Transcript Highlights:

• And it depends on the relationship between the health plan and the pharmacy and the PBM, but the PBM
• So it highlights the big PBM. Fact sheet.
• And that's where the insurance companies make their money is the PBM.
• It used to be, many years ago, when PBMs—my understanding of the history of it—PBMs used to be big consolidators
• Through the PBM and then the insurance company.

Keywords: 1184, house, all

Transcript Highlights:

• I'm going to use a bad word, okay, but we have a PBM. Okay, um, I know, sorry, Senator Butler.
• I know we do use a PBM, and the main...
• We use a PBM, but we also spend a lot of time trying to manage the PBM as well.
• That is our PBM. PBM. They shouldn't be telling us; we should be telling them. I mean, that's...
• Understand the concerns about the PBMs, and that's why we have such tight processes.

Keywords: 923, senate, all

Transcript Highlights:

• the PBM?
• three big PBMs are also losing out. Yes. three big PBMs are also losing out. Yes.
• do with negotiating with uh PBMs. do with negotiating with uh PBMs.
• This is not regulating PBMs.
• This is not regulating PBMs. This law. This is not regulating PBMs.

Keywords: 928, house, all

Summary: The committee first heard Senate Bill 47, sponsored by Sen. Regina Birdsell at the request of the Insurance Department. The bill would codify the department’s interpretation that a birth mother’s health insurance is the primary coverage for a newborn, unless the mother has no insurance or coverage under an employer-sponsored plan. Birdsell and Insurance Commissioner DJ Benton Court said the measure is a clarification of existing practice and intended to protect vulnerable newborns; a question from Rep. Miles clarified that if a young woman is on her parents’ policy, the newborn would generally be covered under that family coverage. The hearing on SB 47 was then closed. The committee then took up Senate Bill 121, introduced by Grant Bosi for Sen. Kevin Avard, which would require insurers to notify the Insurance Department when they stop writing an entire line of business or, in some cases, Medicare Advantage plans. Commissioner Benton Court said the bill arose from disruption in the Medicare Advantage market, where consumers, brokers, and the department were confused by carriers changing or ending offerings; he said the department wanted a simple notification requirement so it could better advise consumers. Members discussed network adequacy, county-based service areas, and the fact that the bill would make notice a condition of licensure, with possible fines or license action for noncompliance. Witness Paula Rogers of AHIP said her group supported the bill if amended, and the department indicated it would support a change from a 120-day notice period to 90 days to align with state rules; the committee planned to work on an amendment in subcommittee. Finally, the committee heard Senate Bill 247, introduced by Rep. Brian Cole, which would prohibit network exclusion of pharmacies that refuse to dispense prescriptions when PBM reimbursement is below acquisition cost. Cole argued the bill is meant to stop pharmacies from being forced to sell drugs at a loss, describing PBMs as middlemen and saying the measure is a compromise that protects local pharmacies. Members questioned whether consumers would pay more and whether pharmacies voluntarily enter PBM contracts; Cole responded that the bill would let pharmacies refuse unprofitable fills while consumers could still obtain the drug through mail order or other channels. He also said the issue has changed over time because the practice now affects a much larger share of generics and is concentrated among a few PBMs. The hearing remained open as questions continued, with no vote taken in the excerpt.

Transcript Highlights:

• This initiative would require PBMs to report data to gain a better understanding of costs.
• What we don't have is the specifics about the PBMs themselves.
• The current PBM registration requirement would sunset, and PBMs would be required to obtain a license
• It would give us the authority to audit licensed PBMs to ensure compliance with the law.
• licensure of PBMs and HCAI's work related to the data reporting.

Summary: The Assembly Budget Subcommittee on Health held an informational hearing on the Governor’s May Revision, focusing first on the Commission on Behavioral Health, then EMSA, and then the California Department of Public Health (CDPH). The Department of Finance said the state faces a third consecutive deficit and that the May Revision includes difficult trade-offs, including proposed eliminations or reversions of some behavioral health and public health funds. The LAO echoed concern about the structural deficit and said it was still awaiting some budget details before offering a full analysis. For the Commission on Behavioral Health, Finance proposed eliminating $20 million in Mental Health Wellness Act funds, arguing the money would help offset General Fund costs and noting future Proposition 1 innovation funding. The commission strongly opposed the cut, saying it would eliminate or delay launch-ready grants for early childhood supports, full-service partnerships, and peer respite, and would eventually end ongoing grant programming. Several advocates and commissioners testified that the funds support underserved communities and that Proposition 1 is not a substitute for the existing programs. The chair asked Finance to look for alternatives, but no vote was taken. EMSA presented mostly technical budget adjustments: increased authority for the California Poison Control System, a correction to EMSIS funding, and a reappropriation for enterprise services and data management. CDPH then reviewed a broader set of May Revision proposals, including reversions from the California Reducing Disparities Project, workforce development, STD prevention, hepatitis C prevention, hospice, and extreme heat funding, as well as a new generative AI pilot for health facility survey reporting. Members raised concerns about cuts to CRDP and gender health equity programs, especially because many grants are mid-contract and serve underserved communities; CDPH said the reversions were part of solving the deficit and that CRDP had been successful, while also clarifying that abortion.ca.gov would not be eliminated. Public comment was overwhelmingly opposed to the CRDP and related cuts, with many speakers describing the programs as life-saving and cost-effective. No formal votes or actions were taken during the hearing.

Transcript Highlights:

• I would just say Walgreens is an unaffiliated pharmacy, meaning that it doesn't own or operate a PBM.
• also really take a minute to emphasize the importance of looking into pharmacy benefit managers, or PBMs
• PBMs have been an issue for a very long time, and this is a great start to improve accessibility and
• PBMs have been an issue for a very long time, and this is a great start to improve accessibility and
• PBMs have been an issue for a very long time, and this is a great start to improve accessibility and

Keywords: 912, senate, all

Summary: The joint hearing began with SB 59 on prescription drugs, which drew extensive testimony from insurers, pharmacies, patient advocates, and health organizations. Supporters argued the bill would address PBM practices such as spread pricing, unclear reimbursement, and patient steering, and would help independent pharmacies and lower patient costs by passing rebates through to consumers. Opponents from health plans and PBM-related groups raised concerns, while Walgreens supported the measure and suggested amendments to establish a reimbursement floor. After questions, the committee accepted the Hawaii Pharmacist Association’s proposed amendments, added technical changes and a defective date of December 31, 2050, and voted to pass SB 59 with amendments. The remainder of the hearing focused on a series of nominations and reappointments to health, aging, disability, mental health, juvenile justice, and advisory boards. Nominees and agency representatives generally described their backgrounds and interest in serving, with support testimony emphasizing experience, continuity, and the value of volunteer service. Several nominees highlighted issues such as mental health access, substance abuse treatment, elder services, language access, disability access, and rehabilitation services. The Department of Health, SHPDA, DHS, and other organizations largely testified in support of the nominees. No votes were taken on the nominations during the transcript excerpt, and the chair repeatedly thanked the nominees for their service and testimony. The hearing also included brief procedural remarks about time limits, Zoom testimony, and a possible reconvening date in case of technical difficulties.

Transcript Highlights:

• responsibility of where PBMs have sat in our state.
• I think the PBMs have sat in our state.
• Um he did recommend complex with PBMs.
• <00:27:10.159> I states are looking at PBM reform. I states are looking at PBM reform.
• Okay, Colorado's people looking at PBMs.

Keywords: 912, senate, all

Summary: The committee first considered a series of Governor’s Message nominations, largely to the State Council on Developmental Disabilities and one to the Hawaii Advisory Commission on Drug Abuse and Controlled Substances. Testifiers and agencies spoke in strong support of the nominees, emphasizing their advocacy, community involvement, and lived experience. The committee heard from nominees and supporters for John Paul Moses III, Cynthia Fowler, Joshua Eay, Alicia Kim, Raymond Mamea, Maria Christina Valenzuela, Eden Watabayashi, Sierra Whiteside, and Brandy Lynn Macallani Hayen. After hearing testimony, the committee voted to advise and consent on each nomination, with the votes adopted by the members present. The committee then took up SR 53 / SCR 69, which asks the Department of Health to convene a pharmacy benefit manager working group to improve transparency, fairness, and drug affordability. Supporters included the Hawaii Pharmacist Association, the University of Hawaii system, and several individuals, while the Department of Health said the issue is complex and may require additional support or a different structure. Members discussed whether the Department of Health should lead the effort or whether another entity, such as SHIPA with an appropriation, might be more workable; the Department of Health suggested a $100,000 appropriation could be sufficient. Next, SR 56 / SCR 73 proposed a report on the developmental needs of children born during the COVID-19 pandemic. The Office of Wellness and Resilience supported the measure and asked for an extended deadline to the end of 2026, and several youth, mental health, and community organizations testified in support. The committee also heard SR 69 / STR 86 on creating an aeromedical services working group, with support from Air Methods, the Department of Health, and the Hawaii Medical Association, and SR 99 / STR 118 on studying the use of filtered catchment water for business activity, which drew support from the Plumbing and Mechanical Contractors Association and comments from the Department of Health that the issue is complicated and should include the Department of Agriculture. No final votes on the resolutions were taken in the portion of the meeting provided.

Transcript Highlights:

• So, would it be a PBM plan? for uh CVS? So, would it be a PBM plan?
• , a PBM and a pharmacy.
• A PBM and a pharmacy. Now, you pharmacy. A PBM and a pharmacy.
• <05:43:24.000> There<05:43:24.160> are PBMs. They have a choice. There are PBMs.
• There are other<05:43:24.638> PBMs. other PBMs. other PBMs.

Keywords: MS House Floor - 4 February, 2026; 10:00 AM, 925, all

Summary: The House convened with prayer and the pledge, established a quorum, dispensed with reading the journal and bill introductions, and then moved through announcements recognizing visitors in the galleries, including cancer advocacy groups, Mississippi Math and Science School students, a gospel choir, Leadership Greater Jackson, and other guests. Members also made several commendations, including recognition of Elena Johnson’s softball accomplishments and a student’s appointment to West Point. On the general calendar, the House passed House Bill 1076, the SAVE Act of 2026, by a vote of 122-0. The bill is described as a consumer protection measure for veterans that prohibits pay-to-refer arrangements, tightens standards for paid claims assistance, requires written agreements and limits upfront or nonrefundable fees, and adds privacy and disclosure safeguards. The House also passed House Bill 223, designating a segment of Highway 537 as the Sergeant John Howard Tanner Memorial Highway, by 122-0. The chamber then passed House Bill 1112, which revises state aid road division laws to expand purchasing authority, increase authorized vehicles, and allow unused county road funds to be reallocated after a period of time, by 120-1. House Bill 737, with an adopted amendment, allows Medicaid providers to repay certain non-fraud overpayments in installments when immediate repayment would cause hardship and aligns the repayment timeline with federal law; it passed 116-0. The House also passed House Bill 479 on marriage and family therapy and psychology licensure changes, adopting an amendment that extends the time to verify credentials for out-of-state applicants and provides a temporary license, by 121-0. Additional bills passed included House Bill 991 on third-party registration systems for used motor vehicle parts dealers and scrap metal processors (118-0), House Bill 1072 creating voluntary portable benefits accounts for independent contractors (119-0), House Bill 1137 revising CPA licensure education and experience requirements (118-1), House Bill 571 extending the foreign-national contribution ban to ballot measures (111-1), House Bill 630 allowing certain county electors to serve as municipal poll managers in small municipalities (113-4), House Bill 858 requiring election equipment internet connectivity to be disabled on election day (116-1), House Bill 788 changing how affidavit ballots can update voter registration information, with an amendment adopted, (115-3), and House Bill 908 tying Mississippi’s mail-ballot counting rule to the outcome of pending federal litigation so state and local races would be treated the same if the current federal-race rule is struck down (the bill was under discussion at the end of the excerpt).

Transcript Highlights:

• Yet, nothing in law stops<00:42:30.079> insurers<00:42:30.640> or<00:42:30.880> PBMs
• <00:43:04.960> and Senate file 1806 would limit PBMs and Senate file 1806 would limit PBMs
• <01:03:32.240> are Uh, if the plans and the PBMs are Uh, if the plans and the PBMs are getting
• PBMs share the negotiated rebates in whole or in large part with the plan sponsors.
• Thank you for your time. provision for their PBM to retain a provision for their PBM to retain a portion

Keywords: 1187, senate, all

Transcript Highlights:

• Daniel Holland, PBM General Counsel, State Insurance Department. Thank you.
• So could you just clarify, are there five PBMs that are being audited? Is that correct?
• So could you just clarify, are there are five PBMs that are being audited? Is that correct?
• Now, PBMs have multi-million dollar contracts with the state of Arkansas, to your knowledge?
• There's been several objections throughout the process that have come from different PBMs.

Summary: The meeting opened with prayer, approval of the prior minutes, and a monthly revenue report from the Bureau of Legislative Research. The report showed gross general revenue collections up year to date and net general revenue above forecast, with the increase attributed in part to income tax growth, a fiscal-year shift, and lottery-related collections. Members asked no questions, and no action was required on the revenue report. Several subcommittee reports were then presented and adopted, including executive, administrative rules, game and fish/state police, hospital/Medicaid/developmental disability, occupational licensing, PEER, revenue, state insurance programs, and personnel. The executive report noted a waiver request for Jackson County School District construction services and an audit with no findings. The administrative rules report covered agency directives, rulemaking updates, and a few rules pulled for later consideration. The revenue subcommittee held one District 4 tire removal contract until its next meeting, while the state insurance subcommittee reviewed the EBD contract with Boston Consulting Group and approved pharmacy formulary and drug recommendations. A substantial portion of the meeting focused on the State Insurance Department’s examination of pharmacy benefit managers, especially Navitus Health Solutions. Commissioners and staff explained that Navitus objected to producing certain claims data for self-funded plans, raising an ERISA preemption argument, and that the matter was being set for an administrative hearing, likely in April. Members questioned compliance, due process, and the implications of the objection, while the department said the state initiated the examination and was continuing to seek resolution. The committee also reviewed an Arkansas Teacher Retirement System agreement, with one member noting a potential conflict and abstaining. The meeting ended after members reviewed additional reports with no further action and adjourned.

Transcript Highlights:

• Um, after we passed the PBM reform last year, um, they are taking on a huge undertaking.
• compliance and PBM enforcement.
• that position to help with um PBM uh compliance<00:02:16.400> and<00:02:16.720> PBM<00
• <00:02:18.800> And compliance and PBM uh enforcement.
• And compliance and PBM uh enforcement.

Bills: HB372, HB361, HB391, HB372, HB361, HB391

Keywords: Elmore County, rental tax, tax revenue, infrastructure funding, economic development, Ma-Chis Lower Creek Indian Tribe, tribal police, reservation security, state-recognized tribe, law enforcement authority, certified police officer, Peace Officers' Standards and Training Commission, P.O.S.T., trespass, warrantless arrest, tribal land, sovereignty, public safety, Indian tribe, reservation

Transcript Highlights:

• and also the FFS PBM?
• So currently we do have one single PBM. It's MedImpact, as you recall.
• Taking place with the single PBM contract and also the FFS PBM contract.
• What metrics does the single PBM report to DMS?
• <00:39:21.680> reports metrics um that the single PBM reports metrics um that the single PBM

Keywords: 958, all

Summary: The subcommittee met to review the Department for Medicaid Services’ program integrity work. Commissioner Lisa Lee and Program Integrity Director Jennifer Dudinsky outlined Kentucky Medicaid’s structure, funding, enrollment, and spending, including FMAP rates, the size of the Medicaid and KCHIP populations, the number of providers, and 2024 expenditures. They also described the managed care and fee-for-service populations, noting that managed care serves most members while fee-for-service is concentrated in long-term care and waiver populations. Most of the discussion focused on fraud, waste, abuse prevention, and provider oversight. The department described its provider enrollment and certification checks, revalidation requirements, site reviews, fingerprinting for some high-risk providers, and termination grounds such as false application information, Medicare actions, unreported ownership changes, and abandonment of a provider number. Members asked about nonprofit ownership reporting, MCO fraud oversight, and how the department tracks unusual CPT code utilization, especially in behavioral health. The department said it uses data analytics, audits, policy review, and collaboration with behavioral health staff to monitor those trends. Dudinsky explained the division’s four branches: provider licensing and certification, audits and compliance, recovery, and third-party liability/estate recovery. She described prepayment and postpayment audits, referrals of credible fraud allegations to the Attorney General, monthly meetings with the AG’s office, and coordination with the Office of Inspector General, CMS, HHS OIG, MCOs, and other partners. She also explained payment suspensions, stand-downs during law enforcement investigations, and recovery efforts for overpayments, provider/member fraud, and third-party liability. The department said its recovery and avoidance efforts produced more than $251 million in savings so far in 2025. No votes or formal actions beyond approving the minutes were taken.

Transcript Highlights:

• What does transparency look at at PBMs?
• law, the way that under our current PBM law, the way PBM<01:41:19.280> is<01:41:19.520> defined
• And so, they're not falling currently under the definition of a PBM.
• So if a carrier has their own PBM, they will now have to register as a PBM.
• So if a carrier has their own PBM, they will now have to register as a PBM.

Keywords: 1191, senate, all

Transcript Highlights:

• Madam Chair, may I respond to the comment about PBMs?
• First, PBMs engage in a practice called spread pricing.
• What that means is the PBM charges the health plan more than the PBM paid the pharmacy, and they pocket
• I've done a lot of research on PBMs and more broadly on...
• PBMs just suck money out of the system.

Summary: The Assembly Health Committee met on April 22 and took up a special order of bills focused largely on prior authorization and utilization management in health care. The chair framed the discussion as part of a broader legislative effort to reduce delays and barriers to care, especially in behavioral health, chronic disease management, cancer treatment, and rehabilitation services. AB 384 by Assembly Member Connolly would prohibit prior authorization for inpatient mental health or substance use emergency admissions and related physician care; supporters said it would prevent dangerous delays in crisis care, while insurers and health plans warned about fraud, abuse, and ambiguity around residential treatment facilities. The bill was moved on a due pass as amended motion and passed the committee on a party-line style vote, with Republicans largely absent or not voting. The committee then heard AB 510 by Assembly Member Addis, which would require health plans, upon request, to provide a peer reviewer of the same or similar specialty when a treating provider appeals a prior authorization denial or modification. Supporters argued that specialty-matched review would make appeals fairer and more clinically informed; opponents said the requirement was too rigid and that timelines and electronic submission rules needed changes. After discussion about the need for timely, specialty-specific review, the bill was approved on a due pass as amended motion and placed on call. AB 539 by Assembly Member Schiavo would extend prior authorization approvals to one year or the duration of the physician’s prescribed treatment for chronic conditions; supporters cited repeated denials and treatment interruptions, while opponents raised concerns about overbreadth, fraud, and the need for shorter validity periods. The bill was also passed as amended and placed on call. The committee next considered AB 669 by Assembly Member Haney, which would bar concurrent and retrospective review for the first 28 days of medically necessary substance use disorder treatment and limit prior authorization for related outpatient medications. The bill was presented with a powerful personal story from Ryan Matlock’s mother about her son’s death after an insurer cut off treatment early; supporters said the measure would keep patients in care long enough to stabilize, while opponents argued it would reduce oversight and could allow lower-quality or non-evidence-based care. The bill was moved on a due pass as amended motion and placed on call. Finally, AB 512 by Assembly Member Harabedian would shorten prior authorization response times to 24 hours for urgent requests and 48 hours for non-urgent requests; supporters said delays can worsen outcomes, while opponents warned the timelines were unrealistic and could increase administrative burdens and safety issues. The bill was approved as amended and placed on call. AB 574 by Assembly Member Mark Gonzalez was then heard; it would allow up to 12 medically necessary physical therapy sessions for a new episode of care without prior authorization, with supporters emphasizing stroke and neurological recovery and opponents warning of reduced oversight and unnecessary care. The transcript ends during testimony on AB 574, before final action is shown.

Transcript Highlights:

• Um, you know, this PBM issue is bewilderingly complex.
• Um, you know, this PBM issue is bewilderingly complex.
• Um you know this PBM of the committee.
• is to include PBMs at in that<00:21:29.280> work<00:21:29.440> group.
• <00:23:19.280> as<00:23:19.520> as we and we will include the PBMs as as we and we

Keywords: 910, house, all

Summary: The Committee on Health met on April 11, 2025, and heard testimony on a series of Senate concurrent and Senate resolution measures focused on health system oversight, workforce standards, and access to care. Topics included an auditor study on mandated insurance coverage for intravenous ketamine therapy for depression (SCR 8 SD1), a working group on prior authorization reform (STR 10 SD2), a task force on minimum professional standards for community health worker training (STR 16 SD1), a pharmacy benefit manager reform working group (SCR 69 SD1), a pharmacy reimbursement working group (STR 70 SD1), an aeromedical services working group (STR 86 SD1), a catchment-water feasibility study for business use (STR 118 SD1), an auditor study on mandatory coverage for continuous glucose monitors (STR 120 SD1), and a resolution encouraging reduced use of disposable surgical equipment and more sustainable health care practices (STR 194 SD1). Testimony was generally supportive across the measures, with several agencies and organizations noting the need to address complex health policy issues and improve access, transparency, and sustainability. For STR 16 SD1, community health worker advocates strongly supported the resolution but asked for amendments to include the Hawaii Community Health Worker Association on the task force and to require that at least half of the task force members be community health workers. For the PBM-related measures, SHPDA said it was willing to convene the work group and described the issue as complex, while the Pharmaceutical Care Management Association asked that PBMs be included in the working group. For STR 10 SD2, SHPDA supported the effort to reduce prior authorization burdens and said the process is a "black box" that needs reform; the chair later noted the administration’s commitment to the issue. For STR 86 SD1, the Department of Health supported the aeromed working group, and the chair proposed a House Draft 1 with technical changes and added representation from independent provider operators. In decision making, the committee adopted the chair’s recommendations on all measures considered. SCR 8 SD1 was passed as is. STR 10 SD2 was deferred. STR 16 SD1, STR 70 SD1, STR 118 SD1, STR 120 SD1, and STR 194 SD1 were passed as is. SCR 69 SD1 was passed with amendments, and STR 86 SD1 was passed with amendments. The meeting concluded with adjournment after all votes were taken.

Transcript Highlights:

• Right now, PBMs will keep a portion and... ...the drug manufacturer gets passed through.
• PBMs cannot create networks without them.
• I will also say there is bipartisan support in Congress to regulate PBMs.
• PBMs have their role in setting the ultimate price that consumers pay.
• And this has to do with PBMs.

Summary: The committee heard testimony on several bills, beginning with SB 41 by Senator Wiener, which would regulate pharmacy benefit managers by increasing transparency, banning patient steering and spread pricing, and requiring full pass-through of rebates. Supporters, including independent pharmacists and health advocates, said PBM practices are driving up drug costs and closing neighborhood pharmacies. Opponents from PBM and health plan groups argued the bill overlaps with recently enacted licensing and reporting requirements, would not lower consumer prices, and may be preempted by ERISA. Members discussed confidentiality issues, consumer savings, and the relationship between SB 41 and the new budget trailer bill; the author asked for an aye vote. The committee then took up SB 378, also by Senator Wiener, aimed at online marketplaces that advertise illegal intoxicating hemp and unlicensed cannabis products. Supporters from labor, public health, and the licensed cannabis industry said online sales are undermining regulated businesses and exposing children to unsafe products. Opponents from tech and hemp industry groups warned the bill is overbroad, could sweep in general-purpose platforms and lawful hemp wellness products, and raises Dormant Commerce Clause and First Amendment concerns. The author said he would narrow the bill, remove industrial hemp references, and address strict liability and standing issues; members largely focused on how to target illegal products without capturing lawful marketplaces. SB 243 by Senator Padilla addressed AI companion chatbots, with supporters including Common Sense Media and transparency advocates warning that these systems can be addictive, manipulative, and dangerous for minors and vulnerable users, citing studies and the death of a Florida teenager. The bill would require disclosures, anti-addiction design limits, self-harm protocols, audits, reporting, and a private right of action. Tech and business groups opposed the measure as overly broad and said its definitions could sweep in general-purpose AI tools; several members supported the goal but questioned the breadth of the definitions and the private right of action. Finally, SB 522 by Senator Wahab would extend just-cause eviction protections to rental units that were previously covered by the Tenant Protection Act but were destroyed in disasters and later rebuilt. Supporters, including Los Angeles city officials and tenant advocates, said the bill would help keep displaced renters housed after wildfires and other disasters. Apartment and realtor groups opposed it, arguing it would remove a key exemption needed to finance rebuilding and could discourage post-disaster reconstruction. Members expressed support for tenant protections in disaster areas, and the author asked for an aye vote.

Transcript Highlights:

• Daniel Holland, PBM General Counsel, State Insurance Department. Thank you.
• So could you just clarify, are there five PBMs that are being audited? Is that correct?
• So could you just clarify, are there are five PBMs that are being audited? Is that correct?
• Now, PBMs have multi-million dollar contracts with the state of Arkansas, to your knowledge?
• There's been several objections throughout the process that have come from different PBMs.

Summary: The committee met and opened with a prayer, then approved the prior meeting minutes and received the monthly revenue report from the Bureau of Legislative Research. The report showed gross general revenue collections up year to date and net general revenue above forecast, with the staff noting changes driven by casino gaming transfers, income tax growth, and a lottery-related collection. No action was required on the revenue report. Several subcommittee reports were then presented and adopted, including the executive committee, administrative rules, game and fish/state police, hospital/Medicaid/developmental disability, occupational licensing, PEER, revenue, state insurance programs, and personnel. Topics included a Jackson County School District cooperative purchasing waiver, rulemaking updates from several agencies, federal immigration and wildlife issues, SNAP and Medicaid waiver reimbursement rates, occupational authorization reviews, temporary appropriations and transfer requests, a tire removal contract held for later review, EBD pharmacy and medical drug recommendations, and personnel items. The PEER report also included questions to the State Broadband Director about a provider with delinquent property taxes; he said the provider would not be brought forward until the issue is resolved and that broadband grant payments are tied to performance milestones. The most extended discussion came during review of a State Insurance Department report on pharmacy benefit manager oversight. Commissioners and members questioned Navitus Health Solutions’ refusal to provide certain claims data for self-funded plans in an affiliate pricing examination. The department said the matter is being briefed and set for an administrative hearing, likely in April, and that the dispute centers on ERISA preemption and state authority to request the data. Members also asked about the status of the other PBMs under review and whether they had raised similar objections. After all reports were adopted or filed as reviewed, the meeting adjourned with no further business.

Transcript Highlights:

• The Medicaid PBM is an affiliate of Medicaid Pharmacy, where the PBM can set the rate of reimbursement
• The Medicaid PBM is an affiliate of Medicaid Pharmacy, where the PBM can set the rate of reimbursement
• I want to make sure we heard correctly that we can have a situation where a PBM owns the PBM and the
• That we can have a situation where a PBM owns the PBM and the pharmacy.
• The PBM can pay X to their pharmacy but then pay less than X to everybody The PBM can pay X to their

Summary: The Senate Committee on Health and Human Services convened to discuss interim charges regarding fraud, waste, and abuse in Texas human services, particularly focusing on Medicaid and childcare programs. The meeting highlighted the importance of preventing misuse of taxpayer funds, with testimony from various stakeholders emphasizing the need for increased oversight and accountability in these programs. Key points included the alarming rise in healthcare fraud in other states, the necessity for Texas to enhance its fraud prevention measures, and the potential financial repercussions of failing to meet federal compliance standards. Several committee members expressed concerns about the impact of fraud on vulnerable populations, particularly those relying on Medicaid services. Testimonies from experts underscored the effectiveness of Texas's Office of Inspector General (OIG) in combating fraud, yet pointed out existing vulnerabilities, such as inconsistent enforcement and the need for better data sharing among agencies. The discussion also touched on the challenges faced by hospice care providers, with a significant increase in the number of hospices in Texas raising concerns about quality and oversight. The committee heard from various witnesses, including representatives from health plans and advocacy organizations, who provided insights into the complexities of managing Medicaid and the importance of maintaining program integrity. The meeting concluded with a commitment to further explore legislative solutions to enhance oversight and ensure that resources are directed to those in genuine need.

Transcript Highlights:

• Number two, PBMs, something you and I discussed in our office.
• So I want to move to PBMs because PBMs are driving up drug prices.
• President Trump is absolutely committed to fixing the PBMs.
• But I think that we need to reform the PBMs.
• Well, it doesn't mean I would let the PBMs write their own ticket.

Transcript Highlights:

• I'm thrilled with the success of the PBM unit after years of inaction against corrupt practices from
• a number of PBMs.
• With very little effort from my office after standing up the PBM unit and diving into the misbehavior
• But PBMs are effectively robber barons. That's what they are.
• It's a PBM that's wholly owned by it.

Keywords: 914, all

Transcript Highlights:

• However, PBMs don't treat all of their in-network pharmacies the same.
• However, PBMs don't treat all of their in-network pharmacies the same.
• Local pharmacies are However, PBMs don't treat all of their in-network pharmacies the same.
• Unfortunately, the biggest obstacles we face are PBMs.
• Unfortunately, the biggest obstacles we face are PBMs.

Bills: SB1052, SB1115, SB1118, SB1120, SB1121, SB1124, SB1171, SB1172, SB1174, SB1175, SB1214, SB1233, SB1235, SB1316, SB1345, SB1372, SB1399, SB1458, SB1494, SB1496, SB1564, SB1602, SB1621, SB1628, SB1630, SB1631, SB1668, SB1672, SB1814, SB1821

Keywords: assisted living, health care, hyperbaric oxygen therapy, physician orders, informed consent, AHCCCS, remote work, state agency, employment, public health, housing, zoning, middle housing, urban development, duplexes, triplexes, fourplexes, townhomes, historic preservation, radiation protection

Summary: The committee first heard Senate Bill 1121, which would prohibit hospitals from requiring lead aprons for cardiac catheterization staff when a radiation protection system is in place, while still allowing hospitals to require aprons outside the designated safety zone or when exposure levels warrant additional protection. An amendment added flexibility for radiation safety officers to require lead or other PPE if exposures approach occupational limits and removed expedited rulemaking language. Supporters, including the sponsor and interventional cardiologists, argued the devices reduce radiation and orthopedic injuries and improve recruitment and retention; hospital groups shifted to neutral after the amendment. The committee adopted the amendment and passed SB 1121 on a 9-2 vote. The committee then considered Senate Bill 1120, which would require hospitals performing cardiac catheterization procedures to equip at least 50% of those rooms with radiation protection systems by 2027. Supporters said the systems protect clinicians from radiation and long-term injury, while opponents, including hospital and radiology groups, argued the bill was overly prescriptive, could create a captive market, and might not fit all rooms or procedures. After adopting a children’s hospital exemption amendment, the committee passed SB 1120 on a 6-6 vote, with the chair breaking the tie in favor of the bill. Senate Bill 1118, an appropriation measure tied to the radiation protection system proposal, was also advanced after brief discussion, passing 6-5. The committee then took up Senate Bill 1214, which would create guardrails for non-FDA-approved stem cell and regenerative therapies, including provider standards, informed consent, advertising limits, reporting requirements, and a private right of action for violations. Supporters described it as a patient-protection and access bill, while testimony emphasized concerns about unregulated “bad actors” and patients traveling out of state for treatment. The committee adopted an amendment removing a reference to the National Law and passed SB 1214 on a 9-3 vote. The transcript then began discussion of SB 1630, which would create a Medicaid-funded home and community-based service benefit for adults with serious mental illness, with AHCCCS taking a neutral position and estimating a significant fiscal impact.