Transcript Highlights:

• to CMS.
• CMS sent us a notice of award, which requires us to reallocate our budget and resubmit to CMS by the
• CMS sent us a notice of a award which requires us to reallocate our budget and resubmit to CMS by the
• It's federally funded and comes from CMS.
• It's federally funded comes from CMS.

Bills: HB2190, HB2202, HB2233, HB2251, HB2252, HB2396, HB2437, HB2689, HB2796

Keywords: physician assistants, licensure compact, medical services, multistate practice, patient care access, healthcare workforce, military families, adverse actions, dementia care, telementoring, healthcare education, rural communities, grant funding, HB 2233, rural health transformation, rural health transformation program, AHCCCS, Arizona Health Care Cost Containment System, Joint Legislative Budget Committee, JLBC

Summary: The committee began with a presentation from the Alzheimer’s Association Desert Southwest Chapter and Dr. Anna Burke of Barrow Neurological Institute on the scope of Alzheimer’s disease, the shortage of specialists, low rates of timely diagnosis, and the need for caregiver support and early intervention. Speakers emphasized that Arizona is a leader in Alzheimer’s research and that lifestyle changes, new therapies, and research funding offer hope, but only if patients are diagnosed earlier and providers are better trained. The committee then heard House Bill 2202, which would appropriate $300,000 over three years for a dementia care telemonitoring/telementoring grant program through the Department of Health Services to help providers statewide learn best practices in dementia care. Supporters, including the Alzheimer’s Association, Dr. Danny Cabral, and a patient advocate, said the bill would address major gaps in provider training and improve early diagnosis and treatment. There was no opposition, and the committee voted 11-0 to give HB 2202 a do pass recommendation. The committee next took up House Bill 2251, the “Jordan and MacTerry Act,” which would expand licensed midwives’ authority to administer certain medications, require liability insurance disclosure and reporting, and create an Arizona Midwifery Advisory Committee. Supporters said the bill would improve safety, oversight, and access to emergency medications in home births, while opponents from ACOG and the Arizona Osteopathic Medical Association raised concerns about the adequacy of oversight, the medication list, and whether eight hours of pharmacology training is sufficient. After testimony from midwives, physicians, and stakeholders, the bill was held for further stakeholder work and anticipated floor amendments. House Bill 2252, which would allow certified nurse midwives, certified professional midwives, or licensed midwives to accompany a patient in a ground ambulance during transport if approved by medical direction, also drew support and opposition. Supporters argued it would preserve continuity of care in emergencies, while firefighters and EMS representatives objected to ambiguity and scene control concerns. That bill was likewise held for further stakeholder meetings. The committee then recessed and reconvened for later presentations on federal budget and health-related topics.

Transcript Highlights:

• CMS utilized to come up with those cuts. CMS utilized to come up with those cuts.
• We don’t know yet what’s going to happen with CMS and our proposed rule.
• We don’t know yet what’s going to happen with CMS and our proposed rule.
• We don’t know yet what’s going to happen with CMS and our proposed rule.
• We don’t know yet what’s going to happen with CMS and our proposed rule.

Keywords: 928, house, all

Summary: The committee to study long-term managed care met to approve the prior meeting minutes, with a clarification that “OB3” referred to the “one big beautiful bill.” The minutes were then approved. Chair Jim Kofalt outlined the day’s agenda, which included testimony from the Granite State Home Health and Hospice Association, the New Hampshire Association of Counties, and later DHHS. He also noted that future meetings were expected soon and that the meetings were being livestreamed on YouTube. Granite State Home Health and Hospice Association, represented by Kellyanne Totten and Amy Moore, urged inclusive planning and a cautious, phased approach if managed care is considered. They emphasized that home care providers are not uniform, with different licensing and service models, and said any pilot should include varied provider types, rural and southern regions, and agencies of different sizes. They warned that workforce shortages, inflation, and a possible 9% CMS cut to Medicare home health payments could force agencies to reduce service areas or service types. They also said the 2023 Medicaid CFI rate increase has begun to lose its effect. In response to questions, they said the rural health transformation fund may help with planning and telehealth but likely cannot be used directly for rates or recruitment/retention. They also described the New England Home Care Nurse Residency Program, a Department of Labor grant, as a way to bring new registered nurses into home care with added training and school partnerships. The New Hampshire Association of Counties, through county nursing home administrators Craig Labore and David Ross, revisited the earlier Step Two managed care discussions from 2016-2018. They said prior consultants found the long-term services and supports system was underfunded and needed investment to stabilize providers and expand community-based care. They argued the same concerns remain today and said a managed model would jeopardize the Medicaid quality incentive payment program and, for county nursing homes, the proportionate share payment program. Their testimony was generally opposed to moving forward with managed long-term services and supports without significant additional funding and safeguards.

Transcript Highlights:

• /c><00:05:19.680> stated<00:05:20.120> that<00:05:20.240> the requirements, um CMS
• I think that would allow us to fully implement and be in compliance with CMS by the due date of January
• >> So, again, CMS requires that our rates be actuarially sound. So, our rates are submitted to CMS.
• So that was just my only comment. rates are uh submitted to CMS.
• They are rates are uh submitted to CMS.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on January 12, 2026, to approve the December 10, 2025 minutes and continue finalizing its findings and recommendations. Members reviewed findings on administrative inefficiencies, Medicaid and workforce participation under HR 1, Medicaid budget growth, rural health transformation fund development, and provider tax/state-directed payment changes. The board approved a motion to change “pilot” to “partnership” in the workforce-related recommendation, and also adopted a technical amendment clarifying overlapping HCBS services by removing reference to adult daycare waiver services and revising the language to focus on reducing duplication, simplifying provider contracting, and standardizing processes across programs. A separate technical correction was noted to change “DMS” to “DPH” in the rural health transformation finding, to be handled in the final edits. Several findings drew discussion but no final substantive vote during the meeting. On the rural health transformation fund, Dr. Berg said Kentucky had done well in federal funding and noted limits on what could be shared publicly, while Commissioner Lee said a public website had been created and recommended the department reference be changed to the Department for Public Health. Finding five prompted extended discussion about provider taxes, state-directed payment reductions under HR 1, and whether the board should address the relationship between actuarial studies, MCO payments, and actual provider reimbursement more directly. Senator Meredith and others argued for a broader, more transparent baseline review of rates across provider groups, while Commissioner Lee said CMS will require certain fee schedule comparisons to Medicare beginning July 1, 2026, and that quarterly expenditure reports already go to LRC. The board did not finish resolving finding five during the meeting and agreed to return to it after staff prepared more explicit language. Members also discussed the possibility of an all-payers claims database as a better way to understand what is being paid across payers and services. No final vote on the full findings package was taken in the portion of the meeting provided, but the board did adopt the noted amendments and continued working through the remaining language.

Transcript Highlights:

• So, we wanted to make directly from CMS.
• >> So, CMS ... big sigh there.
• Um, it's also being called the Working Families and Tax Cuts Act by CMS.
• Um, so there's lots of Act by CMS.
• have not been notified yet from CMS have not been notified yet from CMS about<02:16:34.399> what

Keywords: 912, senate, all

Summary: The joint informational briefing by the Health and Human Services and Commerce and Consumer Protection committees focused on projected impacts to Hawaii consumers from federal changes affecting Med-QUEST and the ACA marketplace, including the loss of ACA premium tax credits, OBVA/HR1-related Medicaid changes, immigrant eligibility restrictions, and new Medicaid work/community engagement requirements. Committee members noted the meeting was being streamed live and emphasized the need to explain potential coverage losses affecting a significant share of the state population. Med-QUEST administrators reported current enrollment at 390,766, about 27% of Hawaii’s population, and broke that down into major groups including roughly 128,000 ACA expansion adults and about 52,000 parent/caretaker relatives. They said the expansion adult population would be most affected by the new federal requirements, which will shorten renewal periods from 12 months to 6 months and impose community engagement rules beginning in late 2026 and 2027. They described the work requirement as 80 hours per month of work, community service, work program participation, or half-time education, with an income-based pathway tied to $580 per month at the federal minimum wage; they also noted a long list of exemptions, but said many details are still awaiting federal guidance and rulemaking. The administrators said federal changes to immigrant eligibility would eliminate Medicaid coverage for certain noncitizen categories, with an estimated 1,200 to 2,400 people affected, though about 200 may remain covered through a state-funded program for otherwise eligible individuals. They also said marketplace subsidies would no longer be available for some immigrants under 100% of the federal poverty level starting January 1, 2026, with further restrictions expected in 2027. For Hawaii overall, they estimated the new Medicaid work and renewal rules could push an additional 19,000 to 38,000 people into uninsured status, with another estimated 6,000 at risk from the six-month renewal process alone. Members asked about how exemptions would be determined, especially for medically frail and seriously mentally ill individuals, and administrators said they were still awaiting detailed federal rules and were working on data-matching and verification processes to reduce coverage losses.

Transcript Highlights:

• the additional coverages and rate increases provided or approved by the legislature and approved by CMS
• /c><00:03:54.360> and<00:03:54.560> approved<00:03:55.120> by<00:03:55.280> CMS
• by the legislature and approved by CMS by the legislature and approved by CMS over<00:03:56.079>
• So we made that request with the renewal CMS.
• <01:26:30.480> um CMS um CMS um U<01:26:33.239> had<01:26:33.400> a<01:26:33.560

Keywords: 1189, house, all

Summary: The House Finance Division 3 work session continued its review of the Department of Health and Human Services’ Medicaid budget and related policy issues, with CFO Nathan White and Medicaid Director Henry Litman presenting updated materials. The discussion focused on a crosswalk between the adjusted FY 2025 Medicaid budget and the governor’s FY 2026 recommendation, plus handouts showing service additions, eligibility changes, dental rates, and other Medicaid changes since 2019. The department also said it would provide a clearer breakdown of the pharmacy cost-sharing item by general, federal, and other funds. Members asked detailed questions about the Medicaid enhancement tax, the 80% plan, and how funds are allocated between hospital payments, directed payments, and DSH uncompensated care. The department explained that the MET is being used more toward rates and directed payments to better align with federal matching rules, while DSH remains important for uncompensated care. They also noted that a pending Senate Bill 249 would keep the 80% structure and move to Senate Finance. On the trigger law, the department identified the governing provision as Chapter 342:12, Laws of 2018, and explained that if the federal match for Medicaid expansion falls below 90%, the state must notify legislative leaders and participants and the program would sunset after 180 days unless the legislature acts. The committee also reviewed current Medicaid expansion enrollment and program trends. Officials said enrollment was just under 59,000 as of March 3, with about 87,000 people enrolled over the past year and more than a quarter-million residents having used the program over its lifetime. They said enrollment has fallen from a post-pandemic high of nearly 97,000 and may eventually settle in the low 50,000s. Finally, the department discussed federal DSH funding risk, saying New Hampshire could face a significant reduction if Congress does not extend current protections, which is part of why the state has shifted more funding toward payment rates and directed payments.

Transcript Highlights:

• In 2004, CMS finalized national prior authorization reporting rules to go live this year.
• McKay, this would be through the CMS system, I'm sorry, Madam Chair, I apologize to you, that the CMS
• The CMS interoperability rules only apply to certain impacted payers.
• What percentage would we capture with CMS versus the rest of the health plans that we have?
• It wasn't in our role; it wasn't how CMS rolled it out.

Keywords: 1182, all

Summary: The committee heard House Bill 2433, which would require insurers offering Medicare supplement policies to people 65 and older to also offer them to Medicare beneficiaries under 65 with ALS or end-stage renal disease, with enrollment periods and premium protections tied to 65-year-old rates. Supporters, including dialysis and ALS advocates, said the bill would help a small population facing high out-of-pocket costs and could improve access to transplants and care; opponents argued it would shift costs onto older seniors and raise Medigap premiums. The committee recommended the bill do pass on a 12-0 vote. The committee also heard House Bill 2593, appropriating $1.5 million to the University of Arizona for the Arizona Perinatal Psychiatry Access Line. The sponsor and physicians testified that the line helps obstetric and pediatric providers quickly consult on perinatal depression, postpartum psychosis, suicidality, and other mental health crises, improving outcomes for mothers, children, and families and reducing costly emergency and crisis care. The bill received a do pass recommendation on a 10-1 vote. House Concurrent Resolution 2013, proclaiming June 2026 as Celebrate Life Month, drew emotional testimony from a young woman with spina bifida and another speaker supporting the sanctity of life. Some members objected that the state should focus on practical supports such as paid leave, child care, and health care access, while others supported the resolution as a statement of human dignity. The resolution passed the committee 7-5. The committee then approved House Bill 4010, creating a Board of Genetic Counselors and licensure standards, after testimony from genetic counselors and a patient advocate about the need for qualified counseling and better access; it passed 11-1. Later, the committee approved House Bill 2196, which would require pharmacy benefit managers to reimburse non-affiliated pharmacies at least their acquisition cost and pay a dispensing fee, and establish an appeals process. Independent pharmacists and their coalition said PBM practices are driving closures and unfairly favor affiliated pharmacies, while PBM and employer representatives warned of major cost increases and said the bill would interfere with private contracts; the bill passed 11-1. The committee also adopted a strike-everything amendment to House Bill 2182 requiring insurers and health plans to report claims denial and prior authorization data to DIFI, and then gave the amended bill a 12-0 do pass recommendation. Finally, the committee approved House Bill 2189, directing the Board of Nursing to update rules for licensed health aides and collect annual data, with the sponsor and board staff saying it would help implement routine ventilator care in the home; it passed 12-0. The committee then began hearing House Bill 2404, a strike-everything amendment on inter-facility transports for behavioral health patients, but the transcript cuts off before action on that bill.

Transcript Highlights:

• which the National Pediatric Readiness Assessment is not conducted, and it requires them to work with CMS
• The evaluation of the child to be eligible for CMS services stays in DOH.
• There are major functions that CMS does, and they will remain.
• They will continue to do the child abuse death review unit, the child protection teams, the CMS, the
• The only thing that is moved is the administration of the managed care plan that CMS children are under

Summary: The Health Policy Committee met for its final meeting of the session and handled a very full agenda, beginning with a few housekeeping items and a brief thank-you to staff. Senate Bill 596 was temporarily postponed. The committee then reconsidered and amended SB 1606 on patient access to records, clarifying portal access obligations and deleting a section that would have improperly affected nursing home facility records; the bill was reported favorably as a committee substitute. The committee also recommended confirmation of a block of appointees and separately confirmed Chavon Harris as Secretary of the Agency for Health Care Administration after testimony focused on transparency, financial oversight, Medicaid managed care accountability, and internal controls at AHCA. Harris said she would prioritize staffing, monitoring, and improved reporting, and several health care groups waived in support. The committee next heard and passed several bills, including claims bills SB 28 and SB 22 for South Broward Hospital District settlements, both reported favorably. It also approved SB 772 on undesignated glucagon in schools, SB 998 on allowing physician assistants and APRNs to complete death certificates under hospice/palliative protocols, SB 1412 on home health agency administration and staffing flexibility, SB 1800 creating a Parkinson’s disease research consortium at USF, SB 306 on Medicaid managed care network access during holidays and after hours, SB 1768 on stem cell therapies and informed consent, SB 1602 on pediatric readiness standards in emergency departments, SB 1156 on the home health aide program for medically fragile children, SB 1490 on Children’s Medical Services and Medicaid managed care administration, and SB 1182 on Medicaid coverage of continuous glucose monitors. Most of these bills were amended, generally to narrow scope, align with the House, or make technical changes, and most received support from provider associations, advocacy groups, or affected institutions. The most debated measure was SB 1270, which combined several health freedom and medical marijuana provisions. The strike-all amendment retained language prohibiting discrimination based solely on vaccination status, added protections related to mRNA vaccine documentation requirements, and included medical marijuana regulatory and background-screening language. The committee heard extensive testimony both in support and opposition, including concerns from senators about whether the bill would force providers to treat patients contrary to medical judgment, and support from witnesses arguing it protected patient autonomy and access to care. After a time-certain motion, the bill was reported favorably as a committee substitute. At the end of the meeting, senators recorded their votes on selected tabs, and the committee adjourned.

Transcript Highlights:

• So, since 2017, New Hampshire was under a corrective action plan from CMS.
• So, it’s been a few years we’ve been in compliance with CMS.
• <00:15:47.519> The corrective action plan from CMS. The corrective action plan from CMS.
• <00:15:55.120> This we've been in compliance with CMS.
• This we've been in compliance with CMS.

Keywords: 928, house, all

Summary: The Legislative Performance Audit and Oversight Committee met to accept prior minutes and receive updates on ongoing audits. Audit staff reported progress on three education-related reviews: special education (34 of 71 observations completed, draft expected in the second quarter and final in the summer), education freedom accounts (22 of 41 observations completed, draft expected in the second quarter and final in the summer), and the doorway program (5 of 13 observations completed, draft expected by the end of February and final by April or May). No committee questions were raised on the audit status update. The committee then discussed possible future oversight topics, beginning with SNAP and concerns about fraud and work requirements. Members suggested inviting DHS officials and contract administrators to explain program operations and compliance, and also discussed whether the Department of Justice Medicaid fraud unit or other experienced officials could provide useful context. Members noted New Hampshire’s existing oversight layers, including the Executive Council and the joint HHS oversight committee, while also expressing interest in hearing more directly from department staff about staffing and contract management capacity. A substantial portion of the meeting focused on whether to pursue an audit of special education at the local school level. Members debated whether to wait for the ongoing statewide special education review and a legislative study commission report, or to begin scoping a local audit now so work could start sooner. Supporters argued that local-level spending, identification rates, and effectiveness vary widely by district and that an audit should examine both costs and outcomes; others cautioned that the scope would need to be manageable given limited audit staff and that the statewide report may help narrow the focus. The committee also briefly discussed a potential audit of the Bureau of Elderly and Adult Services, but no decision was made on that item.

Transcript Highlights:

• Prior to this, it was documented in special terms and conditions and negotiated between CMS and states
• Yeah, I believe that we do have that in writing from CMS, from previous questions that we have asked
• If we don't have it in writing from CMS, we could try to obtain it.
• set up an Indian managed care entity to provide care for Indian patients and then be recognized by CMS
• And then be recognized by CMS and IHS, and what that does is it allows the tribes to provide services

Summary: The committee met at Spirit Lake Tribe and heard an extended discussion with Spirit Lake tribal leaders and program directors about government-to-government relations with the state. Chairwoman Street and others outlined a number of concerns and requests, including taxation of tribal and trust lands, state school support for non-beneficiary students, homelessness services, Indian-managed health care, gaming/e-tabs, the Feather Alert system, industrial farming near waterways, tourism and cultural issues, and the need for more consistent tribal consultation. Committee members responded that many of these issues had previously been passed along without direct action, and several members emphasized the committee’s role in education, communication, and preparing possible legislation or resolutions for the next session. Tribal representatives also offered to provide training on treaties, IHS 638, and compact services to help legislators better understand tribal jurisdiction and billing issues. A major portion of the meeting focused on Spirit Lake Fish and Wildlife concerns, especially jurisdictional “gray areas” around hunting and fishing on the reservation, recognition of tribal licenses, and the boundary of the reservation around Spirit Lake/Devils Lake. Tribal officials said they wanted a co-stewardship agreement or MOU with the state to clarify jurisdiction, improve cooperation, and address invasive species and aquatic nuisance species. Committee members discussed whether to draft legislation or a resolution directing the executive branch and state agencies to negotiate such an agreement, and they asked for further input from the North Dakota Game and Fish Department at a future meeting. The committee also discussed county involvement in land status changes and trust land issues, with Spirit Lake leaders describing a past Benson County resolution that tried to block fee-to-trust transfers and saying it was later rescinded. The committee then heard from Benson County tax equalization director Randy Thompson, who explained how the county values land and handles tax-exempt, inundated, and fee-to-trust parcels. Members asked about the impact of tax-exempt lands on county services and discussed prior legislation that helped counties with large tax-exempt bases. The committee also received a presentation from Dr. Steven Smith of Sisseton Wahpeton College, who described the college’s programs, economic impact, and funding needs, including support for non-beneficiary students and workforce training. Members asked about expanding tribal college education into correctional settings, and Smith said the idea was worth exploring through the tribal college system. Finally, HHS interim medical services director Christoph Framing presented remotely on 1115 Medicaid waivers and the IMD exclusion, explaining current state funding mechanisms for inpatient and residential behavioral health services and the bill draft directing HHS to pursue a waiver for IMD payments.

Transcript Highlights:

• Prior to this, it was documented in special terms and conditions and negotiated between CMS and states
• Chair Holly, members of the committee, yeah, I believe that we do have that in writing from CMS, from
• If we don't have it in writing from CMS, we could try to obtain it.
• also has an 1115 IMD waiver that was approved by the Centers for Medicare and Medicaid Services, or CMS
• and IHS... ...and then be recognized by CMS and IHS.

Summary: The committee met at Spirit Lake Tribe and first heard welcoming remarks and introductions from tribal leaders and program directors. Chairwoman Street and other tribal representatives outlined a range of concerns and requests for state action, including taxation of reservation lands, support for non-beneficiary students at the tribal school, homelessness funding, Indian-managed health care, gaming and e-tabs, Feather Alert improvements, industrial farming near waterways, tourism, and better state-tribal consultation. Committee members responded that the meeting was intended to improve understanding and communication, and several members suggested future legislation or resolutions could be used to advance some of the issues. The tribe also offered to provide training on treaties, IHS 638, and compact services to legislators and staff. A major portion of the discussion focused on Spirit Lake fish and wildlife jurisdiction and the lake boundary. Tribal representatives asked for an MOU or co-stewardship agreement with the state to clarify hunting and fishing rights, recognize tribal licenses, and reduce recurring disputes over “gray areas” on the reservation and lake. Committee members discussed whether to draft a bill or resolution directing the executive branch and state agencies to negotiate such an agreement, and asked that North Dakota Game and Fish be invited to a future meeting. Related concerns included aquatic nuisance species prevention, with both sides agreeing that more aggressive boat inspection and cleaning measures would be beneficial. The committee also discussed taxation and county relations. Tribal leaders raised concerns about county resistance to fee-to-trust transfers and about property and vehicle taxation affecting members living on or near reservation lands. Committee members and tribal counsel reviewed federal treaty principles and court cases, and one member noted that the committee had previously taken no formal action on similar issues. Later, Benson County’s tax equalization director explained how the county values taxable land, handles inundated land applications, and tracks land coming off the tax rolls when the tribe repurchases acreage. The discussion ended with a presentation from the president of Sisseton Wahpeton College, who described the college’s programs, economic impact, and funding needs, followed by an HHS presentation on 1115 Medicaid waivers and the IMD exclusion as the committee moved to its next topic.

Transcript Highlights:

• document a patient's progress on more than a quarterly basis unless more documentation is required by CMS
• So you're saying that CMS requires it every quarter and we're requiring it every month, and so we just
• Madam Chair, Representative... more documentation is required by CMS to meet the needs of the patient
• Currently, CMS, Centers for Medicare and Medicaid Services requires that a social Currently, CMS, Centers
• So you're saying that the CMS required every quarter and we're requiring it every month and so we just

Bills: SB1095, SB1114, SB1116, SB1162, SB1164, SB1178, SB1179, SB1249, SB1253, SB1346, SB1347, SB1446, SB1561, SB1813

Keywords: gender transition, minors, irreversible surgery, health professionals, puberty-blocking drugs, medical procedures, prohibition, Arizona Revised Statutes, behavioral health, patient brokering, appropriation, state funds, Maricopa County, claims review, medical necessity, American Indian health program, healthcare regulations, healthcare compliance, behavioral health technicians, licensing

Summary: The committee first heard Senate Bill 1114, which would appropriate $1 million to the Maricopa County Attorney’s Office to investigate behavioral health patient brokering statewide. Sponsor Sen. Karen Werner described the bill as a response to fraud involving vulnerable Native Americans and said the county attorney would investigate the whole state. Some members questioned why the Attorney General was not handling the work and whether the funding should go to a county office, while others supported the effort. The committee voted 10-1 with one present to give SB 1114 a due pass recommendation. The committee then considered Senate Bill 1116, which would require that denials or adverse appeal decisions on behavioral health claims for the American Indian Health Program be reviewed by someone with at least two years of relevant clinical experience. Access testified neutral but said the bill’s language was too broad and could increase appeals and staffing needs, estimating about $490,000 for eight FTEs. Sen. Werner said the bill was meant to prevent inappropriate denials by reviewers without relevant expertise. Members raised concerns about definitions and staffing, and the committee approved the bill 7-4 with one present. Senate Bill 1346 would require Access to notify providers of claim deficiencies within 72 hours and decide corrected claims within 10 business days. Supporters said the measure would reduce long delays and help providers stay afloat; Access said it was working on process improvements but warned the bill would require more staff and system changes, estimating about $580,000. The committee passed SB 1346 7-5. Senate Bill 1347, requiring insurance coverage for fertility preservation services for cancer patients at risk of infertility, drew strong support from cancer survivors and advocates, with insurers neutral; the committee passed it unanimously 12-0. The committee also heard Senate Bill 1813, which would require Arizona State Hospital admissions to be based on clinical need rather than county of residence. Supporters argued the Maricopa County cap unfairly delays treatment and is not required by the underlying court ruling, while ADHS warned the bill could conflict with the Arnold v. Sarn settlement and could shift access away from rural counties. After extensive discussion, the committee passed SB 1813 9-2 with one present. Finally, the committee began hearing Senate Bill 1178, which would allow naturopathic physicians to administer IV antibiotics, antivirals, and antifungals; the initial testimony was largely opposed by medical associations on patient-safety and training grounds, with supporters yet to testify in the excerpt provided.

Transcript Highlights:

• itself um what we'll be happy to CMS itself um what we'll be happy to answer<00:10:36.040> any
• <00:11:15.519> requirements<00:11:16.000> that to align it to the CMS requirements
• that to align it to the CMS requirements that will<00:11:16.240> be<00:11:16.360> coming
• Another point raised by HMSA is that there is a CFR/CMS rule that is about to come out.
• <00:13:11.120> that's that there is the um CFR CMS that's that there is the um CFR CMS that's

Keywords: 912, senate, all

Summary: The committee heard testimony on a long calendar of health-related measures, beginning with SB 297, a proposed constitutional amendment to protect reproductive freedom. Supporters included medical, labor, and advocacy groups, while opponents, including Hawaii Family Forum and Hawaii Christian Coalition, argued the term “reproductive freedom” was too vague and could be misunderstood. Testimony on SB 350, a similar constitutional amendment protecting contraception, also drew strong support from medical and advocacy groups and opposition from religious organizations; one witness said the measure was especially important to protect reproductive care and contraception. Several bills focused on health system administration and public health. SB 1438 on home care agencies, SB 1439 on nuisances, SB 1441 on transferring the AAHU regional health care system to the Department of Health, SB 1442 on children’s mental health services, SB 1443 on the Department of Health, SB 1444 on general excise tax, and SB 1445 on youth mental health all received mostly supportive testimony from state agencies and community organizations. On SB 1445, the Hawaii State LGBTQ Commission asked that LGBTQI+ and Native Hawaiian youth be specifically considered in mental health services. SB 1450, creating an intensive mobile team pilot for houseless individuals with serious brain disorders, drew support from state agencies and providers; a street medicine advocate said the pilot could help address sustainability, insurance, and service delivery on the streets. The committee also heard testimony on access and workforce measures, including SB 1596 on nursing, SB 1565 on acupuncture, SB 1564 on Medicaid, SB 1418 for an emergency DHS appropriation, SB 1417 on crimes against protective services workers, SB 1411 on Medicaid third-party liability, SB 1399 on a family resilience pilot program, SB 1398 on trauma-informed care, SB 1281 on telehealth, and SB 1279 on telepharmacy. Most of these measures drew broad support from agencies, provider groups, and advocacy organizations. On SB 1281, HMSA opposed the bill as written, warning about audio-only telehealth and federal rule changes, while other health groups supported it as important for rural, kupuna, and disabled residents. On SB 1417, a Honolulu Police Department captain supported stronger protections for DHS workers but could not provide complaint data and said he would follow up later. The hearing ended with the chair noting quorum and asking whether the committee was ready for decision making; no votes or final actions were recorded in the transcript.

Transcript Highlights:

• So, clearly it sounds like CMS has identified that as well.
• So, clearly it sounds like CMS has identified that as well.
• looking at the CMS, you're inatient in looking at the CMS, you're inatient in ICU,<00:34:10.879> and
• Um, so then in line 24 where it says, uh, DHS shall submit to CMS any amendment.
• Um, so then in line 24 where it says, uh, DHS shall submit to CMS any amendment.

Keywords: 1191, senate, all

Transcript Highlights:

• <00:16:15.959> introduced that bother me is when CMS introduced that bother me is when CMS
• insurers from following the lead of CMS insurers from following the lead of CMS which<00:18:48.320
• <00:23:00.720> rules future uh for example if uh CMS rules future uh for example if uh CMS
• Nagel noted, CMS led the charge on EMR.
• It was over 20 years ago that CMS started with EMRs, and so it is the norm.

Keywords: 1189, house, all

Transcript Highlights:

• The bill seeks to align state regulations with CMS regulations, so we would just be consistent.
• Every state around us has the same regulations and follows CMS standards.
• And again, it's consistent with CMS regs.
• These services are 100% covered by CMS and not the state of Arizona.
• initiate complaint investigations relating to nursing care institutions in a manner consistent with CMS

Bills: HB2049, HB2050, HB2051, HB2072, HB2082, HB2085, HB2177, HB2178, HB2179, HB2183, HB2195

Keywords: radiation therapy, particle accelerator, critical access hospitals, patient care, rural healthcare, AHCCCS, lactation care, breastfeeding, health services, healthcare access, Cesar Chavez, public holiday, state law, holiday repeal, Arizona Revised Statutes, childhood cancer, rare diseases, research funding, healthcare, clinical trials

Summary: The committee opened with attendance and member introductions, then heard a series of health-related bills, many focused on access to care in rural and underserved communities. HB 2049 would allow particle accelerators for radiation therapy in critical access hospitals and counties under 400,000 population under general supervision; sponsors and rural oncology witnesses said it would reduce travel burdens for cancer patients while maintaining safety protocols. HB 2050 updated radiologic technologist statutes to align with current national standards, adjust accreditation and clinical-hour requirements, and allow radiologist assistants to work under supervision rather than direct supervision; an amendment also added registered nurses to the list of professionals not needing a separate license to use diagnostic X-ray machines. Both bills were supported by testimony about workforce shortages and access, though one member voted no on HB 2050 over concerns about oversight and board authority. Both measures received do-pass recommendations, with HB 2050 amended. The committee then unanimously advanced HB 2082, which creates a Childhood Cancer and Rare Childhood Disease Research Commission to award grants for phase-one pediatric cancer and rare disease trials. Testimony came from families affected by pediatric brain cancer, including a parent who described traveling internationally for treatment and a college student currently undergoing treatment who urged the state to invest in research. Members expressed strong sympathy and support, and the bill passed 12-0. Next, HB 2015 would require Access to cover breastfeeding and lactation services in multiple settings; the sponsor and medical witnesses described breastfeeding as preventive care with benefits for infants and mothers, while Access testified neutral and noted a fiscal estimate was being developed and that the amendment would protect the state if CMS does not approve the services. The bill, as amended, also received a unanimous do-pass recommendation. The committee also approved HB 2177, which directs Access to seek CMS waivers so tribal and Indian Health Service facilities can be reimbursed for certain covered services, including dental care, for American Indian and Alaska Native members. The sponsor and a Sage Memorial Hospital representative said the bill would help rural tribal facilities keep services local and maximize federal matching funds; it passed unanimously as amended. HB 2178, requiring a state agency medical chief officer to hold an active medical or osteopathic license, was described as a cleanup measure after a lapse in licensure exposed a statutory gap, and it also passed unanimously. HB 2179, which clarifies definitions separating air ambulance from ground ambulance regulation, was supported as a technical clarification to avoid unintended consequences and likewise received unanimous approval. Finally, the committee advanced HB 2183, which creates an emergency medicine study committee to examine Arizona’s EMS system, including rural and urban capacity, workforce burnout, uncompensated care, and emergency department utilization. The sponsor said the study would help the state understand system pressures and identify policy solutions; firefighters, health care advocates, and an emergency medicine nurse practitioner testified in support, emphasizing the ER’s role as the safety net and the strain from staffing shortages, rural closures, and high volumes. The bill was still under discussion at the end of the transcript, with testimony continuing after the initial supporters spoke.

Transcript Highlights:

• CMS came back and told us that that was not allowed—to define an increased benefit limit tied to a diagnosis
• We're carrying the rate increase forward now, and we're working with CMS.
• We're carrying the rate increase forward now, and we're working with CMS and the dentists on how to move
• And CMS has approved the rate increase, so we are ready to implement with a July 1 start date.
• can't splice that special-needs diagnosis out to receive a better benefit or whatever, I think is what CMS

Keywords: 1204, all

Summary: The committee reviewed a series of Medicaid and health-related administrative rules, most of them tied to 2025 acts. Early items covered presumptive eligibility end dates, adding a definition of fictive kin for foster children, and updating ABLE account disability onset age. The committee also reviewed rules on continuous glucose monitors, RSV vaccine administration fees, ET3 telemedicine exemptions for ambulance services, dental rate increases, physical and occupational therapy access, and the Healthy Moms Healthy Babies and lactation consultant provisions. Most rules were reviewed without objection, though several members asked for fiscal and implementation details, especially on the CGM rule and the dental rate rule. The most extended discussion centered on the dental rate increase under Act 1025. DHS said the rule applies only to oral surgeons’ dental services as written, while the Arkansas State Dental Association and legislative sponsors argued the intent was to raise rates for a broader set of dentists performing the same procedures, especially for adults with special needs. Members discussed the statutory language, CMS constraints, bifurcated rates, and the estimated additional cost of about $1.5 million annually if general dentists were included. The committee ultimately reviewed the rule, but the chair noted the testimony and lawmakers indicated they would work on a fix next session. Another major exchange involved the CGM rule. Members questioned the reported $3 million two-year fiscal impact, the prior authorization process, and whether DME providers would be forced into a pharmacy-based system. DHS explained that the same vendor would handle prior authorizations and that the billing system changes were already live, but one member moved to expunge the earlier review vote and then said he would hold the rule pending further clarification. The committee also reviewed rules on adverse decisions appeals, CNA training, substance abuse and mental health network-status disclosures, new certification rules for doulas and community health workers, cosmetology/body art, massage therapy, lead-based paint, radiation control, radiologic technology licensure, and mobile home/RV park standards. The meeting ended with all remaining items reviewed and the committee adjourned.

Transcript Highlights:

• And largely that's related to behavioral analysis and CMS, which is now a component, or largely a component
• It's a stronger impact, and it's largely coming from that CMS and behavioral analysis component.
• But we're seeing that the rate increases, it looks like, particularly for CMS, are huge cost drivers
• we need to dig deeper into exactly how those costs are being driven, because particularly it's for CMS
• driven, because particularly exactly how those costs are being driven, because particularly it's for CMS

Summary: The committee met to receive Amy Baker’s presentation on Florida’s long-range financial outlook for fiscal years 2026-27 through 2028-29. Baker said the forecast assumes continued but moderating economic growth, with Florida GDP slowing from recent highs, personal income remaining above average, wages continuing to rise faster than job growth, and population growth eventually slowing as the state approaches 2030 and the baby-boomer cohort fully ages into retirement. She also highlighted weakening housing and real-estate-related revenue, especially documentary stamp collections, along with low consumer sentiment as signs of caution in the outlook. Baker explained that the state’s near-term general revenue picture improved largely because of legislative actions taken in the prior session, including contingency releases, reversions, and other budget adjustments, rather than from major new revenue growth. She said reserves remain strong at nearly $15 billion, or just under 30% of general revenue, with the budget stabilization fund at its constitutional maximum. The main spending pressures identified were critical needs and other high-priority needs, led by a new recurring transfer to the emergency preparedness and response fund and by Medicaid, where rising service costs and medical inflation—especially behavioral analysis costs in managed care—are driving higher expenditures despite lower caseloads and a slightly better federal match. Members questioned the accuracy of the forecast, the Medicaid cost drivers, the treatment of the governor’s emergency fund, federal funding assumptions, and whether recent federal legislation was reflected in the numbers. Baker said the outlook assumes current federal funding paths continue, that the new federal tax/revenue law had not yet been fully incorporated because agencies were still reviewing it, and that the emergency fund line was calculated from recent appropriations without distinguishing specific uses. She also said the vetoed $750 million did not affect the budget stabilization fund because it reverted to unallocated general revenue. No bills were heard, no votes were taken, and the committee adjourned after the presentation and discussion.

Transcript Highlights:

• CMS has a great deal of control over those. They have to certify our systems.
• <01:02:54.799> CMS federally funded on most of those.
• CMS federally funded on most of those.
• So, think of CMS as a homeowners association.
• So, think of it, think of CMS as there.

Keywords: Appropriations - Room 216, 24 February, 2026; 1:30 PM, 925, all

Summary: Legislative leaders opened the hearing by focusing on statewide technology issues affecting agencies, including rising IT costs, cloud migration, cybersecurity risks, procurement delays, and the need for better coordination across government systems. They said the meeting was intended to hear from agency directors about current challenges and possible legislative solutions. The ITS director described the state’s IT structure as decentralized but increasingly moving toward shared services. He highlighted recent legislative and executive actions on cloud computing, artificial intelligence, procurement modernization, and data sharing, including House Bill 1491, Senate Bill 2426, Senate Bill 2267, House Bill 958, and an executive order on AI. He said ITS has worked with large agencies on a cloud center of excellence, a procurement modernization advisory council, and a state data exchange, and noted plans for a master contract, potentially with OpenAI, that could be available to all public entities. He also emphasized cybersecurity, saying the state is seeking a secure operations center and a broader “cyber maturity” approach after recent incidents. On procurement, he said the goal is to speed up purchasing while keeping it safe, and on optimization he pointed to potential savings from consolidating duplicate agreements, such as multiple Microsoft enterprise contracts. In response to questions, he said exceptions to centralization would be based on business and technical architecture and regulatory requirements such as HIPAA, CISA, or FERPA, rather than ad hoc decisions.

Transcript Highlights:

• Um, obviously we'd have to submit that to CMS to get the approval, but it's for you get 90/10 for what
• Um, obviously we'd have to submit that to CMS to get the approval, but it's for you get 90/10 for what
• Um, obviously we'd have to submit that to CMS to get the approval, but it's for you get 90/10 for what
• And CM,<00:31:50.480> the<00:31:50.640> Centers<00:31:50.880> for<00:31:50.960><
• c> Medicare<00:31:51.279> and CM, the Centers for Medicare and CM, the Centers for Medicare

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:36 Department for Medicaid Services 00:01:44, 958, all

Summary: The House Budget Review Subcommittee on Health and Family Services met for an overview of the Department for Medicaid Services budget. Commissioner Lisa Lee and CFO Steve Beal described Kentucky Medicaid enrollment at about 1.4 million members, including more than 600,000 children, and said the agency’s 2025 total budget was $20.6 billion. They reviewed enrollment trends before, during, and after the COVID-19 public health emergency, noting that redeterminations begun in 2023 reduced enrollment from its peak but that total membership remains above pre-COVID levels. They also explained the difference between the fee-for-service population, which includes long-term care and waiver members, and managed care members, and gave examples of the kinds of services and diagnoses seen in each group. A major focus was the governor’s recommended Medicaid budget and the department’s forecast process. Lee said the budget is split into benefits and administration, with benefits covering fee-for-service services, managed care capitation, transportation, and Medicare premiums, while administration covers contracts, personnel, operating costs, and IT-related advanced planning documents. She said the department uses a consensus forecasting group and actuary input, and that its forecasts have been within 1% of actual spending in recent years. The department also said the governor’s budget includes new waiver slots to address waiting lists, a 2% staff COLA, and a 10% phase-down on state-directed payments beginning in January 2028. Much of the discussion centered on House Resolution 1 and the funding needed to implement its Medicaid-related provisions, including community engagement requirements, six-month redeterminations, and future cost sharing. Lee said the department requested about $35 million in total funds for fiscal 2027, including about $8.2 million in general funds for system changes to the integrated eligibility system, claims processing, notices, and monitoring; and about $11 million in fiscal 2028 for ongoing maintenance, with about $1.6 million in general funds. She said the department expects to seek federal APD matching funds for the IT work. In response to questions, she explained that community engagement would apply to Medicaid expansion members, with qualifying activities including work, school, volunteering, or equivalent income, and that certain groups such as pregnant women, children, caretaker relatives, and some people with chronic disease or substance use disorder would be excluded. She said the department identified roughly 70,000 expansion members who could be subject to the requirement. No votes or formal actions were taken.

Transcript Highlights:

• Rural Medicaid dollars that the HCA submitted to CMS, the Centers for Medicare and Medicaid, included
• FDA has approved it, but CMS has to write the rules to enact it, and that can take some 12 to 18 months
• You said CMS before. What does CMS stand for?
• However, CMS has to write rules and regulations. Thank you, sir. I appreciate that answer.
• The governor, the legislature, and a number of advocates were on board when they approached CMS.