Transcript Highlights:

• FOR PATIENTS WHO ARE ENROLLED IN THE MEDICAID PROGRAM MEMBERS OF THE MEDICAID MANAGED CARE PROGRAM HOSPITALS
• ACCESS PLAN MOSTLY INCLUDE OUTREACH TO THE PATIENT'S MEDICAID MANAGED CARE PLAN AND ESTABLISHING THE
• THEY WERE REALLY HOMING IN ON THE PER MEDICAID COST PER RESIDENT.
• SOMETIMES AS HIGH AS 75 PERCENT OF MEDICAID MEMBERSHIP.
• EVER SINCE THE MEDICAID UNWIND HAPPEN 67,000 ADDITIONAL KIDS BECAME UNINSURED AND FLORIDA.

Transcript Highlights:

• </c> assumes no reduction in federal Medicaid assumes no reduction in federal Medicaid funding<00:32:
• </c> this point it's our hope that Medicaid this point it's our hope that Medicaid is<00:36:11.040><c
• </c> changes to Medicaid changes to Medicaid funding<00:46:34.440><c> so</c><00:46:34.800><c> yes</c>
• </c> not eligible for Federal Medicaid not eligible for Federal Medicaid funding<00:51:28.200><c> the
• </c> side this is Medicare this is Medicaid side this is Medicare this is Medicaid this<01:01:39.880>

Transcript Highlights:

• </c> to freeze funds uh relating to Medicaid to freeze funds uh relating to Medicaid fraud.<00:51:21.760
• were previously federal Medicaid were previously federal Medicaid relations<01:27:39.840><c> attorneys
• Did you know this: when you see one Medicaid plan in a state, you've seen one Medicaid plan in a state
• </c> approval again from Centers for Medicaid approval again from Centers for Medicaid Services<01:29
• </c> Centers for Medicare and Medicaid Centers for Medicare and Medicaid Services<01:37:48.239><c> for

Transcript Highlights:

• By providing payments for the shortfall in physician Medicaid reimbursement for medical school faculty
• Like the KidCare amendment, this request is to realign the Medicaid services categories to the December
• Like the KidCare amendment, this request is to realign the Medicaid services categories to the December
• The hospital DPP provides direct payments to hospitals in the amount of the Medicaid shortfall, or the
• difference between the cost of providing care to Medicaid-eligible patients and the payments received

Summary: The Legislative Budget Commission met with a quorum present and considered 12 budget amendments, most of which were adopted without opposition. The first amendment transferred $8.2 million in Department of Corrections general revenue authority from salary incentives to contracted services to support the phased demobilization of Florida National Guard troops assisting with correctional staffing. Senator Pizzo questioned the length of the Guard’s deployment and urged a long-term staffing solution, while the department said the Guard presence was being reduced and that about 2,200 employees were in training. The Department of State received an additional $618,391 in federal grant authority for library grants and private cloud costs, and the Department of Transportation’s two amendments were zero-sum work program changes: one realigned funds to production-ready projects and another added three projects over $3 million each to the current-year work program. The commission then approved several Agency for Health Care Administration amendments tied to Medicaid supplemental payment programs. These included funding for the Florida Cancer Hospital Program, indirect medical education payments, disproportionate share hospital payments for the state mental hospitals, the Low-Income Pool program, physician supplemental and public hospital payments, Florida KidCare, and Medicaid services realignment. Members asked about possible federal disallowances in the LIP and physician/public hospital programs, and agency staff said some disallowances were likely but the amount was not yet known. For KidCare and Medicaid, staff explained the changes were based on the December estimating conference, enrollment shifts, and updated actuarial assumptions, including changes to managed care regions and program design. The final amendment restored budget authority for a hospital direct payment program after a prior payment, including a $24.3 million CMS-related amount and $3.2 million in administrative fees, was not processed before fiscal year-end and reverted. Senator Pizzo pressed the agency on how the payment was missed and whether any penalty applied; staff said the invoice was not received and processed in time and that communication issues contributed. After brief debate on each item, the commission adopted all amendments, with one recorded nay on the final item, and then adjourned.

Transcript Highlights:

• And 90 some odd percent of that is the state's Medicaid program.
• It doesn't just unilaterally reduce federal reimbursement rates for Medicaid.
• stay on Medicaid?
• Medicaid has been considered a mandatory program, so as long as Medicaid continues to kind of keep the
• The Medicaid changes I mentioned are significant.

Committee: Senate Senate Committee on Intergovernmental Affairs

Transcript Highlights:

• Medicaid was unable to pay for it.
• Inspector General and the Attorney General Medicaid Fraud Control.
• External, including the Office of Medicaid Inspector General and the Attorney General Medicaid Fraud
• So they usually on a contingency basis will go and look for fraud, waste, or abuse of Medicaid providers
• Then we have external to us, the Office of Medicaid Inspector General.

Summary: The committee met with prayer and approved the January 7 meeting minutes. It then reviewed several Department of Human Services rules. One rule would allow rehabilitative hospitals to open psychiatric units and receive Medicaid reimbursement for psychiatric acute services, addressing a service gap in places such as Jefferson County. Another would let DHS participate in a CMS cell and gene therapy model to support value-based payment agreements for treating sickle cell disorder with CGT therapy. A third DHS rule would exempt the state from the CMS recovery audit contractor requirement. DHS explained that recovery audit contractors typically work on contingency to identify fraud, waste, abuse, or overpayments, but Arkansas law prevents contingency arrangements, so the state relies instead on internal retrospective reviews, a payment integrity office, the Office of Medicaid Inspector General, and the Attorney General’s Medicaid Fraud Control Unit. Members asked for clarification on how those audits work, and DHS described the existing oversight layers. During new business, Representative Pilkington asked about a reported increase in uninsured individuals in a quarterly postpartum report, but DHS said it was not prepared to answer and would follow up offline. Representative Johnson also asked about a handout related to program integrity and Arkansas Medicaid. With no further business, the committee adjourned.

Transcript Highlights:

• And so or remain eligible for Medicaid.
• </c> Medicaid, funding to continue access. Medicaid, funding to continue access.
• ,</c> and the higher needs and in in Medicaid, and the higher needs and in in Medicaid, you<00:09:27.920
• , Medicaid, Medicaid, additional<00:20:18.640><c> 420</c><00:20:19.360><c> million</c><00:20:19.600><
• Uh, and in fact, the in Medicaid.

Summary: The committee met to hear a presentation from Dr. Hicks on the governor’s recommended budget for the next biennium. He reviewed the revenue outlook, noting modest general fund growth, a large rainy day fund balance, and the impact of recent income tax reductions. He said the budget was built around recurring reductions, lower debt service and retirement contribution rates, and the use of excess restricted funds, while protecting K-12 education, Medicaid, postsecondary education, public safety, and pension obligations. Dr. Hicks outlined several major spending and reserve proposals, including $350 million from the Department of Insurance’s excess restricted funds to support Medicaid in the first year, $150 million for the affordable housing trust fund, $125 million for rural hospitals, $100 million to offset lost federal ACA premium tax credits, $75 million for utility assistance, and $50 million for food assistance. In education, the proposal included a phased pre-K for all plan funded by sports wagering tax revenue, a 3% annual salary increase for full-time school personnel, continued full funding of teacher pensions, a 2.5% annual increase in SEEK base funding, and additional support for career and technical education and school facilities. He also discussed Medicaid cost pressures, including higher managed care, pharmacy, behavioral health, and nursing facility costs, and explained the expected effects of federal HR1 changes on Kentucky’s Medicaid program. Those changes include work and community engagement requirements and more frequent eligibility redeterminations for expansion members, which the administration estimated would reduce enrollment by about 4,300 in the first year and 28,000 in the second year. No votes or formal committee actions were taken during the meeting, which was limited to the budget presentation and member questions.

Transcript Highlights:

• He said it was wrong of us to say that the Medicaid fraud unit has not taken enough action on Medicaid
• </c><00:25:42.159><c> And</c> Medicaid funded service providers.
• And Medicaid funded service providers.
• State in 14 Medicaid programs. That's wrong for Minnesota.
• And in the Medicaid fraud control unit.

Committee: House Fraud Prevention and State Agency Oversight Policy

Transcript Highlights:

• </c> in the next track is a Medicaid in the next track is a Medicaid consent<00:55:57.960><c> some</c
• </c><00:57:11.760><c> it</c> get reimbursed for that by Medicaid it get reimbursed for that by Medicaid
• </c> requirements under the State Medicaid requirements under the State Medicaid Program<03:58:33.439
• And because Medicaid underpins our entire health care system, this Medicaid amendment, I believe, is
• And because Medicaid underpins our entire health care system, this Medicaid amendment, I believe, is

Transcript Highlights:

• So have you filed a Medicaid work requirements bill prior to this year? No, ma'am. Okay.
• rolls, of people being dropped off the Medicaid rolls arbitrarily.
• were dropped off arbitrarily, and over half of Medicaid, et cetera, et cetera.
• The Medicaid error rate and the SNAP error rate are very concerning.
• The Medicaid error rate and the SNAP error rate are very concerning.

Summary: The House first established a quorum after introductions of special guests, then moved to bills for perfection. House Bill 2016, concerning anti-Semitism in Missouri schools, colleges, and universities, drew extensive debate. The sponsor said the bill would require educational institutions to adopt non-discriminatory policies protecting Jewish students from harassment and intimidation, use the IHRA definition as a guide, and preserve First Amendment rights. A Pulaski County member offered and secured adoption of an amendment clarifying that protected political, religious, and expressive speech would not be reported, cataloged, or used to create records. Supporters said the bill was needed because of rising anti-Semitic incidents and student safety concerns; opponents argued it singled out one group, could chill discussion of Israel and Palestine, and created a reporting hierarchy. The chamber ultimately adopted the amendment and then ordered the bill perfected and printed. House Bill 2384, a housing and building-code measure, was then taken up. The sponsor said it was aimed at reducing housing costs by rolling back energy-code mandates to 2009 standards, setting clearer permitting timelines, and allowing certain multifamily buildings to use a single staircase. Supporters framed it as a response to Missouri’s housing shortage and rising home prices, while opponents criticized the bill as preempting local control, especially in Kansas City and other municipalities that had adopted newer codes. A Pulaski County amendment was adopted to reduce the number of required hard copies of municipal ordinance books when ordinances are available online. After debate over energy efficiency, safety, and local authority, the House moved the previous question, then adopted the committee substitute and ordered the bill perfected and printed. House Bill 1766, dealing with personal property tax and Hancock limitations, was also perfected and printed. The sponsor said the bill would treat personal property tax growth more like real property under Hancock-style limits, arguing that rapid increases in vehicle values had created windfalls for political subdivisions. Members questioned whether the change would reduce local revenue needed for schools and other services, while supporters said it would protect taxpayers and still allow growth. The House then took up House Joint Resolution 154, which would place a Medicaid work requirement in the Missouri Constitution by mirroring federal policy. The sponsor said it would require able-bodied adults ages 19 to 64 to work, volunteer, attend school, or participate in a work program for 80 hours a month to remain eligible. Opponents raised concerns about administrative burden, documentation requirements, and the impact on vulnerable recipients, while supporters argued the measure should be made permanent through the constitution. The transcript cuts off during that debate, before final action on the resolution is shown.

Transcript Highlights:

• </c> supplemental does is it cuts Medicaid supplemental does is it cuts Medicaid reim<00:47:44.880><c
• </c> the Medicaid provider rate. the Medicaid provider rate.
• </c> program versus traditional Medicaid. program versus traditional Medicaid.
• And that they are not at the Medicaid.
• You know, we get these Medicaid caseload updates.

Transcript Highlights:

• As you know, when we have Medicaid runs, the Medicaid payment does not cover the cost of those EMS runs
• When we have Medicaid runs, the Medicaid payment does not cover the cost of those EMS runs.
• The Medicaid payment does not cover the cost of those EMS runs.
• In 2023, we billed Medicaid medical runs—2.1 million, to talk round numbers.
• a Medicaid run?

Summary: The House Standing Committee on Veterans, Military Affairs, and Public Protection held its first meeting of the 2025 session, welcomed new members, announced a 24-hour rule for committee amendments, and reviewed basic meeting procedures. After roll call confirmed a quorum, members recited the Pledge of Allegiance and prayer. The chair also recognized Representative Thomas for his service to the committee and presented remarks of appreciation as he moved into other duties. The committee then considered House Bill 191, which would extend burial eligibility in Kentucky state veterans cemeteries to certain National Guard and Reserve members who were honorably discharged but never activated under Title 10. Testimony from Rep. Aaron Thompson and KDVA officials explained that the bill aligns with the federal Burial Guard Reserve Act of 2022 and would cover some long-serving Guard and Reserve members, including those who served during disasters such as the Eastern Kentucky floods and western Kentucky tornadoes. Members voiced support, and the bill passed the committee with a favorable recommendation after adoption of a title amendment. Next, the committee took up House Bill 152, which would create a supplemental Medicaid payment program for public EMS agencies through voluntary intergovernmental transfers, with no general fund dollars used. Rep. Michael Meredith and EMS chiefs testified that the measure would help public agencies recover more of the cost of Medicaid transports; one example cited was a local agency that could increase reimbursement substantially under the program. In response to questions, witnesses said the existing program for public and private agencies is mandatory, while this bill creates an additional voluntary enhancement for public agencies only, and that the program could be affected if Medicaid match rates change. The committee approved the bill with a favorable recommendation and a title amendment. The meeting ended with announcements about Military Kids Day on February 25 and a Kentucky National Guard Association reception and dinner on February 15, followed by adjournment.

Transcript Highlights:

• Those personnel will be assigned 100% to Medicaid.
• Those are some of our more complex and... 100% to Medicaid.
• , has been, and so what I'm seeing is we've got some more Medicaid somewhere else.
• So what I'm seeing is we've got some more Medicaid somewhere else.
• And Medicaid will be there to... ...the actual procurement, and Medicaid will be there to provide their

Summary: The committee heard budget presentations for the Department of Administration and the Permanent Building Fund. For Administration, analysts reviewed the agency’s divisions, staffing, dedicated-fund structure, recent budget growth, and the governor’s and JFAC’s recommended changes. The department requested shifts of utility costs from the general fund to dedicated funds, three new positions and funding for Medicaid procurement and contract management, transfers of some positions between divisions, and one-time IT replacement funding. Members also discussed office-space utilization, vacant buildings and land at Chinden and elsewhere, and the department’s efforts to consolidate space and reduce general fund reliance. Director Bailey said the department has reduced or repurposed positions, closed duplicate printing operations, is exploring digital workflows and AI tools, and is trying to move toward a fully dedicated-fund model. He also explained the decision to remove GLP-1 weight-loss coverage from the state health plan due to rapidly rising costs, while noting diabetes coverage remains in place. Committee members questioned the need for higher-level procurement staff for Medicaid contracts, the role of Deloitte and the Department of Health and Welfare in the process, and the status of the MMIS procurement, which Bailey said is currently stayed by the courts after a legal challenge from the second-place vendor. He said the delay will affect MMIS implementation and, in turn, the timing of the broader managed care rollout. Members also asked about vacant state office space, the possible sale of older buildings, and whether agencies such as ITD and Health and Welfare could be moved into state-owned space to reduce lease costs. Bailey said the department is actively working on those facility-planning questions and that agencies at Chinden are paying rent for occupied space. The committee then reviewed the Permanent Building Fund budget, which finances state construction, repairs, and deferred maintenance through dedicated revenue sources and interest earnings. Analysts highlighted the fund’s multi-year project structure, the large deferred maintenance program funded in prior years, and a proposed one-time transfer of $33.75 million in canceled capital project balances to the general fund. They also described a possible redirection of fiscal year 2027 interest earnings to the general fund and a recommended new capital project for an Idaho National Guard readiness center. Administrator Barard reported that the Division of Public Works is managing 595 active projects, with most FY 2025 projects under construction, in design, or complete, and said the division continues to face labor shortages and rising construction costs. Members asked about canceled projects, including the North Idaho reentry center, the Carnegie Library purchase, the ISU pedestrian crossing, the Idaho State Police Lewiston facility, and other projects; staff said some are unlikely to return soon, while others may come back once land or other prerequisites are secured. The committee concluded the hearing and announced it would meet the next day for the Department of Parks and Recreation and the Office of the State Public Defender.

Transcript Highlights:

• We heard previously that would add lactation consultation to Medicaid coverage and reimbursement.
• It's a program to provide Medicaid coverage to doula services by Vice Chair Emanuel.
• Medicaid due to low reimbursement rates.
• Who in the hell want to be on Medicaid? Who want to be on TANF? Who want to be on SNAP? Nobody!
• People do not have access to Medicaid. I mean, medical services. And this is the problem.

Bills: HB741 , HB 1199 , HB2070 , HB2402 , HB2542 , HB2665 , HB2789 , HB3096 , HB3396 , HB3595 , HB3747 , HB4116 , HB4127

Committee: House Human Services

Transcript Highlights:

• Chairman and members of the Senate Medicaid Committee.
• Senate Bill 2674 is about access to care, hospital stability, and fairness in how Mississippi's Medicaid
• procedures is significantly below Medicare and below most southern states. in how Mississippi's Medicaid
• in how Mississippi's Medicaid program<00:01:04.640><c> pays</c><00:01:04.960><c> for</c><00:01:05.119
• to gain meaningful allowing Medicaid to gain meaningful long-term<00:02:57.120><c> savings.

Summary: The Senate Medicaid Committee heard testimony on Senate Bill 2674, which would increase Mississippi Medicaid reimbursement for outpatient vagus nerve stimulation (VNS) procedures used to treat drug-resistant epilepsy. Dave Weinberger of LivaNova said current Medicaid rates are far below Medicare and most neighboring southern states, creating financial pressure on hospitals and causing some to stop offering the procedure. He argued the therapy provides durable clinical benefits and long-term savings for Medicaid, and said the bill would align Mississippi’s rates with Medicare’s 2026 outpatient rates and with other states. Weinberger said the bill would set reimbursement at $45,000 for CPT 64568 and $35,000 for CPT 61885, and framed the measure as improving access, hospital stability, and fairness for vulnerable patients. Committee members did not ask questions during this hearing, though the chair noted the bill had been double referred and would go to appropriations, with a more detailed hearing scheduled for the next day. After discussion, a motion was made that the title was sufficient and the bill do pass. The committee approved the motion, and the bill was reported out of committee.

Transcript Highlights:

• We get an encounter rate, which looks at the cost of providing care to not only Medicaid, Medicaid expansion
• To not only Medicaid, Medicaid expansion, and uncompensated care.
• We develop so many programs, whether it's paying for education or Medicaid or Medicaid expansion, and
• for education or Medicaid or Medicaid expansion or so many things.
• And the Medicaid department has been working, And the Medicaid department has been working with— in fact

Summary: The committee first approved the previous meeting minutes and then heard a detailed annual report from Dr. Thomas Arnold, chair of the Maternal Mortality Review Committee, on maternal mortality trends and policy issues. He explained the committee’s review process, confidentiality protections, and national and North Dakota data showing that most maternal deaths are preventable and that mental health conditions, substance use, cardiovascular issues, infection, hemorrhage, and embolism are the leading causes. Members asked about suicide, domestic violence, midwife training, home births, and whether pregnancy testing at death scenes should be expanded; Dr. Arnold said better coroner education, more investigation of unexplained deaths, and possible post-mortem pregnancy testing could improve case identification, especially in rural areas. He also noted that deaths often occur well after 42 days postpartum and that mental health-related deaths remain a major concern. The committee then heard from State Fire Marshal Dr. Matthew Clark on cigarette reduced-ignition-propensity standards and related fire prevention issues. He recommended updating the state’s cigarette propensity law to current national standards and also raised a separate recommendation to require fast-breakaway oxygen tubing for home oxygen users, citing fatal fires linked to smoking around oxygen. Members asked about implementation, cost, insurance coverage, and whether the standards apply in tribal communities; Dr. Clark said he would provide follow-up information and was willing to help with any legislation, but no agency bill had yet been planned. Next, Christine Greff of the Department of Health and Human Services reported on the North Dakota Stroke System of Care. She described the statewide network of stroke-ready hospitals, registry-based quality improvement, and performance data showing continued improvement in stroke recognition, imaging, thrombolytic treatment, transfers, and EMS pre-notification. She highlighted new quality measures for inter-facility transfers and intracerebral hemorrhage care, and said the system remains strong but depends on continued legislative and hospital support. Committee members asked about participation by the VA hospital and were encouraged to consider outreach to include it more fully in the stroke system. Finally, the committee began a presentation on prior authorization and non-opioid pain treatment from Taha Khan of Vertex Pharmaceuticals. He argued that prior authorization can delay access to non-opioid acute pain medications, especially in the 24- to 72-hour post-discharge window when pain is most severe, and said delays can push patients toward opioids. He emphasized that prior authorization has a role in utilization management but should not create barriers in acute pain care, and he noted that current use of the company’s non-opioid product remains very low. The discussion was still underway when the transcript ended.

Transcript Highlights:

• I said, well, how is this impacting Medicaid? Because people don't pay premiums for Medicaid.
• I said, well, how is this impacting Medicaid? Because people don't pay premiums for Medicaid.
• </c><00:07:19.440><c> patient</c> lose on every Medicare Medicaid patient lose on every Medicare Medicaid
• </c> administration of your Medicaid administration of your Medicaid population<00:09:50.600><c> she<
• Medicaid Medicaid providers<00:10:38.200><c> one</c><00:10:38.880><c> we</c><00:10:39.000><c> sent</

Summary: The Senate Standing Committee on Health Services met with a quorum, first taking up referred administrative regulations. One regulation was deferred, and two others were noted as deficient; with no one wishing to speak, the committee treated the regulations as reviewed. The committee then heard Senate Bill 13 from Chairman Meredith, which would reduce the number of Medicaid managed care organizations from five to three. Meredith argued the bill would reduce administrative burden, improve oversight, help rural providers, and potentially lower costs for families and the Medicaid program. Senators Berg, Herron, and Douglas asked about data, patient impact, network adequacy, and prior authorization burdens; Meredith said the effect on patients would be indirect through better access and less administrative delay. The committee approved a committee substitute and passed SB 13 favorably on a 10-0 vote. The committee next considered Senate Joint Resolution 26, presented by Senator Richardson and Kentucky Pharmacists Association Executive Director Ben Mudd. The resolution asks the Department of Medicaid Services to provide data and cost analysis on paying pharmacists fairly for clinical services already within their scope of practice under Medicaid and KCHIP. Supporters said pharmacists can improve access, especially in rural areas, by providing services such as medication therapy management, chronic disease management, and preventive care, and that the resolution is intended to gather information before any future bill. Senator Douglas questioned whether expanded pharmacy duties have actually improved access or outcomes and whether there is published data; Mudd said the Board of Pharmacy tracks use of protocols but that more data is needed. The committee approved the resolution by roll call, with all members voting aye. At the end of the meeting, Chairman Meredith announced that Senate Bill 27 would be heard for discussion only and not acted on that day so members could review it further. Senator Brandon Storm introduced SB 27, which would create a Kentucky Parkinson’s disease research registry, and noted that a Michael J. Fox Foundation representative could not attend because of a winter storm; her letter was included in the packet. Storm said the registry is intended to support research and policy by tracking Parkinson’s disease in Kentucky, citing national prevalence and cost figures. No vote was taken on SB 27 during this meeting.

Transcript Highlights:

• Medicaid, if we pass something, Medicaid will do it.
• Medicaid will pay for it.
• So are there cutouts for Medicaid?
• Medicaid will pay for it.
• So are there cutouts for Medicaid?

Bills: SB20 , SB21 , SB166 , SB177 , SB181 , SB189 , SM6

Committee: Senate Senate Tax, Business & Transportation

Transcript Highlights:

• I'm imagining we're going to be dealing with the fallout from the Medicaid cuts. this is a big day for
• happening with Medicaid, we might be<00:05:15.360><c> in</c><00:05:15.440><c> a</c><00:05:15.480><c>
• But every hospital serves people who rely on Medicaid, and Medicaid is an important part of every hospital's
• </c><00:20:49.720><c> uh</c> when we were debating the Medicaid uh when we were debating the Medicaid
• </c><00:21:20.760><c> and</c> beautiful bill affecting Medicaid and beautiful bill affecting Medicaid

Transcript Highlights:

• </c> the Medicaid the Medicaid Program<00:32:05.320><c> we</c><00:32:05.480><c> know</c><00:32:05.639
• They're on Medicare or Medicaid.
• They're on Medicare or Medicaid.
• </c> the hospital or on Medicare and Medicaid the hospital or on Medicare and Medicaid that<00:51:14.920
• </c><00:51:25.599><c> Program</c> average um and then our Medicaid Program average um and then our Medicaid

Summary: The committee began by reviewing a large slate of administrative regulations and explaining that it does not approve regulations but can find them deficient and send them back for further work. Members then asked questions on several items, including EMS reciprocity, dental hygienist licensure, and interpreter licensure. The EMS board explained that reciprocity would extend to applicants from any state, not just contiguous states, because the underlying statute had been amended. On the dental regulation, staff said the changes mainly clarified licensure requirements, reinstatement fees, and that dental hygienists administering local anesthetic must do so under direct dentist supervision. The most extended discussion involved the Board of Interpreters for the Deaf and Hard of Hearing. The board chair said the main concern was that the EIPA is an educational specialty assessment, not a nationally recognized certification, yet the regulation would allow it to support full licensure. Members discussed whether that could let educational interpreters work outside their intended scope and whether a separate educational license or statutory change would be more appropriate. The board said it did not think the regulation could be fixed further at this point and suggested a statute could create a narrower educational interpreter license. After discussion, the committee voted to defer both related interpreter regulations, 201 KAR 39:030 and the companion regulation, for further work. The committee then took up two community mental health regulations, 907 KAR 1:044 and 907 KAR 5:005, which had been found deficient in Administrative Regulations. Department for Medicaid Services staff said the rules would expand and rename the mental health associate role as a behavioral health associate, making the role available in many more facilities, but would also require additional coursework or progress toward licensure. Some members and providers raised access-to-care concerns, especially for rural areas and unlicensed staff already working in the field. Staff said the proposal had been revised through work with CMHCs and licensing boards, but the committee ultimately voted to defer both regulations as well. After finishing the regulation review, the committee heard a presentation from the Kentucky Hospital Association on the ATRIP hospital rate improvement program. Hospital representatives said ATRIP is a Medicaid state-directed payment program funded through a provider tax and federal matching dollars, allowing hospitals to receive payments tied to quality measures. They reported improvements including lower Medicaid readmissions, high sepsis screening rates, reduced infections and opioid prescribing, expanded postpartum depression and suicide screening, and training for more than 1,000 people. They said the program has helped hospitals invest in staffing and quality improvement and warned that without it, many hospitals would face severe financial strain.