Transcript Highlights:

• revenue not keeping pace with with CM revenue not keeping pace with rising<01:02:51.359> claims
• from CMS, which results in a premium of $199.94.
• and the pharmacy reimbursement from CMS and the pharmacy reimbursement<01:04:07.440> from<01:
• There's less CMS reinsurance to offset higher specialty drug costs.
• there's less cms there's less cms reinsurance<01:05:56.799> to<01:05:57.039> offset

Keywords: Meeting Start: 00:00:35 Attendance Roll Call: 00:00:55 Approval of Minutes: 00:02:56 Deferred Compensation Authority Update: 00:03:12 Retiree Health Update - TRS: 00:15:58 Retiree Health Update - KPPA: 00:56:13 Adjournment: 01:08:10, 958, all

Summary: The Public Pension Oversight Board met with a quorum, approved the prior minutes, and heard updates from the Kentucky Public Employees Deferred Compensation Authority and the Teachers Retirement System. The deferred compensation update highlighted continued growth in assets to about $4.787 billion and roughly 88,000 participants, strong retention from auto-enrollment, a marketing campaign tied to pay raises that generated additional participation, and a new self-directed brokerage account expected to launch July 1 of the coming year for participants with at least a $40,000 balance, allowing up to 25% of their account to be moved into the brokerage window. The director also described the free financial planning service, which has been used by about 3,500 participants with a high return rate, and said the plan is currently in a fee holiday; if fees are charged, they are capped at $237 per year for most participants. Members asked questions about who provides the CFP service, the fee structure, and the brokerage eligibility threshold. The director said the CFP service is provided through the authority’s service bundle with Nationwide, not as a separate paid service, and explained that the fee cap and current fee holiday are intended to keep the program low-cost. Board members praised the deferred compensation program’s performance and asked for a copy of the legislation referenced in the presentation. TRS then presented on retired teachers’ health insurance. Barnes first clarified how declining federal contributions for federally funded school positions affect the retirement annuity trust, explaining that if those federal dollars fall, the amounts would need to be covered through the SEEK formula and that the projection for those contributions is about $80 million over the next three years. He then reviewed TRS retiree health coverage, distinguishing between KEHP for retirees under 65 or not Medicare-eligible and MEHP for Medicare-eligible retirees, and explained that TRS recently completed RFPs for both prescription drug and medical coverage. TRS will keep Express Scripts for prescription drugs, but will move the Medicare Advantage medical plan from UnitedHealthcare to Humana on January 1, 2026, while keeping the plan design, provider access, and out-of-pocket structure largely unchanged, with a new hearing-aid benefit of $500 per ear. Barnes also reported the 2026 premium and contribution changes: the maximum TRS contribution toward KEHP will rise to $1,144.96 from $930.76, an 18% increase that he said will require roughly $15 million to $16 million more in the state budget, while the MEHP premium will drop to $200 per month from $210. He said the TRS board has statutory authority to set these amounts and that the changes will have mixed actuarial effects, with the KEHP increase being negative overall and the MEHP decrease positive.

Transcript Highlights:

• CMS that they<00:29:25.440> would<00:29:25.600> defer<00:29:26.399> $260<00:29:
• This threat to withhold money, you know, just when you've got the director of CMS telling you, well,
• This threat to withhold money, you know, just when you've got the director of CMS telling you, well,
• You don't have the director of CMS say the state can pick it up, which is not true.
• >> Governor, any timeline on that CMS >> Governor, any timeline on that CMS appeal<01

Keywords: 1187, senate, all

Transcript Highlights:

• Lakeland Village is an intermediate care facility as well as a nursing facility, CMS-certified in both
• Census in the intermediate care facility is 84, with 104 funded beds and 116 CMS-certified beds, and
• Burkrest School up in Shoreline is an intermediate care facility as well as a nursing facility both CMS
• Census and intermediate care nursing facility both CMS certified.
• Census and intermediate care facility is 84 with 104 funded beds and 116 CMS certified beds and the nursing

Summary: The committee heard a lengthy update on Washington child welfare from Casey Family Programs and DCYF. Dr. David Sanders said Washington has sharply reduced out-of-home care and increased kinship placements, but he flagged concerns about low screening-in rates, long stays in foster care for many children, and a recent rise in repeat maltreatment and child fatalities, especially among infants. He urged more focus on infants and young children, better coordination among child protection, health care, and law enforcement, and more proactive review and investigation practices. Members asked for disaggregated data on children lingering in care, fatalities, and causes such as fentanyl exposure. DCYF said it has increased relative placements and guardianships, but also reported a concerning rise in 2025 critical incidents, mostly near-fatalities involving children age three and under, many opioid-related. The department described responses including safe child consults for opioid cases, more training, hotspot analysis, and proposed investments in peer support, public health nurses, community referrals, and an updated safety framework. Members also discussed whether a broader commission on child abuse prevention would be useful, and DCYF said it was open to that idea. The committee then received a DSHS reorganization update from Secretary Angela Ramirez, who described the “Reimagined” plan to consolidate four administrations into three new ones, with the stated goals of reducing silos, improving customer experience, and making transitions between services smoother. She said the agency is seeking statutory changes and CMS approval to align the new structure, and members asked about preparing for federal HR1 impacts, especially SNAP. Ramirez said DSHS is monitoring those impacts closely and emphasized the need for accurate data and cross-agency coordination. Finally, DSHS’s Behavioral Health and Habilitation Administration updated the committee on residential habilitation centers and implementation of Substitute Senate Bill 5393, which phases out Rainier School by June 30, 2027 and limits new admissions. Officials reported current census and staffing levels at the state’s RHCs, said Rainier has had some residents transition to supported living or adult family homes, and explained that emergency and permanent rulemaking was needed to implement the law. They also said Rainier was recently cited by federal surveyors for not meeting the active treatment requirement for two residents, and that the facility has 90 days to return to compliance before possible payment penalties or further remedies. Members pressed for details on the citation, the meaning of active treatment, the assessment process for admissions, and whether Rainier could be repurposed for other services; DSHS said it is working on corrective action and will follow up in writing.

Transcript Highlights:

• Transformation Project, or MTC, and this is an 1115 Medicaid demonstration waiver that was approved by CMS
• At the end of June 2023, CMS approved Washington's 1115 renewal waiver, which included the HRSN benefits
• In January of 2025, CMS approved the protocols, the rate methodology, and implementation plan for these
• Has been found eligible because those are kind of metrics that we will have to report back out to CMS
• You know, I think some of it's not even just the legislature, but CMS in skilled nursing facilities,

Summary: The committee met for what was described as its final meeting, with members and staff reflecting on the work of the Joint Legislative Executive Committee on Aging and Long-Term Care and noting that future work would likely shift to standing health and wellness committees. The meeting began with introductions and then moved into updates on major initiatives that originated from the committee, including Washington Cares, the Dementia Action Collaborative, and Medicaid long-term care programs. Presenters emphasized that these efforts were developed through long-term legislative-executive collaboration and were intended to help Washington prepare for the state’s aging population. On Washington Cares, DSHS described the program’s development from a 2014 research effort to its 2019 enactment, premium collection beginning in 2023, portability improvements in 2024, and 2025 changes including a grandfathered opt-out fix and a framework for supplemental private long-term care insurance. The agency said benefits are expected to go fully live next summer, with a pilot of up to 400 applicants planned for next January. On dementia policy, the Dementia Action Collaborative reported on the state dementia plan, Project ECHO training for providers, and pilot dementia-capable community programs at area agencies on aging, citing preliminary results that about 85% of family caregivers said services helped people remain at home. DSHS also reviewed Medicaid Transformation Project initiatives, including Medicaid Alternative Care, Tailored Supports for Older Adults, presumptive eligibility, and health-related social needs benefits such as rental assistance, nutrition support, and home modifications. The committee then heard an emerging issues panel from ombuds and disability advocates. Patricia Hunter of the long-term care ombuds program raised concerns about staffing shortages, resident rights, surveillance technology, private equity ownership of facilities, and illegal discharges or evictions. Betty Sweeterman of the Developmental Disabilities Ombuds discussed people stuck in hospitals without medical need, gaps in behavioral health services for people with developmental disabilities, and the need for better workforce training. Todd Carlyle of Disability Rights Washington urged expansion and bundling of community supports such as PACT, GOSH, and peer bridgers to reduce repeated institutionalization and support discharge from inpatient psychiatric settings. Provider and labor panels followed, with nursing home, assisted living, supported living, and union representatives all emphasizing workforce shortages, low wages, Medicaid rate inadequacy, case management bottlenecks, behavioral health complexity, and the need for more flexible care models and stronger accountability for rate increases. No formal votes were taken; the meeting ended with public comment on manufactured housing and closing remarks thanking staff and participants for the committee’s work.

Transcript Highlights:

• :24:39.760> from think we will also have feedback from think we will also have feedback from CMS
• CMS. U we know what we would prioritize. CMS. U we know what we would prioritize.
• CMS<00:24:43.200> may<00:24:43.360> also<00:24:43.600> have<00:24:43.760> ideas
• and we work CMS may also have ideas and we work through<00:24:44.799> that.
• It's been an evolving feedback with CMS.

Keywords: 928, house, all

Summary: The committee first approved the draft minutes from September 26. Senator Gray then raised the idea of creating a continuing subcommittee or recurring agenda item on palliative care and hospice, noting that the issues are evolving and suggesting the committee revisit the idea in coming months. The bulk of the meeting focused on Department of Health and Human Services updates. Officials described contingency planning for SNAP amid the federal shutdown, including a USDA notice that November benefits may not be fully funded, letters to participants warning of possible delays, and coordination with the New Hampshire Food Bank and local pantries. They said New Hampshire serves about 42,000 SNAP households, with average benefits around $300 a month, and that the department is also preparing to transfer funds for a special fiscal committee meeting. WIC was discussed separately: officials said WIC benefits had been extended through November 7 using additional USDA funds, but that some community agency-based WIC services may need to pause while money is redirected to food benefits. Officials also outlined New Hampshire’s rural health transformation grant application under the federal One Big Beautiful Bill, describing a potential five-year, up-to-$1 billion opportunity focused on critical access hospitals, small rural hospitals, federally qualified health centers, community mental health centers, and EMS. Members asked about transportation, workforce, and nursing retention; officials said transportation is included in the proposal, housing is not, and workforce supports may include lower tuition or awards but not loan repayment or traditional scholarships. They also said the final application would be submitted in early November and that priorities would be adjusted depending on the eventual federal award. Finally, Medicaid director Henry Lipman gave a quarterly postpartum coverage update. He said postpartum coverage is now nearly universal nationwide, and in New Hampshire 2,351 women had used the benefit through May 2025. He reported that mental health services were the most frequently used postpartum service, followed by preventive care, substance use disorder treatment, and cardiovascular-related care, and noted that Medicaid women have experienced a disproportionate share of maternal deaths. Committee members asked about rural distribution and the share of women receiving mental health services, and Lipman said the department would follow up with additional data. The meeting then moved into the annual update on New Hampshire’s 10-year mental health plan, with staff describing progress toward a more integrated continuum of care and improved data infrastructure.

Transcript Highlights:

• So there is a a priority in terms of CMS So there is a a priority in terms of CMS has<01:26:56.159
• That application is with CMS.
• We know we will have to either withdraw that waiver or amend it while working with CMS.
• , and that are, you know, promoted by CMS, even about, you know, where the provider fraud is.
• CMS has significant latitude determined.

Keywords: 1. Call to Order and Roll Call – 00:00:00 2. Approval of Minutes – 00:02:10 3. Discussion of State-Based Marketplaces and the Federally-Facilitated Marketplace – 00:02:31 4. Discussion of the Role of Kynectors and Navigators – 00:27:29 5. Discussion of Presumptive Eligibility – 01:11:57 6. Discussion of Medicaid Eligibility, Enrollment, and Redeterminations – 01:20:09 7. Update on Rural Health Transformation Program Application Process – 01:47:35 8. Public Comment – 01:59:57 9. Adjournment – 02:06:10, 958, all

Summary: The Medicaid Oversight Advisory Board met for its third meeting and approved the July 30 minutes. The chair outlined a full agenda covering the state-based marketplace versus the federally facilitated marketplace, connectors and navigators, presumptive eligibility, eligibility/enrollment/redetermination, and a rural health transformation update. Commissioner Lisa Lee and Assistant Director David Barry presented first on Kentucky’s state-based exchange, Connect, explaining that it is an integrated eligibility and enrollment system for Medicaid, CHIP, SNAP, TANF, child care, and qualified health plans. They reviewed Kentucky’s move from a state-based exchange to healthcare.gov in 2017 and back to a state-based marketplace in 2021, and said the system helps route applicants to the correct program and allows families to move more easily between Medicaid and exchange coverage as circumstances change. The presenters said the exchange is funded by carrier assessments on qualified health plans rather than general fund dollars, with costs allocated across programs based on use. They said Kentucky’s exchange fees are lower than the federal platform’s and that the state-based system provides local assistance through DCBS offices, connectors, and licensed agents in every county. Members asked about startup and operating costs, fee-setting, and whether any general fund dollars are used; the department said it would follow up with the CFO on fee details and said it was not aware of general fund support for exchange operations. Members also raised concerns about Medicaid eligibility verification and improper enrollment, while the department emphasized that the state system uses different questions than healthcare.gov and is designed to identify the correct coverage based on monthly Medicaid income and annual tax-credit income. The board also discussed enrollment trends, including a COVID-era spike during the public health emergency when disenrollments were largely paused, and current qualified health plan enrollment of more than 97,000 people on Connect. Commissioner Lee explained presumptive eligibility as temporary Medicaid coverage, noting it applies to pregnant women and hospital-based cases, with hospitals able to grant it and certain providers able to grant it to pregnant women. She said full eligibility is still determined within 30 days and that presumptive eligibility ends when full Medicaid eligibility is determined or at the end of the following month. The meeting then shifted to connectors, with representatives from Community Action Kentucky and the Kentucky Primary Care Association describing their statewide outreach network, local offices, and role helping residents apply for Medicaid, renew coverage, report changes, and navigate benefits; they said connectors do not determine eligibility but assist with applications, recertifications, and outreach events across the Commonwealth.

Transcript Highlights:

• We work with a CMS, so the Center for Medicaid and Medicaid Services mandated federal contractor.
• So each state Medicaid agency is required to have a CMS contractor working with them.
• He said he has seen CMS estimating nationwide that it is about a 5% improper payment rate.
• They get $10,713 per person, and the national average according to CMS is $7,569.
• Inspector General Clark. according to CMS is um $7,569. according to CMS is um $7,569.

Keywords: 1183, house

Transcript Highlights:

• previous concern was that the implementation of the bill would require a state plan amendment with CMS
• Bliss's floor amendment in the House, which made coverage of the added services contingent on CMS approval
• Not being in the Health Committee, I'm not all that familiar with how CMS works, but essentially this
• bill, which seems like such a good idea, would not... ...would not become law unless CMS says that it
• currently under our either 1115 waiver or within a state plan amendment, we require us to submit to CMS

Bills: HB2051, HB2324, HB2439, HB2457, HB2686, HB2837, HB2875, HB2953

Keywords: AHCCCS, lactation care, breastfeeding, health services, healthcare access, HB2324, fire code, fire marshal, state fire marshal, municipalities, cities and towns, county-owned buildings, county buildings, intergovernmental agreement, IGA, fire inspection, occupancy certificate, building inventory, local government, county government

Summary: The Committee on Regulatory Affairs and Government Efficiency approved the March 11, 2026 minutes and then heard several bills. HB 2686, a patient-protection measure for outpatient surgical facilities, would require surgeons to file and update a call-coverage plan for hospital complications; the sponsor said it would improve continuity of care and reduce emergency room confusion, and the committee recommended it do pass. HB 2051 would require AHCCCS contractors, subject to CMS approval, to cover breastfeeding and lactation services in multiple settings; supporters described it as a maternal and infant health measure, AHCCCS was neutral and noted a projected state cost of about $1.8 million, and the bill received a do-pass recommendation on a 6-0 vote with one member not voting. The committee also approved HB 2837, which requires compensation disclosure for testimony or written comments in municipal zoning matters and requires certain municipal board members or hearing officers to disclose and recuse for recent conflicts involving entities they served; the sponsor framed it as a transparency and conflict-of-interest bill, and it passed 6-0 with one not voting. HB 2875, concerning commercial drone delivery systems, was amended to allow local regulation of drone facilities near medium and large hub airports within a 2.5-mile buffer and to require consultation with airports; Zipline and industry groups supported the measure as providing regulatory clarity, and the committee adopted the amendment and recommended the bill do pass. HB 2324 would let cities with their own fire codes, through an intergovernmental agreement, have city fire inspectors enforce those codes on county-owned buildings in city limits when state enforcement is burdensome; county and fire officials said it would resolve jurisdictional confusion, and the bill passed 6-0 with one not voting. HB 2439 would exempt single-user public or semi-public cold plunges from ADEQ spa rules, and an amendment removed ADEQ rulemaking authority; county health representatives said the change would reduce confusion, but one member raised public-health concerns, and the amended bill passed 4-2 with one not voting. HB 2457 would allow utilities to bypass the certificate of environmental compatibility process for new plants co-located with large electricity users after notice and a public comment session; the Sierra Club opposed it as reducing public review, while supporters said it preserved some local input and improved efficiency, and it passed 4-2 with one not voting. Finally, HB 2953 would cap certain nondisciplinary and civil penalties imposed by the Board of Pharmacy at $25,000 and allow lower penalties based on prior activity; a supporter said it matched limits used in other regulatory contexts, and the committee recommended it do pass unanimously.

Transcript Highlights:

• the two big blue boxes that you can see on the screen, which is basically they're talking about what CMS
• the two big blue boxes that you can see on the screen, which is basically they're talking about what CMS
• the two big blue boxes that you can see on the screen, which is basically they're talking about what CMS
• So the board will see those in September and make decisions. talking about what CMS, the Centers for
• talking about what CMS, the Centers for Medicare<00:37:27.760> and<00:37:27.920> Medicaid,<

Keywords: Meeting Start: 00:07 Attendance Roll Call: 00:13 Approval of Minutes: 02:28 2025 RS SB 9: TRS Leave Audit Requirements & Process: 03:05 2025 RS SB 10: Overview of Enacted Legislation & Discussion: 28:38 Adjournment: 42:13, 958, all

Summary: The meeting opened with roll call, a quorum was confirmed, and the minutes were approved. The committee then heard testimony on Senate Bill 9, which concerns TRS sick leave audit requirements and process. Auditor Allison Ball’s staff said the audit is an information-gathering review of how teacher sick leave is accumulated, current balances, how many employers use the sick leave function, and the policies and procedures governing sick leave. Members discussed how unused sick leave affects retirement calculations, the distinction between the state’s financial responsibility and school districts’ responsibility, and whether the audit would also examine related leave categories such as personal leave, annual leave, and leave of absence. Committee members emphasized that Senate Bill 9 was intended to add accountability and standardize reporting, including preventing annual leave from being rolled into sick leave. Several members asked for clarification on how sick leave is factored into retirement benefits. Witnesses and members explained that, under the system described, accumulated sick leave can be converted into retirement credit based on a teacher’s daily rate and then multiplied by a percentage, with the school district often bearing the cost. Members also noted nuances in the law, including different accumulation limits by hire date and tier, and that the audit may help the public better understand why some educators retire relatively young. The auditor’s office said it is still early in the process, has met with TRS leadership, and will report back once the audit progresses. The committee also asked whether maternity leave would be included; the auditor’s office said it was not specifically mandated but could be examined if the body requests it. The committee then received an overview of Senate Bill 10 from KPA representatives Ryan Barrow and Rebecca Atkins. They explained that the bill enhances retiree health insurance benefits for certain CRS members who are non-Medicare participants and meet specified career thresholds, with different rules for hazardous and non-hazardous service. They described the benefit as $40 per month per year of service for non-hazardous service and $50 per month per year for hazardous service, both inflated annually, and clarified that these amounts are not cumulative with prior benefit formulas. Members asked about the interaction between the new amounts and existing benefits, and the presenters explained that the bill also changes current employee health insurance contribution rates effective July 1, 2026, with different impacts by tier and hazardous status. The committee discussed the need for clear communication to affected employees and reviewed example calculations showing how the new contribution structure would work.

Transcript Highlights:

• It also aligns timelines and timeframes to CMS so that way there's not confusion between what the state
• is doing and what CMS requirements are.
• It also aligns timelines and timeframes to CMS, so that way there's not a confusion between what the
• state is doing and what CMS requirements are.
• to initiate complaint investigations relating to nursing care institutions that are consistent with CMS

Keywords: 1182, all

Summary: The meeting was a rapid review of a very large bill package, with the chair repeatedly asking staff to keep descriptions high level and many bills placed on third-read consent or consent calendars. A major theme was artificial intelligence: bills would require minors to be told when they are interacting with AI, allow AI-assisted divorce arbitration by consent, create an AI education program, privilege certain AI communications, and require K-12 instruction on ethical and practical AI use. Other education measures addressed school district superintendents, health instruction, anti-Semitism prohibitions, fetal development standards, and school safety, including a bill allowing concealed firearms on school grounds under specified conditions. Several health and public safety bills were also discussed. These included funding and oversight measures for childhood cancer research, nursing care complaint timelines, firefighter cancer data collection, limits on pharmacy penalties, and a bill making it a felony to administer abortion-inducing drugs without consent. Members also heard bills on overtime wage enforcement, domestic violence evidence standards in parenting cases, probation limits for dangerous crimes against children, and a measure expanding manslaughter liability to online encouragement of teen suicide. One sponsor strongly opposed a provisional medical licensing bill for foreign-trained applicants, while other sponsors emphasized rural health access, nurse anesthetist reimbursement parity, and the need for a dental board member who is an oral surgeon. A large portion of the meeting focused on water, land, energy, and state agency oversight. Bills would streamline or change rules for small modular reactors, new power plants, water supply determinations, groundwater transportation fees, water hauling, and state land disposition. Members also considered measures affecting the State Land Department, including audits, oversight boards, continuation, land-use maps for data centers and energy projects, and rules for mineral leases and solar or wind siting. Other topics included wildlife and ranching, Mexican wolf policy, annexation, housing and development incentives, transportation and towing rules, digital driver licenses, and a proposed four-year moratorium on municipal and county fee, tax, and utility-rate increases, which drew questions about stakeholder input and the impact on enterprise funds and local utilities. No recorded roll-call votes were taken in the transcript; most items were simply presented, briefly discussed, and left on consent or calendar status, with one bill noted as held in rules and another pulled for further discussion.

Transcript Highlights:

• We began engaging MCOs and CMS to investigate this in the spring of 2024.
• But as quickly as possible, we have to take the next steps with CMS to provide them with what we heard
• CMS, ultimately, will work with us to determine what the final date is. Thank you.
• And then on August 1st, I Stopped and asked CMS to terminate Housing Stabilization Services.
• I've had multiple conversations with CMS at the federal level in the last month has told me that you

Transcript Highlights:

• <00:31:57.440> on we um have been engaging with CMS on we um have been engaging with CMS on
• <00:32:23.519> Um language as approved by CMS. Um language as approved by CMS.
• So we're still not worked that through yet on a technical assistance basis with CMS.
• They've they've um had a basis with CMS.
• :05:15.760> and talked openly about CMS and talked openly about CMS and accreditation<01:05:16.640

Keywords: 928, house, all

Summary: The committee first approved the draft minutes of its May 16, 2025 meeting, with one correction removing Representative Dry from the attendance list because she was present as a guest rather than an appointed member. The committee then received a Department of Health and Human Services update from Commissioner Lori Weaver, who focused on the rural health transformation grant process. She said the department has been gathering stakeholder input since July, issued a request for information on September 22, and is working toward an end-of-October draft and a November 3 deadline, with a grant writer request expected to go before Governor and Council at no cost to the state. The bulk of the meeting centered on federal changes affecting SNAP and Medicaid. Karen Heert explained that the federal law changes commonly referred to as the “Big Beautiful Bill” or HR1 will affect SNAP eligibility and state costs, including a shift in administrative cost sharing from 50/50 to 75/25 beginning in October 2026 and a possible state share of benefits if New Hampshire’s error rate is too high. She said the program affects about 43,000 households, that New Hampshire’s federal fiscal year 2024 error rate was 7.57% versus a national rate of 10.93%, and that the state must get below 6% to avoid liability. She also said DHS is preparing remediation steps, auditing cases, and seeking technology and staffing support, including a grant for automation and training. Henry Litman then described Medicaid changes under HB2 and the new federal law. He said New Hampshire returned to pre-pandemic eligibility verification rules on July 1, including a 10% income compatibility standard and reduced ex parte renewals, which has increased manual work and contributed to a drop in enrollment from about 185,000 in late June to about 178,000 in early September. He also reviewed new child premiums, pharmacy copays, Granite Advantage premiums, and possible Medicaid work requirements, noting that DHS is working with CMS on implementation details and may use a state plan option rather than an 1115 waiver because it would be less expensive and faster. Members asked several questions about the SNAP error-rate rules, the distinction between administrative and client errors, the effect of unpaid copays, and the timing and legal risk of the Medicaid work requirement; no votes were taken on those policy issues.

Transcript Highlights:

• Department of Health and Human Services or CMS.
• Department of Health and Human Services or CMS.
• That gives CMS very little power to rein in non-compliant hospitals.
• <04:33:44.000> has New Hampshire is wanting and CMS has New Hampshire is wanting and CMS has
• <04:34:46.400> Um CMS rule. Um CMS rule.

Keywords: 1191, senate, all

Transcript Highlights:

• On January<00:18:12.040> 6th,<00:18:12.960> CMS<00:18:13.480> indicated<00:18:14.000
• > their<00:18:14.160> intent January 6th, CMS indicated their intent January 6th, CMS indicated
• We received additional notice from<00:18:28.520> CMS<00:18:29.040> that<00:18:29.200>
• > they<00:18:29.320> would<00:18:29.520> defer<00:18:30.280> $260 from CMS that
• they would defer $260 from CMS that they would defer $260 million<00:18:31.880> of<00:18:31.960

Keywords: 918, senate, all

Summary: The program covered three main topics: Minnesota’s February economic forecast, gun violence prevention efforts, and the growing debate over data centers. Minnesota Management and Budget reported a stronger-than-expected outlook, replacing a projected deficit with a $3.7 billion surplus for FY 2026-27 and a projected positive balance for FY 2028-29, though officials warned the state still faces a structural imbalance and possible federal funding losses tied to Medicaid reimbursements and fraud-related federal actions. Lawmakers also discussed affordability concerns, with Senate Republicans promoting a tax-relief package focused on property taxes, vehicle tab fees, and ending taxes on tips and overtime. A lengthy segment focused on gun violence prevention, including a Capitol rally by Annunciation Catholic Church families, students, and advocates. Senator Ron Latz said an interim working group he co-led with Senator Zeinab Mohamed gathered public and expert input and helped shape ideas for the session. He said there is no single solution, but cited measures such as red flag laws, universal background checks, an assault weapons ban, high-capacity magazine limits, safe-storage requirements, ghost gun and binary trigger bans, and more school counseling and wraparound mental health supports. Latz emphasized that he sees these as compatible with the Second Amendment and said he hopes to build bipartisan support, especially around school counseling and other “common-sense” measures. Latz said the short session and narrow margins mean compromise will be necessary, and that if a package does not pass this year, lawmakers will return to the issue next session while voters should hold legislators accountable in future elections. The final segment introduced the data center discussion, with Senator Bill Liske describing how data centers have grown from small server rooms into large industrial facilities and noting that some communities are considering moratoriums or restrictions because of neighborhood impacts.

Transcript Highlights:

• Prior to H.R. 1, states were entitled to waivers to demonstrate to CMS that a tax met the broad-based
• to pay providers so long as they meet certain requirements set out in rule and receive approval from CMS
• The federal government, H.R. 1, requires the actual guidance from CMS to be available June 2026, so we
• We check regularly with CMS on what's the criteria, what will the process be for that?
• The requirements of the federal government of Homeland Security to have access to data from CMS, the

Summary: The joint informational hearing focused on the impacts of H.R. 1 on California’s Medi-Cal program and on community health effects from recent immigration enforcement actions. Committee leaders said H.R. 1 would sharply reduce federal funding, increase administrative burdens, and worsen access to care, especially for Medi-Cal enrollees, immigrant families, rural communities, and reproductive health patients. The second half of the hearing examined how ICE raids and related federal actions are creating fear, reducing clinic and emergency department use, and disrupting children’s access to schools and early childhood education. Department of Health Care Services Director Michelle Bass outlined the main H.R. 1 provisions affecting Medi-Cal: work requirements, semiannual eligibility redeterminations, shorter retroactive coverage, new cost-sharing, limits on provider taxes and state-directed payments, reduced federal support for emergency and lawful immigrant coverage, and a one-year ban on Medicaid funding for prohibited abortion providers. She estimated millions could lose coverage, with tens of billions of dollars in federal funding at risk. Planned Parenthood Affiliates of California warned the defunding provision could force clinic closures, service reductions, and loss of access to family planning, STI testing, and cancer screenings. The California Hospital Association said the financing changes could cut hospital revenue by tens of billions over 10 years and threaten access, especially for rural and safety-net hospitals. The Western Center on Law and Poverty argued the law would increase churn, paperwork, and uninsured rates, disproportionately harming working adults and people experiencing homelessness. Committee members asked about implementation timelines, notification systems, administrative costs, the effect on immigrant eligibility, and whether California could delay or mitigate some provisions. Bass said the state was still assessing federal guidance, planning county and provider outreach, and exploring a possible delay for work requirements and a transition period for provider-tax changes. Members also discussed how state budget actions may need to be revisited in light of H.R. 1, and how California might preserve access through state-only funding or other policy changes. In the second panel, CHIRLA, Los Angeles County Department of Health Services, and the Children’s Partnership described the health consequences of immigration enforcement. Speakers said raids and data-sharing fears are causing anxiety, trauma, and avoidance of care, with Los Angeles County reporting declines in emergency, urgent care, and clinic visits after enforcement actions. The Children’s Partnership said school and early childhood absences are rising in some communities and that enforcement is undermining children’s emotional well-being and access to education. Members asked for more data and discussed possible state protections, telehealth, mobile care, and legal and policy responses to reduce fear and preserve access to health and education services.

Transcript Highlights:

• Those were required by the Centers for Medicare and Medicaid, CMS.
• A parallel system Medicaid uh CMS.
• So I pulled data from the CMS website, and I guess you can choose whether you want to believe Dr.
• So I pulled data from the CMS website, and I guess you can choose whether you want to believe Dr.
• So I pulled data from the CMS website, and I guess you can choose whether you want to believe Dr.

Keywords: 928, house, all

Summary: The Committee to Study Long-Term Managed Care met to approve prior minutes and outline its schedule, with meetings set for September 24 and September 29 ahead of an October 1 report deadline. The chair said the committee would use the first two meetings to digest testimony, likely ask follow-up questions of DHS, and then work toward conclusions and a report format. The minutes from the previous meeting were approved unanimously. The main testimony came from Sharon Alexander of Amera Health, who argued in favor of moving from fee-for-service Medicaid long-term services and supports to a managed LTSS model. She described managed LTSS as a capitated, quality-driven system used in about 26 states, and said it can improve care coordination, accountability, access to home- and community-based services, and budget predictability. She cited Amera Health’s experience in Pennsylvania and Delaware, including care coordination, housing and transportation support, caregiver programs, and quality benchmarks tied to state oversight. She also said nursing facilities would remain an important option for people who need that level of care. Committee members asked about how the programs are administered, how rates are set, how care managers work, and how quality is measured. Alexander said states contract with managed care organizations at actuarially sound capitated rates, with annual contracts, reporting, and oversight. She explained that care managers typically conduct quarterly assessments and follow up after trigger events such as hospitalization, and that housing coordinators may assist with transitions to the community. On quality, she said states use CMS-related and HCBS benchmark measures covering service timeliness, care planning, transitions, and other outcomes, and that New Hampshire could build on existing metrics rather than starting from scratch. She also noted that rural areas face workforce and transportation challenges, which managed care plans try to address through technology and self-direction options.

Transcript Highlights:

• This is a model that we are participating in through CMS that allows us to enter into value-based payment
• We did not receive any comments on this, and these are going through approval with CMS now.
• This is simply an administrative change required by CMS.
• However, CMS is removing an expiration date of their federal rule and extending that out permanently,

Summary: The Administrative Rules Subcommittee reviewed several agency rules and most were approved without objection. The Department of Agriculture repealed rules tied to the now-repealed Arkansas Catfish Processors Fair Practice Act. The Department of Human Services updated Medicaid policy to clarify child support enforcement treatment for pregnant women, remove the word “forcible” from rape/incest good-cause language, and eliminate a 90-day waiting period for ARKids B after loss of group coverage; members highlighted the significance of the language change and asked for a quick-reference eligibility chart. DHS Medical Services also received approval for a CMS cell and gene therapy model rule for sickle cell drugs and a technical Medicaid-assisted medication-assisted treatment update that was described as cost-neutral and non-substantive. The Department of Labor and Licensing presented several rules implementing recent acts and internal cleanup changes. These included procedures for local construction plan disputes under Act 591, Contractors Licensing Board amendments raising the restricted commercial license threshold from $750,000 to $1.5 million and allowing deferral of owner-complaint investigations during civil litigation, and a similar residential contractors change. The HVACR Licensing Board presented broader revisions under Act 746, including grammar and cleanup changes, elimination of the Class C license with transfer of existing holders to Class B, expansion of allowable work limits, a change to continuing education from four hours annually to eight hours per three-year code cycle, and clarification on training, child labor, and licensing issues. Several members questioned the practical impact of the HVAC changes, but the rule was approved. The committee also granted the Department of Inspector General’s request for exclusion from rulemaking reporting under Act 473, concluding that no rule was necessary because the act already defines the key terms and review process for foreign-adversary cultural exchange agreements. In addition, the Arkansas State Library’s report recommending continuation of its existing rules was accepted. During the status updates on outstanding 2023-session rulemaking, Education explained delays were due to overlapping 2025 amendments and the large volume of rules, while members expressed concern about the length of time since enactment; staff noted only a small number of 2023 rules remain outstanding. The meeting ended after written 2025-session updates were received with no further questions.

Transcript Highlights:

• Now, CMS has different. if you withhold.
• They have to do another CMS.
• They have to do another CMS.
• They have to do another CMS.
• associated rate increase because CMS associated rate increase because CMS hasn't<02:37:07.200>

Keywords: 1187, senate, all

Transcript Highlights:

• And CMS has said within our proposals, they understand there have to be evolution over time, but that
• And CMS has said within our proposals, they understand there have to be evolution over time, but that
• And CMS has said within our proposals, they understand there have to be evolution over time, but that
• <00:10:37.120> And<00:10:37.360> CMS<00:10:37.920> has approved, we can't do
• And CMS has approved, we can't do it.

Keywords: 00:00:20 - Call to Order/Roll Call 00:02:00 - Update on Rural Health Transformation Program 00:29:20 - Discussion of 26RS HB 134 00:36:35 - Roll Call Vote on 26RS HB 134 00:37:41 - Consideration of Referred Administrative Regulations 01:09:44 - Adjournment, 958, all

Summary: The Health Services Committee met to receive an update from Cabinet for Health and Family Services Secretary Steven Stack on Kentucky’s Rural Health Transformation Grant. He explained that all 50 states applied and were awarded funding, and Kentucky received about $212.9 million over five years, with the first year treated as a nine-month period. He emphasized that the award is a cooperative agreement with CMS, is not Medicaid funding, cannot be used to supplant existing funds, and is limited to the five areas approved in Kentucky’s application. He also said the state must submit a revised budget before major spending begins, and that CMS could claw back money if performance metrics are not met. Secretary Stack outlined the five focus areas: maternal health, mental health, oral health, emergency medical services, and chronic disease prevention/management, especially obesity and diabetes. He described possible approaches such as expanding behavioral health crisis stabilization models like EMPath, using teledentistry and mobile services, strengthening EMS staffing and treat-in-place options, and building healthier nutrition and activity supports. He said the application was developed quickly with broad stakeholder input and that the state plans to work with universities, nonprofits, and other partners through procurement and other formal processes. He also noted the program will be overseen by the public health department, with Commissioner John Langfeld leading the effort. Committee members asked about the grant timeline, the split between formula and competitive funding, the role of certificate of need, and whether new laws or regulations would be needed. Stack said the state believes it can implement the approved projects under current law, though some broader policy issues such as certificate of need were not included because they would be risky to change within the grant timeline. Members also asked how stakeholders can submit ideas; Stack pointed them to the public website and contact email, saying additional partner information will be posted soon. The committee did not take any formal vote or action during this discussion.

Transcript Highlights:

• And now with DD as well, we have a CMS-approved method of collecting costs and setting the rate.
• And now with DD as well, we have a CMS-approved method of collecting costs and setting the rate.
• . approved um by by CMS.
• We still need approval, you know, from our waiver through CMS.
• Um but we we the CFI waiver through CMS.

Keywords: 1191, senate, all