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.

Transcript Highlights:

• Then we had the AG come and we talked about Medicaid, and he said, "Well, you know, we have a Medicaid
• Then we had the AG come and we talked about Medicaid, and he said, "Well, you know, we have a Medicaid
• Then we had the AG come and we talked about Medicaid, and he said, "Well, you know, we have a Medicaid
• Then we had the AG come and we talked about Medicaid, and he said, "Well, you know, we have a Medicaid
• Then we had the AG come and we talked about Medicaid, and he said, "Well, you know, we have a Medicaid

Transcript Highlights:

• get Medicaid pay reimbursement.
• business and finance, Medicaid, you all wrote in one.
• Uh, we're going to try to give you the committee Medicaid 101, if you would, on how we pay for Medicaid
• </c> to give you um the committee Medicaid to give you um the committee Medicaid 101<00:09:08.720><c>
• </c> for Medicaid for Medicaid and<00:09:15.040><c> how</c><00:09:15.200><c> the</c><00:09:15.440><c>

Committee: Joint Medicaid

Transcript Highlights:

• Litman and Medicaid, right? And Medicaid is a bit different.
• Litman and Medicaid, right? And Medicaid is a bit different.
• right and and Litman and Medicaid right and and Medicaid<00:20:13.760><c> Medicaid</c><00:20:14.120>
• is a bit different Medicaid Medicaid is a bit different they<00:20:15.320><c> have</c><00:20:15.600>
• Often Medicaid doesn't cover OTC, or over-the-counter drugs, so there are Medicaid recipients that have

Summary: The working session focused on the New Hampshire Prescription Drug Affordability Board’s budget request and its recent work. Early discussion centered on a technical question about a statutory dedicated fund for donations: members asked why the budget did not show a line item for accepting donations, and DHHS CFO Nathan White explained that the statute already authorizes the fund, but because no revenue has been received yet, it does not appear in the budget. He said any future donations would go through the normal process under RSA 14:30-a, with fiscal committee and Governor and Council approval and a memo to the Department of Revenue Administration. The chair clarified that the account was not a prerequisite to soliciting donations, and White said the fund would supplement, not replace, General Fund support. Kirk Williamson, the board’s executive director, then presented the board’s mission and budget. He said the governor’s budget provides about $256,500 in the first year and slightly more in the second, all General Funds, and that the board had distributed a technical amendment to continue the executive director position. He described the board’s role as analyzing prescription drug costs, identifying savings opportunities, monitoring market trends, promoting transparency, and making recommendations to the legislature and public payers. He also emphasized that the board operates publicly, with live-streamed meetings and a stakeholder advisory council that includes unions, state agencies, Medicaid, corrections, higher education, and other stakeholders. A major topic was the board’s estimate of $6 million in potential savings, based on Medicare’s newly negotiated prices for 10 drugs. Williamson explained that the board used those federal negotiated prices as a benchmark to estimate what New Hampshire public payers might be missing by not having similar leverage, and said the board is trying to build evidence for future recommendations rather than directly setting prices. Members asked how those potential savings could become actual savings, and Williamson said the board is sharing findings through its advisory council and feedback loops, though it has not yet sent a formal recommendation letter to specific purchasers. He also discussed the difference between pharmacy-benefit spending, which relies heavily on PBM-negotiated rebates, and medical-benefit spending, which is administered differently and is being added to the board’s next report. Williamson highlighted other work, including a model on Humira and a pending legislative effort to improve biosimilar competition, plus a proposed state-backed pharmacy savings card that would be no cost to the state and could save users about $240 per prescription based on Connecticut’s experience. No votes were taken during the session.

Transcript Highlights:

• Say, with Medicaid.
• Say, with Medicaid.
• Medicaid eligibility.
• Medicaid Services. They'll provide us Medicaid Services.
• </c> Medicaid Services. Medicaid Services.

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.

Transcript Highlights:

• We also have our Medicaid supplemental payments.
• Because of the continuous eligibility requirement in Medicaid, they've stayed in Medicaid for a much
• HHSC has responsibility over the Medicaid program.
• Medicaid program integrity is a three-legged stool. We have an office.
• And they also have the Medicaid Fraud Control Unit.

Committee: House Appropriations - S/C on Article II

Transcript Highlights:

• Let's talk about the Medicaid redetermination process that we went through in '23 and '24.
• And financing of our own Medicaid program.
• Does Medicaid get money back? How the savings went. Thank you. Thank you. One more question.
• Which large Medicaid-managed care plans have common ownership or control with CVS?
• Medicaid controls the budget.

Bills: S0688 , S1414 , S0186 , S0902 , S0196 , S1574 , S0878 , S1092 , S1032 , S1684 , S1686 , S1760

Committee: Senate Health Policy

Summary: The committee took up several health-related bills and confirmations. It first heard SB 1414 on congenital cytomegalovirus education, which would require the Department of Health to develop and distribute educational materials to expectant and new parents through maternity, prenatal, newborn, and OB-GYN settings; an amendment removed a section on required instruction for medical professionals, and the bill was reported favorably as a committee substitute. The committee then approved a block of appointees on tabs 2 through 7 and separately confirmed Chavon Harris as Secretary of the Agency for Health Care Administration after her testimony on Medicaid accountability, transparency, managed care oversight, rural health, behavioral health, and the state’s technology modernization efforts. Senators asked Harris about Hope Florida, Medicaid redeterminations, the CORE project, an anti-marijuana ad campaign at DCF, and compliance with a federal Medicaid-related court order; she said she would follow up on some issues. The confirmation was recommended favorably, with Senator Berman voting no. The committee next passed SB 186 on student health and safety, which expands epilepsy and seizure-disorder training requirements to more school personnel, including bus drivers and charter school staff, and requires seizure-first-aid posters and updated Department of Health education efforts. It also approved SB 902 on Department of Health issues after amendments narrowed the bill’s scope and added provisions on medical marijuana regulation, early childhood intervention, practitioner accountability, and autism workforce development; one speaker raised concerns about marijuana dispensary location restrictions and low-THC ratios. SB 196 creating a uterine fibroid research database was also reported favorably after an amendment protecting patient privacy; the bill drew emotional testimony from a patient describing severe symptoms and the need for more research. SB 688 on naturopathic medicine was approved after committee discussion about scope of practice, referral obligations, and whether naturopathic care should be adjunctive to conventional medicine; supporters described complementary care and access issues, while opponents worried about delayed treatment for serious disease. Later, the committee passed SB 1574, “Maddie’s Law,” to add biliary atresia screening to newborn screening using the same blood specimen already collected at birth and to launch an education campaign; parents of a child affected by the disease testified that earlier screening could have prevented severe harm. SB 878 on clinical laboratory personnel was reported favorably to address staffing shortages by allowing Florida to rely more directly on federal CLIA standards for qualified lab workers. SB 1092 on podiatric medicine was approved after an amendment narrowed it to cellular/tissue-based products and podiatrists’ use of certain therapies; the bill also addresses continuing education, informed consent, and advertising disclosures. SB 1032 on medical marijuana was amended and passed, aligning physician certification and card renewal timelines, setting 70-day and 35-day supply limits, and reducing the fee for honorably discharged veterans while preserving funding for FAMU; Senator Harrell opposed it, saying the longer timeframes were too much of an expansion. The committee also heard SB 1760 on Medicaid coverage transparency from Senator Brodeur, who said the bill focuses on accountability and fiscal responsibility, but the transcript cuts off before further discussion or action on that measure.

Transcript Highlights:

• Let's talk about the Medicaid redetermination process that we went through in '23 and '24.
• In many cases, PBMs will not allow the Medicaid recipient to go to a local pharmacist.
• Which large Medicaid-managed care plans have common ownership or control with CVS?
• Medicaid controls the budget.
• Medicaid controls the budget.

Committee: Senate Health Policy

Transcript Highlights:

• Yes, we focus on Medicaid. I can speak for the Health Care Authority. Yes, we focus on Medicaid.
• So this is traditionally what we consider our Medicaid expansion population.
• So this is specific to the Medicaid expansion population.
• to be able to participate in the Medicaid program, which all states do, and draw down federal Medicaid
• program, which all states do, and draw down federal Medicaid matching funds.

Committee: House Appropriations

Summary: The House Appropriations Committee held a work session covering juvenile rehabilitation system capacity, behavioral health capacity, federal funding changes, and a 2026 budget overview. DCYF officials said the juvenile rehabilitation population is older, includes more adult-sentenced youth and post-25 residents, and is projected to keep growing, creating crowding at Green Hill School and placement limits across the system. They described safe operating capacity concerns, staffing turnover, mental health acuity, and the need for additional medium-security and specialized mental health beds, including a proposed Parkland facility and continued development of Harbor Heights. Committee members were told to follow up separately with questions, and the presentation moved on due to time. Behavioral health officials from DSHS and HCA then reviewed forensic and civil capacity. DSHS described expanding state hospital and civil treatment capacity through Olympic Heritage, Maple Lane, Brockman Campus, and a new 350-bed forensic hospital at Western State, while noting ongoing construction, staffing, and funding issues. HCA outlined its strategy to move long-term civil commitment care into community settings through contracted long-term civil commitment beds, intensive behavioral health treatment facilities, PACT teams, and intensive residential treatment teams. Members asked about out-of-state placements, Medicaid funding, and the differences among facility types; officials said the goal is to right-size inpatient capacity while expanding community-based supports. OFM then presented an update on federal funding and the effects of H.R. 1 and H.R. 5371. Agency staff said H.R. 1 would tighten SNAP work requirements, reduce exemptions, shift some lawful immigrants to state-funded food assistance, increase state administrative and benefit costs, and affect Medicaid eligibility, redeterminations, cost sharing, and state-directed payments. HCA estimated major Medicaid caseload reductions and significant future fiscal impacts, while OFM also noted marketplace subsidy changes and higher education and K-12 downstream effects. H.R. 5371 was described as a short-term federal funding extension through January 30, 2026, with some full-year appropriations and a change affecting hemp producers. Finally, Mary Monroe gave a 2026 supplemental budget preview, citing declining NGFO revenue forecasts, reversions, vetoes, and the added uncertainty from H.R. 1, with the projected ending fund balance moving from positive amounts to a negative outlook over the four-year period.

Transcript Highlights:

• We also see this incline of the Medicaid long-term services and supports population.
• And remember that home and community-based services and Medicaid is an option.
• $4.5 million in annual state Medicaid costs, assuming that this would begin in 2027.
• This is something that other states are looking at specific to Medicaid.
• Those services specified by the Centers for Medicare and Medicaid Services.

Summary: The committee began with an extended work session on the long-term care workforce. DSHS Assistant Secretary B. Rector described the new Home and Community Living Administration and outlined major workforce pressures: Washington had about 126,000 long-term care workers in 2022, with demand expected to outpace supply as the 85-plus population and dementia prevalence rise sharply. She emphasized that direct care workers are largely women, people of color, and immigrants, and that family caregivers are also a major part of the system. She highlighted recruitment and retention efforts funded through federal Money Follows the Person dollars, including high school training partnerships, a retention toolkit, transportation support, caregiver newsletters, tribal workforce navigators, and a remote caregiving pilot. Committee members asked about career pathways, technology use, and turnover drivers; Rector said wages, benefits, unstable hours, and workplace support are key issues and promised follow-up data. Aidan Swain of the Washington Health Care Association said skilled nursing and assisted living facilities face acute RN vacancies, wage pressures, and Medicaid reimbursement that does not cover costs, and urged modernization of training, better reimbursement, and continued support for facility-based care. Maddie Fouch of SEIU 775, representing about 55,000 caregivers, said low wages, weak benefits, lack of voice, and certification delays are driving turnover and shortages, and argued for higher compensation, better worker protections, and more transparent reimbursement. Catherine Smith of Behavioral Health Solutions described growing behavioral health needs in nursing homes, the role of expanded behavioral supports programs, and credentialing delays that slow hiring. No votes were taken; the panel was informational only. The second agenda item was an overview of the palliative care benefit work group report required by 2024 legislation. Nico Jansen of the Office of the Insurance Commissioner explained that the work group, convened with the Health Care Authority, studied a potential palliative care benefit for fully insured commercial plans and also Medicaid, PEBB, and SEBB. He said palliative care is a philosophy of care focused on symptom management, coordination, and support for serious illness, and is distinct from hospice because it can be provided alongside curative treatment. The actuarial analysis concluded that creating a new benefit would likely increase costs, estimating about a 28-cent per member per month increase overall and roughly $2.6 million to $4.5 million in annual state Medicaid costs if implemented in 2027. Jansen said the consultants did not find sufficient evidence to assume savings from avoided hospitalizations or long-term care, though several work group members disagreed and submitted response letters. Senators asked about other states, Medicare, health homes, and whether more research could clarify cost savings; OIC said some states, including Hawaii, are moving ahead with Medicaid palliative care benefits, Medicare covers some related services but not in the same way, and further evidence may emerge over time. OIC did not take a position on whether the Legislature should create the benefit. The final presentation covered health care price transparency tools in Washington and federally. Evan Klein and HCA Chief Data Officer Vishal Chaudry reviewed federal hospital and health plan transparency rules, the state all-payer claims database, prescription drug price transparency, the Health Care Cost Transparency Board, the Prescription Drug Affordability Board, and other reporting systems. They explained that the APCD contains claims from fully insured commercial plans, Medicaid, and public employee programs, but not self-insured employer data except for limited voluntary submissions. They also described how machine-readable files, consumer price tools, and aggregated dashboards are used, and noted that data limitations, delays, and complexity remain significant. Senators asked about voluntary self-insured participation, the role of AI in making data more usable, and whether transparency can really help consumers given access barriers and medical debt. HCA said AI is increasingly used by private entities to mine large transparency datasets, but state agencies still face limits in data access and analytic capacity. The committee did not take action; the session was informational and ended with a discussion of how transparency data might better inform policy and purchasing decisions in the future.

Transcript Highlights:

• I want to talk about the Medicaid trust fund. I guess that's I-6. L-6, okay.
• But it's dedicated to Medicaid.
• The Medicaid program will try to function with the current— Best of our ability, the Medicaid program
• to be able to control those costs using Medicaid funds."
• So the Medicaid trust fund is a compilation of many different funds.

Committee: All ALC-PEER

Summary: The committee met with a quorum, opened with a prayer recognizing the death of Reverend Jesse Jackson, and then worked through a series of appropriation and transfer requests. In Section B, it approved a $273,000 temporary appropriation for the Department of Labor and Licensing. In Section C, it approved two Infrastructure Investment and Jobs Act requests: $280 million for the Department of Transportation and $195 million for the State Broadband Office to support Arkansas BEAD broadband grants, including an extra help position. Members questioned the broadband awards, provider amendments, buildout timelines, accountability, and the status of unawarded locations; the broadband director said no provider had requested speed changes, awards would be monitored with milestone-based payments, and remaining locations would be addressed later as federal guidance is received. The committee also approved transfers in Section D, including $458,000 for the Department of Correction, $25 million for Department of Education programs such as declining enrollment and teacher incentive funding, and $229,000 for Shared Administrative Services project management support. In Section E, the committee considered a $4.7 million budget stabilization trust fund loan for the Office of State Technology to implement ServiceNow and related IT modernization, cybersecurity, and governance tools. Members pressed agency officials on repayment, cost savings, and whether the loan would simply roll over existing costs; officials said repayment would come through agency rates over a five-year period and that the new payment would be lower than the current loan being retired. The committee voted to give favorable advice to the Governor on the loan request. In Section F, the committee reviewed cash fund requests for wage and hour claims, unclaimed property, and a heritage grant; in Section G, it reviewed a $1.1 million federal grant to expand college and career coaching in rural districts; in Section H, it reviewed pay plan and performance fund requests totaling millions across multiple agencies; and in Section I, it reviewed budget manual formatting changes. The latter part of the meeting focused on reports, especially the Medicaid trust fund. DHS and DFA officials reported the fund balance had declined from prior years and was down to about $394 million after seven months, with further decline expected by year-end. Senators and representatives asked about the appropriate reserve level, the impact of pending Medicaid rules and legislation, FMAP changes, and whether additional funding would be needed in the upcoming budget. Officials said projections are updated regularly, more than 10 rule packages remain pending with CMS, and the governor and legislative leaders will discuss additional capital needs during budget development. Members also discussed the importance of balancing Medicaid spending with new federal funding and maintaining flexibility for critical areas such as labor and delivery. The committee then adjourned without further action on the reports.

Transcript Highlights:

• FIRST WE WILL BEGIN WITH BRIAN MEYER, THE DEPUTY SECRETARY OF THE DIVISION OF MEDICAID.
• AS MEDICAID DIRECTOR FOR THE STATE MEDICAID PROGRAM.
• THE QUARTERLY MEDICAID SERVICES APPROPRIATION REPORT KNOWN INTERNALLY AS THE BURN REPORT.
• IT IS JUST A METHODOLOGY THAT PERHAPS LINKS IT TO MEDICAID UTILIZATION.
• I THINK IT IS COMING UP WITH A METHODOLOGY THAT MORE CLOSELY IS SUPPORTED BY MEDICAID COSTS.

Transcript Highlights:

• Medicaid recipient.
• This next rule does two things in the Medicaid program.
• This next rule does two things in the Medicaid program.
• Our system does allow for that, so that is not a problem within either the Medicaid rules or the Medicaid
• to Medicaid clients.

Summary: The committee reviewed a series of Arkansas Medicaid and Department of Health rules, many implementing 2025 acts. Early items covered presumptive eligibility and Medicaid policy updates, including adding a definition of fictive kin for foster children and changing the disability onset age for ABLE accounts from 26 to 46. Another rule clarified that continuous glucose monitors may be billed by both pharmacies and durable medical equipment providers, with committee members questioning prior authorization timing, system lag, and a fiscal impact estimate of about $3 million over two years; the rule was reviewed, but members requested additional cost breakdowns. Other Medicaid-related rules addressed an RSV vaccine administration fee increase, an ET3 telemedicine exemption for ambulance treat-triage-transport services, a dental rate increase under Act 1025, expanded physical therapy access, and the Healthy Moms, Healthy Babies package covering doulas, lactation consultants, remote monitoring, and expanded prenatal testing. Most were reviewed without objection after brief discussion or no questions.

Transcript Highlights:

• I'm the Deputy Secretary for Medicaid.
• Find out and have individuals call to find out how many Medicaid patients a provider will take.
• For this amendment, the Centers for Medicare and Medicaid Services awarded the agency $209 million to
• service to individuals and Medicaid Within general revenue and trust funds, under the Medicaid service
• to individuals and Medicaid long-term care budget entities, to address projected surpluses.

Summary: The Legislative Budget Commission considered 21 budget amendments, most of them routine authority adjustments tied to federal grants, Medicaid payment programs, and trust fund realignments. The Department of Education received $14.751 million for a Preschool Development Grant to support early learning system improvements, workforce credentialing and training, IT modernization, and related early childhood certification work. The Department of Veterans Affairs shifted $2.2 million within its trust fund to cover higher nursing home occupancy, replace contract nursing with OPS staff, and meet rising operating costs. The Department of Health moved about $9.1 million to support Disability Determinations, where roughly 140,000 cases were pending or in process, and said the change would help reduce backlog and avoid a deficit. The Agency for Health Care Administration presented multiple amendments for Medicaid-related programs, including $766 million for indirect medical education, $1.9 million for managed care network adequacy audits, $209 million for the Rural Health Transformation Program, and several large supplemental payment programs for hospitals and physicians; members asked about CMS approval delays, provider access, and how rural funds would be distributed. The commission also adopted an amendment realigning KidCare funds, placing a $32.1 million surplus into reserve, though several members objected that the state had not yet implemented the 2023 KidCare expansion and that children remained on a wait list. Another Medicaid amendment placed a $376 million surplus into reserve after updated estimating conference projections. Other agencies also received approvals. FDLE received $16.26 million to buy counter-unmanned aircraft systems equipment such as radar and RF sensors to detect and mitigate drone threats. The Department of Juvenile Justice received $1.6 million for the Florida Scholars Academy and a Social Services Block Grant realignment, with staff confirming corrective action had been taken after prior audit findings about allowable SSBG spending. The Division of Emergency Management received federal pass-through authority for FIFA World Cup security and counter-UAS funds, both controlled by the Miami host committee, and members noted the state had little direct oversight over how those local grants would be used. The Department of Commerce received $148.4 million for Community Development Block Grant Disaster Recovery work, with questions focused on the split between housing, infrastructure, and administrative costs. The Department of State received $408,377 for arts and culture federal grant obligations. All amendments were adopted, generally without objection, after brief questioning and no public testimony.

Transcript Highlights:

• I'm the Deputy Secretary for Medicaid.
• For this amendment, the Centers for Medicare and Medicaid Services awarded the agency $209 million to
• Under the Medicaid services to individuals and Medicaid long-term care budget entities to address projective
• services to individuals and Medicaid...
• Within general revenue and trust funds, under the Medicaid services to individuals and Medicaid long-term

Summary: The Legislative Budget Commission met to consider 21 budget amendments, beginning with the Department of Education’s request for $14.751 million in federal grant authority for the Preschool Development Grant. Members asked whether any funds would support VPK or provider payments; the department said the money is for birth-to-kindergarten early learning work, including IT modernization, workforce credentialing, training, and streamlining director certification. The amendment was adopted without objection. The commission then approved amendments for the Department of Veterans Affairs to shift $2.2 million within its trust fund to cover higher nursing home occupancy and reduce staffing agency use, and for the Department of Health to realign about $9.1 million for disability determinations amid a backlog of roughly 140,000 cases. The Agency for Health Care Administration presented multiple Medicaid-related amendments, including $766 million for indirect medical education, $1.9 million for managed care network adequacy audits, $209 million for the Rural Health Transformation Program, and several large supplemental payment programs for KidCare, hospitals, physicians, cancer hospitals, nursing IME, and public hospital payments. Members questioned network adequacy, rural access, and the KidCare surplus and expansion; the KidCare realignment drew debate, with some members objecting because the 2023 eligibility expansion has not been implemented, but the amendment passed on a roll call vote. Other amendments adopted included FDLE’s $16.3 million for counter-UAS detection and mitigation equipment, DJJ’s $1.6 million for Florida Scholars Academy and a Social Services Block Grant realignment, and emergency management pass-throughs for FIFA World Cup security and counter-drone funding to the Miami host committee. The Department of Commerce received $148.4 million for disaster recovery under the CDBG-DR program, with questions about the split between housing, infrastructure, and administrative costs. The Department of State also received $408,377 for arts and culture grant authority. Most amendments were adopted without objection, and the commission adjourned after completing the agenda.

Transcript Highlights:

• Medicaid impact. Also, these premium increases. So I thank you for working this out.
• So this is just allowing for us to look at options outside of just the Medicaid.
• Or Medicaid, Medicare, or any other type of coverage that meets basic standards.
• Our population is about 2,500 and 14,920 individuals are on Medicaid.
• McKinley County has a population of about 72,000, with 47,388 individuals on Medicaid.

Committee: Senate Senate Health & Public Affairs

Transcript Highlights:

• We have Brian Meyer, Deputy Secretary for Medicaid, here to present amendment EOGB 2026-0831.
• My name is Brian Meyer, Deputy Secretary for Medicaid, and I'd like to thank you for this opportunity
• I do know that there are a lot of supplemental payments on the Medicaid side that cover uncompensated
• I also know the next amendment is another program that addresses Medicaid shortfall.
• Bad debt, also we're reading that here, Medicaid and Children's Health Insurance Program, and I'm very

Summary: The Legislative Budget Commission met with a quorum present and considered two Agency for Health Care Administration budget amendments related to Medicaid supplemental payments. The first amendment, EOGB 2026-0831, authorized $2.1 billion in budget authority for the Low-Income Pool to support safety-net providers with uncompensated charity care. Members asked about the timing of AHCA’s submission to CMS and whether the program addressed hospital shortfalls for insured patients and CHIP-related concerns. AHCA said approvals have generally been slower under the current federal review process, and the amendment was adopted without objection. The second amendment, EOGB 2026-0875, placed $7.9 billion in reserve for Florida’s Directed Payment Program for Hospitals pending final CMS approval. Senators and representatives questioned the role of hospital attestations regarding hold harmless agreements, whether any agreements had to be unwound, and how long final approval might take. AHCA said all hospitals had submitted attestations, no unwinding was known to be necessary, and approval was expected soon. Members also raised concerns about cancer hospitals, including Moffitt and the University of Miami, not participating in the directed payment program. AHCA responded that those institutions participate instead in a separate Florida Cancer Hospital supplemental payment program, which had already been approved. Both amendments were adopted without objection, and the commission then adjourned.

Transcript Highlights:

• And maybe just to add, uh, our colleagues at Medicaid already did analysis of their Medicaid data to
• </c><00:52:53.040><c> already</c> uh our colleagues at Medicaid already uh our colleagues at Medicaid
• </c> the numbers, I know the Medicaid the numbers, I know the Medicaid colleagues<00:53:10.960><c> are
• waiting for Medicaid.
• basically to adult Medicaid.

Summary: The meeting opened without a quorum, so approval of the prior draft minutes was deferred until later. The committee then heard a DHS update from Commissioner Lori Weaver and COO David Weers, who described the recent flood at the Brown building and the relocation of nearly 400 DHS staff while operations are restored. They also outlined New Hampshire Care Connections, a privacy- and consent-focused closed-loop referral platform intended to improve referrals among providers, reduce duplication, and support continuity of care, with an Upper Valley implementation partnered with Dartmouth Health and an Epic integration already underway. Members asked whether the system would merge medical records or simply track referrals. DHS said it is not intended to store or transmit full medical records, but to integrate with providers’ electronic health record systems so referrals can be sent, received, and tracked, with consent controls limiting what information can be shared. Officials said the project will be tested over the coming months, with metrics, governance, and advisory committee oversight, and that it is tied to broader rural health transformation efforts and statewide implementation after the regional pilot. The committee also received the annual report from the Child Care Advisory Council. Maryanne Barter and Jessica Carver said the council worked with licensing to streamline the child care licensing rules, reducing the handbook by about 30%, and is now helping develop an informal dispute resolution process, revising the Granite Steps for Quality system, and creating a clearer handbook for providers handling state scholarship audits. They reported ongoing concern about child care closures and workforce shortages, said there is currently no wait list for child care assistance, and discussed questions about federal CCDF immunization requirements, which DHS said it would follow up on with federal technical assistance partners. After quorum was established, the committee moved to approve the minutes from the prior meeting.

Transcript Highlights:

• <00:42:53.280><c> with</c><00:42:54.079><c> Medicaid</c><00:42:54.640><c> reimbursement</c> Medicaid
• with Medicaid reimbursement Medicaid with Medicaid reimbursement being<00:42:55.839><c> lowballed</c>
• <00:43:04.960><c> payment</c> Medicaid payment Medicaid payment up<00:43:07.440><c> to</c><00:43:07.760
• ,<00:43:36.960><c> that</c> Medicaid, that Medicaid, that uh<00:43:39.599><c> half</c><00:43:39.839><
• And [clears throat] a good Medicaid.

Bills: HB0111 , HB0112 , HB0122

Committee: Senate Appropriations