Transcript Highlights:

• point the testifier made, nursing home administrators are mandated by the federal government under CMS
• point the testifier made, nursing home administrators are mandated by the federal government under CMS
• point the testifier made, nursing home administrators are mandated by the federal government under CMS
• point the testifier made, nursing home administrators are mandated by the federal government under CMS
• of Minnesota rules and the federal CMS of Minnesota rules and the federal CMS rules<00:21:10.720

Bills: HF339, HF1272, HF2121, HF2122, HF1216, HF1003, HF2319

Keywords: HF339, Nursing Home Workforce Standards Board, nursing homes, long-term care, elder care, workforce standards, certified worker organizations, labor funding, general fund appropriation, worker grants, Minnesota labor law, nursing home staffing, caregiver workforce, section 181.214, HF1272, nursing home, boarding care home, nursing home workers, labor standards, Medicaid-certified facility

Transcript Highlights:

• amend that waiver, we would have to submit that information to LRC before we submitted that waiver to CMS
• It is currently in the public comment period and anticipated to meet the deadline for submission to CMS
• Um, and then we will engage with CMS as soon as it has been submitted to them. Okay. All right.
• Um and then we will engage with CMS<00:18:09.120> as<00:18:09.240> soon<00:18:09.440>
• as soon as it is as it been CMS as soon as it is as it been submitted<00:18:10.960> to<00:18:

Keywords: 958, all

Summary: The Budget Review Subcommittee for Health and Family Services met for its first meeting, established quorum, and heard a presentation from Department for Medicaid Services Commissioner Lisa Lee and CFO Steve Becktold. The department reviewed its compliance with House Bill 695, which requires legislative approval before certain Medicaid eligibility, service, benefit, or waiver changes, along with fiscal impact reporting to the Legislative Research Commission. They described current waivers, including home and community-based waivers, managed care and transportation waivers, and the 1115 re-entry waiver, and said the community engagement waiver is in public comment and on track for submission to CMS. They also said required reports and other HB 695 tasks, including a pharmacy rebate fund, budget analyses, expenditure reports, and a behavioral health scorecard, are underway or completed as required. The CFO outlined Medicaid’s budget, saying the department has two appropriation units and projecting near-full use of state funds while leaving some federal funds unspent because of matching-rate differences. They reported roughly 211 filled positions and 11 vacancies. Members asked about the vacancy makeup, the behavioral health scorecard, and whether a provider involved in quality metrics could have a conflict if used in the scorecard process; the department said it would follow up. Members also asked about the community engagement waiver and its interaction with federal policy, and the department said CMS guidance is still pending and that it will proceed under HB 695. A substantial portion of the discussion focused on federal Medicaid policy changes under a reconciliation bill, including possible limits on provider taxes, directed payments, cost-sharing, and community engagement requirements. Department officials said the final federal impact is still uncertain because the Senate bill is not finalized, but they have modeled several scenarios and warned that any reduction in federal support or benefits would be harmful, especially for hospitals and rural hospitals. They estimated Medicaid benefits are funded about 80% federal and 20% state overall, with expansion populations closer to 90% federal funding, and said administrative costs would also rise if federal requirements change. Members also asked about work requirements and eligibility. The department said the community engagement waiver would mainly affect the expansion population, which they estimated at about 450,000 people out of roughly 1.5 million total Medicaid enrollees, and that many groups are exempt, including children, the aged, blind, disabled, and people in substance use disorder treatment. Officials said they can provide data on how many enrollees are working or work-ready and explained that their eligibility system is designed to prevent duplication by automatically placing people in the correct category and correcting errors quickly. They also noted a federal proposal to require expansion eligibility reviews every six months, compared with current annual renewals.

Transcript Highlights:

• And in the case of nursing homes, uh, you um have to strive to improve the CMS rating if it is at one
• And in the case of nursing homes, uh, you um have to strive to improve the CMS rating if it is at one
• And in the case of nursing homes, uh, you um have to strive to improve the CMS rating if it is at one
• And in the case of nursing homes, uh, you um have to strive to improve the CMS rating if it is at one
• a diminishment of a CMS rating if it's at least three stars.

Keywords: 1187, senate, all

Transcript Highlights:

• CMS came back and told us that that was not allowed, to define an increased benefit limit tied to a diagnosis
• We're carrying the rate increase forward now, and we're working with CMS and the dentists on how to move
• believe, of about $38 million for this rule: $29 million for this year, $39 million for next year, and CMS
• diagnosis out once you're Medicaid eligible to receive a better benefit or whatever, I think is what CMS

Summary: The committee reviewed a series of Arkansas DHS and Department of Health rules, most tied to 2025 legislation. Early items covered Medicaid changes including presumptive eligibility application timing, adding a fictive kin definition for foster child eligibility, raising the able account disability onset age to 46, allowing continuous glucose monitors to be billed by both pharmacy and DME providers, increasing the RSV vaccine administration fee for children, a telemedicine exemption for ET3 ambulance services, and a physical therapy access rule that also included occupational therapy. Members generally asked limited questions and most rules were reviewed without objection. A major portion of the meeting focused on the dental rate increase rule under Act 1025. DHS said it implemented rate increases for certain pediatric, special-needs, and oral surgeon services, but not orthodontics, and it interpreted the act as applying only to oral and maxillofacial surgeons, not general dentists. The Arkansas State Dental Association and legislative sponsors testified that the intent was to cover general dentists performing oral surgery procedures for special-needs patients, estimating the broader interpretation would add about $1.5 million annually. Committee members debated the plain language of the act versus legislative intent, and the rule was reviewed, but with testimony noting the issue should be fixed in future legislation. Later items included the Healthy Moms, Healthy Babies rule adding doula and lactation consultant billing and remote monitoring benefits; an adverse decisions rule extending provider appeal time from 35 to 65 days; CNA training program updates; PASSE network-status disclosure rules; certification rules for community-based doulas and community health workers; cosmetology, massage therapy, lead-based paint, radiation, radiologic technology, and RV park rule updates. Most of these were described as technical, statutory, or federally driven changes and were reviewed without objection. The committee briefly reopened the CGM rule after a motion to expunge the prior vote, and Representative Wardlaw said he would hold the rule for further review because he believed the billing changes did not match the law’s intent. The meeting ended with no further business and adjournment.

Transcript Highlights:

• Then CMS gave us, well, actually, we got $200 million initially, and then CMS came back and gave us the

Bills: HB4030, HB4031, HB4032, HB4033, HB4034, HB4035, HB4036, HB4037, HB4038, HB4039, HB4040, HB4041, HB4042, HB4043, HB4044, HB4045, HB4046, HB4047, HB4048, HB4049, HB4050, HB4051, HB4052, HB4053, HB4054, HB4056, HB4057, HB4065, HB4067, HB4071, HB4072, SB1144, SB1145, SB1146, SB1147, SB1148, SB1149, SB1156, SB1157, SB1158, SB1159, SB1161, SB1162, SB1163, SB1164, SB1165, SB1166, SB1167, SB1174, SB1175, SB1176

Keywords: education funding, budget appropriations, public schools, teachers' retirement, early childhood education, aeronautics, infrastructure, funding, sustainability, Oklahoma, mining, operator fees, coal production, noncoal mining, department of mines, revenue, state budget, budgetary reform, financial legislation, fiscal accountability

Bills: HB4030, HB4031, HB4032, HB4033, HB4034, HB4035, HB4036, HB4037, HB4038, HB4039, HB4040, HB4041, HB4042, HB4043, HB4044, HB4045, HB4046, HB4047, HB4048, HB4049, HB4050, HB4051, HB4052, HB4053, HB4054, HB4056, HB4057, HB4065, HB4067, HB4071, HB4072, SB1144, SB1145, SB1146, SB1147, SB1148, SB1149, SB1156, SB1157, SB1158, SB1159, SB1161, SB1162, SB1163, SB1164, SB1165, SB1166, SB1167, SB1174, SB1175, SB1176, HB4030, HB4031, HB4032, HB4033, HB4034, HB4035, HB4036, HB4037, HB4038, HB4039, HB4040, HB4041, HB4042, HB4043, HB4044, HB4045, HB4046, HB4047, HB4048, HB4049, HB4050, HB4051, HB4052, HB4053, HB4054, HB4056, HB4057, HB4065, HB4067, HB4071, HB4072, SB1144, SB1145, SB1146, SB1147, SB1148, SB1149, SB1156, SB1157, SB1158, SB1159, SB1161, SB1162, SB1163, SB1164, SB1165, SB1166, SB1167, SB1174, SB1175, SB1176

Keywords: education funding, budget appropriations, public schools, teachers' retirement, early childhood education, aeronautics, infrastructure, funding, sustainability, Oklahoma, mining, operator fees, coal production, noncoal mining, department of mines, revenue, state budget, budgetary reform, financial legislation, fiscal accountability

Transcript Highlights:

• HMSA provided comments on the measure, highlighting that there are new CMS requirements beginning in
• Under the new CMS requirements, prior authorization timelines will be shortened further, reducing the
• frustrations under the new CMS frustrations under the new CMS requirements<01:20:39.840> prior
• I strongly support the CMS guidelines, which will become available to everybody in 2027.
• It's different than what CMS is attempting to do, but I certainly support their new rule.

Keywords: 910, house, all

Summary: The joint hearing covered HB 553 on biomarker testing coverage, HB 556 on colorectal cancer screening access, and later HB 712 on 340B drug pricing. For HB 553, the American Cancer Society Cancer Action Network, patient advocates Natalie Heyman and Susan Hirano, a surgical oncologist, and the American Lung Association strongly supported the bill, arguing that biomarker testing should be covered when ordered by a doctor and guided by current evidence. DHS and several insurers offered comments and requested amendments, with DHS saying it appreciated the intent but wanted changes. The committees then voted to pass HB 553 with amendments, including a House draft and a defective date of July 1, 3000; both the House Health and Human Services and Homelessness committees adopted the recommendation unanimously. For HB 556, testimony focused on closing gaps in colorectal cancer screening, especially for uninsured and underinsured patients who can get stool-based screening but then cannot access follow-up colonoscopies. Community Clinic of Maui, ACS CAN, and the American Cancer Society supported the bill, with ACS CAN urging a program similar to the breast and cervical cancer control program and offering amendments. DHS requested that the program and appropriation not conflict with executive budget priorities, and the committees noted technical amendments, a defective date, a blank appropriation amount, and corrections changing Medicare references to Medicaid. HB 556 was also passed with amendments by both committees. The hearing then moved to HB 712 on 340B drug pricing and contract pharmacies. The Department of Health and the Attorney General’s office expressed concern that the bill would require the state to regulate private commercial activity and said the department lacked the expertise and resources to implement it as written, suggesting it might belong in a different statutory section. In contrast, PhRMA opposed the bill, while Hawaii Pacific Health and Hawaii Island Community Health Center supported it, saying 340B savings are important for hospital services and patient access to low-cost medications, especially where manufacturers have restricted shipments to contract pharmacies. No vote on HB 712 was taken in the portion provided.

Transcript Highlights:

• We're accountable to CMS at the federal level.
• Is it based on trending upward, national average, regional average, or CMS requirements?
• We asked: Do we need them for CMS? Do we need them for LFC?
• CMS is supposed to implement the rules by December 31st of 2026 before the work requirements come in.
• From the application, what the end game is, what the vision is from CMS on that.

Transcript Highlights:

• licensed by the Office of Long-Term Care on behalf of the Centers for Medicare and Medicaid Services, or CMS
• , and subject to On behalf of the Centers for Medicare and Medicaid Services, or CMS, and subject to
• So, CMS, but in real time, in practice at the facility, it's the professional staff.
• Care and C.M... ...relate back to policies specifically around what the Office of Long-Term Care and CMS
• So the survey, the CMS, OLTC surveyors...

Summary: The Joint State Agencies committee met to approve prior minutes and then focused on the death of Zachary Moore at the Southeast Arkansas Human Development Center, later clarified in discussion as the Warren facility. DHS officials described Moore’s background, said he died after a prolonged prone restraint followed by a delayed chemical restraint, and reported that 13 staff were terminated, the superintendent was replaced, a consultant was brought in, and the agency entered a settlement with the family for $725,000. Members pressed DHS on the cause of death, restraint policies, staff training, supervision, family notification, and why the family had not been kept informed; DHS said a family-notification procedure exists but that communications during litigation had been handled through counsel. The committee also heard that six staff had been criminally charged with manslaughter and neglect of a vulnerable person, and that the death certificate listed the manner of death as homicide with cause of death tied to physiologic stress associated with struggle and prone restraint. DHS officials gave broader context on the five human development centers, their licensing and accreditation, resident population, mortality review process, and training programs. They said the centers serve highly medically and behaviorally complex residents, that annual restraint training and CPI-based instruction are required, and that the mortality review committee and Office of Long-Term Care review deaths and make recommendations. Members repeatedly criticized the agency for not having complete information at the meeting and for what they saw as gaps in oversight, staffing, and chain-of-command clarity during emergencies. DHS responded that the Warren facility had not been meeting the same standards as the others, that the consultant’s root-cause analysis identified multiple failures, and that new crisis-team and chain-of-command procedures were being drafted. A second major topic was staffing and recruitment. Members discussed low pay, turnover, use of float and on-call staff, rural staffing shortages, and a waiting list of about 2,000 people for home- and community-based services. DHS said CNAs at the centers start at about $39,000 a year, that a broader retention and recruitment plan is being drafted for all five centers, and that a separate rate study for PASS services will be implemented in January 2027 but does not cover CNA pay. The meeting ended with testimony from Moore’s mother, Angela Stevens, who said money could not replace her son and urged stronger training, background checks, and supervision so other residents would be protected. The committee asked DHS to keep members and Stevens updated on consultant reports, recruitment efforts, and follow-up on the family communication issue, and then adjourned.

Transcript Highlights:

• We do send it to CMS also. CMS signs off on it as we are making those payments throughout the year.
• Is that CMS-driven? So where does the rate that we get for our per diem rate come from?
• Just while we have the Secretary at the table, our state CMS plan, maybe a year ago, a little bit longer
• Just while we have the secretary at the table, our state CMS plan, maybe a year ago, a little bit longer

Keywords: 1204, all

Transcript Highlights:

• We have aligned federal CMS timeframes with state Investigator arrives to a facility.
• We have aligned federal CMS timeframes with state timelines to provide clarity and transparency to both
• We have aligned federal CMS timeframes with state, investigator arrives to a facility.
• We have aligned federal CMS timeframes with state timelines to provide clarity and transparency to both
• The 12-month time frame aligns Arizona's process with CMS standards that hospitals already comply with

Bills: HB2050, HB2082, HB2176, HB2195, HB2202, HB2307, HB2584

Keywords: radiologic technologist, radiologist assistant, radiology, imaging, x-ray, diagnostic x-ray, fluoroscopy, mammography, computed tomography, CT technologist, nuclear medicine technologist, bone densitometry, radiation safety, radiation licensing, scope of practice, health workforce, rural health care, critical access hospital, supervision, telehealth

Summary: The committee approved the minutes and then heard House Bill 2050, which updates Department of Health Services rules for radiologic technologists and radiologic assistants. The bill changes school accreditation and training requirements, reduces clinical hours, revises supervision and scope-of-practice rules, adjusts fees, and removes radiologic technologists from the telehealth health care provider definition. Testimony from a radiologic technologist supported the bill as an update to outdated standards and a response to workforce shortages, while a nurse practitioner supported the section allowing NPs to use diagnostic x-ray machines under nursing board standards. HB 2050 passed 7-0 with a do-pass recommendation. The committee then considered House Bill 2082, which creates a Childhood Cancer and Rare Childhood Disease Research Commission and expands the research fund to include appropriations, gifts, donations, and federal grants. An amendment shifted grant-awarding authority to the DHS director, required the commission to set criteria and review applications, and added public meeting requirements; it also tied funding to at least $5 million in available resources and removed the return-on-investment reporting requirement. Supporters said the bill would strengthen pediatric cancer research and leverage an underused funding source, though members raised concerns about oversight. The bill was amended and then passed 7-0. House Bill 2176 and House Bill 2195 both dealt with DHS licensing and complaint-investigation procedures for health care institutions and nursing care institutions. HB 2176 allows DHS to deny licenses or ownership changes based on serious prior licensing problems or safety risks, and it sets notice, investigation, and deficiency-statement rules; speakers from public health and hospital groups supported it as improving transparency and preventing bad actors from cycling through ownership. HB 2195 limits DHS access to certain personnel records, requires deficiency statements within 10 business days, and bars investigations of incidents older than 12 months; an amendment delayed implementation to July 1, 2027 and added corrective-plan and off-site review provisions. Both bills passed 7-0 as amended. The committee also approved House Bill 2202, which appropriates $300,000 annually for a dementia care tele-mentoring program to train providers statewide, especially in rural and underserved areas. The Alzheimer’s Association and a patient with younger-onset Alzheimer’s testified that the program would improve early diagnosis and care, though one senator opposed state funding on the view that medical schools should teach the material. HB 2202 passed 6-1. Finally, House Bill 2307, addressing placement for dangerous, incompetent, non-restorable defendants when secure state hospital beds are unavailable, drew the most debate. An amendment replaced out-of-state placement with a temporary, limited-use solution involving up to three beds at the Arizona State Hospital forensic campus, created a study committee, and shifted some non-psychiatric costs to counties; counties and hospital stakeholders opposed the county-cost language, while sponsors and DHS said the measure was an emergency stopgap. The amended bill passed 4-3. The committee then passed House Bill 2584 4-3, which prohibits public funds from being used for genetic sequencing equipment from foreign adversary countries or entities; supporters framed it as a national security measure, and opponents voted no. The committee then adjourned.

Transcript Highlights:

• that they] would much prefer to work with the department than have to try to hash this thing out with CMS
• that they] would much prefer to work with the department than have to try to hash this thing out with CMS
• that they] would much prefer to work with the department than have to try to hash this thing out with CMS
• that they] would much prefer to work with the department than have to try to hash this thing out with CMS
• In fact, when my team has had conversations with CMS, they've been taking notes on a lot of the work

Keywords: 1191, senate, all

Transcript Highlights:

• The rates were changed to whatever CMS...
• The rates in the code as to what those taxes were were changed to whatever CMS will allow.
• And the overall hospital, that could probably be done administratively because CMS allows a lower rate
• Administratively because CMS allows a lower rate, that'll be phased down over time.

Keywords: 994, senate, all

Summary: The Senate Finance Committee met with a quorum present and first approved the minutes from the January 15 morning meeting. The main agenda item was the Department of Revenue’s budget and revenue presentation from Secretary Eric Nelson, Deputy Secretary Peter Shirley, and Deputy Secretary Mark Mucco. Nelson said the state remains double-A rated with a positive outlook, the budget includes a 5% personal income tax reduction, and the 2027 general revenue estimate is $5.493 billion, up $170 million from the prior year. Shirley gave an economic overview, saying West Virginia is forecast to see continued but slowing employment growth, continued wage growth, gains in private education/health services and business services, declines in some sectors, improving labor force participation relative to the nation, and strong recent net in-migration. He also noted continued growth in natural gas production and a modest rebound in coal production, though coal faces longer-term demand pressure. Mucco reviewed revenue trends and said 2025 collections were about $5.5 billion, below the prior year but above estimate, with personal income tax and sales tax driving the surplus. He explained that the forecast incorporates the 5% PIT cut and annual conformity to the federal One Big Beautiful Bill Act, including changes such as Section 179 expensing, bonus depreciation, R&D expensing, business interest deductions, and a new manufacturing facility expensing provision. He also discussed the effects of tax credits, severance tax volatility, declining tobacco revenues, and health care provider tax changes tied to federal Medicaid rules. He said road fund revenues are largely flat absent policy changes, and county commission revenues are growing faster than state revenues. Members asked about when new economic development projects like NewCore would appear in the projections, how much 20,000 new jobs would matter, whether the department had a calculator for job-growth impacts, the status of recent tax cuts, road fund growth, tobacco/vape taxation, and whether migration data could be broken down by county. The witnesses said major projects are not yet in the S&P-based forecast but would likely add jobs, wages, and tax revenue over time; they estimated 20,000 jobs would be a significant increase. They also said the state is unlikely to hit the current personal income tax trigger in the near term. No substantive votes were taken beyond approving the minutes, and the committee adjourned after a motion carried by voice vote.

Transcript Highlights:

• It is a state plan amendment that we put in with CMS to exempt us from the recovery audit contractor
• So we asked CMS to provide us with the waiver of that requirement.
• CMS approved it, and we are now here getting that approved by this body and happy to take any questions

Summary: The Administrative Rules Subcommittee reviewed a series of agency rules and related requests. The Department of Corrections and Post-Prison Transfer Board reported quarterly updates with no questions, and several Commerce rules were approved, including repeals tied to the minority business enterprise and women-owned business enterprise programs and the Consolidated Incentives Act because they were superseded by Act 116 or duplicative of statute. The Insurance Department’s new rule for online marketplace guarantee providers was also approved, with Airbnb used as an example of the type of platform covered. The Department of Education presented an update to the Arkansas Adult Diploma Program to align payment milestones with Act 502 of 2025, and DFA presented a rule implementing a new tax credit for Arkansas rice used in beer and sake production under Act 874 of 2025. Members asked about verification of grain bills and whether the credit was broadly available; DFA said the rule tracks the statute and requires producers to submit the grain bill with their return. DHS then presented a SNAP rule implementing federal changes from Public Law 119-21, including raising the able-bodied adult without dependents age limit to 64, changing treatment of dependents and exemptions, and adjusting energy assistance income treatment; the rule was approved despite one public comment. Later, DHS Medical Services amended the Medicaid Rehab Hospital Manual to allow rehab hospitals to operate psychiatric units and bill Medicaid for those services, and also secured approval for a recovery audit contractor exemption because Arkansas law bars contingency-fee contractors and the state already has other program integrity safeguards. The Board of Public Accountancy’s rules implementing Act 428 of 2025 were approved after discussion of a new CPA licensure pathway requiring a bachelor’s degree plus two years of experience, changes to substantial equivalency for out-of-state CPAs, and removal of a government/not-for-profit coursework requirement. The committee also approved the Department of Education’s request to be excluded from certain reporting requirements, retained all 18 DAPSAF rules under a review of Group 3, filed outstanding 2023-session rulemaking updates, and adjourned after filing monthly updates.

Transcript Highlights:

• It is a state plan amendment that we put in with CMS to exempt us from the recovery audit contractor
• So we asked CMS to provide us with the waiver of that requirement.
• CMS approved it, and we are now here getting that approved by this body and happy to take any questions

Summary: The Administrative Rules Subcommittee met to review a series of agency rules and related requests. The Department of Corrections and Post-Prison Transfer Board reported quarterly updates and had no questions, so both were filed. The Department of Commerce sought repeal of rules tied to the minority and women-owned business enterprise programs and the Consolidated Incentives Act, explaining the rules were repealed by implication or duplicative of statute; all were reviewed and approved. The Insurance Department presented a new rule implementing Act 426 of 2025 for online marketplace guarantee providers, using Airbnb-style host damage protection as an example, and it was approved. The Department of Education updated the Arkansas Adult Diploma Program rule to reflect statutory payment amounts for milestones and diplomas, and it was approved. DFA presented a rule creating a reporting method for the Arkansas rice beer and sake excise tax credit; members asked about verification of Arkansas rice use, and the rule was approved. DHS presented a SNAP rule implementing federal changes to work requirements and energy assistance counting, including raising the able-bodied adult without dependents age limit to 64 and removing some exemptions; it was approved after questions about terminology and waiver-related issues. The committee also approved DHS Medicaid rules allowing rehab hospitals to bill for psychiatric units and exempting Arkansas from the federal recovery audit contractor requirement, citing other program integrity measures already in place. The State Board of Public Accountancy, under Labor and Licensing, presented rules implementing Act 428 of 2025, including a new CPA licensure pathway with a bachelor’s degree plus two years’ experience, substantial equivalency for out-of-state CPAs, and removal of the government not-for-profit accounting requirement; despite some negative comments, both rules were approved. The committee then granted the Department of Education’s request to be excluded from certain reporting requirements, and approved its request to retain all 18 Division of Public School Academic Facilities and Transportation rules under Act 781 review. Remaining outstanding 2023-session rulemaking and monthly updates were noted in packets with no questions, and the meeting adjourned.

Transcript Highlights:

• So that's any given time for the five years if CMS gives us the authority for this waiver.
• So that's any given time for the five years if CMS gives us the authority for this waiver.
• given time for the five years if CMS given time for the five years if CMS gives<00:29:09.840>
• So, I don't know<00:36:23.200> if<00:36:23.440> CMS know if CMS know if CMS I<00:36:25.280
• <00:36:30.320> I<00:36:30.560> can't the CMS would agree to that.

Keywords: 958, all

Summary: The committee met with a quorum and first heard brief presentations on Kentucky’s 2025 Preventive Health and Health Services Block Grant and Title V Maternal and Child Health Block Grant. Department for Public Health staff explained that the preventive health block grant provides about $2.3 million annually and supports programs such as accreditation and performance improvement, local health department grants, community health workers, prescription assistance, asthma and COPD programs, workforce development, and a sexual assault programs set-aside. They said the Title V block grant provides about $11.7 million, with 35% directed to children and youth with special health care needs and 65% to maternal and child health populations, largely through local health departments and a five-year needs assessment process. After no questions, a motion was made and seconded to approve both block grants. The roll call vote passed 19-0, and the two block grants were approved. The committee then approved the minutes from the prior meeting. The next item was a discussion of the child waiver created in House Bill 6. Committee members raised concerns that the proposed 1915(c) waiver did not match the legislature’s intent, which they said was to move children from the Michelle P. waiver to free slots for adults. Cabinet officials from DCBS, behavioral health, and Medicaid described the proposed “Community Health for Improved Lives and Development” waiver as a targeted home- and community-based program for children under 21 with severe behavioral health or developmental needs, including those stepping down from inpatient or residential care or at risk of out-of-home placement. They said the waiver is designed for about 100 slots, uses a standardized needs-based assessment, and includes case management, community living supports, home modifications, respite, supervised residential care, and clinical therapeutic services. Officials said the public comment period ended July 15, responses are being compiled for August submission to CMS, and the waiver is part of the broader Families First initiative.

Transcript Highlights:

• This particular methodology set by CMS looks at several components that go into the delivery of health
• And so just on the screen here you'll see some of the component parts that CMS looks at in deriving the
• looks at several components set by CMS looks at several components that<00:05:09.960> go<00:05
• My comment is that the RVU system was identified by people from DHS as actually coming from CMS.
• CMS it is<01:09:10.679> not<01:09:10.920> a<01:09:11.080> CMS<01:09:11.920>

Bills: HF1005

Keywords: health insurance, medical assistance, behavioral health, reimbursement rates, primary care services, physician fee schedule, managed care, residential services, 1183, house

Transcript Highlights:

• CMS pays that rate.
• rate is set CMS pays that rate<00:04:58.400> um rate um rate um so<00:05:00.560> CMS<00
• Let's say we approve right now and then you go through the CMS process.
• Let's say we approve right now and then you go through the CMS process.
• Let's say we approve right now and then you go through the CMS process.

Keywords: 1183, house

Transcript Highlights:

• So, since 2017, New Hampshire was under a corrective action plan from CMS.
• So, it's been a few years we've been in compliance with CMS.
• So again, we are now in compliance with CMS, and she just wanted to let you know that.
• <00:15:55.120> This we've been in compliance with CMS.
• This we've been in compliance with CMS.

Keywords: 1189, house, all

Summary: The Legislative Performance Audit and Oversight Committee approved the November 7 minutes with three abstentions and then received status updates on several ongoing audits. Audit staff reported that the special education oversight audit was in report-writing, with 34 of 71 observations completed and a draft expected in the second quarter and a final report in the summer. The education freedom accounts audit had 22 of 41 observations completed, with a draft also expected in the second quarter and a final report in the summer. The Doorway program audit had 5 of 13 observations completed, with a draft expected by the end of February and a final report by April or May. The committee then discussed possible new oversight topics, prompted by concerns about fraud in other states and the need to ensure New Hampshire programs are not vulnerable. Members suggested hearing from DHS officials, contract administrators, and possibly the Department of Justice Medicaid fraud unit about SNAP and other programs, as well as reviewing staffing levels in HHS contract management. There was also discussion of whether to revisit the Bureau of Elderly and Adult Services, though members noted that prior work on that area had been suspended because of litigation. A representative from HHS, Teresa Narrow, briefed the committee on the Bureau of Developmental Services. She said the state had been in compliance with CMS since July 1, 2023 after resolving issues tied to a system redesign and billing changes, and that provider-side billing problems had also been fixed. She also described three existing bodies involved in developmental disability housing oversight, including the Council on Housing Stability, the ABLE Housing Task Force, and a legislative study committee created by HB 168 in 2024. Committee members asked for her notes to be shared. The committee spent substantial time debating whether to pursue a new special education audit at the school-district level. Members discussed the need to examine why some districts have much higher special education rates and costs than others, and whether a statistically selected sample of schools could be used. Audit staff said no new audits could begin until about May or June and that only a couple of auditors would then be available. Members also noted that a legislative study committee is already working on special education and may issue a report later this year, and the committee appeared to leave the school-level audit idea as a potential future item rather than taking immediate action.

Transcript Highlights:

• For reimbursement, we have to have a methodology, and CMS has to approve that methodology.
• have a um a a a um we have to have a um a a a methodology<00:10:22.040> and<00:10:22.160> CMS
• <00:10:22.760> to<00:10:22.880> approve<00:10:23.200> that methodology and CMS
• has to approve that methodology and CMS has to approve that methodology<00:10:24.399> and<00:
• It's required in the federal regs and then be submitted to CMS for approval.

Keywords: 958, all

Summary: The Budget Review Subcommittee on Health and Family Services met with a quorum still coming together and first handled roll call and minutes. The main presentation came from the Department for Medicaid Services, with Commissioner Lisa Lee and CFO Steve Beckle giving an overview of Kentucky Medicaid, its federal-state financing structure, and the department’s 1915(c) home- and community-based waiver programs. They explained FMAP funding levels for traditional Medicaid, administration, IT, expansion adults, and CHIP, and noted the size of the program, including more than 600,000 Kentucky children eligible for Medicaid or CHIP, about 485,000 expansion adults, over 69,000 enrolled providers, and $18.5 billion in 2024 expenditures. A major focus was the waiver system, including the acquired brain injury waivers, model waiver, independence waiver, Michelle P. waiver, and Supports for Community Living waiver. The department said these waivers are intended to keep people with physical or developmental disabilities in home and community settings rather than facilities, and that many services are not covered by Medicare or commercial insurance. Officials described participant-directed services, interagency administration, and eligibility rules, including that some waiver programs use the child’s income only rather than family income. They also reported an unduplicated waiver wait list of 13,930 people and said the General Assembly had added waiver slots in the last budget, including 650 ABI slots and 1,275 more to be allocated July 1, 2025. The department also discussed a waiver rate study conducted by Guidehouse, explaining that CMS requires a defensible rate methodology because there is no Medicare or commercial benchmark for many waiver services. They said the study used cost and wage surveys, provider and stakeholder input, and aimed to improve transparency, provider stability, and rate parity. Officials reviewed prior COVID-era Appendix K rate increases and budget-driven increases, and said the budget ultimately funded rates at about 70% of the benchmark study, while preserving higher existing rates where needed so no provider would be cut. They highlighted larger differences in behavioral support and case management rates, and said a public report is available. Members asked several questions about the potential impact of federal FMAP changes, especially possible reductions in the enhanced match for expansion adults and Medicaid IT/admin activities. DMS said any FMAP reduction would require more state general fund dollars, estimating about $75 million for each 1% drop in the expansion match, while impacts on administrative IT funding would depend on the systems being built or implemented in a given year. Members also pressed for clarification on waiver wait-list procedures, funded versus filled slots, and what happens when someone on the wait list is later found ineligible. DMS said people on the wait list may not yet have been assessed, can be reevaluated if conditions change, and are still eligible for regular Medicaid state-plan services if they qualify, even if they are waiting for waiver services.