Transcript Highlights:

• managed care plan, establishing that relationship between that patient and a primary care setting as
• Medicaid managed care program.
• State Medicaid managed care program.
• “I didn’t mean their Medicaid managed care plan.
• Again, managed care—that coordination with the managed care organization—is just one key component of

Summary: The committee met to receive implementation updates on recently enacted health care laws from AHCA and the Department of Health. AHCA reported on rural emergency hospitals, explaining the new Class 4 hospital designation, rule changes completed June 1, 2025, and that no Florida hospitals have yet converted, though one North Walton/DeFuniak Springs-area hospital has expressed interest. AHCA also reviewed the non-emergent care access plan requirement for hospitals with emergency departments, saying 83 plans had been received since July 1 and 63 approved, with plans emphasizing patient education, referrals to primary care or urgent care, and coordination for Medicaid managed care enrollees through the Florida HIE/ENS system. Members asked about HIE capacity, data collection, and whether the plans would identify shortages or trigger accountability measures; AHCA said it had moved to a new HIE vendor and would continue gathering data. AHCA also updated the committee on the TEACH workforce program, reporting $6.8 million in FY 2024-25 spending across 59 parent organizations and 229 facilities, with more than 1,800 students and nearly 380,000 clinical hours reimbursed, and said a federal 1115 workforce waiver was unlikely to move forward under CMS. On KidCare, AHCA said House Bill 121’s expansion to 300% of the federal poverty level remains blocked by federal litigation and CMS action tied to premium nonpayment rules, and members and public witnesses urged prompt implementation and asked for enrollment/disenrollment data and the rural health transformation funding outlook. Public testimony largely supported the NCAP and TEACH programs and pressed for action on KidCare. Representatives from health centers said NCAP has strengthened hospital-health center relationships and improved care coordination, including reduced recidivism in some hospitals. A Bond Community Health Center physician said TEACH is helping offset the burden of training students and could help address workforce shortages, especially in rural and underserved areas. Advocacy groups urged the committee to push for implementation of the KidCare expansion, citing children in the coverage gap and rising uninsured rates. The Department of Health then presented on several programs from the 2024-25 session. It reported on the Florida Reimbursement Assistance for Medical Education (FRAME) program, including 78 dentists and 15 dental hygienists funded under the dental track and nearly 1,300 medical professionals funded overall, with 123 dental applications and 71 funded dentists in the most recent cycle. DOH also updated the Screening and Services Grant Program, the Health Care Innovation Revolving Loan Program, the statewide telehealth maternity care program, and the swimming lesson voucher program, noting strong participation and outcomes such as reduced ER visits and improved postpartum follow-up in the maternity program. Finally, DOH said implementation of the HIV prevention drug/pharmacist dispensing law is underway, with three certification courses approved and five certifications issued. Members asked about barriers to wider use of HIV prevention drugs, more detailed maternal outcome data, and the dental workforce program report; DOH said more detailed reports would follow.

Transcript Highlights:

• And long-term supports and services into managed care.
• agencies, managed care plans, policy experts, advocates, and others.
• system, the managed care payment system generally, have been very complex.
• This is for all 26 managed care plans, three dental managed care plans, 57 county mental health plans
• Medical managed care and dental managed care plans licensed under the Knox-Keene Act are allowed to use

Keywords: 988, house, all

Transcript Highlights:

• Enhanced care management launched in January 2022 to provide high-touch, in-person, comprehensive care
• Enhanced care management launched in January 2022 to provide high touch in-person comprehensive care
• So the difference is managed care plans.
• For managed care plans in California.
• It requires health care service plans, including Medi-Cal managed care and dental managed care plans

Summary: The committee heard a budget oversight hearing on the Department of Health Care Services, focusing first on the overall Medi-Cal budget and a March General Fund loan to cover a current-year shortfall. DHCS said the 2025-26 budget proposal totals $193.4 billion, with Medi-Cal projected at $188.1 billion total funds and $42.1 billion General Fund, driven by higher enrollment, pharmacy costs, managed care growth, and costs tied to eligibility expansions and the COVID-era redetermination unwinding. The department said the $3.44 billion loan was needed to manage cash flow and ensure timely payments to providers and plans, while the LAO noted Medi-Cal’s cash-basis budgeting creates volatility and that more detailed estimates would come with the May Revision. Members discussed federal Medicaid threats, the need for transparency on cost drivers, and the impact of pharmacy spending, long-term care, and immigration-related coverage expansions. The second major topic was family health programs, including California Children’s Services, the continuous coverage unwinding, and opioid settlement fund spending. DHCS described CCS funding methodology changes, ongoing county stakeholder work, and a delayed rollout of CCS monitoring and oversight until July 1, 2025, while county representatives and advocates argued the program is underfunded and asked for more technical assistance and a delay in implementation. On the unwinding, the department explained that federal redetermination flexibilities helped maintain coverage after the pandemic, but the Governor’s budget proposes ending them at the end of June 2025; advocates urged making the flexibilities permanent to avoid coverage losses. For opioid settlement funds, DHCS and Finance said the budget increases funding for naloxone distribution while reducing other harm-reduction spending based on updated settlement revenues, prompting criticism from members and public commenters who argued the change would weaken effective harm-reduction programs. The hearing also included an update on Proposition 35 implementation. DHCS said the voter-approved measure continuously appropriates MCO tax revenues beginning in 2025, with up to $4.6 billion annually available for specified Medi-Cal and provider investments in 2025 and 2026, but implementation depends on consultation with the required stakeholder advisory committee. The department and LAO noted uncertainty about future federal rules affecting the MCO tax after 2026. Public testimony largely supported maintaining Medi-Cal expansions, protecting immigrant coverage, preserving harm-reduction funding, and increasing support for community health workers, pediatric dental care, and CCS county administration. No votes were taken during the portion of the hearing provided.

Transcript Highlights:

• I'd argue that much of the managing of care of the managed care organizations is managing their claims
• I'd argue that much of the managing of care of the managed care organizations is managing their claims
• I'd argue that much of the managing of care of the managed care organizations is managing their claims
• I'd argue that much of the managing of care of the managed care organizations is managing their claims
• I'd argue that much of the managing of care of the managed care organizations is managing their claims

Keywords: 918, senate, all

Summary: The segment focused first on Senator John Marty’s bill, SF 3612, which would remove private insurers and HMOs from Minnesota’s state health care programs and replace them with a statewide administrative services model. Marty argued that managed care has created churn, coverage disruptions, and administrative waste in Medicaid and MinnesotaCare, and said the state should instead pay providers directly while investing more in care coordination, case management, and wraparound services through primary care clinics and county-based purchasers. He said the goal is better care, not just savings, though he also cited potential taxpayer savings and pointed to Connecticut as a model. He acknowledged the bill is not expected to become law this year and said a fiscal note and more details are still pending. Marty said the proposal has support from the governor and groups such as the American Cancer Society, but that his current co-authors are all DFL members. He expressed hope for bipartisan support and said the simpler system would also improve fraud detection and transparency. He addressed concerns about insurance-industry jobs by saying workers should be treated fairly and that retraining and dislocated-worker assistance would be part of the transition. He also said the broader goal is universal coverage for all medical needs, including mental health and dental care, without co-pays or deductibles. The second half highlighted Senator Jeff Howe and Minnesota’s Hometown Heroes Assistance Program for firefighters. Howe described the program as a statewide effort for roughly 20,000 career, paid-on-call, and volunteer firefighters that provides up to $20,000 in assistance for occupational illnesses such as cancer and heart disease, along with training, counseling, and family support. He said the program helps firefighters process trauma and has been recognized as the nation’s most comprehensive firefighter well-being initiative. Howe said the most recent version of the bill received unanimous bipartisan support in both chambers, and he suggested future expansions could include retired firefighters and possibly peace officers. The segment also noted a separate therapy approach using retired racehorses to help first responders work through trauma, with participants saying it has helped them stay on the job and manage anxiety and PTSD.

Transcript Highlights:

• The theory was that the HMOs could save money by managing care.
• Though in practice, I managing care.
• I think the senators referred to, you know, not managing care, managing cost.
• I think the senators referred to, you know, not managing care, managing cost.
• care be improved if the current managed care model is eliminated?

Keywords: 1187, senate, all

Transcript Highlights:

• You mentioned Medicaid managed care and of course, as we know, Medicaid managed care started small.
• of Medicaid managed care recognized. >> Thank you.
• managed care structure.
• And the movement of the managed care plan is a pretty technical one that that just but managed care under
• Then the managed care plan.

Keywords: 999, senate, all

Transcript Highlights:

• care management.
• So all of our other managed care plans operate generally at the lower bound rate of a managed care rate
• coordination and care management.
• coordination and care management.
• provided to members in managed care.

Summary: The Assembly Budget Subcommittee on Health held a May Revision hearing covering several health-related budget proposals and broader concerns about the state’s budget structure. The Chair opened by praising some May Revision changes, such as added health IT funding, county administration support tied to Medi-Cal changes, a delay in Medi-Cal cuts for some lawfully present immigrants, and additional support for Covered California subsidies, while criticizing proposed increases in Medi-Cal premiums, changes to senior eligibility, the lack of a Medi-Cal dental solution, and other reductions affecting counties, mobile crisis units, workforce incentives, and physician shortages. The Legislative Analyst’s Office said the state’s budget condition remains weak despite progress on the structural deficit, and the Department of Finance said the May Revision uses a mix of reductions, reforms, revenue proposals, and fund shifts to cut out-year deficits. The committee first heard Department of State Hospitals proposals, including adjustments to county bed billing authority, contract exemption language for online clinical/pharmacy subscriptions, reversion of unspent funds, a revised Metro Central Utility Plant replacement project, electronic health record implementation, and workforce development funded partly through Behavioral Health Services Act resources. DSH also described savings and realignments in incompetent-to-stand-trial and conditional release programs, including extending the independent placement panel program and shifting funds to support additional bed capacity and a mental health rehab center. Members asked about the use of BHSA funds for workforce programs, and the department said the proposal would replace General Fund support with BHSA reimbursements. The Emergency Medical Services Authority proposed funding for statewide behavioral health crisis response guidance and for enterprise system development, and the Department of Managed Health Care proposed modernization of its complaint system and claims-settlement data system to improve oversight and comply with AB 3275. The largest discussion centered on the administration’s BHSA spending plan under Proposition 1, including state-directed prevention, workforce, and other uses, plus General Fund offsets for existing programs. The LAO questioned whether some proposed offsets fit Proposition 1’s non-supplant and eligible-use requirements, while the administration argued the uses were consistent with the measure and that the state-directed share can be adjusted annually. The Commission for Behavioral Health’s proposals drew the most public and member concern. The administration proposed cutting the commission’s Innovation Partnership Fund from $20 million to $10 million and reducing the Community Advocacy Program by $6.7 million, while redirecting BHSA dollars to other state purposes and direct services. Commissioners, advocates, and several members argued the cuts would weaken community voice, reduce support for underserved populations, and disrupt grants already in process; they also objected to using BHSA funds to backfill General Fund commitments. Public commenters, including youth, disability, behavioral health, LGBTQ, tribal, veteran, immigrant, and community-based organization representatives, overwhelmingly opposed the cuts and urged preservation of prevention, advocacy, mobile crisis, and innovation funding. No votes or final actions were taken during the hearing.

Transcript Highlights:

• I worked exclusively in the Medicaid managed care area.
• live with our SMMC, statewide Medicaid managed care 3.0 program.
• Data shows that year over year in managed care, quality has improved.
• Yesterday, we had in our health care human services committee, we had talked about managed care and a
• So that's one way, like retail-wise, but from a more holistic perspective, our care... ...care managers

Summary: The committee held a panel discussion focused on how Florida health care organizations are working to improve access, quality, and affordability. Panelists from Florida Community Care/Independent Living Systems, Sunshine Health, AdventHealth, UF Health, and Nemours described their approaches, including Medicaid managed care, value-based contracting, community partnerships, mobile screening units, smart-room technology, telehealth, and specialized programs for maternal health, children, and complex chronic conditions. Several speakers emphasized that managed care and coordinated care can improve outcomes while reducing unnecessary utilization and costs. Members asked about the impact of Medicare’s V28 changes, mobile cancer screening, urgent care versus emergency room billing, pediatric specialty access, complaint resolution, Black maternal mortality, provider shortages, network adequacy, and the use of AI in prior authorization. Witnesses said V28 has affected providers and revenue, UF Health’s mobile screening program is expanding beyond a few cancer types, and its urgent care model bills patients at the appropriate level rather than both urgent care and ER rates. Nemours said it reduced specialty wait times through scheduling changes, telemedicine, and registry tools, while AdventHealth described postpartum coordination and maternal heart programs to reduce maternal complications and mortality. On complaints and access problems, panelists said their organizations use patient/member advocates, care managers, call centers, and escalation processes to resolve issues, and Sunshine Health specifically discussed a transportation complaint that was addressed with its vendor and the family. Sunshine Health also said it is not using AI for prior authorization, though it is exploring responsible uses elsewhere, and Florida Community Care said it is not using AI in utilization management. In closing, panelists identified workforce shortages, provider burnout, and high-cost drugs as the biggest ongoing challenges. The meeting ended with thanks to the panel and adjournment after Representative Brackett moved to rise, without objection.

Transcript Highlights:

• costs for managed care and fee-for-service.
• There are certain benefits that are only available in managed care, including enhanced care management
• and care management, like ECM.
• provided to members in managed care.
• provided to members in managed care.

Keywords: 987, senate, all

Transcript Highlights:

• Unfortunately, the current managed care model does not do that.
• So I'm advocating managed care doesn't work for us.
• managed care model does not do that. managed care model does not do that.
• > care<00:47:30.400> doesn't So I'm advocating managed care doesn't So I'm advocating managed
• <00:53:00.880> care Medicaid and its managed care Medicaid and its managed care contractors

Keywords: 958, all

Summary: The Medicaid Oversight Advisory Board met with a quorum, approved the November 12 minutes by voice vote, and then heard a presentation from former Governor Ernie Fletcher and Dave Johnson on Medicaid reimbursement for substance use disorder (SUD) treatment. Fletcher argued that addiction should be treated as a chronic disease requiring a longer continuum of care, not just short residential stays, and said recovery should combine clinical treatment with social supports such as housing, transportation, employment, peer coaching, and recovery housing. He cited data on overdose trends, low treatment rates, and high costs for people with SUD, and said current reimbursement models create poor incentives and do not adequately support long-term recovery or measure outcomes well. Fletcher proposed a “carve through” model administered at the MCO level with standardized metrics, data sharing, and an independent recovery coordinator that would assess patients, coordinate care, and connect them to clinical and social recovery services. He suggested using bundled payments, shared savings, and partial risk arrangements, with recovery housing reimbursed on a PMPM or weekly basis and funded in part through existing Medicaid spending and other sources such as opioid abatement funds. He also emphasized peer support, telemedicine, criminal justice coordination, workforce and education supports, and the use of technology, including text messaging and possibly AI, to maintain long-term follow-up and identify relapse risk. Members questioned how the model would work in practice, especially the education and staffing requirements for recovery coordinators, reimbursement levels, and how many patients each coordinator or peer would serve. Fletcher said peers could be certified and would need additional training in assessments such as ASAM and recovery residence standards, but he did not give a precise salary figure, saying the market and bundled rates would determine that. He also said follow-up should continue for years, noting relapse risk over the first 18 to 24 months and that meaningful employment and ongoing peer contact help sustain recovery. No formal vote or action was taken on the substance use presentation.

Transcript Highlights:

• Meanwhile, patients who could have been cared for by a primary care provider or social worker can end
• The CARES programs varied in the services they provided.
• Out of hospital care back to the home.
• OEDC has six units that manage 16 economic development programs.
• And targets, establishing a performance management framework, and developing a process to manage program

Summary: The Joint Legislative Audit and Review Committee’s Initiative 900 subcommittee held a hybrid public hearing on two State Auditor performance audits. The first audit examined efforts to reduce non-emergency use of emergency systems through CARES programs. Auditors reported that Washington has 52 fire-agency-led CARES programs in 26 counties, but many communities without programs said they need one. Major barriers included unstable funding, difficulty hiring qualified staff, volunteer-based rural departments, and lack of statewide guidance. The audit also found that only about half of programs tracked both required performance measures, and it recommended that the legislature consider private insurance reimbursement options and convene a statewide work group to develop guidance, standards, and possible changes to the role of the Department of Health. Agency representatives and fire officials largely supported the findings and emphasized that short-term grants and one-year contracts make programs hard to sustain. Committee discussion focused heavily on financing, especially Medicaid reimbursement and accountable communities of health (ACHs). Auditors clarified that the 10% figure cited in the report referred to direct Medicaid reimbursement for treat-and-refer services, which some agencies do not pursue because the $115 rate is too low relative to the administrative effort. Several fire officials testified that their programs rely on grants and ACH support, but that funding is often year-to-year and uncertain. They also described the value of CARES programs in reducing emergency room use, jail detentions, and long ambulance wait times, while noting barriers to sharing patient records across systems. Members asked whether the new public safety sales tax authority could help, but fire district representatives said it is not a direct funding option for them. The second audit reviewed performance management in the Department of Commerce’s Office of Economic Development and Competitiveness. Auditors found that the division does not yet have a statewide economic development strategic plan and that performance management is inconsistent across its 16 programs. In a limited review, all six sampled programs had goals, but only half clearly identified performance measures and targets, and only three tracked outcomes and published results. The audit highlighted leading practices from other states, including strategic planning, regular progress reporting, aligning program goals with agency goals, and using performance-based contracts and grant monitoring. Recommendations urged Commerce to seek stakeholder input, assess internal and external conditions, set goals and measures, align programs with the strategy, and strengthen monitoring and evaluation. Commerce officials agreed with the audit and said the division is already working toward a strategic plan, with a new assistant director to be hired and a target of completing the work by mid-next year. Members pressed the department on how the plan would connect to workforce, higher education, housing, and other economic development systems, and asked Commerce to return to JLARC next year with progress updates. The meeting ended with instructions for submitting written public comments and notice of the next JLARC meeting schedule.

Transcript Highlights:

• to direct a managed care plan to pay a provider a certain amount.
• On the managed care side, this cares reported to us that they they paid for 959,000 biomarker claims,
• care contracts and the competition rates for managed care.
• managed care side, you know, we've managed care plan contracts have been updated.
• And the all these examples to manage the managed Care channel that managed care provider doesn't actually

Transcript Highlights:

• And case managers do a comprehensive assessment to create a comprehensive care plan, which is the written
• And case managers do a comprehensive assessment to create a comprehensive care plan, which is the written
• What I'm trying to understand is, as a case manager ensuring the person's under care, my understanding
• What I'm trying to understand is, as a case manager ensuring the person's under care, my understanding
• permanent care. permanent care.

Keywords: 928, house, all

Summary: The committee first approved the minutes and consent calendar, then moved through several Department of Health and Human Services Medicaid-related rules. Rule 25-220 from the Department of Energy was postponed until June so stakeholders would have more time to review revised language. Rule 25-240, involving Medicaid income verification and deductible provisions for medically needy applicants, was adopted after staff noted the cited sections had expired but the agency said it had continued operating under federal law and the state plan; the agency also said it had begun rulemaking on the cited provision. Rules 25-265 and 2633 were also adopted, with staff explaining that although parts of the rules had expired, the agency had continued implementing the policies through the Medicaid state plan, billing manuals, and related rules. The most extended discussion centered on rule 25-304 from the Bureau of Aging and Adult Services, which covers case management services for the CFI program. Staff and the agency explained that the amended conditional approval request clarified how case management agencies indicate staffing capacity, how telehealth decisions are evaluated, and that the department—not the case management agencies—sets the timeline for accepting or denying cases. The agency said the rule is intended to ensure participants are not pushed into telehealth when they do not want it or cannot use it, while leaving technical and clinical telehealth decisions to the provider. A case management provider testified in opposition to parts of the rule, arguing that the committee should not require agencies to admit unverified patients, that reimbursement-rate issues belong in legislation, that the quality-management section duplicates existing licensure oversight, and that the telehealth language improperly gives case managers authority over how other licensed providers deliver services. Committee members questioned whether the telehealth language was simply allowing case managers to determine whether telehealth fits a person’s care plan, and agency representatives responded that this was the intent. No final vote on rule 25-304 is shown in the transcript excerpt.

Transcript Highlights:

• care partners. from other public sources through our managed care partners.
• Medicaid managed care. Today, about 98% of Medicaid clients are in Medicaid managed care.
• Managed care works just like insurance; the state.
• Everything at this point is in Medicaid managed care. Managed care works just like insurance.
• care setting before carving in any waivers into managed care.

Keywords: 1184, house, all

Transcript Highlights:

• Currently, the Agency for Health Care Administration manages all the other managed care plans in the
• state, and this would complete that so that they are now managing all the managed care plans and not
• Currently, the Agency for Health Care Administration manages all the other managed care plans in the
• Currently they are carved out of managed care contracts and the They are carved out of managed care contracts
• Now, present day, AHCA has been managing this statewide Medicaid-managed care process for 10 years.

Summary: The Health Care Facilities and System Subcommittee met with a quorum and considered five bills. HB 1101 on out-of-network providers drew the most discussion; Rep. Albert said it would require written notice when a patient is referred to an out-of-network provider and would count certain insurer payments toward deductibles. Several members and the Florida College of Emergency Physicians raised concerns about placing the burden on doctors’ offices, possible delays in referrals, and unclear enforcement, but the bill was reported favorably 16-2. Public testimony included support from AARP and concerns from emergency physicians about ER workflow and insurance-network transparency. The committee then unanimously approved PCS for HB 475, reducing fines for ambulatory surgery centers that violate good-faith estimate requirements from $1,000 to $250 per day, with a lower maximum penalty. The bill sponsor said the change was intended to right-size penalties for smaller facilities; witnesses from surgery centers and HCA supported it. HB 797, which would allow a nonprofit retirement community serving veterans and spouses to create veteran-and-spouse nursing home beds and transfer a certificate of need within 100 miles, also passed unanimously after members discussed whether it could affect access for veterans; the sponsor said it would create additional private beds rather than displace existing ones. HB 1085 on the Children’s Medical Services Program was amended and reported favorably 14-3. The bill would move managed care plan operations for medically fragile children from the Department of Health to AHCA, keep clinical eligibility at DOH, and shift PPEC services fully into managed care. The adopted amendment changed the waiver provision to require AHCA to develop and present a comprehensive redesign plan for the Medicaid model waiver for children receiving private duty nursing. Several members supported the goal but raised concerns about eliminating family choice and the impact on medically fragile children. Finally, HB 1353 on home health care services passed unanimously. The bill would remove geographic limits on home health administrators, allow more licensed RNs including contract RNs to perform visits, and revise the home health excellence award program. Supporters said it would address workforce shortages and improve access, while one member warned it could increase costs and competition for nurses. The committee adjourned after reporting all five bills favorably.

Transcript Highlights:

• care management.
• members in managed care.
• members in managed care.
• members in managed care.
• members in managed care.

Keywords: 988, house, all

Transcript Highlights:

• The managed care does include the acute medical, the long-term care, and the home-care, home-community-based
• And the response from APD was, “You have the Medicaid-managed care waiver.”
• And the response from APD was, “You have the Medicaid-managed care waiver.”
• I mean, I’m on Medicaid-managed care. Medicare. The pilot is a very important program.
• We do have some concerns as it relates to the managed care pilot.

Summary: The committee met with a quorum present and heard six bills, all of which were reported favorably. HB 1567, relating to insulin administration by direct support professionals, was amended to clarify the type of insulin that may be administered and to allow supervision of self-administration of an insulin pen. Supporters described the bill as a way to keep people with developmental disabilities in group homes rather than forcing institutional placement; the amendment and bill both passed unanimously, 17-0. PCS for HB 1103, on services for persons with disabilities, would expand the APD managed care pilot statewide in phases, require more transparency on waitlist data, create a statewide family care council, and address transition services for young adults leaving foster care. Testimony was mixed: supporters emphasized the long APD waitlist and the need for a voluntary option, while some witnesses and members raised concerns about the accelerated rollout, limited data, and preserving consumer-directed care. The committee adopted the bill 17-0. CS for HB 127, on exceptional student education, would create micro-credentials and coordinate with the Florida Center for Students with Unique Abilities and OSHA to support students with disabilities transitioning to work; it passed 17-0 after testimony from a parent and advocates. HB 989, concerning licensure of family foster homes, was amended to streamline license transfers for foster parents moving within Florida while maintaining oversight and directing DCF rulemaking. A teacher and other supporters said the bill would reduce bureaucracy and help children remain in stable homes; it passed 17-0. PCS for HB 1091, on substance abuse and mental health care, updates processes related to the 988 crisis line, methadone treatment needs assessments, and forensic evaluators, and adds data/reporting requirements for DCF managing entities. After one amendment and testimony from supporters and one opponent, it passed 16-0. Finally, HB 633, on behavioral health managing entities, was amended and then approved 17-0; it requires more structured data and reporting from managing entities to increase accountability and transparency in the behavioral health system.

Transcript Highlights:

• As we heard earlier as well, health care, not just public sector health care, health care in general,
• And we need to do a better job with matching managed care requirements.
• And we need to do a better job with matching managed care requirements.
• Those who are reliant on continuing to receive care from DMH case managers will continue to get the quality
• , pediatric health care, and oncology care.

Keywords: 995, all

Summary: The committee heard budget testimony from Department of Mental Health Commissioner Brooke Doyle, who said DMH serves about 29,000 people and is facing rising demand, higher operating costs, and uncertainty about federal funding. She explained that the FY26 budget prioritizes fully funding the state-operated inpatient system, which is at 100% occupancy and often serves people transferred from Bridgewater State Hospital, while making reductions in other areas to balance the budget. Those reductions include a 50% cut to case managers, a pause on closing the Pocasset unit pending a working group on Cape access, and changes to youth and contracted services such as right-sizing IRTP and CIRT, reducing Youth PACT from seven teams to three, scaling back flex and jail diversion grants as ARPA funds wind down, and preserving the behavioral health helpline and community-based crisis services. Members from Western Massachusetts and the Cape raised concerns about access, staffing, and the impact of cuts, and Doyle said the department would continue operating IRTP services, improve the referral process, and work with stakeholders on the Pocasset review and other access issues. The committee also discussed school-based mental health, 988, loan forgiveness for workforce recruitment, and the role of co-response programs for law enforcement. Secretary Robin Lipson then testified for the Executive Office of Aging and Independence, describing a proposed FY26 budget increase of about 21% to support councils on aging, home care, elder abuse investigations, caregiver support, care transitions, and nutrition programs. She said the agency is managing rising demand, especially from the growing 80-plus population, and noted uncertainty around federal Older Americans Act funding after the federal disbursement agency was disbanded. To control costs, the office will manage intake and caseload growth in a fully state-funded home care program, but current clients will not lose services. Lipson also highlighted a new $1 million line item for local mini-grants to support age-friendly initiatives. In questions, members focused on elder scams, and Lipson said scams are increasing and the agency is working with banks, district attorneys, and public awareness campaigns. The Health Policy Commission’s Executive Director David Seltz presented the agency’s FY26 request and said the biggest challenge is health care affordability, with family premiums near $29,000 annually and many residents delaying care because of cost. He emphasized that recent legislation significantly expands HPC’s role through a new Office of Pharmaceutical Policy and Analysis, which will examine the drug supply chain and pricing, and a new Office of Health Resource Planning, which will support statewide planning around closures and access gaps. The new law also creates task forces on maternal health access and primary care, and adds transparency and oversight for private equity in health care. Members asked about pharmaceutical costs, GLP-1 weight-loss drugs, 340B, and maternal health closures; Seltz said the data show rapid growth in GLP-1 spending and that the new offices will help the state better understand cost drivers and access problems. The Center for Health Information and Analysis then began its testimony, describing its role as the state’s data hub for health care spending, utilization, quality, and affordability analysis.

Transcript Highlights:

• We operate Crotch Mountain community care, which is case management, and we also do CMF Kids, which works
• So long-term care began long-term care.
• programs for the benefit of management programs for the benefit of child<01:31:23.679> care<01
• > u child care facilities foster care u child care facilities foster care u placement<01:35:50.400
• . management. management.

Keywords: 1191, senate, all

Transcript Highlights:

• JJ JUST ESCAPED THE MANAGED HEALTH CARE PLAN FOR CHILDREN WITH HEALTH CARE NEEDS LIKE THE WAIVER YOUR
• SO IF YOU SWITCH TO MANAGED CARE I TRUST YOU WILL ENSURE THAT ANYTHING PEOPLE ON THE MANAGED CARE PILOT
• IS MANAGED CARE THE RIGHT WAY TO DO IT? I DON'T KNOW.
• IT IS MANAGED CARE AND SENATOR DAVIS I UNDERSTAND THAT YOU ARE NOT A FAN OF MANAGED CARE.
• CARE AND THERE'S NO OPT IN OPT OUT NOW AND, SO, IF WE ARE ROLLED INTO MANAGED CARE WITH NO OPT OUT ONCE

Keywords: 999, senate, all