Transcript Highlights:

• layer to this in that if you get a hospital license, the federal government, under a policy called EMTALA
• So that EMTALA, the Emergency Medical Treatment and Active Labor Act, does not allow hospital settings

Summary: The committee met at Spirit Lake Tribe and heard an extended discussion with Spirit Lake tribal leaders and program directors about government-to-government relations with the state. Chairwoman Street and others outlined a number of concerns and requests, including taxation of tribal and trust lands, state school support for non-beneficiary students, homelessness services, Indian-managed health care, gaming/e-tabs, the Feather Alert system, industrial farming near waterways, tourism and cultural issues, and the need for more consistent tribal consultation. Committee members responded that many of these issues had previously been passed along without direct action, and several members emphasized the committee’s role in education, communication, and preparing possible legislation or resolutions for the next session. Tribal representatives also offered to provide training on treaties, IHS 638, and compact services to help legislators better understand tribal jurisdiction and billing issues. A major portion of the meeting focused on Spirit Lake Fish and Wildlife concerns, especially jurisdictional “gray areas” around hunting and fishing on the reservation, recognition of tribal licenses, and the boundary of the reservation around Spirit Lake/Devils Lake. Tribal officials said they wanted a co-stewardship agreement or MOU with the state to clarify jurisdiction, improve cooperation, and address invasive species and aquatic nuisance species. Committee members discussed whether to draft legislation or a resolution directing the executive branch and state agencies to negotiate such an agreement, and they asked for further input from the North Dakota Game and Fish Department at a future meeting. The committee also discussed county involvement in land status changes and trust land issues, with Spirit Lake leaders describing a past Benson County resolution that tried to block fee-to-trust transfers and saying it was later rescinded. The committee then heard from Benson County tax equalization director Randy Thompson, who explained how the county values land and handles tax-exempt, inundated, and fee-to-trust parcels. Members asked about the impact of tax-exempt lands on county services and discussed prior legislation that helped counties with large tax-exempt bases. The committee also received a presentation from Dr. Steven Smith of Sisseton Wahpeton College, who described the college’s programs, economic impact, and funding needs, including support for non-beneficiary students and workforce training. Members asked about expanding tribal college education into correctional settings, and Smith said the idea was worth exploring through the tribal college system. Finally, HHS interim medical services director Christoph Framing presented remotely on 1115 Medicaid waivers and the IMD exclusion, explaining current state funding mechanisms for inpatient and residential behavioral health services and the bill draft directing HHS to pursue a waiver for IMD payments.

Transcript Highlights:

• As we all know, both state and federal law, via EMTALA, creates a mandate for an emergency care safety

Bills: S0158, S0314, S0618, S0684, S0838, S0990, S1000, S1082, S1452, S1494, S1500, S1568, S1706

Keywords: pet insurance, consumer protection, insurance regulation, policy disclosure, agent training, payment stablecoin, financial regulation, anti-money laundering, state oversight, digital currency, financial services, workers compensation, Florida statute, commercial insurance, insurance board, electronic signatures, vehicle titles, insurance regulations, auditing, total loss vehicles

Summary: The Banking and Insurance Committee heard and advanced a wide range of insurance, financial services, and probate bills. Early in the meeting, SB 1000 on trust fund interest for attorney trust accounts was explained as setting a floor and ceiling tied to the Wall Street Journal prime rate and was reported favorably. The committee then took up CS/SB 1082 on a statewide provider and health plan claim dispute resolution program for emergency out-of-network claims. After extensive discussion about the relationship between the state and federal No Surprises Act processes, an amendment was withdrawn due to concerns about clarity and scope, but the bill itself was supported by providers and insurers and was reported favorably. The committee also approved SB 684 on electronic signatures for total loss vehicles and vessels, CS/SB 158 on pet insurance consumer disclosures and agent education, SB 1494 expanding breast cancer screening coverage, CS/SB 314 on digital assets and stablecoin issuers, and CS/SB 1500 on uncontested probate procedures and small-estate administration. SB 618 on workers’ compensation insurance was amended to raise the consent-to-rate cap for workers’ compensation policies from 10% to 20% and then reported favorably, with supporters saying it would help keep higher-risk employers in the voluntary market. CS/SB 1568 creating a Florida Stablecoin Pilot Program was amended to remove authority for a Florida coin and limit the program to existing stablecoins, then passed. Later, the committee approved CS/SB 838 on electronic payment convenience fees for retail installment contracts, with the sponsor emphasizing that a fee-free payment option must still be offered. SB 1452, the Department of Financial Services agency bill, was amended and reported favorably; it covered My Safe Florida Home administration, insurance and licensing changes, unclaimed property updates, and other DFS-related provisions. The committee also passed SB 1706 on the My Safe Florida Condominium Pilot Program, targeting owner-occupied condominiums at or below 80% of area median income, and SB 990 on protected cell captive insurance companies, which supporters said would modernize Florida’s captive insurance laws and encourage more competition. The meeting ended with all listed bills reported favorably and the committee adjourned.

Transcript Highlights:

• when to collect the data so that we don't violate any of our federal regulatory requirements like EMTALA
• when to collect the data so that we don't violate any of our federal regulatory requirements like EMTALA
• Uh, that also allows us to..." "...our federal regulatory requirements like EMTALA, which requires that

Bills: SF0122, SJ0006, SF0121, SF0106

Keywords: medical necessity, insurance, healthcare policy, independent review, claim processing, shared parenting, family law, joint custody, child well-being, parental rights, pharmacy, collaborative care, healthcare, prescriptions, patient safety, Wyoming Pharmacy Act, welfare, Medicaid, employment, eligibility verification

Transcript Highlights:

• So as we all know, both state and federal law via EMTALA creates a mandate for an emergency care safety

Summary: The Senate Committee on Banking and Insurance met with a quorum present and heard a full agenda of bills, most of which were reported favorably. Early in the meeting, SB 1000 on trust fund interest for attorney trust accounts was explained as setting a floor and ceiling tied to the Wall Street Journal prime rate and passed without objection after supportive testimony from banking and credit union groups. The committee then took up CS/SB 1082 on a statewide provider and health plan claim dispute resolution program; the sponsor described it as a way to move emergency out-of-network payment disputes away from costly litigation and into an independent dispute resolution process modeled on the federal No Surprises Act. A proposed amendment drew significant questions from senators and concerns from the Florida Insurance Council about confusion over state versus federal eligibility and possible effects on contracted rates, and the sponsor ultimately withdrew the amendment. The underlying bill was then supported by health care and insurance stakeholders and reported favorably. SB 684 on electronic signatures for total loss vehicles and vessels also passed, with Progressive Insurance waiving in support. The committee next approved CS/SB 158 on pet insurance, which requires continuing education for agents, clearer consumer disclosures, and annual reporting to OIR; the amendment was technical and adopted. SB 1494 on breast cancer screening coverage was presented as expanding required coverage for mammograms and supplemental screenings for certain insurance products, and it passed with support from cancer and radiology groups. CS/SB 314 on digital asset issuers was amended to create a Florida framework for payment stablecoin issuers consistent with the federal GENIUS Act, allowing state-level regulation as an alternative to federal supervision, and was reported favorably. SB 1500 on uncontested probate proceedings, including higher small-estate thresholds and clearer authority for personal representatives, also passed after a banking-related amendment requiring letters of administration for safe deposit box access was adopted. Later, the committee approved CS/SB 618 on workers’ compensation insurance, which raises the consent-to-rate cap for workers’ comp policies from 10% to 20% and adjusts the Florida Workers’ Compensation Guarantee Association board membership; a carrier representative testified that the change would help keep more high-risk accounts in the voluntary market. CS/SB 1568 on a Florida Stable Coin Pilot Program was amended to remove authority for DFS to create a Florida coin, limit the pilot to existing stablecoins with at least $1 billion market capitalization, and require qualified public deposit handling; it then passed. CS/SB 838 on electronic payments for retail installment contracts clarified that convenience fees for electronic payments are permissible while preserving a fee-free option, and it was reported favorably after questions about consumer access to free payment methods. SB 1452, the Department of Financial Services agency bill, made a wide range of administrative changes affecting My Safe Florida Home, unclaimed property, licensing, bail bonds, and other DFS functions; a late-filed amendment on title insurer appointments was adopted, and the bill passed. The committee also approved SB 1706 on the My Safe Florida Condominium Pilot Program, targeting condo hardening assistance to owner-occupied units meeting income and occupancy criteria, and SB 990 on protected cell captive insurance companies, which the sponsor and industry witnesses said would modernize Florida law and promote insurance competition and economic activity. The meeting ended with all bills on the agenda reported favorably and the committee adjourning without objection.

Transcript Highlights:

• A federal investigation confirmed that the hospital had violated EMTALA laws and placed Jojo in imminent

Summary: The Senate Judiciary Committee heard three bills. SB 514, by Senator Harrell, clarified that medical quality review committees used by managing entities are treated like other medical review committees for purposes of civil liability and public records protections. The committee adopted a Harrell amendment removing the word “malpractice” from the title, heard support from the Florida Hospital Association, Florida Association of Managing Entities, and Florida Smart Justice Alliance, and then voted 11-0 to report the bill favorably. The committee then took up SB 734, by Senator Yarborough, which would repeal the current wrongful death exception that bars certain parents and adult children from recovering non-economic damages in medical negligence cases. The bill drew extensive testimony from families describing deaths they said were caused by medical negligence and from supporters including AARP and the Florida Justice Association, while opponents from the health care, insurance, and business sectors argued it would raise malpractice premiums, increase litigation, worsen physician shortages, and reduce access to care. After debate, the committee voted 9-2 to report the bill favorably. Finally, SB 538, by Senator Bradley, was presented as the state courts legislative package. It updates court operations by clarifying duty judge requirements, removing a location limit on duty hearings, repealing a cap on arbitrator compensation in court-ordered non-binding arbitration, and allowing alternative judicial authentication of oaths and acknowledgments when a court seal is unavailable. The bill received supportive waiver forms from the Florida Bar ADR section and several judges, and was reported favorably on an 11-0 vote. The committee then adjourned.

Transcript Highlights:

• I'm being told that that is covered by EMTALA. That's covered by what? EMTALA. Oh.
• EMTALA. Oh. Is there any other questions? Yes.
• EMTALA stands for the Emergency Medical Treatment and Labor Act.

Summary: The Florida Senate opened with prayer, the Pledge of Allegiance, and several recognitions, including interns, Denim Day awareness for sexual assault survivors, a resolution honoring Vietnam veterans exposed to Agent Orange, and a memorial proclamation for former Senator Karen Johnson Gendron. The chamber then moved to special-order bills, with senators also briefly discussing the session’s pace and thanking staff and colleagues for their work. The first major bill, on driving and boating offenses, was amended and passed 37-0. As amended, it increases penalties for repeat DUI/BUI manslaughter and vehicular homicide/vessel homicide offenses, and adds notice requirements and misdemeanor penalties for refusing lawful breath or urine tests. Senators also passed SB 306 on Medicaid providers 37-0, requiring Medicaid managed care plans to offer more after-hours and holiday access and ensuring more primary care appointment availability outside regular business hours. The Senate then passed a major condominium and cooperative associations bill, also 37-0, after extensive debate and multiple amendments. The measure extends deadlines for structural integrity reserve studies, adds flexibility for reserve funding and budgeting, tightens rules for managers and inspectors, limits certain requirements to buildings of three or more habitable stories, and extends the rescission period for condo purchases. Senators from both parties praised the bill’s sponsors for years of work responding to post-Surfside safety and affordability concerns. The longest and most contentious item was SB 7016/HB 1205 on constitutional amendment petition procedures. Sponsors said the bill responds to fraud and abuse in the citizen initiative process by tightening circulator rules, requiring faster submission of signed petitions, adding voter notification, increasing penalties, and shifting costs to sponsors. Opponents argued it would burden volunteers and make it harder for citizens to qualify initiatives. The chamber adopted a series of amendments, including changes to the petition-circulator threshold, volunteer protections, submission timing, invalid-signature investigation thresholds, and notice/cure provisions, while debate continued over whether the overall package would protect election integrity or suppress citizen-led amendments.

Transcript Highlights:

• I'm being told that that is covered by EMTALA. Senator Berman. That's covered by what? EMTALA. Oh.
• EMTALA. Oh. Is there any other questions? Yes.
• EMTALA stands for the Emergency Medical and Treatment Leave Act.

Summary: The Senate began with opening prayer, the Pledge of Allegiance, and several recognitions, including interns, Denim Day awareness, and a resolution honoring Vietnam veterans exposed to Agent Orange on the 50th anniversary of the fall of Saigon. The chamber also observed a moment of silence for former Senator Karen Johnson Gendron. After routine business, the Senate took up several special-order bills. The first major bill, transportation offenses involving death, increased penalties for repeat DUI/BUI manslaughter and vehicular homicide offenses. An amendment added penalties for refusal to submit to breath or urine testing and required law enforcement to notify suspects of those penalties. The bill passed 37-0. The Senate then passed SB 306 on Medicaid providers, requiring broader after-hours and holiday access to care and setting network standards for Medicaid managed care plans, also by a 37-0 vote. The chamber next considered a major condominium and cooperative associations bill responding to post-Surfside safety and financial concerns. Senators described the measure as balancing building safety with financial relief, extending reserve-study deadlines, allowing temporary reserve relief after inspections, tightening oversight of managers and inspectors, and adjusting voting, resale, and reserve rules. After extensive debate and praise from members for the bill’s sponsors and staff, the bill passed 37-0. The longest discussion centered on a constitutional amendments/petition process bill aimed at curbing fraud in citizen initiative petitions. Sponsors argued that the 2024 petition process was plagued by fraud and identity theft and proposed tighter rules for circulators, faster submission deadlines, voter notification, penalties, and limits on petition handling. Senators offered and adopted multiple amendments, including changes to petition-circulator definitions, invalid-signature thresholds, and voter notification procedures. After a substitute amendment was withdrawn, the Senate continued debating the underlying amended bill, with members split between concerns about election integrity and worries that the bill would burden volunteers and make it harder for citizen initiatives to qualify.

Transcript Highlights:

• I'm being told that is covered by EMTALA. That's covered by what? EMTALA. Yes.
• EMTALA stands for the Emergency Medical and Treatment and Labor Act.

Bills: HCR35, SJR59, SJR84, SCR30, SB127, SB317, SB324, SB457, SB506, SB511, SB529, SB547, SB584, SB619, SB636, SB646, SB659, SB715, SB732, SB735, SB771, SB784, SB800, SB801, SB904, SB1026, SB1049, SB1065, SB1181, SB1224, SB1250, SB1383, SB1467, SB1524, SB1528, SB1531, SB1568, SB1585, SB1640, SB1681, SB1754, SB1757, SB1777, SB1972, SB1980, SB2007, SB2041, SB2046, SB2050, SB2055, SB2069, SB2080, SB2119, SB2138, SB2139, SB2154, SB2201, SB2225, SB2268, SB2306, SB2308, SB2310, SB2330, SB2366, SB2375, SB2392, SB2401, SB2422, SB2480, SB2514, SB2530, SB2533, SB2543, SB2544, SB2589, SB2610, SB2615, SB2623, SB2660, SB2662, SB2693, SB2695, SB2707, SB2722, SB2742, SB2753, SB2807, SB2843, SB2844, SB2858, SB2880, SB2885, SB2891, SB2925, SB2938, SB2986, SJR3, SJR18, SB5, SB914, SB963, SB1197, SB1415, SB1437, SB1786, SB326, SB767, SB769, SB783, SB1035, SB1271, SB1619, SB1637, SB1806, SB1, SB260, HB135, HB 1109, HCR35, HCR64, SJR36, SJR50, SJR63, SJR84, SJR59, SCR12, SCR39, SCR48, SCR19, SCR30, SCR3, SB2023, SB619, SB2742, SB646, SB1026, SB2880, SB62, SB666, SB847, SB284, SB854, SB1073, SB810, SB1505, SB583, SB1502, SB507, SB1434, SB1376, SB1585, SB1772, SB2016, SB1163, SB1122, SB731, SB397, SB508, SB1436, SB287, SB261, SB1882, SB393, SB1791, SB529, SB209, SB2429, SB1999, SB511, SB2309, SB510, SB584, SB1085, SB2046, SB1975, SB2717, SB1262, SB1524, SB636, SB2056, SB884, SB517, SB1200, SB1845, SB1863, SB2681, SB2200, SB2199, SB1757, SB2050, SB2458, SB2201, SB2660, SB2662, SB1065, SB801, SB2533, SB3014, SB3013, SB758, SB1721, SB2366, SB1013, SB2797, SB2383, SB1754, SB2119, SB2448, SB1777, SB1283, SB2392, SB2076, SB2786, SB2876, SB2284, SB2225, SB1540, SB2929, SB1972, SB2540, SB2595, SB2217, SB715, SB2330, SB1383, SB500, SB1640, SB2001, SB2080, SB506, SB2514, SB2753, SB2398, SB1241, SB2927, SB2173, SB2538, SB898, SB1449, SB2529, SB1531, SB2846, SB2476, SB986, SB1181, SB2075, SB2154, SB2864, SB1359, SB2386, SB771, SB2844, SB2550, SB1351, SB1423, SB1931, SB2245, SB2589, SB2707, SB2807, SB410, SB659, SB2776, SB2693, SB2580, SB1980, SB1886, SB1234, SB739, SB456, SB127, SB1666, SB2843, SB2801, SB800, SB2055, SB784, SB2986, SB735, SB1012, SB324, SB2926, SB2938, SB2007, SB2138, SB1242, SB2615, SB1049, SB2310, SB1224, SB2972, SB1568, SB2841, SB2885, SB3016, SB2858, SB2610, SB2139, SB1856, SB2035, SB2308, SB2306, SB2041, SB1528, SB1681, SB1141, SB2401, SB2530, SB2375, SB547, SB1266, SB1373, SB1467, SB2069, SB2269, SB2480, SB2544, SB672, SB904, SB2695, SB2891, SB2422, SB2543, SB1854, SB317, SB2539, SB2532, SB2925, SB1250, SB2082, SB2203, SB457, SB2357, SB2721, SB243, SB1285, SB2568, SB1959, SB1442, SB1454, SB2520, SB2541, SB1708, SB1237, SB1844, SB1586, HB1392, HB22, SB1551, SB3039, SB2819, SB66, SB629, SB1015, SB2342, SB2903, SB2933, SB1965, SB2477, SB3029, SB2605, SB2419, SB1957, SB375, SB250, SB777, SB628, SB2523, SB2367, SB2703, SB2608, SB2778, SB3044, SB2965, SB2521, SB865, SB127, SB506, SB529, SB584, SB659, SB735, SB771, SB784, SB800, SB1049, SB1383, SB1531, SB1568, SB1681, SB1972, SB1980, SB2007, SB2041, SB2046, SB2050, SB2080, SB2225, SB2306, SB2308, SB2366, SB2392, SB2544, SB2610, SB2660, SB2662, SB2807, SB2843, SB2844, SB2885, SB2938, SB2986, SB324, SB1065, SB1754, SB2330, SB2693, SB2858, SR448, SR463, HCR35, SB324, SB619, SB646, SB1026, SB1065, SB1754, SB2330, SB2693, SB2742, SB2858, SB2880, SB3063, HJR5, HJR98, HB 109, HB 114, HB388, HB421, HB431, HB879, HB 1244, HB1399, HB1445, HB1672, HB1695, HB1734, HB1875, HB1893, HB1950, HB2152, HB2217, HB2558, HB2559, HB2775, HB2789, HB2809, HB2856, HB3012, HB3126, HB3135, HB3163, HB3229, HB3306, HB3513, HB3770, HB4134, HCR56, HCR102, SB3063, HJR5, HJR98, HB 109, HB 114, HB388, HB421, HB431, HB879, HB 1244, HB1399, HB1445, HB1672, HB1695, HB1734, HB1875, HB1893, HB1950, HB2152, HB2217, HB2558, HB2559, HB2775, HB2789, HB2809, HB2856, HB3012, HB3126, HB3135, HB3163, HB3229, HB3306, HB3513, HB3770, HB4134, HCR56, HCR102

Keywords: spaceports, tax-exempt bonds, aerospace investment, Texas space economy, Federal legislation, education funding, Texas State Technical College System, capital projects, infrastructure, higher education, tax exemption, property tax, homestead, fire damage, constitutional amendment, Birding Capital, Matagorda County, wildlife, conservation, Texas Legislature

Transcript Highlights:

• EMTALA law requires that a patient who is critically ill be accepted... ...care and EMTALA law requires

Bills: HB4138, HB4139, HB4140, HB4141, HB4142, HB4143, HB4144, HB4145, HB4146, HB4147, HB4148, HB4149, HB4150, HB4151, HB4152, HB4153, SB1831, SB1832, SB1833, SB1834, SB1835, SB1836, SB1837, SB1838, SB1839, SB1840, SB1841, SB1842, SB1843, SB1844, SB1845, SB1846

Keywords: appropriations, education funding, health care, general fund, state budget, local funding, gaming, pari-mutuel, horse racing, regulatory assessment, first-time starters, budget implementation, federal funds, government services, budget stabilization, financial reporting, capital outlay, infrastructure, veterans services, highway construction

Summary: The committee met in a special joint appropriations session to review the FY 2027 budget package, including House Bill 4138 and Senate Bill 1831, the general appropriations or “feed” bills. Staff described the budget as including a one-time transfer of state funds, a 5% lump-sum reduction to most agencies’ discretionary general-fund budgets, continued funding for the state health insurance plan and school facilities, and various one-time restorations or reversions of prior appropriations. Members spent much of the meeting clarifying how the 5% reductions would work, noting that formula and mandatory funding such as K-12 basic aid are excluded, while the governor’s executive branch would decide how to implement the cuts within agencies. The chair repeatedly emphasized that the committee was not specifying line-item cuts and that agencies would have discretion over implementation. A large portion of the discussion focused on the practical effects of the budget on universities, public safety, health care, rural programs, and fund sweeps. Arizona Board of Regents and university representatives said the proposed reductions would amount to more than $85 million statewide and could affect programs such as the Arizona Promise Program, Teachers Academy, and tuition freezes, though no specific program cuts were written into the bill. Other testimony raised concerns about fund sweeps from encumbered balances, including university research funds, housing trust funds, utility regulation funds, and ADOT-related accounts, with some members warning about possible impacts on rural infrastructure and federal matching dollars. The committee also discussed the state employee health plan, including a $228 million general-fund infusion and proposed employee premium increases over three years, as well as questions about corrections, forestry and fire management, and rural critical access hospitals. Public testimony was largely opposed to the budget. Speakers from Opportunity Arizona, the Arizona Board of Regents, health care, and local government argued that the package would reduce support for education, housing, SNAP, health care access, and rural communities while preserving tax benefits for data centers and wealthy taxpayers. A mayor from Globe described severe flood damage and asked for state help for a flood relief fund, while a motorcycle safety advocate questioned a proposed transfer from the motorcycle safety fund. Committee members debated whether the budget’s effects should be described as speculative or as likely consequences of the broad cuts, and several exchanges became contentious over comparisons to the Great Recession and references to federal tax policy. The meeting ended with continued public testimony and no final vote taken in the portion provided, though leadership had earlier said the committee planned a mass roll-call vote on all the bills at the end.

Bills: SB206, SB904, SB933, SB1436, SB1500, SB1553, SB1557, SB1567, SB1644, SB1645, SB1651, SB1794, SB1833, SB1849, SB1984

Keywords: SB206, emergency medical services, EMS, ambulance, 911 response, emergency response, essential services, federal funding, grant funding, public health, health care facility, municipality, county, ambulance service district, tribal entity, public entity, contract ambulance service, Oklahoma, 63 O.S. 2021 Section 1-2502, emergency clause

Bills: SB1465, SB2110, SB1771, SB206, SB1584, SB1386, SB1696, SB1806, SB1428, SB1390, SB1381, SB201, SB1778, SB1332, SB1836, SB1369, SB1794, SB1290, SB175, SB1379

Keywords: professional engineers, surveyors, licensure board, sunset extension, state board, occupational licensing, engineering license, surveying license, professional regulation, regulatory board, sunset review, emergency clause, Oklahoma O.S. 59, board appointments, lay member, Oklahoma Workforce Commission, workforce development, data collection, economic development, outside counsel

Transcript Highlights:

• So because of EMTALA, which really requires all patients are screened, and if you have the ability to

Summary: The subcommittee met to review Department of Human Services hospital payments in Arkansas Medicaid, with DHS Secretary Janet Mann and Deputy Secretary Misty Eubanks presenting first, followed by Arkansas Hospital Association Executive Vice President Jody Ann Tritt and a brief comment from Arkansas Children’s. DHS outlined the main hospital payment streams: fee-for-service per diem payments, upper payment limit (UPL) supplemental payments, cost settlements, and smaller payments such as graduate medical education and disproportionate share hospital funds. Members asked for plain-language explanations of cost settlements, why per diem rates vary by hospital type, and why UPL applies to private hospitals. DHS said cost settlements and UPL are mechanisms to help offset Medicaid underpayment, with SFY 2025 hospital payments totaling hundreds of millions of dollars and no general revenue used for supplemental payments beyond the state share funded through hospital assessments and related financing structures. Committee members focused heavily on whether Arkansas hospitals are adequately reimbursed and why rural hospitals struggle. Tritt explained that critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals operate under different federal and state rules, and said lower per diem rates for some facilities help with cash flow and later cost settlement adjustments. She said Arkansas hospitals are under financial strain, citing a negative patient services margin statewide and noting that Medicaid, Medicare, and commercial payers all contribute to the problem. She also said the association had just authorized a statewide survey of hospital finances and costs, which she expected would take about a year to complete. A major theme was commercial insurance reimbursement. Tritt argued Arkansas hospitals are paid far less than hospitals in neighboring states even though premiums are similar, and said administrative burdens, prior authorizations, and denials add to the problem. She said hospitals receive about 52 to 53 cents on the dollar for Medicaid costs without UPL and about 78 cents with UPL, still below cost. Members also discussed Medicare wage index issues, Medicare Advantage, and whether hospitals could use technology or alternative arrangements to improve finances. No votes were taken on the hospital presentation. At the end of the meeting, DHS provided a brief update on Living Choices and assisted living reimbursement. Officials said one assisted living facility, Pillars of the Community in Crossett, had announced closure, with nine waiver clients being transitioned to other settings. DHS said the current cost reporting period was underway and that a new rate study could be ready for review before the end of the fiscal year if reports were submitted on time. Members also asked about the broader waiver plan, and DHS said the next waiver iteration would likely be brought back to the committee in the summer.

Transcript Highlights:

• The witness continued that, because of EMTALA, hospitals must screen all patients and, if they have the

Summary: The subcommittee met to review Arkansas DHS hospital spending and reimbursement methods, with Secretary Janet Mann and Deputy Secretary Misty Eubanks explaining Medicaid hospital payments. They described fee-for-service per diem payments, cost settlements, and the upper payment limit (UPL) program, noting that SFY 2025 hospital payments included $688 million in inpatient/outpatient claims, $473 million in UPL payments, $248 million in cost settlements, and about $47 million in other payments such as graduate medical education and disproportionate share hospital funds. Members asked about why per diem rates vary, how cost settlements work, why UPL applies mainly to private hospitals, and how assessment fees are structured and funded. DHS said the hospital assessment fee is broad-based and uniform, used as the state share to draw federal funds, and that supplemental hospital payments after federal match totaled $548 million with no general revenue used. The Arkansas Hospital Association’s Jody Ann Tritt then gave a broader overview of the hospital landscape, explaining the different hospital types in the state, including critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals. She said Arkansas hospitals face financial strain, citing a negative 5.18% patient service margin statewide and lower reimbursement than surrounding states. She argued that Arkansas hospitals are paid less than hospitals in neighboring states for similar services, that commercial payer rates and administrative burdens are a major problem, and that Medicaid and Medicare rates remain below cost even with UPL support. She also said hospitals are the backbone of community care, provide emergency and public health functions, and are looking for ways to invest in technology and telehealth but often lack the revenue to do so. Members pressed for clearer data on hospital finances, reimbursement adequacy, and the impact of commercial insurers. Tritt said the association had just authorized a statewide survey to gather updated financial information from hospitals, which she said would take about a year to complete. She also explained that Medicaid pays weekly, Medicare and commercial plans can involve delays and denials, and that hospitals often spend significant resources on revenue cycle work. The discussion ended with a brief update on assisted living reimbursement: DHS said one facility, The Pillars of the Community in Crossett, had announced closure, nine Living Choices waiver clients were being transitioned, and the updated rate study would be available after cost reports are collected, likely before the end of the fiscal year. The meeting then adjourned.

Transcript Highlights:

• What I meant was that, well, first of all, I think under EMTALA, they can't say they won't treat them

Summary: The committee heard and approved several health care bills. Senate Bill 68, by Senator Harrell, would require all hospital emergency departments to be prepared to treat children by maintaining pediatric equipment, staff training, written policies, a pediatric care coordinator, and completion/public posting of the National Pediatric Readiness Assessment. Senator Harrell said the bill is intended to improve pediatric emergency care in general hospitals, and the bill was supported by the Florida College of Emergency Physicians and the Florida Chapter of the American Academy of Pediatrics. It passed favorably. The committee also approved Senate Bill 154, which corrects the Mobile Act for dentists and dental hygienists by requiring graduates of out-of-state dental schools seeking licensure by endorsement to have attended a CODA-accredited school. The bill drew support from dental and dental hygienist groups and passed favorably. Senate Bill 40, by Senator Sharif, would require Medicaid managed care networks to ensure at least half of primary care providers offer appointments outside regular business hours, including evenings and weekends, to improve access and reduce emergency room use; it also passed favorably. A lengthy discussion centered on Senate Bill 254, also by Senator Harrell, which would tighten oversight of nursing education programs, create a temporary provisional license and preceptorship for new graduates awaiting NCLEX results, require remediation for low-performing programs, add standardized admission and exit-exam requirements, and allow the Department of Health to inspect programs unannounced. Supporters said the bill would improve quality and help students gain experience, while opponents warned it could reduce the number of nursing programs and worsen shortages, especially among private schools. After debate and testimony from nursing and school representatives, the bill passed favorably, with Senator Davis voting no. The committee then received an OPPAGA presentation on interstate health care licensure compacts. OPPAGA reviewed how Florida uses licensure by endorsement, telehealth registration, and compacts for nurses, psychologists, and physicians, and explained the potential benefits and drawbacks of joining additional compacts, including portability, data sharing, and emergency staffing versus costs, administrative burdens, and possible conflicts with Florida scope-of-practice laws. No action was taken on the presentation, and the meeting adjourned after Senator Davis requested to be recorded in support of SB 68 and SB 154.

Transcript Highlights:

• to emergency and labor care under the Emergency Medical Treatment and Labor Act, better known as EMTALA
• to emergency and labor care under the Emergency Medical Treatment and Labor Act, better known as EMTALA

Keywords: U.S. House of Representatives Floor Proceedings on Monday, April 20, 2026, 1012, house, all

Transcript Highlights:

• But I just want to add that this is in stark contrast to EMTALA, which is the Emergency Medical Treatment
• This language does not supersede EMTALA, which requires any person to come into an emergency department

Keywords: 1187, senate, all

Transcript Highlights:

• So because of EMTALA, which really requires all patients are screened, and if you have the ability to

Keywords: 1204, all

Transcript Highlights:

• So we actually—there's a lot of challenges when somebody shows up to an emergency room from EMTALA and

Summary: The committee held a panel discussion focused on how Florida health care organizations are working to improve access, quality, and affordability. Panelists from Florida Community Care/Independent Living Systems, Sunshine Health, AdventHealth, UF Health, and Nemours described their approaches, including Medicaid managed care, value-based contracting, community partnerships, mobile screening units, smart-room technology, telehealth, and specialized programs for maternal health, children, and complex chronic conditions. Several speakers emphasized that managed care and coordinated care can improve outcomes while reducing unnecessary utilization and costs. Members asked about the impact of Medicare’s V28 changes, mobile cancer screening, urgent care versus emergency room billing, pediatric specialty access, complaint resolution, Black maternal mortality, provider shortages, network adequacy, and the use of AI in prior authorization. Witnesses said V28 has affected providers and revenue, UF Health’s mobile screening program is expanding beyond a few cancer types, and its urgent care model bills patients at the appropriate level rather than both urgent care and ER rates. Nemours said it reduced specialty wait times through scheduling changes, telemedicine, and registry tools, while AdventHealth described postpartum coordination and maternal heart programs to reduce maternal complications and mortality. On complaints and access problems, panelists said their organizations use patient/member advocates, care managers, call centers, and escalation processes to resolve issues, and Sunshine Health specifically discussed a transportation complaint that was addressed with its vendor and the family. Sunshine Health also said it is not using AI for prior authorization, though it is exploring responsible uses elsewhere, and Florida Community Care said it is not using AI in utilization management. In closing, panelists identified workforce shortages, provider burnout, and high-cost drugs as the biggest ongoing challenges. The meeting ended with thanks to the panel and adjournment after Representative Brackett moved to rise, without objection.

Transcript Highlights:

• So under EMTALA, our first and foremost priority is to evaluate, treat, and stabilize patients' emergency
• We have already heard reported one case of an EMTALA violation, so somebody who went to the hospital,
• ...heard reported one case of an EMTALA violation, so somebody who went to the hospital and was denied

Bills: HB216

Keywords: HB216, Texas abortion law, abortion-inducing drug, medication abortion, mifepristone, misoprostol, telemedicine, in-person exam, physician presence, out-of-state physician, reproductive healthcare, abortion regulation, Health and Safety Code, Occupations Code, consultation services, remote prescribing, pro-life, pro-choice

Summary: The Committee on Public Health met with a quorum and heard public testimony on a long agenda, with members repeatedly reminded of a two-minute limit for witnesses. Several bills were voted out favorably, including HB 2588 on cottage food, HB 1639 on cancer incidence and female firefighters, HB 2581 on a reporting form for contracted services for pregnant women, and SB 922 on electronic disclosure of certain sensitive medical information. Those measures generally passed on party-line or near-unanimous votes, while HB 216 on itemized medical statements was left pending after the committee substitute was withdrawn. The committee also left pending HB 5141, HB 4638, HB 2035, HB 4813, HB 2264, HB 4014, and HB 3829 after hearing testimony and questions. The final item introduced in the excerpt was HB 4408 on health care market transparency and corporate consolidation, but the discussion was cut off before testimony or action was completed. A major theme of the hearing was mental health diversion and access to treatment. HB 5141, by Rep. Howard, would allow Travis County to use vacated Austin State Hospital property for a local mental health jail diversion center; law enforcement, the Travis County sheriff, county judge, and urban counties group all testified in support, describing the lack of alternatives for people in crisis and the burden on jails and emergency rooms. Members asked about eligible offenses, bed capacity, and whether the facility would serve only Travis County, and the bill was left pending. HB 2264, by Rep. Schoolcraft, would create a friends-and-family form for loved ones to provide information to providers during emergency mental health treatment; NAMI and hospital groups supported it, while one neutral witness and several members raised concerns about patient control, credibility of information, and liability protections. The bill was also left pending. The committee also heard multiple psychedelic-therapy and drug-policy bills. HB 4813 would speed Texas rescheduling of Schedule I substances if the FDA reclassifies them, with testimony focused on psilocybin and MDMA and their potential use for PTSD and depression; members questioned whether the bill was too broad and how state rescheduling works, and it was left pending. HB 4014 would direct HHSC to study psychedelic therapies, building on prior state research, and witnesses said Texas should prepare regulatory and clinical infrastructure before FDA approval; it too was left pending. HB 2035 would require parents to be informed that they may seek substance-use treatment for a child even if one facility turns them away, prompted by a constituent’s account of a fatal fentanyl overdose after receiving incorrect advice; it was left pending. HB 4638 would extend and expand the Texas Pharmaceutical Initiative board and timeline, with the author saying the program is still in early implementation and needs more time, and it was left pending as well. Other bills addressed public health administration and animal welfare. HB 3829 would require a study of the animal-friendly account and its grant process for spay/neuter funding, with the author arguing that the current application and reimbursement process is too burdensome for shelters and nonprofits; no opposition was heard and the bill was left pending. HB 2581 and HB 1639 were reported favorably, while HB 216 drew discussion about enforcement of itemized medical billing and was held after the committee substitute was withdrawn. Throughout the hearing, members also discussed broader concerns about homelessness, competency restoration waitlists, jail overcrowding, and the need for more treatment options outside the criminal justice system.

Transcript Highlights:

• We believe the triage system suggested in Section 18 of the bill conflicts with EMTALA.
• Under EMTALA, hospitals are legally required to provide a medical screening exam and stabilize patients

Bills: AB568, SB90, SB133, SB147, SB229, SB233, SB240, SB245, SB280, SB378, SB393, SB417, SB434, SB494, SB495

Keywords: higher education, Nevada System of Higher Education, operational expenses, instructional expenses, public funding, education funding, teacher grants, classroom supplies, instructional support, specialized personnel, civics education, Nevada Center for Civic Engagement, funding, youth programs, civic involvement, Southern Nevada, Clark County, Las Vegas Valley, regional planning, economic resiliency