Video & Transcript Research : 'underpayment'

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MS

Mississippi 2026 Regular Session

Public Health and Welfare - Room 216, 3 March, 2026; 3:00 PM

Public Health and Welfare

Transcript Highlights:
  • By the way, there's no more underpayment through spread pricing or below-cost reimbursement or retroactive
  • There's no more underpayment through spread pricing or below-cost reimbursement.
Summary: The committee first took up House Bill 1622, a strike-all amendment to create a pilot program for certain small-community hospitals to receive limited certificate-of-need exemptions. The bill would allow qualifying hospitals to open a geriatric psychiatric unit without a CON, permit each hospital one additional CON exemption for a service otherwise requiring one, cap dialysis-unit exemptions at eight hospitals, continue existing moratoriums with periodic Department of Health review, allow facilities in Issaquena or Humphreys Counties under limited conditions, and add a loser-pays rule for unsuccessful CON court challenges. Technical corrections were made, the strike-all amendment was adopted, and the bill was reported do pass as amended by voice vote. The committee then moved to House Bill 942, where Senator McMahan offered an amendment to allow a Lee County chiropractor to advertise as a neurologic chiropractor and list related credentials. Members questioned whether chiropractic neurology is recognized in Mississippi and raised concerns about the practitioner’s prior discipline by the board, but the chair ruled the amendment germane. The amendment failed on voice vote, and the bill itself then passed and was reported to the floor. The committee next considered House Bill 1034, but no amendment was offered. It then took House Bill 479 off the table. That bill extends the temporary licensing period for psychology and marriage-and-family-therapy boards from 30 to 60 days to allow more time for criminal background checks. Senator Blackwell offered a clarifying amendment to make clear that temporary licenses must be revoked if required background checks or other licensure requirements are insufficient, and that the temporary license does not replace the underlying education, training, and examination requirements. The amendment was adopted and the bill was reported do pass as amended. Finally, the committee heard House Bill 1067, the Rural Health Transformation Program. Senator Hickman explained that the bill would require procurement procedures and reporting for the state’s rural health transformation funds, prioritize projects tied to the original application, and direct funds toward rural and underserved areas such as health professional shortage areas, low-income counties, and places without hospitals. Senators questioned whether the added state rules would layer on top of existing federal requirements and whether the bill could slow distribution or invite litigation, but supporters said it was meant to add transparency and guardrails rather than change the federal program. The bill was discussed at length, but the transcript ends before a final vote on HB 1067.
TX

Texas 89th Regular

89th Legislative Session May 10th, 2025

Texas House Floor Meeting

Transcript Highlights:
  • House Bill 3984 by Oliverson, relating to the identification of underpayments and overpayments under
  • Members, this bill expands a highly successful federally recognized tool for detecting over and underpayments
LA

Louisiana 2026 Regular Session

Health and Welfare May 13th, 2026

Health & Welfare

Transcript Highlights:
  • extrapolation, and require that any recoupment or refund be based only on actual overpayments or underpayments
Keywords: 974, senate, all
Summary: The Senate Committee on Health and Welfare met on May 13 with a quorum present and approved the prior meeting minutes. The committee first heard HB 971, which would equalize Medicaid reimbursement rates between independent clinics and hospital-owned rural health clinics; supporters said independent clinics are disadvantaged by a large payment disparity, and the bill was reported favorable without objection. The committee also recognized visiting Alpha Phi Alpha members and other guests during personal privilege remarks. Members then considered HB 414, which would bar hiring certain health care workers and direct support professionals with serious disqualifying convictions from other states and address background-check issues for therapeutic group homes. After adopting three amendment sets, the bill was reported as amended. HB 740, creating an independent review process for Medicaid behavioral health claim disputes in the coordinated system of care, was amended to clarify applicability and CSOC definitions and then reported as amended. HB 288, which would place the term “miscarriage” alongside “spontaneous abortion” in medical documentation, drew emotional testimony from affected parents and advocates; the committee reported it favorable. The committee also advanced several more bills: HB 405, updating the name of the national acupuncture certifying body, was reported favorable; HB 786, prohibiting extrapolation in certain managed-care claims recoupments, was reported favorable; HB 1095, allowing alternative backup power sources for nursing homes, was reported favorable; HB 403, raising the cottage food gross-sales cap, was amended from $50,000 to $150,000 and then reported favorable; HB 930, modernizing cosmetic-product regulation and creating a small-producer exemption, was reported favorable; HB 557, defining long-term pharmacies for policy purposes, was reported favorable; HB 779, on expedited partner therapy for sexually transmitted diseases, was reported favorable; HB 915, setting utilization-management timelines and standards, was reported favorable; HB 546, expanding criteria for peace officers to take someone into protective custody during a mental health crisis, was reported favorable; HB 796, creating a chiropractic preceptorship program, was reported favorable; and HB 933, authorizing commemorative birth certificates, was reported favorable. The final major item was HB 1041, a “no-mandate” bill barring discrimination based on medical intervention status. The sponsor and Surgeon General said it was aimed at healthy, asymptomatic individuals and not at public health quarantine powers, but Senator Boudreaux objected to exemptions for schools and hospitals and offered an amendment to restore broader coverage. That amendment failed on a roll-call vote, and the bill remained under discussion as the transcript ended, with no final committee disposition shown in the excerpt.
LA

Louisiana 2026 Regular Session

Health and Welfare May 13th, 2026

Health and Welfare

Transcript Highlights:
  • extrapolation, and require that any recoupment or refund be based only on actual overpayments or underpayments
Summary: The Senate Committee on Health and Welfare met on May 13 and approved the minutes from the prior week before taking up a series of House bills, many of them with testimony from sponsors, agency officials, and stakeholders. Early action included HB 971, which would direct LDH to equalize Medicaid reimbursement rates between independent rural health clinics and hospital-owned rural health clinics; the sponsor described a significant payment disparity and the committee reported the bill favorably. The committee also deferred HB 1030 and HB 796 until the following week before moving to other items on the agenda. Several bills dealing with Medicaid and provider regulation were advanced. HB 414, as amended, closes a loophole so health care providers cannot hire unlicensed workers with certain serious out-of-state convictions; amendments addressed effective dates, FBI background-check issues for therapeutic group homes, and delays for direct support professional applicants caused by minor record issues. HB 740, as amended, creates an independent review process for Medicaid claims disputes in the coordinated system of care for behavioral health providers, with amendments clarifying applicability dates and program definitions. HB 786, which prohibits extrapolation in managed care claims recoupments and requires recovery to be based on actual overpayments or underpayments, was also reported favorably. HB 915 set timelines and accountability standards for prior authorization and utilization management in Medicaid managed care and was reported favorably after testimony about delays in care. The committee also heard and passed several bills affecting health professions and facilities. HB 405 simply updates the name of the national acupuncture certification body. HB 1095 allows nursing homes to use alternative power sources while keeping existing generator and fuel requirements. HB 557 defines long-term care pharmacies for policy purposes. HB 779 authorizes expedited partner therapy prescriptions for certain sexually transmitted diseases. HB 933 creates an optional commemorative birth certificate, with part of the fee going to the Office of Women’s Health. HB 796, carried by another representative for the author, establishes a chiropractic preceptorship program with on-site supervision requirements and was reported favorably after questions about student training and patient safety. The committee also heard emotionally charged testimony on HB 288, which would place the term “miscarriage” alongside “spontaneous abortion” in medical documentation and patient communication. Several witnesses described the distress caused by current coding language, and supporters said the change would make records more compassionate and understandable; the bill was reported favorably. HB 403 increased the cottage food gross-sales cap, and after testimony from small producers and the committee’s discussion of other states’ higher limits, an amendment raised the cap to $150,000 before the bill was reported favorably. HB 930 modernizes cosmetic-product regulation and creates a small home-based producer exemption under a wholesale-sales threshold; it was also reported favorably. Finally, HB 1041, a no-mandate bill restricting discrimination based on medical intervention status, prompted extended debate over exemptions for schools, hospitals, and other entities, with one amendment failing on a roll-call vote and the discussion continuing over the scope of the bill and federal funding concerns.
CA
Transcript Highlights:
  • It includes both overpayments and underpayments.
Summary: The joint informational hearing focused on CalFresh enrollment, food insecurity in California, the recent federal shutdown’s disruption of SNAP benefits, and the long-term effects of H.R. 1 on eligibility, benefits, and state and county costs. Opening remarks emphasized that millions of Californians rely on CalFresh, that the shutdown briefly delayed benefits for the first time in the program’s history, and that state and local governments, including Alameda County, stepped in with emergency food aid and funding. Members also framed the issue as both a hunger and affordability problem, with several noting that California’s agricultural abundance contrasts sharply with persistent food insecurity. The first panel presented research and advocacy perspectives on food hardship. PPIC’s Tess Thorman described food insecurity rates, disparities affecting households with children and Black and Latino households, and the role of nutrition programs in reducing poverty. Nourish California’s Betzabel Estudio argued that hunger is a policy choice and highlighted campaigns to expand state-funded food assistance for immigrants, support reentry populations, and continue the CalFresh fruit-and-vegetable incentive program. The California Association of Food Banks’ Josh Wright said food banks are seeing sustained high demand, lower federal food supplies, and cannot replace CalFresh, while urging more state support for food purchasing, school meals, and SunBucks. The second panel reviewed CalFresh operations and participation. The California Department of Social Services reported that CalFresh participation has risen over the past decade, with the state closing much of the participation gap through outreach, simplified applications, and demonstration projects such as the Elderly Simplified Application Project and a minimum nutrition benefit pilot. Alameda County Social Services described local caseloads, application trends, and emergency food distributions during the shutdown, while also warning that H.R. 1’s work requirements, immigrant eligibility restrictions, and possible cost-sharing could reduce enrollment. A student CalFresh ambassador testified about the burdensome application and recertification process and urged more funding for campus basic-needs centers and outreach to reduce stigma and administrative friction. In the final panel, county, food bank, and policy witnesses described the shutdown response and the expected impact of H.R. 1. Alameda County Community Food Bank and the County Welfare Directors Association said counties, food banks, and community partners mobilized emergency funds, pop-up pantries, and food purchasing to bridge the shutdown gap, but warned that hundreds of thousands of Californians could lose benefits under the new federal rules. The California Budget and Policy Center began outlining the scale of federal cuts, noting that H.R. 1 will significantly reduce SNAP funding and shift costs to states. No votes or formal committee actions were taken; the hearing was informational and concluded with discussion of possible state responses, including backfilling benefits, preserving outreach funding, and improving administrative systems to protect enrollment.
NH
Transcript Highlights:
  • to have this one small part of the whole market that we can control make up for all the federal underpayments—I
  • 56.798> federal control make up for all the federal control make up for all the federal underpayments
  • understood<04:47:58.400> that<04:47:59.638> um<04:48:00.638> okay underpayments
  • I understood that um okay underpayments I understood that um okay uh<04:48:01.240> the<04:48:
Keywords: 1189, house, all
Summary: The subcommittee first took up several bills and repeatedly chose to retain or table them rather than advance them. House 167, dealing with past wax, was voted ought to pass; House 312 was retained because members said NCAA-related advertising and uniform policy issues were still unresolved; House 434, requiring insurers to provide rental cars for at least seven days, was voted inexpedient to legislate; and House 454, on biodegradable packaging claims, was also voted inexpedient to legislate after members said the proposal lacked a workable enforcement mechanism and would likely be only a symbolic state-by-state measure. House 721, making gold legal tender, was retained, with members saying the bill needed more work and that the issue was less compelling in New Hampshire because the state has no sales tax. The committee then discussed House 310, which was amended to create a study commission on blockchain and related regulatory issues. The amendment expanded the commission’s charge to include legal, regulatory, financial, technological, and environmental considerations, added review of federal developments, included blockchain-based trust and stable token issues, broadened membership, and extended the repeal and report dates by a year. Members said the commission would help New Hampshire develop expertise and a report for future legislation, while also noting that federal action could affect the state’s role. The amendment was adopted 8-1, and the bill itself was then retained. Finally, the subcommittee heard a revised amendment to House 406 on business filings and registered agents. The Secretary of State’s office explained that the amendment, drafted with input from the Business and Industry Association, narrows the bill to address fraudulent or unauthorized entity filings after a written complaint and sworn statement, sets minimum requirements for registered agents, bars use of commercial mail-drop addresses as registered offices, and allows removal or cancellation of fraudulent filings with penalties for false filings. Members asked about which entities must maintain registered offices and how the rules would affect home-based businesses; the sponsor said most New Hampshire business entities must have a registered office, with some exceptions such as domestic nonprofits and trade names. The discussion emphasized concerns about synthetic entities, identity misuse, and the need for a physical in-state registered agent address.
LA

Louisiana 2026 Regular Session

House of Representatives Apr 22nd, 2026

Louisiana House Floor Meeting

Transcript Highlights:
  • It requires that any recoupment or refund be based solely on actual overpayments or underpayments.
NM

New Mexico 2025 Regular Session

IC - Legislative Finance Nov 17th, 2025

Transcript Highlights:
  • A payment error rate occurs when there is either an overpayment or an underpayment.
US
Transcript Highlights:
  • The margin of underpayment for Rhode Island hospital compared to hospitals across the border ranged from
Summary: The committee convened to discuss critical issues surrounding the nomination of Michael Falkender for the position of Deputy Secretary of the Treasury. This meeting included a series of remarks from committee members who expressed divergent views on Falkender's qualifications and the implications of his appointment. Senator Wyden voiced strong opposition, arguing that Falkender represents harmful policies expected to be perpetuated under the current administration, especially concerning taxpayer privacy and IRS tactics. Meanwhile, other members defended Falkender, noting his extensive experience, including a commitment to transparency in government operations if confirmed.
MN
Transcript Highlights:
  • making mistakes and not doing their work accurately, and as a result, people are receiving over- or underpayments
  • So, who... 4,000 cases and they picked 10 and it was $149 and over underpayments which would have cost
  • So, who... 4,000 cases and they picked 10 and it was $149 and over underpayments which would have cost
  • So, who... 4,000 cases and they picked 10 and it was $149 and over underpayments which would have cost
Keywords: 1187, senate, all
NH

New Hampshire 2025 Regular Session

Senate Health and Human Services (02/06/2025)

Health and Human Services

Transcript Highlights:
  • the agency budget, seeking $1.9 million in each year of the next biennium to address historical underpayments
  • the agency budget, seeking $1.9 million in each year of the next biennium to address historical underpayments
  • the agency budget, seeking $1.9 million in each year of the next biennium to address historical underpayments
Keywords: 1191, senate, all
NH

New Hampshire 2026 Regular Session

House Science, Technology and Energy (02/17/2026)

Science, Technology and Energy

Transcript Highlights:
  • He continued that any reconciliation for overpayment or underpayment of default service rates needed
  • He then described the reconciliation language: any overpayment or underpayment of default service rates
Keywords: 1189, house, all
NH

New Hampshire 2025 Regular Session

House Labor, Industrial and Rehabilitative Services (04/22/2025)

Labor, Industrial and Rehabilitative Services

Transcript Highlights:
  • that doesn't include<02:50:36.000> overpayments<02:50:36.640> or<02:50:36.880> underpayments
  • , include overpayments or underpayments, include overpayments or underpayments, right?
Keywords: 1189, house, all
NJ

New Jersey 2026-2027 Regular Session

Assembly Budget Jun 28th, 2026

Transcript Highlights:
  • And also dealing with the underpayment section, I think, is a good thing.
Keywords: 1146, all
Summary: The Assembly Budget Committee met on June 28, 2026 and considered a long list of budget and policy bills, reporting many of them out of committee, often with amendments. Early measures included AB 2550 on continued dependent health coverage for certain adults with disabilities, AB 4794 allowing tax data sharing with the New Jersey Innovation Authority and Secure Choice Savings Board, and AB 3381/SB 1493 updating occupational therapy licensure requirements. The committee also advanced AB 4014, creating a social media research center at a public four-year institution, though one member opposed it as unnecessary spending given existing research on social media harms. Another bill, AB 5048/SB 1281, would ban certain apparel and diaper products with intentionally added PFAS; some members opposed it over safety and cost concerns, especially for firefighter gear, but it was reported. The committee also moved AB 383, which promotes volunteerism to help FamilyCare and SNAP recipients meet eligibility requirements, and AB 4357, extending telehealth pay parity, though one member objected to parity between telehealth and in-person care. The committee then took up several energy, environmental, and housing-related bills. AB 5188, the Advanced Grid Technologies Act, was released despite opposition from some members and labor interests. AB 2524 would let dual-use solar projects participate in community solar, and AB 5236 would strengthen pediatric psychiatry and behavioral health services; both were reported. AB 5348, allowing temporary use of open-space and related funds for certain municipalities, drew sharp criticism as a diversion of preservation money to fill budget holes, but passed. AB 5280 returned unexpended county appropriations to Hudson County and authorized supplemental operating aid; it also passed despite objections about prior bidding violations. AB 5347 provided certain motor vehicle-related funding to municipalities and was reported, as was AB 5334/SB 4423, appropriating Green Acres and CBT revenues for local open space and park projects. A major portion of the meeting focused on tax and business-related bills. AB 5329 increased the child tax credit for 2026-2028, with testimony urging that the expansion be made permanent; it was reported. AB 3899, the General Contractor Licensing Act, also passed. AB 5310/SB 4406 clarified sentencing under certain circumstances and was reported. AB 5330, allowing temporary transfers in the pension system, drew testimony from NJEA warning that the State Health Benefits Program was in crisis and asking for a longer repayment period to avoid rate spikes; the bill was still reported. AB 1326 created a higher education governance and funding task force and was amended to add a Talmudic institution or theological seminary representative. Later, AB 5333/SB 4424 appropriated additional Green Acres and CBT funds for recreation and conservation projects and was reported. The committee also advanced several business and alcohol-related measures, including AB 5235 establishing the School-Based Partnership for Access and Resilience for Kids program, AB 5325 reducing business formation fees, AB 4836/SB 2368 on portable solar devices, AB 4881 establishing an advanced nuclear energy procurement program, AB 3974/SB 3183 revising renewable energy incentive and solar interconnection rules, AB 4013 creating a social media research center focused on addictive behavior, AB 5225 making temporary alcohol beverage provisions permanent, and AB 5295 revising alcoholic beverage licensing laws. The most contentious debate came on AB 4085, the Fair Price Protection Act, which would restrict “surveillance pricing” and regulate grocery pricing practices. Consumer advocates supported the bill as a protection against individualized pricing, while retailers and chambers of commerce argued the language was too broad and could undermine loyalty programs, discounts, and electronic shelf labels. Despite those objections, the committee voted to report the bill after amendments. Finally, AB 4530/SB 3739 on EV supply equipment standards was reported, and AB 5322 imposing a temporary cap on net operating loss deductions under the corporate business tax sparked strong opposition from business groups and a policy debate over whether legitimate losses and investment-related deductions should be limited; the bill was still moved out of committee.
LA

Louisiana 2026 Regular Session

House of Representatives May 13th, 2026

Louisiana House Floor Meeting

Transcript Highlights:
  • Bacala provides relative to estimated income tax, the calculation period of underpayment, and provides
Bills: HR275, HR276, HR277, HR278, HR279, HR280, HR281, HR282, HR283, HR284, HCR112, HCR113, HR265, HR266, HR267, HR268, HR269, HR270, HR271, HR272, HR273, HCR107, HCR108, HCR109, HCR110, HCR111, SCR63, SCR66, SCR67, SB414, SB484, SB513, HR168, HR174, HR194, HR216, HR264, HCR54, HCR74, HCR79, HCR85, HCR87, HCR94, HCR95, HCR97, HCR98, HCR104, SCR23, SCR29, SCR33, SCR38, HB75, HB705, SB54, SB56, SB72, SB79, SB97, SB105, SB123, SB125, SB129, SB163, SB171, SB252, SB287, SB375, SB386, SB461, SB466, HR84, HR188, HR205, HR3, HR197, HR243, SCR19, SCR3, SCR6, SCR18, SCR11, SCR22, SCR2, SCR20, SCR24, SCR35, HCR6, HB301, HB359, HB657, HB675, HB680, HB727, HB39, HB58, HB112, HB134, HB155, HB187, HB287, HB462, HB782, HB825, HB846, HB903, HB904, HB929, HB941, HB962, HB1200, HB4, HB623, HB944, HB986, HB1098, HB1222, SB45, SB58, SB71, SB81, SB92, SB100, SB109, SB141, SB156, SB181, SB203, SB204, SB205, SB207, SB213, SB214, SB216, SB229, SB257, SB274, SB290, SB304, SB374, SB379, SB396, SB410, SB425, SB427, SB429, SB479, SB522, SB34, SB164, SB172, SB198, SB208, SB232, SB281, SB286, SB317, SB322, SB334, SB380, SB385, SB409, SB417, SB421, SB430, SB439, SB447, SB458, SB510, HB842, HB633, HB1191, HB625, HB1255, HB251, HB582, HB646, HB819, HB998, HB1257, SB197, SB436, SB78, HB901, HR20, HR74, HCR65, HCR71, HB284, HB302, HB306, HB341, HB366, HB393, HB458, HB577, HB603, HB605, HB614, HB733, HB752, HB773, HB798, HB911, HB955, HB996, HB1035, HB1069, HB1113, HB1140, HB1180, HB1240, SB82, SB89, HB258, SB149, SB382, SB441
CA
Transcript Highlights:
  • fire survivors and found that 70% of insured LA fire survivors are having delays, denials, and underpayments
Keywords: 987, senate, all
Summary: The joint Senate hearing of the Natural Resources and Water Committee and the Emergency Management Committee focused on wildfire resilience, with members discussing the SB 254 report on enhancing California’s response to natural catastrophes. Opening remarks emphasized the scale of wildfire damage, the need for prevention and preparedness, and concerns about the affordability and insurability crisis. Senators repeatedly contrasted the relatively small share of funding going to community hardening with the much larger amounts spent on utility wildfire mitigation and landscape-scale projects, and several members raised concerns about CEQA delays, one-time funding, and the need for more sustainable, ongoing financing. The Legislative Analyst’s Office presented an overview showing about $4.7 billion in state wildfire resilience appropriations from 2018-19 through 2025-26, with funding shifting from the Greenhouse Gas Reduction Fund to the General Fund and then to Proposition 4. LAO noted that only about $65 million had been specifically targeted to community hardening, while most funding went to forest health, fuels, research, and related programs. LAO also said one-time funding will decline in coming years and that future GGRF support is uncertain, though General Fund use is not legally precluded. Members asked about maintenance costs, polluter-pays ideas, and whether performance metrics should focus more on property and community risk reduction than acres treated. Cal Fire’s State Fire Marshal described the state’s community wildfire preparedness strategy, centered on home hardening, defensible space, and neighborhood-scale mitigation. He said roughly 4 million homes are in the wildland-urban interface, most built before modern fire-resistant standards, and argued that the state must move from response to prevention. He said Cal Fire is incorporating the SB 254 recommendations into its updated action plan, has streamlined some fuel-reduction projects under a recent executive proclamation, and is shifting some grant funding toward maintenance of existing treatments. Cal OES described the AB 38 pilot and FEMA hazard mitigation work, saying the pilot helped build tools and standards for home hardening but that federal approval delays remain a major barrier; the agency reported 155 hardened properties, 19 under construction, and 370 assessed and waiting. The Wildfire and Forest Resilience Task Force said it has coordinated more than $6 billion in state and federal investments, is moving toward regional block grants and better data-driven prioritization, and is developing separate community and landscape strategies. The hearing ended with discussion of modeling, data gaps, utility coordination, contractor capacity, and possible legislative or budget changes to better align funding and metrics with community safety outcomes.
KY
Transcript Highlights:
  • You could have an administrative underpayment.
  • You could have an administrative underpayment.
Keywords: 958, all
Summary: The Medicaid Oversight and Advisory Board reconvened and heard a presentation from the Attorney General’s Office Medicaid Fraud and Abuse Control unit. AG staff described the unit’s structure and work: it investigates and prosecutes Medicaid provider fraud, and also handles abuse, neglect, and exploitation cases involving vulnerable adults in facility settings when asked to assist. They said the office has prosecutors, detectives, auditors, and support staff, works with federal partners, Commonwealth’s attorneys, CHFS, DMS, OIG, and MCOs, and uses a hotline and referral line for complaints. They also explained the MCO referral process, including monthly meetings, stand-down lists, and review of referrals for a “credible allegation of fraud” before the AG office decides whether to open a criminal or civil investigation. The presentation focused heavily on current fraud trends. Staff said behavioral health is a major concern, along with participant-directed waiver services, medically assisted treatment, cash billing for services, controlled-substance billing, and vision and dental fraud. They gave examples such as duplicate time sheets for family caregivers, questionable Suboxone counseling and urine drug screening practices, and a prior optometry case involving false claims for children’s glasses. They also discussed CMS’s estimate that about 5% of Medicaid payments are improper, noted that most improper payments are at the fee-for-service level, and said there is no reliable overall fraud-rate estimate. They highlighted a sharp shift in behavioral health billing after the cabinet’s November 1, 2024 policy changes, saying individual psychotherapy spending dropped while group billing increased, suggesting providers may have moved billing to different codes. Members asked about the scale and timing of cases, how MCO referrals are screened, and whether the data reflected more people being served or just higher spending. The AG office said investigations can take years, with some federal cases still awaiting sentencing from 2018 and 2019 matters, and that they currently had nine individuals awaiting sentencing in federal court. They also reported 58 hotline reports during the referenced period, six cases opened from MCO referrals, and four additional MCO referrals not accepted for active cases. Several members raised concerns about home-based services and the risk of abuse or fraud when family members are reimbursed, and asked whether the process could be streamlined; the AG office said it had no immediate recommendations but would be willing to return with suggestions after further review.