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A Medicare index was scrapped, but physicians will no longer be able to go after patients when an insurer doesn’t pay for non-contracted emergency work. A sweeping measure allows state insurance regulators to set aside state law if federal officials upend the national health laws.

Pressure from industry groups left the Environment Committee with a bill that will do little more than hand out money from the Volkswagen settlement to replace old engines. Sen. Dembrow wanted a tougher bill that would require off-road equipment to register as cars and trucks do, and phase-out the use of outdated diesel engines that poison the air.

State officials and the hospital industry work on ways to address bottlenecks in the system as more than 500 patients wait for transfers.