Transcript Highlights:

• We have also adopted a model for those alternative payment models (APMs).
• As a public entity, most UC medical revenues are reimbursed through self-financed payments.
• The only portion that we withheld was the Insulin Project milestone payment schedule.
• Seeing no other public comment, we'll move on to issue 5: the Health Care Payments Data Program.
• Nothing if providers cannot get reimbursed for the services they delivered.

Keywords: 988, house, all

Transcript Highlights:

• </c> reimbursement for. reimbursement for.
• Those payments totaled $2.1 million. Those payments totaled $2.1 million.
• </c> and 790 days after final payment. and 790 days after final payment.
• I will note that um there was one payment uh for a project. It was an advanced payment.
• . payment. payment.

Bills: HF3564

Committee: House Legacy Finance

Keywords: Greater Minnesota, regional parks, trails, grants, local government, 1183, house

Transcript Highlights:

• Health centers will continue providing care, but without reimbursement.
• Second, supplemental payments are not mere bonuses for rural hospitals.
• Those mechanisms are how California stabilizes Medi-Cal reimbursement.
• My quick, quick answer is payment.
• My quick, quick answer is a payment.

Keywords: 987, senate, all

Transcript Highlights:

• It's my understanding that federal reimbursements must be used for federal declared emergencies.
• The timing of our reimbursement today is unknown. We have a commitment and a promise.
• The timing of our reimbursement today is unknown. We have a commitment and a promise.
• reimbursements must be used for federal declared emergencies.
• The timing of our reimbursement today is unknown. We have a commitment and a promise.

Keywords: 999, senate, all

Transcript Highlights:

• Payments to district attorneys: 5321; $17,532,175. Payments to coroners: $62,514,617.
• Vehicle Lease Payments.
• and service payments.
• Lease purchase payment for 9 payments for Colorado State University, $17,496,631.
• Lease purchase payment for 9 payments for Colorado State University, $17,496,631.

Keywords: 981, all

Transcript Highlights:

• The fiscal note associated with this bill reflects a reduction in co-payments for families receiving
• This bill creates a separate co-payment for half-day care, aligning family co-payments with the state's
• existing reimbursement structure for providers.
• This bill creates a separate co-payment for half-day care, aligning family co-payments with the state
• existing reimbursement structure for providers.

Bills: SB219 , SB9

Committee: House Appropriations

Keywords: military pension, military retirement pay, veterans, retiree tax relief, income tax exemption, pension exclusion, Delaware income tax, retirement income, state tax subtraction, armed forces retirement, National Guard, Space Force, Coast Guard, NOAA, Public Health Service, taxable income, Title 30, Section 1106, wetlands protection, nontidal wetlands

Summary: The House Appropriations Committee met to hear several bills, with members repeatedly reminded to focus on fiscal impacts rather than policy merits. The committee first considered SB 9 on freshwater wetlands, which would combine tidal and non-tidal wetlands programs into one permitting framework; supporters said the bill resulted from a two-year consensus process and that the governor’s office and DENREC would absorb a significant share of the cost. Public testimony was largely supportive, emphasizing flood control and ecosystem services, though one speaker opposed the spending. The committee voted to release SB 9. The committee then heard SB 278 on child care assistance, which would preauthorize summer camp for eligible school-age children and create a separate lower co-payment for half-day care. The sponsor and the YMCA of Delaware said the change would better align family co-pays with provider reimbursement and make before- and after-school care more affordable for working families. The committee also released SB 278, SB 168 on alcohol delivery for package stores, SB 120 on health insurance coverage for certain testing and treatment, and HB 4, a pilot program for artificial intelligence and extended reality in schools; HB 4 was described as having a near-$3 million fiscal note and a one-year implementation delay because it was not funded in the budget. Later, the committee approved SB 219, which gradually increases the military pension income tax exclusion from $12,500 to $25,000 over three years and includes related joint-filing and residency changes. Supporters argued it would help attract and retain military retirees and bring federal dollars into the state. The committee also released SB 1, a major primary care reform bill that would increase primary care spending and implement hospital payment reforms, with projected long-term savings to the state employee health plan, and SB 325, which expands background checks and wrap-back monitoring for fire service personnel and adds an investigator position for the Fire Prevention Commission. In each case, public commenters and committee members generally supported the bills, and all were released from committee by recorded vote.

Transcript Highlights:

• So this month, I received payment for the work I did in July.
• payment to be issued by January 1, 2026.
• payment to be issued by January 1, 2026. and a one-time stabilization payment to be issued by January
• Payment then to that provider.
• We talked about family fees and slots being reimbursement.

Summary: The California State Assembly Select Committee on Child Care Costs held its first hearing to examine the state of child care access, affordability, and provider compensation. Chair Cecilia Aguiar-Curry and other members described child care as essential infrastructure for working families and the economy, noting that costs are unaffordable for many households and that providers are underpaid. Early testimony came from a San Francisco parent, Quinn Chung, who described the difficulty of finding safe care and the financial and career sacrifices caused by lack of child care, and from Tuolumne County provider Anita Viscini, who detailed her monthly costs, low margins, and the need to work weekends and teach CPR classes to make ends meet. Assemblymembers also emphasized the crisis in rural communities and the need for a long-term strategy. The first policy panel featured Jennifer Troia of the California Department of Social Services, Laura Pryor of the California Budget and Policy Center, and Alexa Frankenberg of Child Care Providers United. Troia said the state has nearly doubled child care funding in five years, expanded subsidy slots, and reached a new tentative three-year agreement with providers that includes cost-of-living adjustments, stabilization payments, and continued work on an alternative rate methodology and single rate structure. Pryor argued that despite funding gains, child care remains too expensive, only a fraction of eligible children receive subsidies, and provider wages remain far below comparable jobs, worsening racial and gender inequities. Frankenberg said the tentative agreement is progress but not enough, calling for a true cost-of-care system, fair wages, paid time off, better support for emergency and nontraditional care, and stronger integration of family child care into the mixed-delivery system. Members asked about why the crisis persists, how the alternative methodology will work, how family fees and sliding-scale help are being used, and why middle-income families still struggle. The panel said the problem reflects long-term underinvestment, a broken market, and a system that still leaves many families without access. The committee also heard an economic panel from Ashley Hoffman of the California Chamber of Commerce and Sarah Bone of the Public Policy Institute of California. Hoffman described employer child care benefits and public-private partnership models in other states, including shared-cost programs and local chamber efforts. Bone said child care costs reduce family financial security and labor force participation, especially for mothers of young children, and estimated that if mothers of young children worked at the same rate as mothers of older children, more than 80,000 additional women could be in the workforce each year. In the final panel, parent and provider advocates, including Jennifer Greppie and Black Californians United for Early Care and Education co-founder Keisha Doyle, argued for fully funding child care, ending waiting lists, protecting culturally affirming care, and addressing racial inequities and private equity’s role in the sector.

Transcript Highlights:

• . reimbursed. reimbursed.
• When was the first reimbursed? When was the first reimbursement<01:39:51.120><c> done?
• The first reimbursement done?
• </c> working on submitting payments soon. working on submitting payments soon.
• . reimbursement. reimbursement.

Committee: House Environment and Agriculture

Keywords: 1189, house, all

Transcript Highlights:

• APD will reimburse for the waiver services on a fee-for-service basis.
• So our fees and the payment structure and the payment mechanism that we utilize for providers is done
• It's a different payment structure, is what I would say to that.
• We have issues providers not getting reimbursement rates.
• We have issues providers not getting reimbursement rates.

Summary: The Health and Human Services Committee received an overview of Florida’s intellectual and developmental disabilities (IDD) managed care pilot, created by legislation in 2023 to test whether a managed care model could integrate Medicaid medical services with iBudget waiver home- and community-based services for adults in pre-enrollment categories. AHCA explained the existing system, the pilot’s scope in Regions D and I, and the rollout timeline, including federal approval, contract execution with Florida Community Care, and the October 2024 go-live. Officials reported that, as of early February, 370 individuals had been sent for onboarding and 168 more were in queue, with about $35.8 million of the appropriation remaining. APD also clarified the difference between the pre-enrollment categories and the waiver waitlist, and noted that crisis cases can be enrolled more quickly depending on eligibility and funding. Florida Community Care described the pilot as a comprehensive managed care model offering medical, long-term care, and iBudget services, plus enhanced benefits such as bed-hold days, caregiver transportation, and help with legal guardianship costs. The plan said it uses one care coordinator, a 1:18 coordinator ratio, a face-to-face assessment within five days of enrollment, and 180 days of continuity of care for existing providers. The company emphasized that it is recruiting providers by offering higher rates than some iBudget rates, lower administrative burden, and network adequacy incentives, while APD said it continues to monitor provider supply and demand and recruit across service types and regions. Members repeatedly questioned whether the pilot’s costs, provider rates, and service levels were truly comparable to the iBudget system, and AHCA and APD said it was too early to draw firm conclusions because claims data are still lagging. Committee members also raised concerns about communication, enrollment delays, provider shortages, and whether the pilot could scale statewide. APD said it has used letters, phone calls, texts, emails, and community meetings to reach eligible individuals, and that some delays stem from required assessments, Medicaid eligibility checks, and level-of-care determinations. Several members asked for more detailed comparisons of costs and provider reimbursement between the pilot and iBudget, and APD said it would provide additional data. Public testimony at the end was strongly critical of managed care, with a participant and his mother describing poor service, transportation failures, and loss of control under prior managed care arrangements, and urging the committee not to expand such a model without safeguards. No votes or formal committee action were taken before adjournment.

Transcript Highlights:

• These funds are used to reimburse an employer for the cost in excess of workers' compensation received
• As previously discussed, this fund is used to reimburse employers for a full rate of salary for peace
• As previously discussed, this fund is used to reimburse employers for a full rate of salary for peace
• reimbursements before spending any general fund appropriation.
• and payment for one reimbursement claim was held over into fiscal year 2026 due to insufficient fund

Keywords: 989, all

Summary: The committee met with a quorum present and first reviewed the Industrial Commission’s base budget and FY 2027 requests. The analyst and agency staff described the commission’s dedicated-fund structure, the IRIS technology modernization project, and several requested adjustments: ongoing support for IRIS maintenance, additional funding for the annual seminar and CWICS training, an increase for the Peace Officer Temporary Disability Fund due to rising claims, and replacement IT hardware. Members asked about the IRIS contract, seminar fees, and the crime victims compensation fund and general fund support. Agency staff said IRIS is still being supported by an outside vendor because OITS lacks the needed expertise, that seminar and training fees are already competitive and the plan is to expand services rather than lower fees, and that crime victims compensation could be covered temporarily by dedicated or federal funds if needed. No votes were taken on the Industrial Commission budget during the meeting. The committee then heard the Public Utilities Commission budget review. The analyst explained the commission’s dedicated funds, staffing, and the FY 2026 trailer appropriation tied to the Wildfire Standard of Care Act, along with a FY 2027 request for IT hardware only. Questions focused on a large variance in the indirect cost recovery fund, which staff attributed to timing of federal reimbursements and rent not being charged to that fund at the time. Commissioners and staff also received positive comments about the implementation of the wildfire-related duties. No action was taken on the PUC budget. Next, the Secretary of State’s budget was presented. The analyst outlined the office’s election, business, and commission functions, noted the prior $10 million election system upgrade, and described FY 2027 requests for a voter pamphlet and guide, overtime for the post-election audit team, and replacement technology. Secretary of State Phil McGrane and staff emphasized the rapid growth in business filings, the office’s revenue generation, and the need to maintain service levels, arguing against ongoing cuts. He said the voter pamphlet request is tied to statutory election-year mailings, the overtime reflects cyclical election workload, and the office is considering AI cautiously due to sensitive voter data. Members asked about business filing growth, the difference between a pamphlet and a voter guide, and the possible impact of hand-counting ballots; McGrane said hand-counting would mainly affect counties, not the state office. The meeting ended with scheduling remarks for the next day’s budget work and a note that the FY 2026 rescission bill was still being processed.

Transcript Highlights:

• This study assumed that reimbursement would be a mix of fee-for-service and then bundled payments in
• So a mix of fee-for-service and then more of an alternative payment model to support reimbursement.
• I'll note that a lot of the palliative care To support reimbursement.
• So this study looks at doing that bundled payment.
• So in terms of Medicare, yes, there are some services reimbursed.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• </c><00:42:24.640><c> withhold</c> example if there was a payment withhold example if there was a payment
• </c><01:20:12.400><c> um</c> so we're already reimbursing um so we're already reimbursing um providers
• </c><01:43:00.000><c> are</c> know is that uh stop payments are know is that uh stop payments are um<
• so stop payment is to 79 CCAP providers so stop payment is a<01:43:47.119><c> tool</c><01:43:47.679>
• </c> earlier tools such as pausing p payments earlier tools such as pausing p payments or<01:43:53.960

Committee: House Human Services Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• On a 36-month loan at 36 percent, it takes 24 on-time payments for us to even recoup any principal on
• Again, it takes, at that 36 percent, two entire years of on-time payments.
• Again, at that 36 percent, it takes two entire years of on-time payments for the company to even make
• This targets practices where payments vary depending on whether the patient or the patient's practice
• Thank you. ...differential reimbursement rate.

Committee: Senate Senate Finance Committee of Reference

Summary: The Senate Finance Committee considered a lengthy agenda of bills covering consumer lending, insurance coverage, professional scope of practice, property tax administration, digital assets, and aviation tax policy. The committee first approved prior committee amendments, then heard SB 1689 on consumer loan thresholds and rates. After sponsor testimony that the bill modernizes outdated lending caps and lowers rates on larger loans, the committee adopted an amendment but the bill failed on a 3-1 vote, with Senator Epstein arguing the structure would shift costs onto smaller borrowers. The committee then passed several health-related measures. SB 1347, requiring insurance coverage for fertility preservation services for cancer patients, was amended and passed 4-2 after testimony from the sponsor and cancer survivors; Senator Epstein opposed the religious-employer definition. SB 1165, eliminating cost-sharing for diagnostic and supplemental breast exams, passed 5-1 after testimony from Senator Angus and Susan G. Komen, with supporters saying it would reduce barriers to follow-up screening. SB 1212, barring insurers from reimbursing providers differently based on vaccination status, also passed 4-2 despite concerns that it could undermine vaccination incentive programs. Other bills advanced or failed after similar debate. SB 1206, addressing contractor and public adjuster conduct after property losses, passed 5-1 with an amendment and support from State Farm. SB 1291, limiting county reassessment and inspections of agricultural property for four years after a successful appeal, passed 5-1 over assessor opposition and farm group support. SB 1649, creating a digital assets strategic reserve fund, passed 4-2 after debate over civil asset forfeiture and whether crypto should be treated as a strategic reserve. SB 1516, expanding an aviation-related tax exemption to aircraft maintenance and repair property, passed 4-1 amid sharp disagreement over whether it was economic development or a tax break for private jets. SB 1554, changing chiropractic statutory language from x-rays to diagnostic imaging, initially failed 3-3 but was reconsidered and later passed 3-2 after additional discussion about its practical effect.

Transcript Highlights:

• to those claims for payment.
• to under reimbursement or inadequate grant funding.
• The other area where 340B entities are being squeezed is in reimbursement.
• In Texas, base Medicaid payments fall well below the actual cost of providing care, reimbursing hospitals
• Total base and supplemental payments net about $18 billion.

Committee: House Insurance

Keywords: 1184, house, all

Transcript Highlights:

• Public hospitals rely heavily on supplemental payments.
• Health centers will continue providing care, but without reimbursement.
• Those mechanisms are how California stabilizes Medi-Cal reimbursement.
• My quick, quick answer is payment.
• My quick, quick answer is a payment.

Keywords: 988, house, all

Transcript Highlights:

• My constituent didn't get their first payment.
• Why doesn't TWC reimburse? you at your full published tuition rates.
• What's the normal time frame that you get reimbursed?
• So, you know, the delay in payment isn't just... that we're missing payments, you know, this past couple
• We've only received two payments out of the allotted 4.

Committee: House Appropriations - S/C on Articles VI, VII, & VIII

Keywords: 1184, house, all

Transcript Highlights:

• It's just one payment, is that correct?
• A one lump sum payment, or it could be paid out over three months, is that correct? Yes.
• , and Texas Workforce Commission adoption subsidy payments.
• The reason why I was in the supplemental is because this is a reimbursement program.
• Just to clarify, those were federal reimbursements, and the feds changed the rules.

Committee: Senate Finance

Keywords: 1185, senate, all

Transcript Highlights:

• Health centers will continue providing care, but without reimbursement.
• Second, supplemental payments are not mere bonuses for rural hospitals.
• Second, supplemental payments are not mere bonuses for rural hospitals.
• Those mechanisms are how California stabilizes Medi-Cal reimbursement.
• My quick, quick answer is payment.

Summary: The joint informational hearing of the Senate and Assembly Health Committees focused on the cost of federal instability for California health coverage, access, and affordability. Opening remarks from members of both houses emphasized that California’s coverage gains under the Affordable Care Act are now threatened by federal policy changes, including the expiration of enhanced premium tax credits, H.R. 1, and new federal regulatory actions. Members repeatedly cited rising premiums, skipped care, medical debt, and the risk that low-income, immigrant, and working Californians could lose coverage or be pushed into less comprehensive plans. The first panel reviewed the federal landscape and state response. Don Joyce described the ACA’s coverage expansions and warned that H.R. 1, regulatory changes, and broader federal retrenchment could reduce coverage and weaken meaningful benefits. Covered California Executive Director Jessica Altman said the loss of enhanced premium tax credits is driving major affordability problems, with average monthly premiums projected to rise sharply and enrollment already down, especially among middle-income consumers. HCAI’s Elizabeth Lansberg explained the Office of Health Care Affordability’s role in slowing spending growth, monitoring consolidation, and setting spending targets, including lower targets for high-cost hospitals and new primary care investment goals. Members asked about bronze plans, high-cost hospitals, administrative burdens, provider taxes, and whether federal advisory changes could affect required benefits such as immunizations. The second panel examined population impacts and cost drivers. UC Berkeley Labor Center’s Miranda Dietz said most Californians get coverage through employers, Medi-Cal, or Covered California, and that affordability problems are widespread across all groups. She projected that California could have up to 2 million more uninsured residents by 2030, largely from Medi-Cal losses, and said higher premiums reduce wages and increase medical debt. Christoph Stremakis of the California Health Care Foundation highlighted survey data showing widespread concern about medical bills, skipped care, and medical debt, and argued that a large share of spending is wasted through administrative complexity, inflated prices, and underinvestment in prevention. Committee members pressed the panel on whether California can sustain coverage without new revenue, how cost-growth targets affect workers and families, how medical debt relief programs like Los Angeles County’s could be expanded, and how OCA can address uncompensated care, consolidation, and prior authorization burdens.

Transcript Highlights:

• And then under certain circumstances, foster parents can ask for a voucher or to be reimbursed for clothing
• clothing allowance and it's excluded from reimbursement.
• They get whatever they do for their month; that could include any incidental reimbursements, the monthly
• payment, or whatever else is lumped into one payment.
• I hope we do look at the reimbursement because I know with growing kids, that's really not a whole lot

Committee: House House Health & Human Services

Keywords: 996, all

Transcript Highlights:

• We can fix this access to care crisis by increasing reimbursement rates while simplifying payment structures
• </c> care has increased while reimbursement care has increased while reimbursement rates<00:05:12.800
• We are reimbursed for less than half of our costs, and as costs continue to rise, that level of reimbursement
• </c><00:18:46.600><c> rates</c> making sure Medicaid reimbursement rates making sure Medicaid reimbursement
• reimbursement reimbursement rates<00:19:38.880><c> this</c><00:19:39.080><c> decision</c><00:19:39.559

Keywords: 1183, house