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HCA summarizes 2026 session: market oversight, coverage assessments and rural hospital reimbursement among action items
Summary
HCA briefed the board on 2026 legislative actions and proposals that affect the board's work, including bills on claims payment timelines, expanded market transaction review, coverage assessments for behavioral health and abortion-service funding, and targeted rural hospital reimbursement changes.
Evan Klein, special assistant for legislative and policy affairs at HCA, briefed the Cost Transparency Board on highlights from the 2026 legislative session and how enacted and contemplated measures intersect with the board's priorities.
Klein said the brief 60-day session was shaped by state budget pressures and federal-level impacts from HR 1. He summarized several items of direct relevance: an HCA agency-request bill (House Bill 2254) passed; timely claims-payment standards were addressed in a Senate bill; market-oversight expansion (referenced as House Bill 2548) broadened state review of material-change transactions; work on payer-provider contracting and prior-authorization is continuing via a multi-year workgroup after House Bill 1589 did not pass; and several bills adjusted reimbursement rules for small rural hospitals.
On coverage assessments, Klein discussed two distinct paths: a failed proposal to create a behavioral-health coverage assessment (House Bill 2720 referenced), and a passed bill (Senate Bill 6182 referenced) establishing a coverage assessment to fund abortion services. He also described direction to transition the Apple Health expansion program from managed care to fee-for-service in 2027 and to increase enrollment in that program.
Board members asked clarifying questions (for example, about preventive services preserved by legislation reported as House Bill 2242) and staff indicated they will circulate details and remain available for follow-up. HCA staff flagged that some of the new reporting obligations (for example, expanded transparency on 340B contract pharmacy pricing) will take time to operationalize and may not yield public data until 2027.
Why it matters: the session produced a mix of regulatory, budgetary and reporting changes that will interact with the board's cost-driver work and market-oversight considerations; staff told the board they will track implementation details and return with specifics as rules and reports are developed.
