Transcript Highlights:

• Tim Kathy, Associate Vice President of Care Coordination for SSM in Oklahoma, CMS does require, for the
• But that's where that original form that you saw comes from, is that CMS requirement.
• General Hospital, which is one of our 39 critical access hospitals in the state of Oklahoma, which by the CMS
• But not only that, the CMS reports excess days in acute care, and that is part of the star ratings program

Summary: The meeting focused on hospital “avoidable days” and the difficulty of discharging medically stable patients who still need post-acute placement or social services. Presenters from Saint Anthony Hospital Midtown, the Oklahoma Hospital Association, City Care, and OU Health described common barriers including lack of skilled nursing, rehab, long-term care, behavioral health, and hospice placements; insurance prior authorization delays; Medicaid and Social Security eligibility delays; guardianship and Adult Protective Services bottlenecks; limited home health and private duty nursing; and the challenge of placing unhoused, uninsured, or medically complex patients. Several speakers emphasized that these delays reduce bed availability, increase emergency department boarding, contribute to staff burnout, and expose patients to hospital-acquired conditions and other harms. The testimony included multiple examples of patients remaining in acute care for days, weeks, or even months after being medically ready for discharge, including patients awaiting guardianship, disability determinations, or placement in facilities willing to accept them. Speakers also highlighted special populations such as patients with behavioral health or substance use disorders, medically fragile children, patients with criminal histories, and unhoused individuals who need respite or hospice care. City Care described its planned 40-bed medical respite facility, set to open in 2027, as a way to provide clinical support and housing navigation for patients too sick to recover on the street or in shelters. Witnesses recommended policy and system changes such as standardizing preauthorization protocols, expanding rural swing-bed and home-based services, increasing public guardianship resources, improving data collection on homelessness, expanding private duty nursing hours, and creating more placement options for complex patients. They also suggested better coordination between hospitals, DHS, APS, the Health Department, and post-acute facilities, including a database of facility services to improve discharge planning and keep patients closer to home. No votes or formal committee actions were taken in the transcript, but the chair indicated the issue would require collaboration across multiple agencies and partners.

Transcript Highlights:

• It requires that providers allow CMS and DHS to conduct unannounced site visits at any of the provider's
• It requires that providers allow CMS and DHS to conduct unannounced site visits at any of the provider's
• It requires that providers allow CMS and DHS to conduct unannounced site visits at any of the provider's
• It requires that providers allow CMS and DHS to conduct unannounced site visits at any of the provider's
• Allow CMS and DHS to conduct unannounced site visits at any of the provider's MA-enrolled locations.

Keywords: 1183, house

Transcript Highlights:

• I think the good news is this bill was drafted with the most recent CMS guidance and requirements in
• , that just came out from CMS, that just came out from CMS, we<01:10:31.520> had<01:10:31.600
• Our nursing homes are surveyed by the state through CMS once a year.
• <01:14:47.440> Our<01:14:47.679> critical through CMS once a year.
• Our critical through CMS once a year.

Bills: HB0117, HB0126

Keywords: informed consent, abortion, civil liability, coercion, healthcare rights, fetal heartbeat, termination of pregnancy, medical emergency, Wyoming legislation, rights of minors, healthcare regulations, parental consent, 916, all

Transcript Highlights:

• year in the taken care of and then last year in the summer<00:16:33.040> the<00:16:33.279> CMS
• came<00:16:33.920> out<00:16:34.079> with<00:16:34.240> guidelines summer the CMS
• came out with guidelines summer the CMS came out with guidelines that<00:16:35.519> individuals
• CMS came back and clarified that they were taking that back, but it was several months before they did
• CMS came back and clarified that they were taking that back, but it was several months before they did

Keywords: 00:00 Call to Order 0:22 Roll Call 1:05 SB 65 Discussion 9:30 SB 65 Vote 11:55 SB 177 Discussion 26:34 SB 177 Vote 30:05 SB 245 Discussion 33:07 SB 245 Vote 33:48 Adjournment, 958, all

Summary: The Senate Standing Committee on Licensing and Occupations met on March 3, 2026, with a quorum present and first took up Senate Bill 65, sponsored by Senator Steve West. The bill would nullify administrative regulations found deficient by the Administrative Regulations Review Subcommittee. West said the committee had found three deficient regulations this year, including one related to vaping rollout problems and one involving GLP-1 coverage expansion for Medicaid. Senator Berg raised concerns that striking the GLP-1 regulation could limit Kentucky’s ability to use these drugs for weight loss and other health benefits, but the sponsor and others said the action would only block the specific regulation and that doctors could still prescribe GLP-1s under existing Medicaid authority. The committee passed SB 65 with favorable expression, 8-2. The committee then considered Senate Bill 177, sponsored by Senator Rick Girdler, and first adopted a substitute. The bill concerns speech-language pathologist licensure. Testimony from Kate Wood Hall and Ann Blandford of the Kentucky Speech-Language-Hearing Association explained that the substitute would remove the mandatory post-professional graduate experience as a requirement for full licensure, while keeping an interim pathway and preserving an optional compact-related pathway. They said the change responds to updated graduate training standards and federal billing issues, including CMS guidance that had temporarily disrupted reimbursement and access, especially in rural areas. Members asked whether the change would weaken standards or affect compact participation; witnesses said it would not, and that the compact option remained available. The committee also noted that pages two and three of the substitute were missing and staff would restore them. Several senators spoke in favor while explaining reservations. Senator Berg supported the bill and shared a personal story about speech therapy in her family. Senator Douglas also voted aye but expressed concern about reducing requirements for trained professionals and about incentives in professional education. Senator Chambers Armstrong asked whether the opt-in structure would create barriers or affect compact participation, and witnesses said it would not increase costs and that other states, including Virginia and Oregon, were pursuing similar approaches. SB 177, as amended by the substitute, passed with favorable expression.

Transcript Highlights:

• Um, we have obviously have to consult with CMS about the collection procedures, but what we're trying
• about um the collection consult with CMS about um the collection procedures<01:10:35.360> but
• We do need to meet with CMS next month to get guidance from them on this.
• We do need to meet with CMS next month to get guidance from them on this.
• We do need to meet with CMS next month to get guidance from them on this.

Keywords: 1191, senate, all

Transcript Highlights:

• We've been working with CMS.
• So I do want to give that as a kind of a positive step that CMS...
• So I do want to give that as a kind of a positive step that CMS has responded in a way that says, okay
• Well, I have you here, and you're talking about how you're talking with CMS, you know...
• Well, I have you here, and you're talking about how you're talking with CMS, you know, the hospital discharge

Keywords: 962, all

Summary: The Complex Care Committee meeting focused first on a new Diabetes Caucus launched at the Capitol. Rep. Johnson described the caucus as a forum to educate people about type 1 and type 2 diabetes, genetic risk, early testing, pregnancy-related diabetes, and ways Medicaid policy might improve prevention and lower long-term costs. Members agreed the caucus could intersect with care management, and Carolyn Grandell of CHNCT offered to share information about current diabetes-related care management services at a future meeting. The committee then heard a detailed presentation from Alex Rigger of the Office of Health Strategy, who is moving to the Office of Policy and Management. He reviewed Connecticut health care benchmark data, including total health care expenditures, medical spending, and market-by-market trends. He said 2023 to 2024 per-capita spending grew more than 8.5% statewide and 14% in Medicaid, with long-term care accounting for about 46% of Medicaid spending and retail pharmacy also identified as a major cost driver. Members asked about enrollment changes, dual-eligible populations, Medicare Savings Program members, 340B drug pricing, and value-based payment models. Rigger explained that his office tracks alternate payment models and quality benchmarks, but does not separately capture 340B data. Discussion then shifted to Medicare Advantage, dual eligibles, and hospital discharge planning. Members said they want better data on how many Medicaid members are in Medicare Advantage plans and whether those plans shift costs back to Medicaid or affect access to care, especially for complex-care patients. Staff noted DSS does have some Medicare Advantage indicators and that CMS is developing encounter-data rules for states. Kathy Holt and others raised concerns about denials, nursing home stays, and the need to compare Medicaid spending for dual eligibles in Medicare Advantage versus traditional Medicare. The meeting ended with plans for follow-up data sharing, including Alex Rigger’s slides, the diabetes caucus materials, and a future discussion with DSS and other agencies; no formal votes were taken.

Transcript Highlights:

• Bakofsky: THE MARKETPLACE ACCOUNTABILITY RULE APPLIES TO THE CMS RULES SO WHAT OIR DID ABOVE AND BEYOND
• QUESTION AND WE WILL PROVIDE DIFFERENT RESOURCES AS TO WHAT THE IMPACTS OF RATES ARE, WHAT THE RULES ARE, CMS
• Bakofsky: CMS HAS PUT OUT RESOURCES FOR CONSUMERS AND WE >> Ms.
• Bakofsky: CMS HAS PUT OUT RESOURCES FOR CONSUMERS AND WE CAN PROVIDE THOSE AS PART OF THAT RESOURCE PACKET
• KNOW WHO THE BEST POINT OF CONTACT IS FOR EVERY INDIVIDUAL AGENCY BUT WE CAN GET YOU THAT INCLUDING CMS

Transcript Highlights:

• from CMS, which results in a premium of $199.94.
• and the pharmacy reimbursement from CMS and the pharmacy reimbursement<01:04:03.200> from<01:
• 04:03.520> C<01:04:04.240> um<01:04:05.359> from<01:04:05.680> CMS<01:04:
• 06.799> which reimbursement from C um from CMS which reimbursement from C um from CMS which um
• there's less cms there's less cms reinsurance<01:05:52.559> to<01:05:52.799> offset

Keywords: Meeting Start: 00:00:35 Attendance Roll Call: 00:00:55 Approval of Minutes: 00:02:56 Deferred Compensation Authority Update: 00:03:12 Retiree Health Update - TRS: 00:15:58 Retiree Health Update - KPPA: 00:56:13 Adjournment: 01:20:33, 958, all

Summary: The Public Pension Oversight Board received updates from the Kentucky Public Employees Deferred Compensation Authority and the Teachers Retirement System. Chris Biddle reported that deferred compensation assets had grown to about $4.787 billion with roughly 88,000 participants, crediting auto-enrollment, targeted marketing around pay raises, and retiree-focused services. He said the board’s self-directed brokerage account, authorized by last year’s legislation, is being designed around a $40,000 account-balance threshold with up to 25% transferable into the brokerage window, tentatively for July 1 of the coming year. He also described the free financial planning program, which has been used by about 3,300 to 3,500 participants with an 87% return rate, and noted that the plan is currently in a fee holiday; members asked about the fee structure and whether the CFP service is provided through Nationwide, which Biddle confirmed. Board members praised the deferred compensation program’s growth and asked for the legislation referenced by Biddle. He said the plan’s annual fees are capped, with a $1 monthly fee plus other charges up to a $225 cap, for a maximum of $237 per year absent a managed account. He also said the program is seeking unified payroll access to expand participation, especially among teachers, and that prior lineup changes saved about $6 million annually in participant fees. Bo Barnes of TRS then addressed retired teachers’ health insurance, first clarifying a prior question about declining federal contributions to the retirement annuity trust. He explained that federally funded school positions generated contributions that rose from $72 million in 2019 to $109 million in 2022, then fell to $85 million this year, with a projection of $80 million over the next three years; if those dollars do not come from federal sources, they would have to be replaced through the SEEK formula. Barnes then reviewed TRS health coverage, explaining that the statutory contract guarantees access to group coverage but not fixed premium levels, and that TRS administers two retiree plans: KEHP for retirees under 65 or otherwise not Medicare-eligible, and MEHP for retirees 65 and older or Medicare-eligible. Barnes said TRS completed RFPs for the 2026 plan year, retaining Express Scripts for prescription drugs and switching the Medicare Advantage medical provider from UnitedHealthcare to Humana, while keeping plan design, provider access, out-of-pocket costs, and benefits materially unchanged. He noted a modest hearing-aid improvement of $500 per ear beginning in 2026. He also reported that the TRS Board approved the maximum state contribution for KEHP at $1,044.96, up from $930.76, an 18% increase that he said would require about $15 million to $16 million more annually, while the MEHP premium would drop from $210 to $200 per month because of the new contract. Using the 2024 valuation, he said the KEHP increase would slightly reduce the health trust funded ratio from 80.4% to 80.1% and raise unfunded liability from $4.036 billion to $4.051 billion. Barnes closed by reviewing the 2010 shared-responsibility reforms that shifted retiree health costs away from a pay-as-you-go model, including phased employee and district contributions and Commonwealth stabilization funding. No votes were taken beyond approval of the minutes.

Transcript Highlights:

• can't—there's no promises here—but we run a chance that once we pass this mandate we can go back to CMS
• The GATS data has been collected by CMS from all of the providers over several years as part of this
• <00:53:59.839> um data data has been collected by CMS um data data has been collected by CMS
• No, it was a CMS initiative.
• is it independent no it was a CMS is it independent no it was a CMS initiative<01:03:21.799>

Keywords: 928, house, all

Summary: The subcommittee discussed three ambulance reimbursement bills and tried to distinguish their approaches. House Bill 185 would require insurers to pay the full amount billed by an ambulance provider when there is no contract rate, with no balance billing to the patient; the Insurance Department clarified that emergency ambulance services are already covered under the benchmark plan, so the bill’s reference to policies without ambulance coverage is effectively meaningless. House Bill 725 would set reimbursement at 325% of the Medicare rate for non-contract ambulance services and prohibit balance billing. House Bill 316 was described as addressing the broader problem that Medicare/Medicaid rates are low and that current balance billing shifts costs to patients or municipalities; its sponsor said the bill would require insurers to pay a rate that gives providers a fighting chance to remain in business, and he viewed 325% of Medicare as the most logical option. Members debated whether insurers should pay the billed amount, a negotiated in-network rate, or a regulated percentage of Medicare. Some argued that out-of-network ambulance providers are underpaid and that in-network rates are often too low to sustain service, especially for emergency providers who cannot steer patients. Others said ambulance companies should not be able to bill whatever they want and questioned the fairness of charging insured patients or insurers more than the service is worth. There was also discussion of whether rate schedules should be reviewed by an oversight body and whether different costs in rural areas justify different reimbursement levels. A recurring issue was balance billing and who ultimately bears the shortfall. Several members said balance billing harms patients and often does not get paid, leaving cities and towns or property taxpayers to cover the difference for municipal ambulance services. Others argued that shifting the cost to insurance premiums would spread the burden more fairly, though it could raise premiums by a few dollars per person per month. No vote or final action was taken in the excerpt; the discussion focused on clarifying the bills and weighing their policy tradeoffs.

Transcript Highlights:

• This is what CMS, Dr.
• CMS is already scrambling, trying to figure out what to do with the 85 million elders who are about 65
• What we have with DHS, with their investigators, they also sometimes work for CMS.
• So we're also aligning our timelines with CMS timelines, so there's less ambiguity between which one
• Osborne, and I already did about that we're not private equity, Joe talked about CMS guidance, is the

Bills: HB2176, HB2333, HB2435, HB2447, HB2617, HB2683, HB2686, HB2725, HB2726, HB2906, HB2953, HB2958

Keywords: health care, licensure, complaints, investigation, safety, patient care, regulatory compliance, prosthetics, orthotics, health insurance, Medicare, medical necessity, disability rights, coverage, reimbursement, internationally trained physicians, medical board, clinical training, provisional license, healthcare workforce

Summary: The committee heard and acted on several health care bills. HB 2726 would require Access contractors to cover diagnosis and treatment of mild obstructive sleep apnea, including a new prescription tongue-stimulation device; supporters said it offers an effective, less burdensome alternative to CPAP and could improve adherence and outcomes, while Access was neutral and raised concerns about cost and bypassing its normal clinical review. The committee adopted the Bliss amendment and then approved HB 2726 as amended on an 8-4 due-pass vote. HB 2435 would create a pathway for internationally trained physicians to receive a provisional Arizona medical license, with a later amendment adding a four-year supervised rural practice requirement and automatic conversion to a full license if criteria are met. Supporters argued it would help address severe physician shortages in rural and underserved areas, especially for cardiology and other specialties, and several doctors testified about their experience and the need for more access. Opponents, including the Arizona Medical Board, said the state already has a case-by-case licensure process for foreign-trained physicians and warned the bill could weaken safeguards and allow insufficiently vetted applicants. After adopting the amendment, the committee approved HB 2435 as amended on a due-pass recommendation. HB 2958 would require Access to cover comprehensive dental care for pregnant women age 21 and older, with a $500,000 pilot program and reporting requirements. The sponsor and public health advocates said preventive dental care during pregnancy can reduce infections and improve maternal and infant outcomes, and the bill drew broad support from health and advocacy groups. The committee passed HB 2958 on an 11-1 due-pass vote. The committee also approved HB 2176, which changes criteria and timelines for health care institution licensing complaints and informal dispute resolution, with supporters saying it would improve transparency and predictability for hospitals while preserving enforcement authority. Finally, the committee heard HB 2447, which would bar insurers from paying certified registered nurse anesthetists less than physicians for the same anesthesia service; opponents argued it would interfere with contract negotiations and raise costs, while supporters said insurer reimbursement cuts are harming rural access and shifting costs to hospitals. The transcript ends during testimony on HB 2447, before any committee vote on that bill.

Transcript Highlights:

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

Summary: The committee met to hear Amy Baker’s presentation on Florida’s constitutionally required long-range financial outlook for fiscal years 2026-27 through 2028-29. Baker said the forecast reflects slower but still positive economic growth, continued above-average personal income growth, rising wages, and population growth that is increasingly driven by in-migration as Florida’s senior population expands. She highlighted weakening housing-related revenue, especially documentary stamp taxes, softer consumer sentiment, and the expectation that Florida will pass 25 million residents by 2030, with nearly a quarter of the population age 65 or older. Baker said the outlook largely retained the March 2025 general revenue forecast, but the Legislature’s 2025 session actions significantly improved near-term funds available by redirecting or freeing up money, including contingency appropriations and reversions. She noted total state reserves are just under $15 billion, or about 30% of general revenue, and that the budget stabilization fund is at its constitutional maximum. The main spending pressures in the outlook were critical needs, led by a new emergency preparedness and response fund transfer and Medicaid growth driven mainly by medical inflation and behavioral analysis costs in managed care, not by caseload growth. Other high-priority needs were also identified, and Baker said the first year shows a projected surplus, but years two and three show shortfalls, meaning fiscal strategies will still be needed. Members questioned Baker about the accuracy of the forecast, Medicaid managed care costs, the emergency preparedness fund, federal funding assumptions, and whether recent federal legislation was reflected in the numbers. Baker said the outlook is a good representation of the total picture, though the Legislature will likely adjust it as conditions change, and that more information on federal changes would come in later estimating conferences. Senator Trumbull asked about the governor’s veto of $750 million, and Baker said it simply returned to unallocated general revenue rather than being spent or added to the budget stabilization fund. The chair closed by warning members to expect a difficult budgeting process and noting that the committee would adjourn without further action.

Transcript Highlights:

• The second thing is CMS changed how they...
• The second thing is CMS changed how they fund these types of plans, and so because of these changes,
• The hope was, I mean, all the CMS changes in the inflation.
• The CMS changes in the Inflation Reduction Act had kind of hit, and we were still trying to wrap our

Bills: HB205, HB226, HB234

Keywords: sales tax, use tax, exemption, tax conformity, tangible personal property, Alabama Department of Revenue, retail tax, consumer use tax, nonresident, religious publications, church magazines, Bible class materials, Sunday school materials, tax administration, indirect tax, state revenue, HB226, homestead exemption, ad valorem tax, property tax

Transcript Highlights:

• by CMS across the country since the rule took effect.
• <01:22:13.600> available hospitals data from CMS available hospitals data from CMS available
• the opposite anyone can go on the CMS the opposite anyone can go on the CMS website<01:22:19.520
• Rules require hospitals and insurers to post the CMS 50.
• It used to be the CMS 300, and now it's actually the CMS 500 medical services that meet the eligibility

Keywords: 1189, house, all

Transcript Highlights:

• And lastly, Kentucky veteran centers have demonstrated high CMS quality of care ratings both in medical
• Federal revenue comes from the VA and from CMS, but it varies and does not always cover the total cost
• by the state below the total cost of care in order to keep care affordable for veterans, sometimes CMS
• Our study found that reducing the average $24 million that the state ... sometimes CMS reimbursement
• can cover sometimes CMS reimbursement can cover the<00:24:47.640> total<00:24:47.880> cost<

Keywords: 958, all

Transcript Highlights:

• 30.800> access<00:12:31.200> to,<00:12:32.080> um Have you talked about, like, CMS
• Regarding the CMS thing, this is a separate thing, you know, they—this is a state tax.
• Regarding the<00:15:17.560> CMS<00:15:18.200> thing,<00:15:18.520> this<00:15:18.720
• > is<00:15:18.880> a<00:15:18.960> separate<00:15:19.560> thing, the CMS
• thing, this is a separate thing, the CMS thing, this is a separate thing, you<00:15:20.200> know,<

Keywords: 1183, house

Summary: Senator Steve Drazkowski and Representative Anderson held a press event promoting the bipartisan, bicameral “Take It Back Act,” a bill aimed at recovering taxpayer money lost to government fraud. They cited major Minnesota fraud cases, including medical assistance fraud, CCAP, and Feeding Our Future, and argued that the state has become a destination for fraud. They said the bill would impose a 100% tax or excise tax on money obtained through fraud, with proceeds deposited into a tax relief fund for income and property tax relief. The sponsors said the measure is intended to create a stronger deterrent and to recover money even when criminal restitution or prosecutions do not fully recoup losses. They discussed examples of unrecovered funds, said the Department of Revenue could use criminal findings, data analytics, and IRS-sharing data to identify fraud, and noted that the bill includes an appeal process through tax court. They also said the current draft focuses on convicted fraudsters and people or organizations determined by the commissioner to have obtained money by fraud, while trying to avoid sweeping in innocent employees or others who were unaware of wrongdoing. Anderson said the bill already has significant bipartisan support, including 11 House Democrats and Senator Rest, and that the House Tax Committee hearing is scheduled for April 30. He said the sponsors are working with the Department of Revenue on implementation and may revise the bill to make administration easier. The sponsors said they hope to move the bill through the House and Senate this session, and they closed by encouraging the press to review the fraud website they referenced, mnfraudfiles.com.

Transcript Highlights:

• It's client data management system CMS and better support its internal staff.
• The CMS modernization assessment focused on 4 key areas that will that will summarize for you this morning
• Cms Bender at this time in complete requirements or consideration as they may change with that selection
• This analysis was built using because from comparable health and human services and CMS implementations
• We also focused on a lot of criteria in in terms of the different models that make up the CMS platforms

Transcript Highlights:

• Last week, CMS had not taken any action, approval or disapproval, on those new opportunities.
• And we're currently in conversations with CMS about what the federal flexibility is to do a waiver or
• And we're currently in conversations with CMS about what their appetite is for such a waiver.
• expand those services, we would need some type of waiver, and we're currently in conversations with CMS
• expand those services, we would need some type of waiver, and we're currently in conversations with CMS

Keywords: 914, all

Transcript Highlights:

• What we would report up to CMS would be just the managed medical assistance, the MMA column there.
• special terms and conditions that we have with the federal Centers for Medicare and Medicaid Services, CMS
• provide, in addition to the rank and file fee for service Medicaid provisions that are required by CMS
• I guess the question would be, are there state-specific penalties versus CMS-specific penalties?
• Have we realized a funding increase from CMS because of the star values from these plans?

Summary: The Health Care Budget Subcommittee took up two bills and then continued oversight discussions with APD and AHCA. CS/HB 27, the Social Work Licensure Interstate Compact, was presented as a way to let Florida social workers practice in other compact states and vice versa; AARP, the Florida Chamber, and NASW Florida supported it, and the bill passed favorably. HB 1127, a child welfare bill, would create a treatment foster care pilot for children with high behavioral needs, improve DCF data collection on commercially sexually exploited children, and expand recruitment for protective investigators and case managers; the bill also passed favorably after brief supportive testimony. The committee then questioned APD at length about the iBudget waiver waitlist, enrollment pace, spending projections, and provider capacity. APD said it had sent more than 1,100 interest letters in categories 3, 4, and 5, enrolled 1,124 people so far this year, and expects to spend about 96.4% of its waiver appropriation, leaving roughly $82 million unspent. Members pressed APD on why prior discussions suggested more reserve was needed, how long the SANS process takes, whether category 6 could be expanded, and whether the agency has enough waiver support coordinators and direct support providers. APD said it has about 1,061 waiver support coordinators statewide, adequate capacity for current enrollees, but would need further analysis if the legislature directed a much larger enrollment increase. Members also asked about outreach, annual maintenance of the waitlist, portability for military families, and whether communication efforts should be privatized. Finally, AHCA walked the committee through the 2023 Achieved Savings Rebate (ASR) report for Aetna and explained how the report is used for financial monitoring, rebate calculations, and transparency. AHCA said the ASR is separate from the medical loss ratio (MLR) calculation, though both are reviewed, and that Florida uses the ASR mechanism rather than an MLR remittance requirement to recover funds from plans. Members asked about related-party disclosures, CVS/Caremark relationships, expanded benefits, encounter data, network adequacy penalties, denials and appeals reporting, interest earned on capitation payments, and whether rate increases were reaching providers. AHCA and the outside auditors said they review the plans’ reported data, reconcile it to underlying records, and can assess liquidated damages for network adequacy violations; several members requested follow-up data on rebates, interest, provider capacity, and related-party reporting.

Transcript Highlights:

• that said not you mentioned from CMS that said not that<00:20:56.920> we<00:20:57.080> had
• And then, because CMS said, "You don't have a system. You better set one up."
• <00:25:39.240> You CMS said, "You don't have a system.
• You CMS said, "You don't have a system.
• They have to be approved by CMS to prevent the contingent cost share.

Keywords: 1187, senate, all

Transcript Highlights:

• DHS claims that restrictions are CMS rules.
• Are they simply asking CMS for permission to restrict services? We need oversight.
• We are asking that you require DHS to communicate with CMS, to show those communications, and justify
• <01:31:57.800> are are CMS rules if CMS policies are are CMS rules if CMS policies are legally
• for permission to uh restrict CMS for permission to uh restrict Services<01:32:20.920> um<01:

Keywords: 1183, house