Providers said MCOs are using automated scrubber software (Optum) to reclassify or downgrade ED claims without medical-record review, which hospitals view as prepayment review; DMS staff said contractually defined prepayment reviews differ and requested specific examples for investigation; Passport offered to walk through differences in practice.

Bill mandates insurers to provide timely responses and clear claims handling procedures.

Billing-company and EMS providers reported that Passport uniquely requests itemized supply lists and is denying supply reimbursements despite other MCOs not requiring itemization; Passport offered to have operations review specific denied claims if providers share samples.

Veterans Guardian and the National Association for Veterans Rights told the SAVA committee their claims-consulting services complement accredited VSOs and help veterans in underserved rural areas; multiple veterans and VSOs countered with warnings about 'claim sharks,' high fees and lawsuits, urging more accredited VSO capacity and stronger consumer protections.

A Mark 3 broker told the King George County School Board that medical claims have risen sharply—about $5 million in medical plus nearly $3 million in estimated pharmacy spend—producing an estimated $8.6 million package and a conservative 18% projected increase for plan year 2026–27. The board pressed for detail on pharmacy reporting, high‑cost claimants and alternatives to Local Choice.

Council reviews multiple claims for the same sign, highlighting issues of communication and repairs.