Transcript Highlights:

• They looked at high school graduation rates and college remediation rates as indicators of whether there
• On the right side, you'll see math proficiency rates.
• It has closed a bit in graduation rates.
• Rating mechanisms, methodologies, and matrices that rate disciplines and levels of study by their cost
• What's our graduation rate at that level, at your level? Mr.

Transcript Highlights:

• Currently in Imperial County, there's a 20% unemployment rate.
• Energy-intensive data centers are being built at an unprecedented rate.
• So the general rate case process, which is the process... True cost of service.
• So there is a supply chain crisis for the basic physical... ...driving up rates.
• Californians pay the highest electricity rates in the continental United States.

Keywords: 987, senate, all

Transcript Highlights:

• <00:06:45.440> or information, promises of high ratings or information, promises of high ratings
• And so there's if my rating was too low.
• <00:11:48.320> No rating. That is unequivocally false. No rating.
• And I think that's the end of rating.
• Could have got that same rating, same timeline through a free service and not having to pay.

Keywords: 1183, house

Transcript Highlights:

• Yeah, the skilled nursing facilities between 2014 and 2026, their rate increased...
• There is a 24% increase in the rate and a 36% decrease in utilization.
• And then in home health, you see for nurses, the rate increase has been, you know, 24%, 26%.
• held flat, or they potentially could see a rate decrease.
• That does not happen... ...flat, or they potentially could see a rate decrease.

Keywords: 995, all

Summary: The subcommittee met with MassHealth LTSS Chief Leslie Darcy to review the Personal Care Attendant (PCA) program and the legislative work group focused on its long-term sustainability and cost containment. Darcy and Charlie described the work group’s five meetings and three consensus recommendations: enforce the 66-hour overtime cap, address fraudulent activity in the PCA program, and eliminate MassHealth handling of PCA paperwork/administrative work for members without a live-in exemption because those members are subject to EVV. They explained EVV as an electronic visit verification system replacing paper timesheets, and noted the rollout is expected to be completed this fall. The group estimated about $7 million in savings from the consensus recommendations and agreed to continue meeting through June to consider additional ideas. Darcy presented data showing the PCA program served about 56,000 members in state fiscal year 2024 and has grown from $1.2 billion in FY20 to $1.6 billion in FY24, with projections near $2 billion by 2027. She said much of the growth is driven by wage increases and older adults using more services, and compared PCA costs with other LTSS programs. The discussion also covered overtime spending, the role of federal financial participation, and how Massachusetts’ PCA program differs from other states because it has no hard caps on hours or activities. Several members emphasized the program’s value for independent living and community participation, while also acknowledging the need to control growth without undermining services. Members asked about undocumented immigrants and MassHealth funding, and Darcy explained that some eligibility categories are state-funded only and do not receive federal matching funds. Another member asked about workforce recruitment and wage pressures; Darcy said recent collective bargaining agreements raised PCA wages, with some workers eventually reaching $25 per hour and the entry wage reaching $20. The group also discussed whether IADL hours are disproportionately high compared with ADL needs, and reviewed data suggesting potential savings if IADL hours were limited relative to ADL hours, though no consensus recommendation was made on that point. The meeting ended with approval of the prior minutes by roll call vote, an update that the next health equity informational hearing is scheduled for May 19, and a motion to adjourn carried unanimously.

Transcript Highlights:

• Chinese manage their exchange rate Chinese manage their exchange rate through<04:33:29.561> a
• <04:35:40.359> practices<04:35:41.240> in exchange rate practices in exchange rate
• rate.
• It's called the CAMELS rating.
• scale it's called the supervisory rating scale it's called the camels<05:15:55.638> rating<05

Keywords: U.S. House of Representatives Floor Proceedings on Monday, February 10, 2025, 1012, house, all

Transcript Highlights:

• want to rate that in there or something. want to rate that in there or something.
• and rate study. and rate study.
• Counties support a rate study.
• So since 2015, there's a rate that is the same rate, and so, um, based on the billable activity— oh,
• 150% of the regular rate.

Keywords: 1187, senate, all

Transcript Highlights:

• rates for 26 and 27. rates for 26 and 27.
• much is going to go, what the tax rate much is going to go, what the tax rate would<04:02:30.560
• Uh rates are interest rates are down.
• And with mortgage rates and other loan rates based on those kinds of decisions, that means mortgage rates
• means mortgage rates are going to go up. means mortgage rates are going to go up.

Keywords: 928, house, all

Summary: The committee heard testimony on Senate Bill 110, as amended by the Senate, which would establish fees for alteration-of-terrain applications and direct the Department of Environmental Services to adopt rules for a permit-by-notification process for certain projects. Trisha Milo introduced the bill for Senator Lang and noted that the department had worked on the amended language. Matt Mayberry of the New Hampshire Homebuilders Association said the industry strongly supported the bill, describing it as a public-private partnership that would speed review for developers without affecting local control, with builders paying the costs rather than taxpayers. Members focused heavily on how the bill’s fee structure and permit thresholds would work, especially for projects near shoreland, wetlands, and protected water bodies. Representative Opel raised concerns about whether the bill reduced review of habitat and shoreland impacts or shifted costs unfairly; Philip Trobridge of DES explained that the bill does not eliminate those reviews and that shoreland projects still receive greater scrutiny. He said the bill creates different tiers, with the permit-by-notification process applying to certain projects between 100,000 and 150,000 square feet that are not in protected shoreland, while larger or shoreland-affected projects remain under the standard review process. He also said the proposed fees were based on sustaining the program, covering added habitat and species review responsibilities, and keeping reviews efficient. Trobridge said the new fee structure would generate about $1.2 million in additional revenue and help fund additional staff and related program costs. He stated that the department had worked with the regulated community and believed the fees were fair and reasonable, though he acknowledged the bill’s wording was confusing and that the threshold could be revisited later if the new process works well. Members also discussed how the state process interacts with local approvals, and Trobridge said both state and local approvals are required before a project can begin. No vote or final action was taken in the portion of the meeting provided.

Transcript Highlights:

• The rate exception process for the disability waiver rate system was one of those pieces.
• Uh we create a individual rates.
• it comes to getting the rates increased. it comes to getting the rates increased.
• When we talk about rate about.
• But then when it comes to<00:59:58.079> the<00:59:58.319> rate to the rate to the rate

Keywords: 1183, house

Transcript Highlights:

• Each time a rate reduction...
• <00:20:55.120> uh clawbacks y'all deal with a rates uh clawbacks y'all deal with a rates uh
• <00:42:57.440> by death rate by death rate by 50%<00:42:59.280> and<00:42:59.400>
• How are the rates set currently for the drug pricing?
• <01:33:35.880> and buy a drug at a at a lower rate and buy a drug at a at a lower rate and

Keywords: 00:00:00 Call to Order/Roll Call 00:01:19 Discussion of 25RS HB 785 00:30:25 Roll Call Vote on 25RS HB 785 00:32:15 Discussion of 25RS HB 61 00:36:42 Roll Call Vote on 25RS HB 61 00:38:07 Discussion of 25RS HB 788 00:51:01 Discussion of 25RS SB 14 01:11:09 Discussion of 25RS HB 685 01:44:57 Adjournment, 958, all

Summary: The House Standing Committee on Health Services met with a quorum and took up House Bill 785, as amended by a committee substitute that combined language from HB 785 and HB 787. The bill was described as addressing Medicaid managed care organization (MCO) audits, provider contract notice and amendment procedures, mental health parity compliance, and related transparency requirements. Supporters said the measure would tighten notice to providers, limit repeated contract amendments and rate reductions, require more standardized audit procedures, and add reporting on Medicaid claims, appeals, and grievances. It also includes a provision requiring coverage of at least two evaluation-and-management billable services per physician per recipient per date of service, and a section addressing narcotic/opioid treatment program licensing and reimbursement language. Testimony in support came from Representative Kim Moore, John Inman of BrightView Health, Michelle Sandborne of the Children’s Alliance, and Kelly Cormic of RYSE. They argued that MCOs often use audits and recoupments in ways that are burdensome, opaque, and financially damaging to providers, especially smaller and rural ones. They cited examples of multiple audit requests in short timeframes, large record requests with short deadlines, delayed or absent feedback, and recoupments taken before appeals are resolved. They also said parity laws are not being consistently enforced and that the bill would give the Department of Insurance authority to suspend or revoke an MCO certificate of authority for willful or repeated parity violations. Committee members generally expressed support for provider protections and transparency, while asking for clarification on the narcotic treatment and E/M billing provisions. Tom Stevens of the Kentucky Association of Health Plans testified in opposition, saying the bill is complex to implement and should be handled through the broader Medicaid oversight work of House Bill 9, the MOAB. He said the issues raised were better suited for that bipartisan stakeholder process and noted the committee substitute had not yet been fully reviewed by his group. After discussion, the committee adopted the committee substitute and then moved to a vote on the bill; the roll call began, with several members recorded as voting yes, but the transcript cuts off before the final vote result is shown.

Transcript Highlights:

• Um, one is that our error rate, so keeping in mind that our error rate and the fraud rate are completely
• Our error rate for SNAP is currently 3.72, with a fraud rate of less than 1%.
• and fraud rate.
• > rate<01:31:45.199> are the error rate and the fraud rate are the error rate and the fraud
• Error rate and fraud rate.<01:32:33.360> That's<01:32:33.600> it.

Bills: SF0122, SJ0006, SF0121, SF0106

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

Transcript Highlights:

• rate is scheduled to end. rate is scheduled to end.
• the CMHC rate.
• up to the daily allowed PPS rate. up to the daily allowed PPS rate.
• rate. I would like to go back and double rate.
• that's the capitated rate. that's the capitated rate.

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board first approved the September 24 minutes and then heard a presentation from four certified community behavioral health clinic providers: Pathways, NorthKey, Seven Counties Services, and NewVista. The presenters explained the difference between traditional community mental health centers and CCBHCs, describing CCBHCs as an enhanced model that integrates behavioral health, primary care, wraparound services, and crisis response. They reviewed the federal history of the model, Kentucky’s entry into the Medicaid demonstration in 2022, and the scheduled end of the enhanced federal match on December 31, 2027. They also emphasized required services such as 24-hour mobile crisis, care coordination, and services for veterans, and described care coordination as a key feature that helps patients follow up after hospital or emergency discharge, manage medications, and connect to transportation and other supports. The presenters gave examples of improved outcomes, including a patient who was able to remain living independently because of coordinated home-based and telehealth support, and they argued that CCBHCs are helping Kentucky build a more responsive crisis system through 988, mobile crisis teams, and crisis stabilization units. They said the model is data-driven, uses performance metrics, and has led to stronger collaboration among community partners. One speaker said more than 100 agencies participated in a Jefferson County community health needs assessment and continued meeting afterward to reduce redundancies and barriers to care. They also said crisis call hub compliance and mobile crisis outreach compliance improved significantly over the past year. Members asked about how navigators and connectors fit into the model, how CCBHCs work with managed care organizations, and how the program could expand statewide. The presenters said navigators are not built into the CCBHC model but may be used through referrals, while the CCBHCs continue to bill MCOs the same way and receive a Medicaid wrap payment for the enhanced rate. They said the goal would be for all community mental health centers to become CCBHCs, but that a state plan amendment would be needed and could not be limited only to CMHCs if submitted to CMS. They estimated about $28 million would be needed statewide to continue the program in the next biennium, combining the loss of enhanced federal match and the state share of enhanced service costs. The board also discussed transportation, with one presenter explaining that their program arranges Medicaid transportation for eligible appointments, and members raised concerns about mental inquest warrant transport and whether sheriffs should remain involved. No votes were taken on the CCBHC or transportation items during the discussion.

Transcript Highlights:

• And interest rates are after capital.
• at more reasonable interest rates. at more reasonable interest rates. attorneys<00:23:49.440>
• <00:33:43.440> Um, rates um to be relatively high. Um, rates um to be relatively high.
• lending to you at the 15% rate, right? lending to you at the 15% rate, right?
• > mostly<01:03:47.440> due with the death rate going up mostly due with the death rate

Keywords: 1191, senate, all

Transcript Highlights:

• In 2022, the legislature capped interest rates on small loans at 36%.
• They don't run interest rates.
• It's not an interest rate; it's a fee, and there is a difference there.
• It's not an interest rate; it's a fee, and there is a difference there.
• Do you have any idea what the average default rate is on these advances?

Transcript Highlights:

• not have to charge that negotiated rate not have to charge that negotiated rate and<01:50:09.600
• Well, the rate, I believe it was Senator Great said the rate that we're doing it.
• Great said the rate that we're doing it. Great said the rate that we're doing it.
• pay uh yes we pay rates to be a member. pay uh yes we pay rates to be a member.
• rate of 8.5%. 8.5%. 8.5%.

Keywords: 928, house, all

Summary: The committee first heard Senate Bill 47, sponsored by Senator Regina Birdsell at the request of the Insurance Department. The bill would clarify that a birth mother’s health insurance is the primary policy for a newborn’s care unless the mother has no coverage or no employer-sponsored coverage. Birdsell and Insurance Commissioner DJ Benton Court said the measure simply codifies the department’s long-standing interpretation of existing law. Representative Miles asked whether the coverage would extend to a grandchild if a young woman on her parents’ plan had a baby, and Birdsell said it would. The hearing on SB 47 was then closed. The committee next heard Senate Bill 121, introduced by Grant Bosi for Senator Kevin Avard. The bill requires insurers to notify the Insurance Department when they stop writing an entire line of business or, in some cases, when they change Medicare Advantage offerings. Benton Court said the bill was prompted by disruption in the Medicare Advantage market, where consumers and the department were confused by carriers exiting, changing plans, or narrowing offerings. He said the department does not regulate Medicare Advantage itself, but does license the carriers, and the notice requirement would help the department advise consumers; he also said noncompliance could affect a carrier’s license and could lead to fines. Members discussed the notice period, and the department and AHIP indicated support for changing it from 120 days to 90 days to align with federal timing. The hearing was closed with plans to work on an amendment in subcommittee. Finally, the committee heard Senate Bill 247, introduced by Representative Brian Cole, which would prohibit network exclusion for pharmacies that refuse to dispense prescriptions when PBM reimbursement is below acquisition cost. Cole said the bill is meant to stop pharmacies from being forced to sell at a loss. Members questioned whether pharmacies voluntarily enter PBM contracts, whether the bill would raise consumer prices, and whether it would mainly affect independent pharmacies. Cole and others said the issue has changed over time because PBMs now control a much larger share of the market, and that the bill would let pharmacies refuse loss-making fills and direct patients to mail order instead. The discussion also noted that the bill excludes Medicare and Medicaid and that the current proposal does not create a middle-ground option for patients to pay a premium at the counter.

Transcript Highlights:

• all of these sort of objective ratings all of these sort of objective ratings um<00:08:57.600>
• rate, 8.9 children per 1,000 children.
• rate, 8.9 children per 1,000 children.
• rate, 8.9 children per 1,000 children.
• rate, 8.9 children per 1,000 children.

Keywords: 958, all

Transcript Highlights:

• My rates are going to go up.
• What is an alternative to the six-month ramp rate that you all are suggesting?
• What is an alternative to the six-month ramp rate that you all are suggesting?
• And so, again, the denominator constantly changes over time as we adjust rates.
• Implementing SB6, transparent and equitable electricity rates are essential.

Keywords: 1184, house, all

Transcript Highlights:

• <00:28:04.760> to rate to rate to 278<00:28:07.279> uh 278 uh 278 uh which<00:28:09.159
• As the tax rates have been cut, the revenues increased.
• As the tax rates have been cut, the revenues increased.
• As the tax rates have been cut, the revenues increased.
• As the tax rates have been cut, the revenues increased.

Keywords: 928, house, all

Summary: The committee first met in a revenue estimate work session to approve an LSR codifying the committee’s revenue estimates. Members reviewed the process for turning the LSR into a House Resolution and discussed how the adopted estimates would be used to amend House Bill 1. After a brief question-and-answer about current revenue splits and the governor’s proposed video lottery and tax-split changes, the committee voted 19-0 to approve the revenue estimates. The committee then moved into executive session on HB 669, which would require all revenue from the statewide education property tax to be deposited into the education trust fund and set an equalized statewide tax rate. Supporters argued the bill would better direct education funding, while opponents said it was unnecessary or duplicative. The committee voted 12-7 to retain the bill (ITL), and a minority report was noted. Next, the committee considered HB 290, which would raise cigarette and electronic cigarette taxes and create a study committee on tobacco and nicotine taxes. Testimony focused on revenue needs, inflation, public health, and concerns that a higher tax could reduce sales or drive purchases across state lines. The committee voted 11-8 to ITL the bill, with a minority report. The committee also ITL’d HB 402, dealing with whether Education Freedom Account payments are taxable income, after debate over unintended consequences and whether the bill’s language was misleading; that vote was 11-8 with a minority report. Finally, the committee opened HB 483, and Representative Tierney moved ITL, arguing the bill’s requirement that the scholarship organization be incorporated in New Hampshire would likely violate the Commerce Clause; the transcript cuts off before the vote on that bill.

Transcript Highlights:

• So if property values go up, you can keep the mill rate the exact same amount and get more money, but
• <00:07:59.520> at<00:07:59.680> which going down, then the the rate at which going
• down, then the the rate at which it'll<00:08:00.160> be<00:08:00.400> per<00:08:01.280>
• So you could have at a general rate up.
• set by other governmental uh mill rates set by other governmental entities.<00:08:55.680> So<

Keywords: 1183, house

Transcript Highlights:

• Obviously, in 2020, due to the pandemic and due to incredibly low interest rates, work from home—you
• Industry due to affordability challenges, prolonged high interest rates, and a new normal land price.
• If I look at Colorado, where the tax rate Is comparable; it's a little bit higher, but it's only taxed
• And when we think about birth rates, all of those things, is that the tail or is that the dog?
• At the end of the day, we pay a lot for these IRBs that come out; they also get g-rated.

Transcript Highlights:

• ><00:14:36.600> that there are only four other rates that there are only four other rates that
• rate as well.
• rate as well.
• rate as well.
• rate as well.

Keywords: 1187, senate, all

Summary: The committee first approved the prior day’s minutes, then heard Senate File 255, which would exempt American Legion and VFW buildings from property tax. The bill’s author and the American Legion Department of Minnesota testified that many posts are struggling financially, that the tax burden can threaten building ownership, and that the posts provide important community services such as charitable gambling support, youth sports, food insecurity assistance, suicide prevention training, and meeting space for veterans and local residents. Several members voiced support, and the bill was laid over for possible inclusion. The committee then took up Senate File 30, a proposal to allow Minnesota estate tax portability for married couples, so a deceased spouse’s unused $3 million exclusion could transfer to the surviving spouse, similar to federal law. The author said Minnesota is an outlier compared with other estate-tax states and that the bill would simplify planning and reduce tax burdens, especially for family farms and other illiquid assets. A CPA and a Minnesota Farm Bureau representative testified that the order of death should not determine tax liability and that portability would help keep family farms intact. The bill was laid over for possible inclusion. Next, the committee adopted an A1 amendment to Senate File 211 and heard the bill, which would create a Minnesota subtraction for Foreign Service pension income, treating it more like military pension income. The author said the change would cover a small number of retirees and would have a minimal fiscal impact, while the testifier described Foreign Service work and said the benefit would recognize their service. The bill, as amended, was laid over for possible inclusion. Finally, the committee heard Senate File 132, which would revise property tax language related to electric power systems by replacing references to attachments and impertinences with broader system-based language. The author said the bill would clarify tax treatment for power co-ops, restore the original intent of the law, and provide stability for Greater Minnesota, with an estimated property tax shift of a little over $700,000. Testimony was beginning when the transcript ended, and no vote on the bill was recorded in the excerpt.