Transcript Highlights:

• We show you registered as an auto claims specialist.
• Auto claims specialists are licensed in over 26 states.
• The average difference on total loss claims was $3,800.
• We looked at 1,200 claims files, and we found that...
• on total loss claims.

Bills: HB345, HB721, HB2580, SB815, HB3057, HB4603, HB3233, SB495, HB3863, HB3914, HB4570, HB5099, HB5173, SB458

Keywords: insurance, appraisal process, disputed losses, residential property, policyholder rights, insurer obligations, natural disasters, appraisal expenses, umpire selection, policyholder, insurer, umpire, claims management, health care, cost disclosure, benefit plan, administrators, traumatic brain injury, health benefit plans, insurance coverage

Transcript Highlights:

• Then there's the adjudication of the claims.
• This will address claims effectively.
• , it cannot be done. ...to add multiple claims, we have to do each claim unless they agree.
• On the other side, about 50% of ER claims are out of network.
• It should be evaluated by qualified human reviewers.

Bills: HB345, HB721, HB2580, SB815, HB3057, HB4603, HB3233, SB495, HB3863, HB3914, HB4570, HB5099, HB5173, SB458

Keywords: insurance, appraisal process, disputed losses, residential property, policyholder rights, insurer obligations, natural disasters, appraisal expenses, umpire selection, policyholder, insurer, umpire, claims management, health care, cost disclosure, benefit plan, administrators, traumatic brain injury, health benefit plans, insurance coverage

Transcript Highlights:

• category. review process that began this fall, and review process that began this fall, and we're<00
• The will undergo a pre-payment review.
• </c> finally, when the pre-payment review finally, when the pre-payment review process<00:02:31.400><
• These claims alone cost taxpayers 20 million dollars.
• These claims alone cost location.

Bills: HF4491, HF4338, HF4288, HF4566

Keywords: Medical Assistance, Medicaid, prepayment review, claims review, fee-for-service, provider integrity, high-risk provider, high-risk service, fraud prevention, program integrity, Department of Human Services, CMS, Centers for Medicare and Medicaid Services, health care billing, medical claims, provider enrollment, Indian Health Service, Minnesota Statutes chapter 256B, human services, medical assistance

Transcript Highlights:

• It's organizing files for human review? It's organizing files for human review? Mr.
• of veteran benefit claims?
• When it comes to these claims, all initial claims for benefits to the VA must be done pro bono.
• Now, the VA does not pay for the veteran to process their claims.
• This definitely needs better guardrails than the digital reviews.

Bills: HB2006, HB2165, HB2245, HB2348, HB2806, HB2901, HB2902, HCR2016

Keywords: sample ballots, elections, primary election, general election, mailing deadline, ballot mailing, county election officials, board of supervisors, secretary of state, early voting list, election administration, voter information, postal service, USPS processing center, city elections, town elections, special district elections, Arizona election law, ballot proofing, party chair

Transcript Highlights:

• Members, House Bill 3647 is an all-payer claims database.
• This would require participating members to share claims and payment data through the state HiE So that
• This just extends the tort claims protection.
• They have tort claims protection. The Questions. Are there any questions?

Bills: HB4423, HB3342, HB3645, HB3647, HB3887, HB4430, HB4431, HB2964, HB3834

Keywords: Oklahoma Health Care Authority, Medicaid, immigration verification, healthcare access, federal reporting, health care providers, auditing, patient rights, claims, protection from fraud, audit process, error correction, hospice care, physician determination, healthcare standards, symptom management, health information exchange, all-payer claims database, health care transparency, health care costs

Transcript Highlights:

• It would require claims to be paid within 30 calendar days of the PBM receiving the claim.
• The standards governing how insurers conduct utilization reviews for mental health and substance abuse
• PBMs claim they save money. Let me repeat that.
• PBMs claim they save money, but over the last 10 years they've increased their worth...
• If PBMs claim they save money, but yet drug costs and premiums keep rising, at this point in time, I

Bills: SB1673, SB1500, SB1447, SB1646, SB2007, SB1275, SB2074

Keywords: prosthetics, health insurance, medical necessity, patient rights, insurance liability, pharmacy benefits manager, healthcare providers, claims processing, reimbursement, insurance regulation, employees insurance, contract awarding, certifications, state procurement, insurance plan, mental health, substance use disorders, utilization review, benefit coverage, pharmacy

Summary: The Senate Business and Insurance Committee met to consider several bills, with the chair emphasizing pharmacy benefit managers (PBMs) and the impact on local and rural pharmacies. Before taking up the bills, the committee announced that Senate Bills 1620 and 1625 would be laid over. The committee also adopted an amendment to Senate Bill 1673 to exempt certain state-funded flexible benefit plans, and then passed the bill, which creates the Prosthetic Access and Accountability Act of 2026 and requires health plans that already cover prosthetic benefits to administer them without disability-based discrimination. The committee then passed several PBM-related measures. Senate Bill 1500 requires PBMs to reimburse rural pharmacies within 30 calendar days. Senate Bill 1447 adds safeguards to the Oklahoma Employee Insurance Plan by restricting PBM contracts, including disfavoring PBMs involved in recent lawsuits or those affiliated with insurers, retail pharmacy chains, specialty pharmacies, mail-order pharmacies, or drug manufacturers. Senate Bill 1646 strengthens utilization review standards for mental health and substance use disorder treatment, and Senate Bill 2007 prohibits PBMs from reducing reimbursement after a successful appeal and adds administrative fees when they fail to make required adjustments. The committee also passed Senate Bill 1275, which requires upfront disclosure of all fees for short-term rental bookings such as Airbnb and VRBO, with only tax added at checkout. Finally, the committee passed Senate Bill 2074 after extensive debate; it would require fairer and more transparent PBM reimbursement using a Medicaid-based methodology and a professional dispensing fee, with supporters arguing it would help independent and community pharmacies and opponents raising concerns about consumer costs and legal issues. All bills considered in the meeting were reported out with favorable votes, and the meeting adjourned after the chair noted one more meeting would be held the following week.

Transcript Highlights:

• It would require claims to be paid within 30 calendar days of the PBM... Receiving the claim.
• Strengthens the standards governing how insurers conduct utilization reviews for mental health and substance
• PBMs claim they save money. Let me repeat that.
• PBMs claim they save money, but over the last 10 years, they've increased their worth on top of what
• If PBMs claim they save money but yet drug costs and premiums keep rising.

Bills: SB1673, SB1500, SB1447, SB1646, SB2007, SB1275, SB2074

Keywords: prosthetics, health insurance, medical necessity, patient rights, insurance liability, pharmacy benefits manager, healthcare providers, claims processing, reimbursement, insurance regulation, employees insurance, contract awarding, certifications, state procurement, insurance plan, mental health, substance use disorders, utilization review, benefit coverage, pharmacy

Bills: HB2947, HB2964, HB3143, HB3144, HB3342, HB3344, HB3519, HB3522, HB3530, HB3645, HB3647, HB3834, HB4300, HB4422, HB4423

Keywords: behavioral health, Medicaid expansion, clinical interns, mental health services, licensing requirements, medical records, patient rights, privacy, fees, healthcare access, legal claims, medical marijuana, license transfer, Oklahoma Medical Marijuana Authority, moratorium, business regulation, commercial grower licenses, licensing restrictions, agriculture, Medicaid

Transcript Highlights:

• So to review, there's four main objectives that this bill accomplishes.

Bills: SB 6, SB6, SB504, SB765, SB815, SB929

Keywords: hemp, consumable hemp, hemp-derived cannabinoids, CBD, cannabidiol, CBG, cannabigerol, delta-8, delta-9, intoxicating hemp, hemp gummies, hemp vape, edibles, cannabinoid regulation, hemp licensing, retailer registration, product registration, QR code labeling, child-resistant packaging, minor access

Transcript Highlights:

• We have no problem prohibiting the use of AI for denying claims.
• State law requires Texas licensed health care professionals to review claims denied.
• and Claims Act and have an entirely different process.
• That's a claims dispute.
• When you say 'there,' you mean the original claim? Yeah.

Bills: SB 6, SB6, SB504, SB765, SB815, SB929

Keywords: hemp, consumable hemp, hemp-derived cannabinoids, CBD, cannabidiol, CBG, cannabigerol, delta-8, delta-9, intoxicating hemp, hemp gummies, hemp vape, edibles, cannabinoid regulation, hemp licensing, retailer registration, product registration, QR code labeling, child-resistant packaging, minor access

Transcript Highlights:

• We need to amend the budget resolution in order to account for the claims bill that is before us today
• </c> $73,000 to accommodate uh the claims $73,000 to accommodate uh the claims bill<00:01:12.640><c>
• This is the annual claims bill. The part about the exoneration claim is the biggest chunk of this.
• I think it was a day or two before the claims hearing last year.
• So, uh, we the claims hearing last year.

Bills: SF3446, HF3247

Keywords: claims against the state, settlement, appropriations, exoneration, corrections claims, claims, state appropriation, corrections, community service, 1183, house

Transcript Highlights:

• It doesn't get claimed. OK. Right.
• cannot prove an established relation relationship with the child, and it will create an administrative review
• if a potential child was to be adopted by Texas parents, um, the receiving state, we would have to review
• Bill 142 repeals the outdated requirement that the Office of Inspector General conduct an annual review
• of Medicaid claims, a process that consumes thousands of hours but yields limited results.

Bills: HB 26, HB 140, HB 141, HB 142, HB 215

Keywords: Medicaid, nutrition support, maternal health, chronic conditions, pilot program, DFPS, Department of Family and Protective Services, child protective services, child abuse investigations, child neglect, child exploitation, advisory committee, Family and Protective Services Council, council abolition, foster care, due process, investigative procedures, child welfare, parental rights, family preservation services

Transcript Highlights:

• FWP is also reviewed as are others. Also want to thank Senator Fincham for working with us.
• Her claim is that she was there against her permission.
• Her claim is that she was there against her permission.
• The amendment further requires the claim and supporting medical record documentation to be reviewed,
• Providers would end up having to hire attorneys to submit these same claims for an appeal.

Bills: SB1072, SB1111, SB1114, SB1116, SB1122, SB1179, SB1250, SB1308, SB1455, SB1456, SB1457, SB1487, SB1547, SB1549, SB1551, SB1552

Keywords: reimbursement rates, intellectual disabilities, community services, economic security, funding appropriations, automated license plate readers, law enforcement, privacy, data access, public records, behavioral health, patient brokering, appropriation, state funds, Maricopa County, claims review, medical necessity, American Indian health program, healthcare regulations, healthcare

Transcript Highlights:

• what it says property valuation and that type of claims.
• ..over claims paid and valuations and all that.
• And when you say, of a hearing, are you saying to review current rates or review rates that have been
• What do you mean by reviewing rates? I think of the question.
• Yeah, I think it would be to review rates that had been filed to be changed.

Bills: HB3048, HB3259, HB3646, HB3696, HB3780, HB3781, HB3802, HB3818, HB4294, HB4488, HB2929

Keywords: insurance, nonadmitted insurers, surplus lines, insurance regulation, Oklahoma, health insurance, contracting entities, medical providers, enrollment, beneficiary rights, property and casualty, rates, filing, Insurance Commissioner, regulation, property, regulations, actuary, rate filing, independent review

Transcript Highlights:

• In March of 2017, I posted a review on Google and Yelp discussing the security changes.

Bills: HB 660, HB 4845, HB 3902, HB 5396, HB 4615, HB 1825, HB 1403, HB 4336, HB 4585, HB 4371, HB 863, SB 1589, HB 5223, HB 3195, HB 2734

Keywords: child protective services, adult protective services, caseload limits, call processing goals, child-care licensing, employee workload, reporting requirements, employee caseload limits, protective services, workload management, accountability, Department of Family and Protective Services, employee goals, call processing, child care, human resources, government accountability, Medicaid, provider enrollment, revalidation

Transcript Highlights:

• In March of 2017, I posted a review on Google and Yelp discussing the security changes.

Bills: HB660, HB4845, HB3902, HB5396, HB4615, HB1825, HB1403, HB4336, HB4585, HB4371, HB863, SB1589, HB5223, HB3195, HB2734

Keywords: child protective services, adult protective services, caseload limits, call processing goals, child-care licensing, employee workload, reporting requirements, employee caseload limits, protective services, workload management, accountability, Department of Family and Protective Services, employee goals, call processing, child care, human resources, government accountability, Medicaid, provider enrollment, revalidation

Transcript Highlights:

• So someone submits their paperwork, and it goes through a review process.
• I reject that claim. I think that's a little inaccurate.
• It improves the claims process transparency, protects the right to submit claims, applies insurance code
• , and having an independent review process as outlined in the bill.
• Just a few quick examples: from this week, a hospital in South Plains has 122 claims.

Bills: HB660, HB4845, HB3902, HB5396, HB4615, HB1825, HB1403, HB4336, HB4585, HB4371, HB863, SB1589, HB5223, HB3195, HB2734

Keywords: child protective services, adult protective services, caseload limits, call processing goals, child-care licensing, employee workload, reporting requirements, employee caseload limits, protective services, workload management, accountability, Department of Family and Protective Services, employee goals, call processing, child care, human resources, government accountability, Medicaid, provider enrollment, revalidation

Transcript Highlights:

• Sections 610, 611, and 612 outline the claims resolution process, including the authorization of court
• Section 614 outlines the distribution waterfall, and the remaining sections, 615 through 622, discuss claims
• This adjuster license is valid and renewable only while the licensee adjusts claims as a salaried employee
• Don Isaacson, welcome. without taking the examination to only adjust claims as a salaried employee of
• with a circumstance that has developed with respect to Arizona company-based adjusters who adjust claims

Bills: SB1181, SB1252, SB1254, SB1415

Keywords: certified public accountants, CPA certification, accounting regulations, professional standards, continuing education, assignment for benefit of creditors, ABC act, insolvency, creditor claims, debt liquidation, business wind-up, receivership, liquidation, secured creditors, unsecured creditors, proof of claim, voidable transactions, fraudulent transfer, wage claims, priority claims

Transcript Highlights:

• They can deny your entire claim.
• Is that a consequence of the initial claim, or is that now a new claim that's been brought out against
• Is that a consequence of the initial claim or is that now a new claim that's been brought out against
• When you file the claim, you're going to have to make an allegation of some nature to defend the claim
• Do they look at claims cost in this process? Do they look at claims cost in this process?

Bills: HB282, HB293, HB390, HB456, HB460, HB561, HB819, HB1023, HB1047, HB1101

Keywords: employment discrimination, criminal history, rehabilitation, hiring process, human rights, gender identity, sexual orientation, workplace equality, labor rights, domestic abuse, unpaid leave, employee rights, workplace protection, mental health, survivor support, workers' compensation, employment benefits, claims process, fraud prevention, legal petition

Bills: HB4248, HB3194, HB3849, HB4095, HB4302, HB3342, HB3344, HB3287, HB3645, HB3647, HB3930, HB3931, HB1818, HB4454, HB4336

Keywords: HB4248, hemp beverage, hemp drinks, THC beverage, cannabis beverage, intoxicating hemp, age restriction, under 21, minor possession, youth access, public health and safety, Title 63, Oklahoma Statutes, retail sales, alcohol-style regulation, controlled substances, beverage regulation, pregnancy centers, abortion, abortion-inducing drugs