Video & Transcript Research : 'utilization controls'

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TX

Texas 89th Regular

Insurance Mar 26th, 2025

Insurance

Transcript Highlights:
  • Texas law contains various requirements that apply to certain insurers when engaging in utilizing...
  • It is important to note that House Bill 1818 does not add any new utilization review requirements.
  • I mean, each examination of the utilization? Yes. Okay. Does TDI do this already?
  • I know that we have current statute that balances efforts to control costs such as prior authorization
  • Under this bill, and we said the requirements of this bill to do utilization review exams, please align
TX

Texas 89th Regular

Insurance Mar 26th, 2025

Insurance

Transcript Highlights:
  • In relation to anything in the policy or anything in the policy, even the controlling authority for the
  • About 70% of the Texas market is controlled by just two major VBMs.
  • That's the decision we all have to make: how do we control costs while preserving the quality of life
  • How do we control costs?
  • So the question is, how do we, as physicians, where can we contribute to controlling costs?
TX

Texas 89th Regular

Health and Human Services May 20th, 2025

Health & Human Services

Transcript Highlights:
  • We always try, when possible, to utilize Texas law because Texas has a strong support system.
  • the graduate medical education, of these students in foreign countries to be validated and to be utilized
  • in the United States. ...of these students in foreign countries to be validated and to be utilized in
  • Pre-authorization is a process used by health plans to manage costs and utilization of services.
  • Three-share has been around for a long time, actually, and not that many people utilize it, but UTMB
Summary: The committee met without a quorum at first, then established a quorum with five members present. Members heard and left pending several House bills, including HB 4743 on allowing hospitals to license mobile stroke units under a hospital license, HB 4129 on earlier DFPS enforcement tools for single-source continuum contractors in community-based foster care, HB 4903 creating a Quad Agency Child Care Initiative to coordinate child care regulations across state agencies, HB 3812 revising the gold card/prior authorization process for physicians, HB 4535 requiring written informed consent before COVID-19 vaccination and a standardized state information sheet, and HB 4666 reducing the frequency of some HHSC reports to the legislature. The chair also noted HB 35 would be voted on later after a subcommittee back was received, and that a large number of bills would be heard the next day. Most of the testimony focused on HB 4535 and HB 4730. On HB 4535, supporters argued the bill would strengthen informed consent for COVID vaccination by requiring written consent and clearer state-level information about risks, manufacturer liability protections, and adverse-event reporting; opponents, including a pediatrician and medical groups, said existing federal and state informed-consent materials already cover these topics and warned the bill could create duplicative paperwork and penalties. On HB 3812, the Texas Medical Association supported changes that would extend the gold-card evaluation period to one year, raise transparency, and make prior authorization exemptions easier to administer, while health plans said they were neutral and viewed the bill as a balance between reducing burden and preventing fraud or unsafe care. HB 4730 drew extensive testimony from adoption professionals, birth mothers, adoptive parents, and child welfare advocates. The bill would require DFPS to create a relinquishment form, train child-placing agency staff, and extend the minimum waiting period for voluntary relinquishment from 48 hours to seven days. Supporters of the current law argued the 48-hour period aligns with hospital discharge, allows informed decisions, and helps birth parents and adoptive families begin healing and bonding without pushing children into foster care or creating legal and Medicaid complications. The author said the bill would be revised and that the seven-day provision was a work in progress. No votes were taken on the bills during the meeting; each bill was left pending after public testimony closed.
TX
Transcript Highlights:
  • Secondly, nearly half of all pediatric inpatient utilization is for a psychiatric condition.
  • I would like to draw attention to the amount of time given to the people who've been in control of this
  • I don't have the solution today. think we do but we choose not to utilize it so but get those very clear
  • Relatives of patients who have passed away may refill controlled substance medications.
  • We are not animals to be controlled by a powerful... government, and hospital, and structures that we
TX

Texas 89th Regular

Health and Human Services Apr 8th, 2025

Health & Human Services

Transcript Highlights:
  • Secondly, nearly half of all pediatric inpatient utilization is for a psychiatric condition.
  • I would like to draw attention to the amount of time given to the people who've been in control of this
  • I think we do, but we choose not to utilize it.
  • Relatives of patients who have passed away may refill controlled substance medications if the hospitals
  • That is the same reason we wash our hands and do all of the other infection control procedures.
Summary: The committee first took up several pending bills and reported them favorably: SB 968, SB 636 as substituted, SB 1137, and SB 1138 as substituted. Each was advanced by roll call vote, and the committee also recommended the approved bills for the local and uncontested calendar. The chair then moved to the posted agenda and heard SB 719, a mental health bed-capacity study bill by Senator Eckhart, with a committee substitute that refined the data collection to distinguish state and non-state beds, child and adult beds, include two point-in-time counts, and capture jail diversion data. Testimony on SB 719 was largely supportive from Integral Care, NAMI Texas, and the Children’s Hospital Association of Texas, all of whom said Texas needs better data on inpatient psychiatric capacity, workforce needs, and future demand. Several witnesses described long waits for beds, especially for forensic restoration, and argued the study would help target future investments. Senator Perry and others noted the state has already made major investments in new beds and urged the bill to account for beds already coming online; the committee ultimately withdrew the substitute and left SB 719 pending after public testimony closed. The committee then heard SB 1864, which would allow small egg producers to sell ungraded eggs more broadly, including to restaurants and retailers, with the substitute increasing the weekly sales threshold and addressing sanitation and labeling. Supporters said grading is about size, not safety, and that the bill would help small farms reach new markets; opponents from the Texas Poultry Federation argued grading and candling help identify cracks and defects that can affect safety and quality. The committee adopted the substitute and left the bill pending. It also heard SB 1467, requiring DSHS to share death record information with hospitals for record accuracy and quality review, and SB 912, which would modernize continuing education tracking for health licensing agencies; both bills drew supportive testimony and were left pending. Finally, the committee heard SB 2023, which would create an HHSC grant program to help counties pay for indigent burial costs, with county representatives testifying in support.
HI

Hawaii 2026 Regular Session

CPC Public Hearing - Tue Mar 24, 2026 @ 2:00 PM HST

Consumer Protection & Commerce

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

New Mexico 2026 Regular Session

House - Judiciary Feb 9th, 2026 at 06:43 pm

House Judiciary

Transcript Highlights:
  • As a family member of someone who utilizes a power wheelchair and as an OT, I have seen the benefits
  • So this bill adds economic development businesses that are utilizing an IRB to also benefit from the
  • The C-PACE program is controlled by the counties.
  • We are now on House Bill 72, Controlled Substance Minor Distribution. Madam Chair Chandler: yes.
  • We are now on House Bill 72, Controlled Substance Minor Distribution.
TX
Transcript Highlights:
  • That ensures more control and protections against cyber attacks.
  • Yes, parents absolutely need to have control over the child's record.
  • Older Texans are the highest. utilizers of health care services.
  • A survivor of rape or sexual assault could be denied emergency birth control or HIV treatment.
  • Pharmacists could refuse to fill prescriptions for birth control.
TX
Transcript Highlights:
  • Together they control over 80% of the market.
  • So this control is an inherent conflict of interest. The PBMs are playing both sides of the coin.
  • we lose to taxpayers, but we actually lose to other people that could benefit from it. could be utilized
  • No elevators were working, temperature control systems were down, and vulnerable residents were trapped
  • Control space, also SB 732 is not.
AL

Alabama 2026 1st Special Session

Alabama House State Government Committee Feb 4th, 2026

State Government

Transcript Highlights:
  • They control that. It's part of their homeland.
  • They control that. It's part of their homeland.
  • They control that. It's part of their homeland.
  • They control that. It's part of their homeland.
  • They control that. It's part of their homeland.
HI
Transcript Highlights:
  • And it impacts brain development, the part responsible for attention, learning, mood, and impulse control
Summary: The committee heard testimony on several health-related bills. HB 1864, which would require health insurance coverage for standard fertility preservation services for people undergoing medically necessary treatment, drew broad support from SHIPA, the Department of Health, HMSA, the Hawaii Association of Health Plans, and others. Testifiers emphasized that fertility preservation is routine coverage on the mainland and important for patients facing infertility from cancer or other treatment; one patient described incurring more than $20,000 in costs. The Insurance Division flagged possible Affordable Care Act issues, a potential conflict in the bill’s language about using patient history to determine limits, and a mismatch with state medical-necessity standards. Committee discussion also focused on whether the bill should apply to all women of childbearing age rather than a narrower age-based category. HB 2305 would require nutrition and metabolic education as part of physicians’ continuing medical education. The Hawaii Medical Board opposed the measure, arguing that CME should remain flexible and tailored to each physician’s specialty and warning that topic-specific mandates can expand over time. The Office of the Governor supported the bill, saying it would help the state’s rural health transformation application and could improve federal funding prospects, though the exact impact was unclear. Members questioned whether nutrition is already covered in medical training and whether the requirement should be limited to primary care physicians; the board said Hawaii currently has no topic-specific CME mandates and that physicians can already choose relevant courses. The committee also heard strong support for HB 1597, which would establish an Alzheimer’s disease research center at the University of Hawaii. Supporters from the university, the Alzheimer’s Association, AARP, and others said the center could attract federal research dollars, expand clinical trials, and help address the state’s high Alzheimer’s-related health costs. HB 2159, which appropriates funds for health care workforce development, also received broad support from the University of Hawaii, health systems, and advocacy groups, with no opposition noted. Finally, HB 2121, which would prohibit the sale and distribution of disposable electronic smoking devices, drew support from the Department of Health, youth advocates, and public health groups citing youth addiction, environmental waste, and fire hazards; the department said a separate bill, HB 1573, would be more comprehensive and better defined for enforcement and penalties. The committee ended with HB 1913, creating a veteran services mental health coordinator position at Tripler Army Medical Center, which was supported by veteran services officials and others who said veterans need better navigation and coordination for behavioral health care.
OK
Transcript Highlights:
  • that patient's bill of rights would in any way intimidate patients and families from being able to utilize
  • They couldn't control the medicine getting to that cancer center pharmacy and limit that.
  • They couldn't control the medicine getting to that cancer center pharmacy and limit that.
OK

Oklahoma 2026 Regular Session

Public Health - Part 1 Feb 18th, 2026 at 09:00 am

Public Health

Transcript Highlights:
  • House Bill 4336 updates definitions of acute pain and chronic pain to align them with the Uniform Controlled
  • Anything that's a non-controlled substance.
  • So in this statute, it says that only vitamins, nutrients, and minerals to exclude any controlled substances
  • , ma'am, because again, that's a blood product that by the AG's ruling has been determined as a controlled
  • Current Oklahoma law also prohibits local governments from passing tobacco control ordinances.
TX
Transcript Highlights:
  • We always try, when possible, to utilize Texas law because Texas has a strong support system; our process
  • Control going forward. Thank you, Senator Hancock, for listening to us. We appreciate it.
  • GME, or the graduate medical education of these students in foreign countries, to be validated and utilized
  • Pre-authorization is a process used by health plans to manage costs and the utilization of services.
  • The three-share program has been around for a long time, and many people utilize it.