Senate committees open debate on program-integrity omnibus bill that would codify prepayment review and tighten provider oversight

A joint hearing of the Senate Health and Human Services committees on May 2 opened deliberations on a program-integrity omnibus bill that combines governor proposals and individual member bills.

Chair Hoffman, one of the bill sponsors, told the panel the package was intended to add legislative controls to an existing department authority and to prevent last year’s implementation problems. "By codifying it here, we're inserting more legislative control in the process, including requiring the department to give providers a 60 day notice before imposing prepayment review," she said.

Nonpartisan fiscal staff walked the committee through a spreadsheet showing major fiscal effects. "The net effect of the bill before you is, in fiscal year 2627, there's an expected reduction in future expenditures of 120,200,000 in the 2627 biennium, and then an increase in spending of just over 74,500,000 in the tails," fiscal analyst Kyle Raymond said.

The package groups dozens of proposals thematically: prepayment and post‑payment review authority and metrics for managed care; expanded electronic visit verification and HCBS provider accountability; limits on market‑rate administrative fees; changes to nursing facility rate calculations; and licensing and background‑study reforms, among other items. Staff emphasized some changes are governor proposals modified for the omnibus and that many components previously appeared in other bills.

Members raised recurring concerns about process and timing. Senator Abler warned against reforms that could trap otherwise‑compliant providers in enforcement actions and cited reports from an ombudsman about harmed service recipients. Others questioned whether agencies had sufficient time to implement complex changes and whether the package overlapped with work in other committees.

Committee leaders said the hearing was meant to compile ideas, begin ideation, and surface gaps before the bill moves through judiciary and finance; sponsors committed to continued negotiations and to returning revisions as the measure advances. The committees recessed with multiple amendments to be refined and reoffered later in the process.