Transcript Highlights:

• Engaging in a patent dance that creates barriers to innovation and competition, generics and biosimilars
• This bill makes thoughtful reforms to the... process by which biologic drug makers and biosimilar competitors
• I think we all know that generics biosimilars have to be safe, but for too long the pharmaceutical companies
• that a petition was filed, quote, for the primary purpose of delaying the approval of generic or biosimilar
• Access to affordable generics and biosimilar acts, would anyone like to speak on the bill?

Bills: SB1040, SB1041, SB1095, SB1096, SB1097, SB527

Keywords: drug competition, product hopping, generic drugs, biosimilars, federal regulations, FTC Act, patent, biological products, healthcare access, affordable prescriptions, Medicare, Federal Trade Commission, sham petitions, competition, public health, unfair competition, healthcare, pharmaceutical, antitrust law, pay-for-delay

Summary: The meeting focused on addressing the high cost of prescription drugs and the abusive practices that contribute to elevated prices affecting American families. Several bills were presented, including proposals to end pay-for-delay deals and to enhance transparency in the operations of pharmacy benefit managers (PBMs). The discussion was notable for its emphasis on consumer protection and ensuring that cheaper generic drugs reach the market more effectively. Members expressed frustration over past attempts to pass similar legislation stalling in the Senate, leading to renewed efforts to push these bills forward.

Transcript Highlights:

• AAM represents the generic and biosimilar manufacturers.
• AAM represents the generic and biosimilar manufacturers.
• Almost 90% of the claims dispensed are generic and biosimilars.
• And then we add those biosimilars.
• biosimilar?

Bills: HB591, HB765, HB826, HB870, HB938, HB1151, HB1162, HB1176, HB1196, HB1236, HB1241

Keywords: family leave, insurance, paid leave, employment benefits, caregiver support, liability insurance, coverage defenses, direct action, judgment enforcement, legal procedures, insurance referrals, compensation, non-licensed agents, consumer protection, insurance products, HB 870, Act 907, Louisiana insurance, health insurance, prescription drugs

Transcript Highlights:

• plan of the biosimilar. require a patient to try a biosimilar when the net cost of the plan of the biosimilar
• biosimilar to another biosimilar.
• biosimilar to another biosimilar.
• biosimilar to another biosimilar.
• It is not talking about a biosimilar being switched to another biosimilar.

Keywords: 988, house, all

Transcript Highlights:

• plans, The bill would require a patient to try a biosimilar when the net cost of the plan’s biosimilar
• When we finally did start a biosimilar, she didn’t respond the same.
• When we finally did start a biosimilar, she didn't respond the same.
• We find out weeks later with the biosimilars.
• And in other countries in the world, you know, they have biosimilar, well, they're equivalent of a biosimilar

Keywords: 988, house, all

Transcript Highlights:

• plans, The bill would require a patient to try a biosimilar when the net cost of the plan’s biosimilar
• When we finally did start a biosimilar, she didn’t respond the same.
• And because biosimilars are not exact copies, new problems can...
• And in other countries in the world, you know, they have biosimilar, well, their equivalent of a biosimilar
• And in other countries in the world, you know, they have biosimilar, well, they're equivalent of a biosimilar

Summary: The committee heard several bills, beginning with SB 1312 by Senator Richardson on abandoned endowed-care cemeteries. Richardson described vandalism, theft, and neglect at abandoned cemeteries and said the bill would define abandonment, create a process for local governments to declare a cemetery abandoned, and allow the Bureau to act as conservator of endowment funds. Support came from Marin County, while county and special district groups opposed or had concerns, arguing the bill could shift burdens to local governments or public cemetery districts without enough safeguards. Members expressed general support but noted the need for further work; the bill was discussed but no final vote was taken in the excerpt. The committee then took up SB 758 by Senator Umberg, which would restrict retail sales of nitrous oxide to curb misuse. Supporters, including the League of California Cities, narcotic officers, counties, pediatricians, and other local governments and health groups, said easy access at smoke shops and convenience stores has fueled recreational abuse and health harms. There was no opposition testimony, and members voiced strong support for a statewide approach over city-by-city bans. The bill was well received, with the author closing in support. Dr. Weber-Pierson presented SB 1094, a health care affordability bill on biosimilars and biologic substitution. The bill would allow pharmacists to substitute biosimilars under certain conditions, require advance notice to providers and patients, and add reporting on savings; the author said amendments would strengthen provider notice and preserve the ability to mark prescriptions “do not substitute.” Supporters from health plans, insurers, pharmacies, labor, business, and some provider groups argued the bill would lower costs and expand access. Opponents, including dermatology and rheumatology groups and biotech interests, warned about non-medical switching, prior authorization delays, and patient harm. After extensive discussion, the committee voted 13-0 to pass SB 1094 to the Committee on Health. The committee also passed SB 849 by Dr. Weber-Pierson, which would bar reinstatement of physicians who surrendered their licenses while a sexual misconduct accusation was pending. The Medical Board and California Medical Association were generally supportive or neutral, and members praised the bill’s patient-protection focus. SB 993 by Senator Ochoa Bogh, which limits routine disclosure of identifying information for mental health professionals in correctional and psychiatric settings while preserving complaint processes, also passed unanimously to Appropriations. SB 1002 by Senator Niello, extending the David Hall Act to allow certain patients in remission to continue telehealth care with out-of-state specialists, drew strong patient support but opposition from the Medical Board and CMA over licensure and oversight concerns; the committee voted it out on a split roll with some members not voting. Finally, SB 1263 by Senator McGuire, aimed at protecting wildfire survivors and workers by requiring licensed, trained contractors for post-disaster residential debris removal, received support from labor and the Contractors State License Board, with contractors raising a narrower amendment concern about scope.

Transcript Highlights:

• I am all in favor of biosimilars.
• one, but to try the biosimilar.
• I am all in favor of biosimilars.
• This just allows for cost savings, try the biosimilar first.
• This just allows, you know, to try a biosimilar to see if that... ...allows, you know, to try a biosimilar

Summary: The committee heard several bills, but much of the meeting focused on House Bill 306, which would require disclosure when a consumer is interacting with a chatbot rather than a human. Sponsor Senator Townsend described it as a consumer protection measure and said the bill is meant to keep pace with rapidly changing AI technology. Committee members and witnesses raised concerns about the bill’s enforcement structure, especially private rights of action and penalties that could apply even without actual consumer harm. The Department of Justice said the bill would apply where the conduct has a Delaware nexus, and that the disclosure requirement is the key consumer protection. Industry witnesses and chambers of commerce opposed the bill as drafted, arguing it would create broad compliance burdens and expose businesses to excessive litigation risk without a harm requirement or clearer safe harbor language. Earlier in the meeting, the committee discussed House Bill 429, which would update Delaware’s step therapy exception process to include biosimilars and interchangeable biologics. Senator Poore and supporters from Highmark and the Department of Insurance said the bill would modernize insurance law, improve access to effective treatments, and reduce costs; they cited national savings from biosimilars and said the bill has agency support. Members asked about Delaware-specific savings, patient switching, and how the process would work, but no vote was taken during the discussion. The committee also heard House Bill 310, which would exclude large data centers from Blue Collar Jobs Act tax credits; the sponsor said the bill is intended to ensure large energy users contribute more to state and local revenues, while supporters and opponents debated competitiveness and community impacts. House Bill 406, on allowing insureds to choose their auto repair shop, and Senate Bill 347, a cleanup bill related to medical debt collection and personal property levies, were also presented without opposition in the hearing. House Bill 253, concerning who may receive letters testamentary or of administration, was described as a cleanup to align statute with existing practice. The committee approved the meeting minutes, but the transcript does not show final votes on the bills discussed.

Transcript Highlights:

• , not with biosimilars.
• biosimilar to another biosimilar.
• , not with biosimilars.
• biosimilar to another biosimilar.
• It is not talking about a biosimilar being switched to another biosimilar.

Summary: The Assembly Health Committee heard several measures, beginning with SB 331 by Sen. Menjivar, which would require large-group health plans to cover hearing aids for children. The author and supporters described the bill as a long-running effort to address a developmental emergency and reduce out-of-pocket costs for families, while opponents were absent. Testimony from parents, advocates, medical experts, and organizations emphasized the importance of early access to hearing aids; committee members voiced strong support, and the bill was moved on a do-pass basis to Appropriations, with several members requesting to be added as coauthors. The committee then heard SB 608, also by Sen. Menjivar, to expand access to condoms in school-based health centers and related settings and to prevent barriers such as ID checks. Supporters, including students and school health advocates, argued the bill would improve sexual health and reduce stigma, while opponents from family and faith groups argued it would undermine parental authority and normalize early sexual activity. The bill was supported by committee members and moved forward on a do-pass basis to Appropriations. Next, SB 971 by Sen. Choi proposed community-based healthy aging partnerships for older adults, with testimony from the California Senior Legislature and supporters from aging and dementia organizations. The measure was described as voluntary and focused on connection, independence, and local collaboration; there was no opposition, and the committee moved it on a do-pass basis to Appropriations. The committee also heard SB 869 by Sen. Weber Pierson, which would require warning icons and statements on chain restaurant menus for beverages with very high added sugar content. Supporters framed it as a transparency and public health measure, while restaurant and beverage industry representatives opposed it unless amended, citing cost and menu-space concerns; the bill was nevertheless moved on a do-pass basis to Appropriations after a roll call vote, with some members voting no and the measure placed on call. The committee also considered SB 950 by Sen. Weber Pierson, aimed at ensuring timely coverage of FDA-approved, medically necessary treatments for early-onset Alzheimer’s disease on commercial plans. Supporters, including the Alzheimer’s Association and a patient advocate, said the bill would reduce delays and barriers to care, while health plan representatives opposed it over step therapy and utilization-management concerns. Members discussed the limited treatment window and the need for early access, and the bill was moved on a do-pass basis to Appropriations. In addition, SB 490 by Sen. Umberg would set timelines for DHCS investigations of unlicensed sober living homes and allow counties to assist if the department cannot act in time; supporters from Anaheim and a patient-brokering survivor described serious abuse and oversight gaps, while county behavioral health representatives opposed the county role as an unfunded and potentially liability-creating burden. After discussion, the bill was also moved on a do-pass basis to Appropriations. Finally, the committee began hearing SB 1037 by Sen. Weber Pierson on health insurance affordability and rate review, with supporters arguing it would tie premium increases more closely to affordability targets and public reporting; the transcript cuts off before the committee completed action on that measure.

Transcript Highlights:

• <00:31:41.840> product effectiveness of a biosimilar product effectiveness of a biosimilar
• <00:31:59.799> competition opportunities for biosimilar competition opportunities for biosimilar
• <00:32:02.480> can by adding biosimilars Minnesota can by adding biosimilars Minnesota can
• regarding the biologic and biosimilar regarding the biologic and biosimilar Provisions<00:51:09.119
• to lower cost biosimilars to lower cost biosimilars am<00:51:27.880> also<00:51:28.160>

Keywords: 1187, senate, all

Transcript Highlights:

• the biosimilar launched, providing immediate cost relief to patients.
• And let me share that the pipeline for biosimilars is growing.
• I have a... to Humera biosimilars, saving $1.5 billion to date.
• And so, oh, the biosimilar issue—interesting.
• And so, oh, the biosimilar issue—interesting.

Summary: The committee first heard Senate Bill 1414 by Sen. Polsky on congenital cytomegalovirus (CMV) education. The bill would require the Department of Health, working with medical experts, to create and distribute CMV educational materials to expectant and new parents or caregivers through hospitals, birth centers, and OB/GYN practices. An amendment removed a section that would have required instruction for medical professionals, and the amended bill was reported favorably as a committee substitute. The committee then took up a block of confirmations. Appointees on tabs 2 through 7 were recommended favorably in one vote, and Chavon Harris was separately confirmed as Secretary of the Agency for Health Care Administration after extensive questioning. Senators praised her leadership and experience, while others raised concerns about Medicaid redeterminations, the state’s CORE modernization project, Hope Florida, and a DCF anti-marijuana ad campaign; Harris said she would follow up on some issues and defended the agency’s work on transparency, managed care oversight, and access to care. Her confirmation was recommended favorably, with Sen. Berman noting opposition. Several health-related bills were then heard and advanced. SB 186 by Sen. Garcia expanded epilepsy training requirements for school personnel, including charter school bus drivers, and was reported favorably. SB 902 by Sen. Garcia, after amendments narrowing dental workforce provisions and allowing certain seizure rescue medication delegation to family home health aides, was reported favorably; testimony focused on medical marijuana regulation, practitioner accountability, and concerns about park and child-care proximity restrictions. SB 196 by Sen. Sharif created a uterine fibroid research database with privacy protections and was reported favorably after emotional testimony from a patient and supporters. SB 688 by Sen. Rodriguez would reestablish licensure of naturopathic doctors; it drew both support and skepticism about diagnosis and treatment boundaries, but was reported favorably. SB 1574, Maddie’s Law, would add biliary atresia screening to newborn screening and was strongly supported by parents describing a delayed diagnosis; it was reported favorably. SB 878 on clinical laboratory personnel, SB 1092 on podiatric medicine and certain cellular/tissue-based products, and SB 1032 on medical marijuana registry timelines and veteran fee waivers were also reported favorably, while SB 1032 drew debate over longer renewal/supply periods. The committee then began SB 1760 on Medicaid oversight and program transparency, with the sponsor describing the bill’s creation of a joint legislative oversight committee and a legislative actuary.

Transcript Highlights:

• We also modeled spending on Humira, which only recently had a biosimilar launch.
• Biosimilars, you can think of them as the generic to a biologic.
• the source of our biosimilar pricing?”
• “Biosimilars, you can think of them as the generic to a biologic.
• the source of our biosimilar pricing?”

Keywords: 928, house, all

Summary: The working session focused on the New Hampshire Prescription Drug Affordability Board’s budget request and its recent work. Early discussion centered on a technical question about a statutory dedicated fund for donations: members asked why the budget did not show a line item for accepting donations, and DHHS CFO Nathan White explained that the statute already authorizes the fund, but because no revenue has been received yet, it does not appear in the budget. He said any future donations would go through the normal process under RSA 14:30-a, with fiscal committee and Governor and Council approval and a memo to the Department of Revenue Administration. The chair clarified that the account was not a prerequisite to soliciting donations, and White said the fund would supplement, not replace, General Fund support. Kirk Williamson, the board’s executive director, then presented the board’s mission and budget. He said the governor’s budget provides about $256,500 in the first year and slightly more in the second, all General Funds, and that the board had distributed a technical amendment to continue the executive director position. He described the board’s role as analyzing prescription drug costs, identifying savings opportunities, monitoring market trends, promoting transparency, and making recommendations to the legislature and public payers. He also emphasized that the board operates publicly, with live-streamed meetings and a stakeholder advisory council that includes unions, state agencies, Medicaid, corrections, higher education, and other stakeholders. A major topic was the board’s estimate of $6 million in potential savings, based on Medicare’s newly negotiated prices for 10 drugs. Williamson explained that the board used those federal negotiated prices as a benchmark to estimate what New Hampshire public payers might be missing by not having similar leverage, and said the board is trying to build evidence for future recommendations rather than directly setting prices. Members asked how those potential savings could become actual savings, and Williamson said the board is sharing findings through its advisory council and feedback loops, though it has not yet sent a formal recommendation letter to specific purchasers. He also discussed the difference between pharmacy-benefit spending, which relies heavily on PBM-negotiated rebates, and medical-benefit spending, which is administered differently and is being added to the board’s next report. Williamson highlighted other work, including a model on Humira and a pending legislative effort to improve biosimilar competition, plus a proposed state-backed pharmacy savings card that would be no cost to the state and could save users about $240 per prescription based on Connecticut’s experience. No votes were taken during the session.

Transcript Highlights:

• time that the biosimilar launched, providing immediate cost relief to patients.
• We saw an opportunity to truly jump-start the adoption of biosimilars.
• And the pipeline for biosimilars is growing.
• ...biosimilars, how much of that money did the state get?
• And so, oh, the biosimilar issue. Interesting.

Bills: S0688, S1414, S0186, S0902, S0196, S1574, S0878, S1092, S1032, S1684, S1686, S1760

Keywords: cytomegalovirus, education, maternal health, newborn care, infectious diseases, student health, epilepsy, seizure disorders, school safety, training requirements, medical marijuana, low-THC cannabis, neurofibromatosis, healthcare, state regulations, child care facilities, public safety, grant program, uterine fibroids, health database

Summary: The committee took up several health-related bills and confirmations. It first heard SB 1414 on congenital cytomegalovirus education, which would require the Department of Health to develop and distribute educational materials to expectant and new parents through maternity, prenatal, newborn, and OB-GYN settings; an amendment removed a section on required instruction for medical professionals, and the bill was reported favorably as a committee substitute. The committee then approved a block of appointees on tabs 2 through 7 and separately confirmed Chavon Harris as Secretary of the Agency for Health Care Administration after her testimony on Medicaid accountability, transparency, managed care oversight, rural health, behavioral health, and the state’s technology modernization efforts. Senators asked Harris about Hope Florida, Medicaid redeterminations, the CORE project, an anti-marijuana ad campaign at DCF, and compliance with a federal Medicaid-related court order; she said she would follow up on some issues. The confirmation was recommended favorably, with Senator Berman voting no. The committee next passed SB 186 on student health and safety, which expands epilepsy and seizure-disorder training requirements to more school personnel, including bus drivers and charter school staff, and requires seizure-first-aid posters and updated Department of Health education efforts. It also approved SB 902 on Department of Health issues after amendments narrowed the bill’s scope and added provisions on medical marijuana regulation, early childhood intervention, practitioner accountability, and autism workforce development; one speaker raised concerns about marijuana dispensary location restrictions and low-THC ratios. SB 196 creating a uterine fibroid research database was also reported favorably after an amendment protecting patient privacy; the bill drew emotional testimony from a patient describing severe symptoms and the need for more research. SB 688 on naturopathic medicine was approved after committee discussion about scope of practice, referral obligations, and whether naturopathic care should be adjunctive to conventional medicine; supporters described complementary care and access issues, while opponents worried about delayed treatment for serious disease. Later, the committee passed SB 1574, “Maddie’s Law,” to add biliary atresia screening to newborn screening using the same blood specimen already collected at birth and to launch an education campaign; parents of a child affected by the disease testified that earlier screening could have prevented severe harm. SB 878 on clinical laboratory personnel was reported favorably to address staffing shortages by allowing Florida to rely more directly on federal CLIA standards for qualified lab workers. SB 1092 on podiatric medicine was approved after an amendment narrowed it to cellular/tissue-based products and podiatrists’ use of certain therapies; the bill also addresses continuing education, informed consent, and advertising disclosures. SB 1032 on medical marijuana was amended and passed, aligning physician certification and card renewal timelines, setting 70-day and 35-day supply limits, and reducing the fee for honorably discharged veterans while preserving funding for FAMU; Senator Harrell opposed it, saying the longer timeframes were too much of an expansion. The committee also heard SB 1760 on Medicaid coverage transparency from Senator Brodeur, who said the bill focuses on accountability and fiscal responsibility, but the transcript cuts off before further discussion or action on that measure.

Transcript Highlights:

• This language does not include lower-cost biosimilars.
• This language does not include lower-cost biosimilars.
• This language does not include lower-cost biosimilars.
• our laws don't inadvertently create barriers to biosimilar adoption.
• our laws don't inadvertently create barriers to biosimilar adoption.

Keywords: 1183, house

Transcript Highlights:

• the thing is in order for a biosimilar the thing is in order for a biosimilar to<02:09:47.119>
• is a biosimilar.
• is a bio ilar biosimilar is a biosimilar is a bio ilar uh<02:20:21.840> the<02:20:22.120>
• Innovator and biosimilar Innovator and biosimilar drugs<02:27:01.800> uh<02:27:01.880>
• biologic markets for which biosimilars biologic markets for which biosimilars have<02:33:40.520>

Keywords: 1189, house, all

Transcript Highlights:

• <00:48:04.640> product effectiveness of a biosimilar product effectiveness of a biosimilar
• ,<00:48:20.400> which interchangeable biosimilars, which interchangeable biosimilars, which
• By adding biosimilars, downward.
• <01:21:40.880> in By requiring a lower cost biosimilar in By requiring a lower cost biosimilar
• <01:21:45.600> savings we can ensure that biosimilar savings we can ensure that biosimilar

Keywords: 1187, senate, all

Transcript Highlights:

• Depent doesn't have a biosimilar yet.
• While not every patient will want to go to a biosimilar whenever they're approved, they need to have
• If they're more beneficial, then that means they're not the same, so you can't get a biosimilar approval
• And that's what it would do is it would define biologic or biosimilars. It would point to that.
• , and substantial ongoing investments in biosimilar research and development.

Keywords: 1191, senate, all

Transcript Highlights:

• remove those from our formulary as we are preferring lower-cost alternatives, which do include biosimilars
• And the pricing... ...do include biosimilars in the market.
• You'll look at item one, two, three, four, and six are biosimilars that are coming onto the market that
• one, two, three, four, and six are biosimilers that are coming on to the market that we are just, Biosimilars

Summary: The State Insurance Programs Oversight Subcommittee met to review and approve several State Board of Finance actions related to employee benefits and pharmacy coverage. Grant Wallace, Director of the Employee Benefits Division and Office of Property Risk, presented a $280,000 Boston Consulting Group contract to help develop a third-party administration RFP, and the committee approved it. The committee then considered pharmacy formulary recommendations for December 2025, January 2026, and February 2026, along with February 2026 medical drug recommendations. Across the formulary items, Wallace explained that some drugs were being removed from prior authorization requirements, some were being updated to reflect FDA guidance or dosage changes, and others were being left not covered because lower-cost alternatives already exist or clinical evidence was insufficient. Notable changes included removing Skyrizi and Renvoke from the pharmacy formulary in favor of lower-cost biosimilars, adding certain generics, and adding a subcutaneous version of Keytruda for faster administration. The committee approved each set of recommendations by motion and voice vote. Members also raised broader questions about the impact of new drug-pricing programs such as Trump RX, Cost Plus, and other manufacturer discount efforts, as well as concerns about PBM oversight and whether Navitus is complying with state law. Wallace said the department is still studying those issues and working with Navitus to assess pricing opportunities and compliance. Senator Boyd also asked about whether affiliated pharmacies are being paid more than independent pharmacies, noting he had not received a prior response; Wallace was asked to follow up. The meeting concluded with no further business and adjournment.

Transcript Highlights:

• Skyrizi and Renvoke will be removed from the formulary in favor of lower-cost alternatives, including biosimilars
• You'll look at item one, two, three, four, and six are biosimilars that are coming onto the market that
• two, three, four, and six are biosimilers that are coming on to the market that we are just, ...biosimilars

Summary: The State Insurance Programs Oversight Subcommittee met to review and approve several Employee Benefits Division (EBD) and pharmacy formulary actions. Grant Wallace, director of EBD and the Office of Property Risk, presented a $280,000 Boston Consulting Group contract to help develop the third-party administration RFP, and the committee approved it. The committee also approved the December 2025, January 2026, and February 2026 pharmacy formulary recommendations, along with February 2026 medical drug recommendations. The formulary changes focused on removing prior authorization for injectable migraine CGRPs, replacing a discontinued capsule with a tablet, updating items for FDA guidance, and leaving some drugs not covered when lower-cost alternatives or insufficient efficacy data existed. For February 2026, EBD recommended removing Skyrizi and Renvoke in favor of lower-cost biosimilars and other alternatives, re-tiering several drugs to encourage generics, adding an anti-seizure medication developed by the Department of Defense, and adding a subcutaneous version of Keytruda for faster administration. The medical drug list similarly shifted toward biosimilars and aligned coverage for Skyrizi and Renvoke across pharmacy and medical settings. Members raised broader questions about the impact of new pharmaceutical discount programs such as Trump RX and Mark Cuban Cost Plus, as well as concerns about PBM compliance and whether Navitus might be violating state law or paying affiliate pharmacies more than independent pharmacies. Wallace said the new programs and their effects were still being studied, that EBD was working with Navitus to evaluate pricing opportunities, and that Navitus had said it was in compliance with Rule 118, though additional research and auditing were underway. All items were approved by voice vote, and the meeting adjourned after no further business.

Transcript Highlights:

• And one way that we can do this is by making it easier for generic and biosimilar drugs to come to market
• to help lower the cost of insulin, we've been included a provision to create a new competitive biosimilar
• Do you support the concept of a new expedited pathway for biosimilars to compete, for example, with branded
• I am a big believer that we need to figure out a way to get biosimilars approved quicker without cutting
• The way that patent law has enabled patent thickening, which makes it more difficult for biosimilars

Keywords: nominations, labor, health, veterans, Social Security, Elon Musk, transparency, government accountability

Summary: The meeting primarily focused on various executive nominations and their implications on labor and health affairs. Significant discussions surrounded the nomination of Mr. Sonderling as the Deputy Secretary of Labor, with members expressing concerns about workforce cuts affecting veterans and Social Security employees. There was also a debate led by a member regarding the authority and influence of private individuals, specifically citing Elon Musk's involvement in government decisions. Such discussions raised questions about transparency and accountability within governmental agencies, leading to a proposal for Mr. Musk to provide testimony before the committee.

Transcript Highlights:

• There were very few generics or biosimilar drugs available for biologic drugs.
• There were very few generics or biosimilar drugs available for biologic drugs.
• And so you might have a biosimilar drug, or excuse me, a biologic drug that costs $8,000 per treatment
• Now the biosimilar, so the generic biologic drug might be available at a fraction of that cost.
• And Megan, who determines that something is a biosimilar? Is that FDA or some other entity?

Keywords: 908, all

Summary: The committee met to review the history and current treatment of North Dakota health insurance mandates, with presentations from Blue Cross Blue Shield of North Dakota, Sanford Health Plan, the Public Employees Retirement System (PERS), and the Insurance Department. The discussion focused on how mandates apply differently to fully insured, self-funded, ACA, Medicaid, and PERS plans; how the state’s benchmark plan and federal essential health benefits affect coverage; and how the existing process requires cost-benefit analysis and, for certain measures, a PERS pilot period before broader application. Presenters also reviewed the long list of existing state mandates, including provider, beneficiary, and coverage requirements, and noted that many were enacted decades ago and have not been revisited despite changes in medical evidence and treatment options. Witnesses from the carriers argued that mandates should be reviewed periodically because some are outdated, can create unintended costs, and may not align with current medical guidance. Examples cited included PSA screening, off-label drug coverage, prior authorization rules, step therapy, and cost-sharing provisions for mental health and substance use treatment. They emphasized that carriers often cover services without a mandate when supported by clinical evidence, and that mandates can shift costs to employers and employees, especially in the fully insured small-group market. They also suggested possible policy improvements such as clearer mandate definitions, better transparency around cost-benefit analyses, a regular 10-year review of mandates, and more timely submission of proposals through the interim process. PERS and the Insurance Department highlighted a recurring tension over what counts as a mandate and when a measure triggers the state’s defrayal obligation under federal law. PERS described its interim committee process, the April 1 deadline for fiscal-impact proposals, and the limited pilot program used for certain measures, noting that only a few bills have gone through the full pilot process. The Insurance Department explained that it views new benefit mandates through the lens of the ACA benchmark plan and essential health benefits, distinguishing true new benefits, such as infertility coverage, from changes to existing benefits, such as telehealth or insulin cost-sharing caps. No votes were taken on policy changes; the meeting was informational, with members asking questions about costs, applicability, transparency, and whether a periodic mandate review should be established.

Transcript Highlights:

• A biosimilar, a bioequivalent, excuse me, is literally you're looking at almost the same molecules.
• Is there a way to get the PBM to look inside the specialty sector and see what we can do with biosimilars
• For instance, that Humira, which normally costs $6,700, has a biosimilar that costs about $1,006, which
• specialty sector and figure out how we're going to move from these more expensive biologics to their biosimilars
• You're recognized. ...these more expensive biologics to their biosimilars? You're recognized.

Summary: The Budget Committee met with a quorum and took up several bills. HB 677, relating to state-covered fertility preservation for employees undergoing cancer treatment, was introduced as coverage for egg and sperm preservation for up to three years, with an estimated fiscal impact of about $813,000. After brief questions and no public testimony or amendments, the bill passed unanimously and was reported favorably. The committee then considered CS/HB 59, which would reform Florida’s wrongful incarceration compensation process by extending the filing deadline from 90 days to two years, removing the clean-hands requirement, and allowing exonerees to choose between the state compensation process and a civil lawsuit; it was supported by the City of Flagler Beach and passed unanimously. CS/HB 1313, which recreates the Resilient Florida Trust Fund in the Department of Environmental Protection before its scheduled termination in 2025, also passed unanimously after supportive testimony from advocacy groups. The committee received a lengthy presentation from the Department of Management Services on the State Group Insurance Program and the recent Revenue Estimating Conference. The presentation covered enrollment, revenues and expenditures, rising medical and pharmacy costs, emergency room utilization, GLP-1 drug spending, and options for tighter formulary and utilization management. Members asked about ER cost growth, GLP-1 coverage and copays, PBM oversight and potential conflicts, avoidable ER visits, cancer screening claims, dental and vision costs, specialty drug biosimilars, and possible savings from more restrictive pharmacy models. DMS said it would follow up on several questions and noted ongoing work on cancer coordination, preventive screening, biomarker testing, and a proposed member-facing benefits platform. The committee also heard extensive testimony on HB 301, which would raise sovereign immunity caps from $200,000 per person and $300,000 per incident to $1 million and $3 million, align limitations periods with private claims, and allow government entities to settle above the caps without a claims bill. Local governments, school-related entities, and county and city associations opposed the bill, warning of major fiscal impacts, higher insurance costs, and pressure on services; several speakers urged smaller increases or a tiered approach. Proponents, including families affected by catastrophic injury or death, argued the current caps are too low and the claims bill process is inefficient and unfair. After debate, the bill passed on a recorded vote, with some members voting no, and was reported favorably.