Transcript Highlights:

• In addition, GDSP has emergency regulation authority.
• Hi, I'm Susan Finlay, Chief Deputy with Health Quality and Emergency Response.
• They strengthened their emergency preparedness through training and exercises.
• The Emergency Medical Services Authority plays a crucial role.
• Emergency services and disaster preparedness are incredibly important.

Keywords: 988, house, all

Transcript Highlights:

• declaring an emergency. declaring an emergency.
• therefore, and declaring an emergency. therefore, and declaring an emergency.
• House Bill 884, emergency.
• Corrections and declaring an emergency. Corrections and declaring an emergency.
• House Bill 897, emergency.

Keywords: 958, all

Summary: The House convened with prayer and the Pledge of Allegiance, then approved the journal, excused absent members, and suspended rules to allow co-sponsorships and vote modifications. The clerk reported Senate Bills 156, 173, and 193 had passed the Senate and requested concurrence. Committee reports were then read, advancing a number of bills on banking and insurance, judiciary, licensing/occupations, and primary/secondary education, including measures on insurance, fraudulent practices, virtual currency kiosks, eminent domain, DUI, legal representation, costs and fees, barbering, fire protection, licensing background checks, dentistry, school reporting, teacher certification, and educator placement. Those favorable reports were treated as first readings and placed on the calendar. The chamber then took up House Bill 307, the “My Kentucky Future Act,” on proactive post-secondary admission. Sponsors explained that the bill would send opt-in letters from public universities to eligible high school juniors, include a common application for the state’s public institutions, and share data with KY Stats to track outcomes. Members asked about scholarships, the target student group, and privacy; the sponsor clarified that participation is voluntary, the letters do not guarantee admission, and the program is meant to streamline college access. House Committee Substitute 2 and House Floor Amendment 2 were adopted, and HB 307 passed 97-0. House Bill 418 on domestic violence was then considered. The sponsor said the bill prioritizes the non-offending parent, requires abusive parents to address violent behavior before unsupervised visitation, and gives courts more tools to consider false abuse allegations and victim advocates’ testimony. House Committee Substitute 1 was adopted, and after brief discussion the bill passed 96-1. House Bill 593 on data centers followed; its sponsor said the measure is intended to support data center development while protecting ratepayers from subsidizing infrastructure risk, requiring companies to bring their own generation, buy power on the open market, or prepay certain costs. After adopting House Committee Substitute 1, the bill passed 90-8. The House also passed House Bill 5 on prison educational programs, with a committee substitute and a floor amendment adding data collection on post-release employment; it passed 99-0. Finally, House Bill 584 on licenses for prescribing or dispensing controlled substances was debated. The sponsor said the bill removes a permanent ban so a physician who has regained licensure may apply for DEA registration, while opponents raised concerns about repeated misconduct and the ability to practice without DEA authority. The transcript cuts off before final disposition on HB 584.

Transcript Highlights:

• So can you help me understand why this is exigent or emergency?
• So one might say tax relief is an emergency. Okay. Follow-up?
• Is this an exigent or emergent need to pass this resolution?
• see this would create an emergency.
• But I'm telling you, emergency, would you agree?

Keywords: 1204, all

Transcript Highlights:

• know, I was originally a physicist and I'm very interested in the emerging technologies.
• <00:10:22.200> Technologies interested in the emerging Technologies interested in the emerging
• that explicitly looks at these emerging that explicitly looks at these emerging Technologies<00:
• emergency worker working the case, you just simply can't sort it out that quickly.
• <03:12:32.800> even reaction can turn into an emergency even reaction can turn into an emergency

Keywords: 1189, house, all

Transcript Highlights:

• She had an emergency section. Was it an emergency? She had preeclampsia.
• , emergency plans.
• emergency agencies as necessary.
• ... ...considerations you have for the 90th session under emergency plans: the local emergency management
• post-emergency.

Keywords: 1185, senate, all

Transcript Highlights:

• They're an emergency department that has a lot of outpatient services.
• They're an emergency department that has a lot of outpatient services.
• But we're really proud of the five rural emergency hospitals that we have in the state.
• They're an emergency department that has a lot of outpatient services.
• But we're really proud of the five rural emergency hospitals that we have in the state.

Summary: The subcommittee met to review Arkansas DHS hospital spending and reimbursement methods, with Secretary Janet Mann and Deputy Secretary Misty Eubanks explaining Medicaid hospital payments. They described fee-for-service per diem payments, cost settlements, and the upper payment limit (UPL) program, noting that SFY 2025 hospital payments included $688 million in inpatient/outpatient claims, $473 million in UPL payments, $248 million in cost settlements, and about $47 million in other payments such as graduate medical education and disproportionate share hospital funds. Members asked about why per diem rates vary, how cost settlements work, why UPL applies mainly to private hospitals, and how assessment fees are structured and funded. DHS said the hospital assessment fee is broad-based and uniform, used as the state share to draw federal funds, and that supplemental hospital payments after federal match totaled $548 million with no general revenue used. The Arkansas Hospital Association’s Jody Ann Tritt then gave a broader overview of the hospital landscape, explaining the different hospital types in the state, including critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals. She said Arkansas hospitals face financial strain, citing a negative 5.18% patient service margin statewide and lower reimbursement than surrounding states. She argued that Arkansas hospitals are paid less than hospitals in neighboring states for similar services, that commercial payer rates and administrative burdens are a major problem, and that Medicaid and Medicare rates remain below cost even with UPL support. She also said hospitals are the backbone of community care, provide emergency and public health functions, and are looking for ways to invest in technology and telehealth but often lack the revenue to do so. Members pressed for clearer data on hospital finances, reimbursement adequacy, and the impact of commercial insurers. Tritt said the association had just authorized a statewide survey to gather updated financial information from hospitals, which she said would take about a year to complete. She also explained that Medicaid pays weekly, Medicare and commercial plans can involve delays and denials, and that hospitals often spend significant resources on revenue cycle work. The discussion ended with a brief update on assisted living reimbursement: DHS said one facility, The Pillars of the Community in Crossett, had announced closure, nine Living Choices waiver clients were being transitioned, and the updated rate study would be available after cost reports are collected, likely before the end of the fiscal year. The meeting then adjourned.

Transcript Highlights:

• Yeah, it wouldn't be like an emergency stay order.
• Some lawmakers will say that people will fake medical emergencies.
• Some lawmakers will say that people will fake medical emergencies.
• with police force instead of emergency medical care.
• to emergency medical care, as H. 1743, H. 1745, and S. 1230, S. 1232?

Keywords: 995, all

Summary: The Judiciary Committee heard testimony on a wide range of criminal justice, victim services, and records-sealing bills. Early testimony focused on H.1811, the Clean Slate automated record-sealing bill, with supporters arguing that automatic sealing after existing waiting periods would remove barriers to jobs, housing, and education without changing eligibility rules. Advocates from legal aid, business, and housing organizations said the current petition-based system is underused, burdensome, and costly, while opponents of expanding surveillance-related laws urged the committee to preserve privacy protections. The committee also heard testimony on H.1693, which would immediately seal records in cases ending without conviction and clarify the presumption of innocence, with speakers describing how dismissed cases still create lasting collateral consequences and prevent people from moving forward. No votes were taken during the hearing. Several bills centered on victim safety and domestic violence. Senator Michael Moore testified for S.1201, which would keep child-protective orders in effect even if the parent or guardian who filed them dies, and for S.1204, which would update the wiretap statute. Multiple survivors and advocates supported S.1215 and S.1222, arguing for a narrow wiretap defense for recordings made to document threats or abuse and for making GPS tampering a separate felony offense. Testifiers described situations in which GPS devices were cut off or disabled and said current law leaves victims at risk and gives abusers too much leeway. The committee also heard emotional testimony on H.1685/S.1238, a bill prompted by the suicide of Stavri Yanka in custody, with the sponsor, his mother, and the sheriff describing the need for better information-sharing so suicide-risk information follows a person into custody. Law enforcement and prosecutors supported several due-process and dangerousness-related bills. MassCOP, the Boston Police Patrolmen’s Association, and the State Police Association backed H.1828/S.1039/S.1235, which would require de novo Superior Court review for POST Commission suspensions over two weeks or decertifications, arguing officers need a meaningful appeal beyond administrative review. The committee also heard support for H.1691, expanding the dangerousness statute to additional offenses; Bristol County District Attorney Quinn said the changes would let prosecutors seek detention in serious cases such as child rape and manslaughter when facts warrant it. In contrast, the Committee for Public Counsel Services opposed expanding dangerousness detention, warning that pretrial detention causes serious harms and disproportionately affects Black and Hispanic defendants. The hearing also included testimony on H.1654/S.1063 to enhance victims’ rights and H.1525, which would rename and expand community corrections into community justice programs, with supporters emphasizing reentry, reduced stigma, and broader service access.

Transcript Highlights:

• It's strictly for emergencies.
• . emergencies. emergencies.
• school is deemed a financial emergency." school is deemed a financial emergency."
• line seven deemed a financial emergency line seven deemed a financial emergency by<01:24:27.840>
• language for emergency financial needs? language for emergency financial needs?

Keywords: 1191, senate, all

Transcript Highlights:

• And House Bill 214, emergency.
• House Bill 280, an act relating to health care and declaring an emergency.
• medications are not a an emergency medications are not a an emergency rescue<00:18:32.400> medication
• therefore, and declaring an emergency. therefore, and declaring an emergency.
• House Bill 453, an emergency.

Keywords: Convene 00:00 Senate Message 05:10 Calendar/2nd Readings 07:06 Report of Committees 07:47 Orders of the Day 08:52 HB 176 09:09 HB 178 12:19 HB 280 15:34 Motions, Petitions, and Communications 19:55 Introduction of New Bills and Resolutions 32:05 Recess for ConC and Rules Meeting 32:05 ConC and Rules Report 39:04 Adjournment 40:48, 958, all

Summary: The House convened with prayer and the Pledge of Allegiance, established a quorum, excused absent members, and approved the journal. The Senate then communicated passage of Senate Bills 10 and 28 and requested concurrence. The House also received second-reading reports for several bills, including measures on custody, human sexuality instruction in schools, tax increment financing, death benefits, postsecondary education, and disabled veterans, along with committee reports advancing bills on agriculture, criminal trespass, concealed firearms, human trafficking, sexual performance material involving minors, reading and writing in schools, and educators. The chamber then took up and passed three health-related bills. House Bill 176, on prior authorization, was explained as a bipartisan effort to reduce insurance-related delays and bureaucracy in patient care; it passed 90-1. House Bill 178, on the psychiatric collaborative care model, was presented as a budget-neutral way to expand timely mental health access through primary care settings; it passed unanimously, 93-0. House Bill 280, a Kentucky Board of Nursing cleanup bill and school rescue-medication update, was amended by House Committee Substitute 1 to restore language allowing investigations involving abuse and to update school medication provisions; the substitute and the bill as amended both passed 94-0. House Resolution 35, recognizing January 21, 2026 as Certified Registered Nurse Anesthetist Day in Kentucky, was introduced, taken from committee, and adopted. During announcements, members noted upcoming committee meetings and events, including a reception for highway contractors and related groups, and several committee cancellations. One member also spoke about a catastrophic fire in Williamsburg, asking for prayers for the community and first responders. The Committee on Committees and Rules then reported referrals for numerous newly introduced bills to standing committees and made changes to the 2026 Committee on Impeachment, removing Representatives Marzian and Donworth and appointing Representatives Watkins and Gentry. The House then adjourned until 2:00 p.m. Thursday, January 22, 2026.

Transcript Highlights:

• This is a new emerging technology.
• This is a new emerging technology.
• and coordination among agencies during air quality emergencies.
• Unfortunately, California has seen these emergencies become more frequent and complex.
• and coordination among agencies during the air quality emergencies.

Keywords: 987, senate, all

Transcript Highlights:

• <00:30:21.000> room they do present in the emergency room they do present in the emergency
• not just the emergency department. not just the emergency department.
• emergency emergency hospitals. emergency emergency hospitals.
• inpatient services and will do outpatient emergency facilities, emergency services kind of things.
• in their emergency departments. in their emergency departments.

Keywords: 958, all

Summary: The committee opened its sixth and final interim meeting with roll call, quorum confirmation, approval of the prior minutes, and a brief change in agenda order to preserve quorum and accommodate presenters’ schedules. Members then moved through several proposed health-related items with limited discussion, and the chair noted the committee would reconvene in January for further conversation. The first substantive item was a proposal relating to utilization controls for non-opioid analgesics in Medicaid. Senator Gerald Neal and Tara Hyde of People Advocating Recovery argued that pain parity is needed so patients can access non-opioid options without prior authorization or step therapy barriers, especially in acute pain situations and for people in recovery. Senator Berg supported the concept and suggested expanding the approach to other prescriptions by allowing physicians to explain why step therapy is inappropriate at the time of prescribing; another member cautioned against unintended cost increases if non-opioid drugs are used as add-ons to opioids. The committee then heard a proposal on physician assistants from Senator Scott and Andrew Rutherford of the Kentucky Academy of Physician Assistants. They described a shift from a supervisory to a collaborative practice model, with practice scope set at the practice level, limited Schedule II prescribing authority under guardrails, and permission for PAs to perform driver’s license vision testing. Supporters said the changes would improve rural access, reduce administrative burden, and align Kentucky with neighboring states; a question from Representative Bratcher focused on experience requirements and how the proposal compares with nurse practitioner rules. No vote was taken. Finally, Representative Nancy Tate, Adia Wuchner, and Representative Jason Nemes introduced a 2026 proposal aimed at “protecting vulnerable people.” They described a broad package focused on abortion pill trafficking, marketing to minors, commercial surrogacy, assisted suicide, and organ procurement safeguards, arguing that current law leaves gaps and that additional criminal and civil penalties are needed. The presentation was informational only, with no action taken before the meeting ended.

Transcript Highlights:

• c> related hospitals, emergency pregnancy related hospitals, emergency pregnancy related medical<
• <00:37:36.480> abortion woman may require an emergency abortion woman may require an emergency
• :04.880> that<00:38:05.040> a emergency department determines that a emergency department
• <00:38:06.320> pregnancy patient has an emergency pregnancy patient has an emergency pregnancy
• <01:06:41.039> We majority that was an emergency. We majority that was an emergency.

Keywords: Senate streaming session for Tuesday, February 10, 2026, 960, senate, all

Summary: The Senate convened with an invocation, confirmed a quorum, and welcomed several guests and groups, including Maryland Library Association members, Stephen Decatur High School’s boys soccer team, Clarksburg High School’s girls flag football team, NAMI representatives, Baltimore Promise, local soil conservation district representatives, and a 911 center leader. The chamber also journalized the invocation and prepared for the Governor’s upcoming State of the State address by exchanging messages with the House and appointing Senate members to escort the Governor and Lieutenant Governor. The body then took up a series of Finance Committee bills, most of them receiving favorable reports and being ordered to third reading without objection. Measures discussed included SB 14 on small business health insurance SHOP enrollment effective dates; SB 22 on Department of Disabilities housing programs and affiliated foundations; SB 134 on Medicare supplement policy enrollment periods; SB 139 on third-party administrator enforcement; SB 199 on the Individuals with Disabilities and Service-Disabled Veterans Voting Fund; SB 205 codifying federal mental health parity requirements; SB 216 on unemployment insurance confidentiality; SB 43 on the Maryland Community Investment Venture Fund; SB 46 on state veterans cemeteries interment provisions; and SB 226 on the Maryland Heritage Area Authority. Several bills had brief amendments or procedural issues. SB 22 received a technical amendment changing “Attorney General” to “Office of the Attorney General.” SB 199 received an amendment adding a co-sponsor, and SB 46 was briefly set to lie over under the rule after a senator requested time to review a technical clarification. The chamber also received House Bill 1, which was referred to committee, and SB 624 was reassigned to the Education, Energy, and the Environment Committee. Most committee reports were adopted unanimously or without objection, and the Senate repeatedly congratulated the honored school teams and library advocates.

Transcript Highlights:

• So, number one, authorized emergency vehicle 42-1102, subsection 6.
• It doesn't matter what the emergency is for.
• <00:04:18.799> Sometimes the emergency is for. Sometimes the emergency is for.
• :36.640> of rescue type emergency where time is of rescue type emergency where time is of the<
• This is for emergency special situations.

Keywords: 981, all

Summary: The committee first debated amendments to Senate Bill 35, a road safety measure increasing penalties for improper passing and related dangerous driving offenses. Amendment L17, which would have exempted certain emergency situations and volunteer first responders from the penalties, was opposed by the bill sponsor and others and failed on a voice vote. Amendment L18, which broadened the exemption for first responders en route to emergencies, also failed after discussion. Supporters of the bill argued it targets some of the state’s most fatal crashes, while opponents said the penalties were too harsh and could disproportionately affect rural and working-class drivers. The committee then passed Senate Bill 35 as amended. The committee next considered House Bill 1273 on transportation network companies and driver compensation. Supporters said the bill responds to reduced driver earnings under app-based pricing models and seeks to require a larger share of fares to go to drivers, while opponents warned it could harm the industry, reduce service, and interfere with business decisions. The bill passed after debate. Senate Bill 114, concerning spirituous liquor manufacturers’ sales rooms, then passed with supporters describing it as a limited, locally controlled permit to help distillers offer additional on-premise options while preserving local approval authority. Finally, House Bill 1138 on organized retail theft prevention advanced through committee reports and was presented as a grant-and-advisory-board program housed in the Department of Public Safety. Sponsors said it would fund investigations, prosecutions, technology, training, and prevention efforts aimed at organized retail theft and gift card fraud, modeled after Colorado’s auto theft grant program. The bill was described as targeting felony-level organized theft rather than ordinary shoplifting, with annual reporting and a sunset date built in. The transcript ends during discussion of the bill, after the committee reports were adopted and the bill was introduced for final passage discussion.

Transcript Highlights:

• Senators, we have a program review this afternoon from the Division of Emergency Management.
• As some projects close out, new projects emerge.
• Let's talk education and let's talk counties in emergency management.
• Some county emergency managers are well-versed.
• They're former state emergency management employees.

Summary: The committee received a program review from the Florida Division of Emergency Management on the 2024 hurricane season and FEMA reimbursement process. Deputy Director Keith Pruitt described the impacts of Hurricanes Debby, Helene, and Milton, including major storm surge, flooding, tornadoes, debris removal, power restoration, flood-control deployments, sheltering, and logistics missions. He emphasized that Florida’s approach is “federally funded, state managed, locally executed,” and said the division has already obligated large amounts of public assistance funding and mitigation dollars while continuing to work on remaining missions and reimbursements. A major focus of the discussion was how local governments can better document and vet debris-removal and other disaster costs so they are eligible for FEMA reimbursement. Chair DiCeglie and other senators raised concerns about local planning, commercial debris collection, and whether counties and municipalities that spend money up front will be reimbursed. Pruitt explained that eligibility depends on documentation, scope of work, insurance, and FEMA rules, and that the state’s FROC process is intended to help counties identify eligible work before costs are incurred. He also said commercial debris may be eligible in some cases but is not guaranteed, and that counties should coordinate early with FDEM and FEMA. Senators also asked about possible FEMA reforms, the age of outstanding reimbursement claims, and a proposed state fund to advance money to fiscally constrained counties while they wait for FEMA payments. Pruitt said Florida’s system is a national best practice, but that more county-level training and clearer coordination would help reduce de-obligations and audit problems. He said the reimbursement-advance idea is still being developed, and that the state continues to look at ways to streamline mitigation through programs like Elevate Florida. The committee took no formal action beyond hearing the presentation, and the meeting adjourned after closing comments from senators praising FDEM’s work.

Transcript Highlights:

• We're not be used in emergencies.
• procedure when it comes to emergencies. procedure when it comes to emergencies.
• procedure in emergencies. procedure in emergencies. All right.<00:09:04.560> Next.
• use of seclusion as an emergency use of seclusion as an emergency procedure<00:27:34.000> and
• We're talking about seclusion as an emergency, as a restrictive procedure in an emergency.

Keywords: 1187, senate, all

Transcript Highlights:

• Gabrielle Santoro with the Emergency Medical Services Authority.
• Or to the emergency room, if they have to see people through the emergency room because they no longer
• Historically, we had covered outpatient renal dialysis as emergency care, and we defined that as emergency
• Emergency physicians are not included.
• Medi-Cal. ...to emergency-only Medi-Cal.

Summary: The Assembly Budget Subcommittee on Health held a May Revision hearing covering several health-related budget proposals and broader concerns about the state’s budget structure. The Chair opened by praising some May Revision changes, such as added health IT funding, county administration support tied to Medi-Cal changes, a delay in Medi-Cal cuts for some lawfully present immigrants, and additional support for Covered California subsidies, while criticizing proposed increases in Medi-Cal premiums, changes to senior eligibility, the lack of a Medi-Cal dental solution, and other reductions affecting counties, mobile crisis units, workforce incentives, and physician shortages. The Legislative Analyst’s Office said the state’s budget condition remains weak despite progress on the structural deficit, and the Department of Finance said the May Revision uses a mix of reductions, reforms, revenue proposals, and fund shifts to cut out-year deficits. The committee first heard Department of State Hospitals proposals, including adjustments to county bed billing authority, contract exemption language for online clinical/pharmacy subscriptions, reversion of unspent funds, a revised Metro Central Utility Plant replacement project, electronic health record implementation, and workforce development funded partly through Behavioral Health Services Act resources. DSH also described savings and realignments in incompetent-to-stand-trial and conditional release programs, including extending the independent placement panel program and shifting funds to support additional bed capacity and a mental health rehab center. Members asked about the use of BHSA funds for workforce programs, and the department said the proposal would replace General Fund support with BHSA reimbursements. The Emergency Medical Services Authority proposed funding for statewide behavioral health crisis response guidance and for enterprise system development, and the Department of Managed Health Care proposed modernization of its complaint system and claims-settlement data system to improve oversight and comply with AB 3275. The largest discussion centered on the administration’s BHSA spending plan under Proposition 1, including state-directed prevention, workforce, and other uses, plus General Fund offsets for existing programs. The LAO questioned whether some proposed offsets fit Proposition 1’s non-supplant and eligible-use requirements, while the administration argued the uses were consistent with the measure and that the state-directed share can be adjusted annually. The Commission for Behavioral Health’s proposals drew the most public and member concern. The administration proposed cutting the commission’s Innovation Partnership Fund from $20 million to $10 million and reducing the Community Advocacy Program by $6.7 million, while redirecting BHSA dollars to other state purposes and direct services. Commissioners, advocates, and several members argued the cuts would weaken community voice, reduce support for underserved populations, and disrupt grants already in process; they also objected to using BHSA funds to backfill General Fund commitments. Public commenters, including youth, disability, behavioral health, LGBTQ, tribal, veteran, immigrant, and community-based organization representatives, overwhelmingly opposed the cuts and urged preservation of prevention, advocacy, mobile crisis, and innovation funding. No votes or final actions were taken during the hearing.

Transcript Highlights:

• <00:08:08.320> room the occupancy, how many emergency room the occupancy, how many emergency
• delivery system, overwhelming emergency delivery system, overwhelming emergency departments,<00:
• The end of the public health emergency The end of the public health emergency in<00:57:22.920>
• Emergency medicine and Bemidji.
• been mentioned, their emergency been mentioned, their emergency department<01:07:45.960> sees

Bills: HF4343

Keywords: sales tax, use tax, advertising tax, taxable services, digital advertising, online marketing, marketing services, search engine marketing, lead generation, internet advertising, ad agency, media buying, campaign planning, Minnesota tax law, service tax, broadening tax base, web advertising, promotional services, 1183, house

Transcript Highlights:

• One, we have seen a significant increase in people using emergency room for non-emergency services.
• for non-emergency emergency room for non-emergency services.<00:28:23.679> So<00:28:24.080>
• <00:32:17.840> It non-emergency medical transport. It non-emergency medical transport.
• non-emergency transport services. non-emergency transport services.
• emergency that these people are home. emergency that these people are home.

Keywords: Meeting Start 00:00:00 Roll Call 00:00:15 HB 1 Discussion 00:02:00 HB 1 Vote 00:15:05 HB 2 Discussion 00:17:20 HB 2 Vote 01:13:20, 958, all

Summary: The committee met on House Bill 1, which would implement Kentucky’s participation in the federal education freedom tax credit program. Sponsors said the bill would allow donors to receive a federal dollar-for-dollar tax credit for contributions to scholarship granting organizations, with no state dollars involved, and that public school districts could potentially create their own SGOs. Members asked about the removal of state tax language in the committee substitute, the meaning of the 11th Amendment waiver, whether SGOs could serve only public school students, and whether data collection could be added. The sponsors said the state tax language was unnecessary because the credit is federal, the waiver would allow federal-court litigation over the act, and a district could establish an SGO if it met federal requirements. The committee adopted the substitute and then reported HB 1 favorably with 16 yes votes, one nay, three pass votes, and one abstention. The committee then took up House Bill 2, an act relating to Medicaid and making an appropriation. The sponsor described the bill as a response to federal HR 1 and to concerns raised by the Medicaid oversight board, saying it would address program integrity, eligibility redeterminations, cost sharing, and managed care organization contracts. He said the bill would require periodic eligibility verification for expansion Medicaid enrollees, add modest cost-sharing for some services to encourage use of primary care over emergency rooms, and strengthen enforcement of MCO contracts, with penalties going into a restricted compliance fund. Members asked about the committee amendment, and the sponsor explained it restored flexibility on the number of MCOs in future procurement rather than locking in a reduction. Members also asked whether the bill had gone before the Medicaid oversight advisory board and whether a fiscal note was available; the sponsor said the board’s recommendations were incorporated and fiscal notes were included in the packet. After discussion, the committee adopted committee amendment one to PHS2 and then adopted PHS2 as amended for consideration. The sponsor continued outlining the bill’s provisions, emphasizing that it applied to the expansion population and was intended to align Kentucky law with federal requirements while improving oversight and accountability.

Transcript Highlights:

• Our most recent type is a rural emergency hospital.
• They're an emergency department that has a lot of outpatient services.
• But we're really proud of the five rural emergency hospitals that we have in the state.
• emergency hospital.
• They're an emergency department that has a lot of outpatient services.

Summary: The subcommittee met to review Department of Human Services hospital payments in Arkansas Medicaid, with DHS Secretary Janet Mann and Deputy Secretary Misty Eubanks presenting first, followed by Arkansas Hospital Association Executive Vice President Jody Ann Tritt and a brief comment from Arkansas Children’s. DHS outlined the main hospital payment streams: fee-for-service per diem payments, upper payment limit (UPL) supplemental payments, cost settlements, and smaller payments such as graduate medical education and disproportionate share hospital funds. Members asked for plain-language explanations of cost settlements, why per diem rates vary by hospital type, and why UPL applies to private hospitals. DHS said cost settlements and UPL are mechanisms to help offset Medicaid underpayment, with SFY 2025 hospital payments totaling hundreds of millions of dollars and no general revenue used for supplemental payments beyond the state share funded through hospital assessments and related financing structures. Committee members focused heavily on whether Arkansas hospitals are adequately reimbursed and why rural hospitals struggle. Tritt explained that critical access hospitals, rural emergency hospitals, PPS hospitals, and specialty hospitals operate under different federal and state rules, and said lower per diem rates for some facilities help with cash flow and later cost settlement adjustments. She said Arkansas hospitals are under financial strain, citing a negative patient services margin statewide and noting that Medicaid, Medicare, and commercial payers all contribute to the problem. She also said the association had just authorized a statewide survey of hospital finances and costs, which she expected would take about a year to complete. A major theme was commercial insurance reimbursement. Tritt argued Arkansas hospitals are paid far less than hospitals in neighboring states even though premiums are similar, and said administrative burdens, prior authorizations, and denials add to the problem. She said hospitals receive about 52 to 53 cents on the dollar for Medicaid costs without UPL and about 78 cents with UPL, still below cost. Members also discussed Medicare wage index issues, Medicare Advantage, and whether hospitals could use technology or alternative arrangements to improve finances. No votes were taken on the hospital presentation. At the end of the meeting, DHS provided a brief update on Living Choices and assisted living reimbursement. Officials said one assisted living facility, Pillars of the Community in Crossett, had announced closure, with nine waiver clients being transitioned to other settings. DHS said the current cost reporting period was underway and that a new rate study could be ready for review before the end of the fiscal year if reports were submitted on time. Members also asked about the broader waiver plan, and DHS said the next waiver iteration would likely be brought back to the committee in the summer.

Transcript Highlights:

• I was like, we need an emergency clause right now. Okay, so I super appreciate the clarification.
• treatment and emergency evaluation.
• That is our emergency 72-hour hold statute.
• This is because the court process is slower than the emergency hold.
• The statute directs you back to the 72-hour hold if it's an emergent situation.