditor said was beyond the scope of the audit but could be considered by the Legislature. An OIC representative said the commissioner is willing to help educate insurers, post information on the OIC website, and share contact information with DSHS, and that the agency is open to further discussion. No public testimony was offered, and no votes or formal committee actions were taken at the hearing.

Transcript Highlights:

• Okay, this is the Sedgwick claims management service.
• This is our claims manager, kind of the third-party administrator on the property insurance side.
• , managing the... ...the important part of having the consistency in who's starting the claim, managing
• We had a good year, knock on wood, but... ...managing the claims.
• All right, seeing no other business before us, we're adjourned. ...managing the claims.

Committee: All ALC-STATE INSURANCE PROGRAMS OVERSIGHT SUBCOMMITTEE

Summary: The State Insurance Programs Oversight Subcommittee met on June 17 and reviewed a series of Employee Benefits Division and Office of Property Risk items. The committee approved formulary changes for March and April that favored lower-cost generics, removed some new-to-market drugs from coverage pending more evidence, and made maintenance changes to migraine and diabetes medications. Members also approved a cell and gene therapy policy that would route those therapies through prior authorization rather than automatic coverage; officials said the process should not delay urgent cases and that no current members would be affected. The committee then reviewed a UAMS pharmacy benefit consultant contract amendment, but after extended discussion about the written scope and dollar amounts, the motion was approved with the understanding that any use of optional services would return to the committee for further review. The committee also reviewed the U.S. Able Mutual/Blue Advantage third-party administration contract and the CompSack employee assistance program contract, which officials said would reduce per-member costs and add services. The subcommittee approved proposed 2027 rates for state employees and public employees, with a 9.8% increase for state employees and a 4.9% increase for public school employees. Officials also reported that the UnitedHealthcare rebid was in its final negotiation stage and would return in August, with medical and pharmacy coverage split as previously recommended. In response to questions, the director said the division was considering broader preventive-care offerings, including weight-loss drug coverage, but would proceed cautiously and with strong utilization controls and holistic support if such a program were adopted. On the property risk side, the committee reviewed permanent rules making prior temporary rules permanent, a contingency-fee subrogation contract, and renewals for claims management, actuarial services, and investment management. Members raised concerns about Sedgwick’s claim-adjustment timeliness and communication with school districts after severe weather events; officials said performance guarantees and communication expectations had been strengthened, but the renewal was kept at three years for continuity. Finally, the committee approved 2026-27 captive insurance program rates, which included no change to minimum deductibles, a 10% overall rate reduction, and bucketed rate changes by entity type. Officials said the captive program was working as intended, with improved actuarial support and claims experience, and the meeting adjourned after the approvals.

Transcript Highlights:

• They look at the pending claims, the severity of those claims, and essentially make a prediction of what
• They look at the pending claims, the severity of those claims, and essentially make a prediction of what
• and in the cost of those claims.
• But just by definition, all these claims are old claims.
• And there are a lot of old claims.

Summary: The Ways and Means Committee held a work session covering the state revenue outlook, caseload forecasts, wildfire costs, budget balance, tort liability, water supply, and pension policy. The Economic and Revenue Forecast Council reported modest near-term U.S. growth, no near-term Washington employment growth in 2026, continued personal income growth, and elevated inflation, with tariffs and federal policy cited as major risks. Revenue forecasts were slightly improved for the current biennium by about $105 million but down about $185 million for the next biennium. Members asked about income inequality and housing permits; staff said personal income is an aggregate measure and housing production remains below long-term needs. The Caseload Forecast Council then reported that most forecasts were unchanged or only slightly changed, but several programs increased, including Washington College Grant, Working Connections, aged/blind/disabled cash grants, nursing homes, home and community services, and developmental disabilities personal care. The largest policy-driven change was in Medicaid low-income adult caseloads, where federal H.R. 1 was projected to reduce coverage substantially through narrower eligibility, community engagement requirements, and shorter eligibility periods. The committee also heard a wildfire funding update and a 2025 fire season review. Staff explained that the state budgets $93 million annually for suppression and uses supplemental appropriations for costs above that level, with an estimated state supplemental need of about $139 million for the current year. Department of Natural Resources officials said 2025 fire activity remained below the 10-year average in acres burned, but fires were more complex and closer to communities, contributing to higher residence loss. They described expanded use of aircraft, firefighters from other states, corrections crews, and the Arcadia 20 hand crew, and said the state did not need National Guard ground support this year. A budget preview then showed that the near general fund outlook had worsened after vetoes, lapses, and forecast changes, and that maintenance-level costs alone would leave a projected negative balance by fiscal year 2027 and about $4.3 billion by fiscal year 2029, before any policy decisions. Jason Seams, the state risk manager, reported a sharp rise in tort claim costs, with indemnity expenses nearly doubling from fiscal year 2023 to 2025 and DCYF accounting for most of the increase. He said the state self-insurance liability account has run deficits for four straight biennia and is now facing nearly $600 million in deficits, driven largely by a surge in DCYF claims, especially juvenile rehabilitation and long-running sex abuse cases. Members asked about the role of old claims, comparisons with other states, excess insurance, and whether more Attorney General staff could reduce special assistant attorney general costs. The committee then shifted to water policy, hearing from tribal leaders, Ecology, and the Washington Water Trust. Tribal witnesses emphasized overappropriation, declining flows, climate impacts, and the need for legislative oversight and tribal participation in water policy. Ecology described major projects in the Odessa sub-area, Yakima Basin, and Dungeness, along with the need for storage, recharge, conservation, and policy changes to support water supply development. The Washington Water Trust argued that climate change is reducing summer flows and that the state needs more funding, enforcement, and long-term commitment to restore instream flows. The final item was a pension update on LEOFF 1 surplus assets; staff reviewed two 2025 bills that would have merged or restructured the plan and used surplus assets, but neither passed, and instead the budget directed the Select Committee on Pension Policy to study the issue and report back.

Transcript Highlights:

• The one outstanding item is also the most challenging and most costly: the Integrated Claims Management
• I'll talk about the three most complex projects first, so our Integrated Claims Management System, which
• At the same time, we were doing market research for the Integrated Claims Management System as well.
• At the same time, we were doing market research for the Integrated Claims Management System as well.
• The claim that this proposal merely manages a workload or returns the program to its original intent

Keywords: 987, senate, all

Transcript Highlights:

• Claims volume is expected to grow quickly. Currently, 10 LEAs are able to submit claims.
• They shared at that webinar that seven LEAs have filed claims, 18 claims, two of those claims came from
• And really, that's a matter of the providers submitting 837P claims and EDI claims.
• This is for all 26 managed care plans, three dental managed care plans, 57 county mental health plans
• Health care coverage and claim reimbursement require health plans to reimburse claims no later than 30

Keywords: 988, house, all

Transcript Highlights:

• </c> 80% of NEMT spending is in managed care. 80% of NEMT spending is in managed care.
• Claims Act.
• </c> under the False Claims Act. under the False Claims Act.
• and uh, and claim scrutiny.
• </c> claims in on a quarterly basis? claims in on a quarterly basis?

Committee: House Fraud Prevention and State Agency Oversight Policy

Keywords: 1183, house

Transcript Highlights:

• And those are estimated claims.
• I mean, the same claims exist, but the value of those claims has gone up exponentially.
• Right now, we assign claims and assign values to each of our claims.
• for each claim, both what has actually gone out the door and what we value the claim to be.
• In CYFD, any claim, we have 2,600 claims, totally an estimated claim right now of $400 million.

Summary: The committee first heard Senate Bill 246, which would require licensure and inspections for massage therapy establishments. The sponsor and Regulation and Licensing Department said the bill is intended to close a gap in oversight, improve sanitation and public safety, and help address human trafficking and prostitution concerns. Supporters from the massage therapy profession and industry groups said establishment licensing would create accountability and protect legitimate practitioners, while AMTA took a neutral position but supported the rulemaking process. Several senators raised concerns about privacy, home-based businesses, and whether mobile or traveling therapists would be affected; the department said the bill would apply to establishments, not individual therapists, and that home inspections would be governed by rules. The committee voted 8-0 to give SB 246 a do pass recommendation. The committee then took up Senate Bill 300, an appropriation for CYFD computer hardware and software to improve compatibility with the national child welfare management system. The sponsor said the goal was to reduce delays and improve data sharing, especially in child welfare and ICWA-related cases. Members asked about the current system and how the funding would help, and the sponsor said the bill was aimed at better interoperability. The committee voted 8-0 to send SB 300 forward with a do pass recommendation. Finally, the committee considered Senate Bill 146, which would amend the New Mexico Civil Rights Act. The bill and committee substitute would align the legal standard more closely with federal deliberate indifference language, reduce damages caps, shorten the statute of limitations, require 90 days’ notice, and bar double recovery under both the Civil Rights Act and Tort Claims Act. Supporters, including county and city representatives, law enforcement, AFSCME, and risk management officials, argued the changes were needed to control rapidly rising claims costs and protect public budgets. Opponents from the ACLU, civil rights, poverty, immigrant, and LGBTQ advocacy groups said the bill would weaken accountability, reintroduce qualified immunity-like protections, and make it harder for people harmed by government actors to seek justice. After a failed motion to table and a 5-5 vote on the committee substitute, the bill remained in committee and did not advance.

Transcript Highlights:

• Okay, this is the Sedgwick claims management service.
• This is our claims manager, kind of the third-party administrator on the property insurance side.
• consistency in who's starting the claim, managing the... ...the important part of having the consistency
• in who's starting the claim, managing the claim, and ending the claim is important for the integrity
• the claims.

Committee: All ALC-STATE INSURANCE PROGRAMS OVERSIGHT SUBCOMMITTEE

Keywords: 1204, all

Transcript Highlights:

• Now claims, we last year received 16,384 claims in total.
• Not all those claims have cost associated with them. Some of them are report-only claims.
• To close out Hurricane Ian claims and Hurricane Adalia claims, which are all now closed.
• Hurricane E.N. claims and Hurricane Adalia claims, which are all now closed.
• We're going to send claims, claim forms. We're going to send claims forms to the claimants.

Summary: The subcommittee heard presentations from the Department of Financial Services and the Department of Business and Professional Regulation, then returned to its ongoing budget workshop with the Department of Management Services. DFS’s Division of Risk Management described its role as the state self-insurance fund, covering about 200,000 employees and 27,000 vehicles, paying roughly $150 million in claims last year, and managing a pilot ETS treatment program for veterans and first responders that had 49 patients and 804 treatments as of the latest report. The Division of State Fire Marshal outlined its fire prevention, training, emergency response, and grant programs, including hurricane deployments, the Florida State Fire College, and several capital and grant requests for roof, courtyard, memorial, and equipment needs. The Division of Rehabilitation and Liquidation explained how it handles insolvent insurers under Chapter 631, currently administering 14 estates with $1.2 billion in assets and $3.7 billion in liabilities, and said no new receiverships had been opened since February 2023. Members asked about grant backlogs, fire truck procurement delays, memorial repairs, and whether affiliate transfers were occurring in insurer liquidations. Secretary Griffin then updated the committee on DBPR’s implementation of House Bill 1021 on community associations. He said the department had used the new authority to expand education, complaint handling, and ombudsman services, including 10 free standardized courses, a new condo website, and a four-hour board certification course that had already drawn more than 12,000 attendees. He reported that outreach to condominium communities had increased by more than 60%, that complaint filings were up 39% while jurisdictional dismissals dropped to 11%, and that about 81% to 82% of the 65 new positions had been filled. Members pressed him on whether the department had enough authority and funding, how condominium counts are determined, how self-reported structural integrity reserve study data is verified, and whether more public-facing complaint tracking and better reporting from local governments or developers would improve the system. The committee then resumed questioning Secretary Allende of DMS about outstanding budget and operations issues. Members focused on the delayed People First contract extension required by statute, with the secretary saying the delay involved technical and contractual complexity in moving a legacy hard-coded system to the cloud. They also revisited the state data team and data catalog project, asking why a statutory 2022 deadline had not been met, how the four-person team and broader data staff were organized, how many applicants were considered for key positions, and what each role was doing. The secretary said the catalog work was being simplified into six metadata fields and supported by a broader community of practice, but no firm completion date was given during the exchange.