Transcript Highlights:

• So, this is the first meeting, an organizational meeting today, regarding the future of payments and
• This is a special initiative commission to study the future of payments and sales transactions by credit
• , credit card fees, mobile payments, buy now, pay later financing, and other aspects of the payments
• check, or similar means; two, the impact of the increasing use of credit cards or other means of payment
• the Commonwealth and provide recommendations on the future use of credit cards and other forms of payment

Summary: The House and Senate chairs opened the first organizational meeting of the special commission created by Chapter 238 of the Acts of 2024 to study the future of payments and sales transactions by credit card and the impacts on small businesses. They explained that the commission’s charge includes reviewing payment trends, cashless transactions, credit card fees, mobile payments, buy now/pay later financing, the costs to small businesses of accepting different forms of payment, and the impact of Section 28A of Chapter 140D. No testimony was taken at this first meeting; it was intended to introduce commission members, outline the process, and begin planning future hearings and a final report with recommendations or options for the Legislature. Members discussed possible hearing topics, including business and consumer impacts of credit card fees, surcharges, and gratuities; the legal and regulatory landscape; and policy considerations such as transparency, reporting requirements, and possible limits on fees. Several members supported the commission’s scope and noted the issue’s timeliness, citing the growth of cashless transactions and the burden of swipe fees on retailers and restaurants. One member suggested the commission also consider cryptocurrency in transactions, and another raised the possibility of holding hearings outside the State House to improve access for small businesses around the state. The chairs said the first public hearing is tentatively set for April 8 in Gardner Auditorium, with additional hearings to be scheduled depending on interest and sign-ups. They said testimony may be offered in person, online, or in writing, and that written testimony will be part of the record. The commission also encouraged members and interested parties to suggest experts, topics, and report formats as the study develops. The meeting ended with a motion to close and an affirmative vote to adjourn.

Transcript Highlights:

• I know that payment was due I think here pretty quick.
• on our bonds are I know our payments on our bonds are I know that<00:14:25.120><c> payment</c><00:14
• .<00:14:42.959><c> Um</c> payment.
• Um payment.
• </c> had enough money to cover our payment. had enough money to cover our payment.

Summary: The committee met on Transportation, approved the prior meeting minutes, and received a road fund update from Transportation Cabinet officials Mike Hancock, Sean McCernan, and Ron Rigney. McCernan reported that FY 2024-2025 road fund revenue came in $38.5 million above the enacted estimate, but was about $11 million below FY24 because of a lower motor fuels tax rate. He said motor vehicle usage tax receipts were stronger than expected, and that the road fund ended the year with a $61.6 million surplus account that, under the budget bill, must be appropriated to state construction. Members focused heavily on how declining motor fuels receipts affect the formula funds that support cities, counties, and rural/secondary roads. Hancock and McCernan explained that lower gas tax receipts reduce both the road plan and revenue sharing, while higher vehicle sales tax receipts from motor vehicle usage go directly to the road fund and do not help the formula distributions. They also said fuel efficiency, hybrid and electric vehicle trends, and the removal of a prior hybrid fee all affect revenue collections. On tolling, officials said Louisville bridge toll revenues are covering bills and commitments, but they did not have the latest collection figures in front of them and said they would provide them later. The committee also asked about project delivery delays, right-of-way acquisition, disaster recovery work, annual contract awards, cash management, and overprogramming in the highway plan. Officials said project delays often stem from right-of-way purchases, utility relocation, and the large volume of projects in the plan, and described the process as a “duck paddling” situation with substantial work happening behind the scenes. They said FY25 contract awards were already just under $998 million by the July letting and expected to exceed last year’s total, and explained that cash balances are managed so they do not fall below $100 million; the current balance was said to be about $166 million. No further votes or formal actions were taken beyond approving the minutes.

Transcript Highlights:

• The state is participating in 5.5% of this issuance, with an annual debt service payment of just over
• The state is participating in 15% of this issuance, with an annual debt service payment of $185,000.
• The state is participating in 5.5% of this issuance, with an annual debt service payment of just over
• The state is participating in 15% of this issuance, with an annual debt service payment of $185,000.
• The state is participating in 5.5% of this issuance, with an annual debt service payment of just over

Summary: The committee first reorganized by electing new co-chairs for the Capital Projects and Bond Oversight Committee: Senator Fanny Fromom? as Senate co-chair and Representative McPherson as House co-chair, both by acclamation. The committee then approved the minutes from the prior meeting and received quarterly capital project status reports from the Administrative Office of the Courts, Finance and Administration Cabinet, and postsecondary institutions. Those reports noted University of Kentucky equipment purchases, several school districts planning general obligation and revenue bond issues, a notification of non-approval for PR 3567, and Kentucky Community and Technical College System asset preservation projects. Kevin Cardwell of the Finance and Administration Cabinet reported two action items: a $5,100 federal-funded Transportation Cabinet renovation of the Rowan County east and westbound rest areas, and a $1 million federal fund increase for the Capitol City Airport terminal building project, bringing the total federal support to $10 million and reducing the need for restricted funds. The committee also received a no-action report on a $1,363,000 Kentucky State University exterior repairs project funded through the 2024 asset preservation pool. Both action items were approved unanimously after roll call votes. The committee approved four lease renewals presented by Natalie Bronner for Cabinet for Health and Family Services locations in Bell, Lee, and Clay counties, plus a parking lease for the Department of Corrections in Jefferson County. Members asked about lease pricing and were told renewals must remain at existing terms and conditions. The committee then approved a $57,000 Kentucky WATS emergency grant for Wood Creek Water District to cover part of arrears tied to the City of Livingston; members discussed the city’s audit delinquency, possible regional water/sewer solutions, and concerns about rates and private involvement, but the grant was approved. Finally, the committee approved a $1 million line-item water grant to the City of Williamsburg with no action required, three Economic Development Fund grants for Bell, Franklin, and Shelby counties totaling $8 million in state support for site acquisition and infrastructure work, and five SFCC-supported school debt issues for Elizabethtown Independent, Erlanger Independent, Boyd County, Henderson County, and Union County. The school projects included middle school, high school, and vocational school renovations or new construction, and members requested a breakdown of the space funded by the debt. All action items were approved, and the meeting adjourned.

Transcript Highlights:

• -2023, when we made the changes to the regs. uh the TANF payment TANF payments uh the TANF payment TANF
• A payment error rate is the rate of errors in payments to recipients.
• A payment error rate is the rate of errors in payments to recipients.
• A payment error rate is the rate of errors in payments to recipients.
• A payment error rate is the rate of errors in payments to recipients.

Summary: The committee first approved the minutes from its September 24 meeting after a motion and second. It then heard a presentation from New Mexico Early Childhood Education and Care Secretary Elizabeth Gragensky on that state’s early childhood system and planned universal child care rollout. She described how New Mexico consolidated multiple prenatal-to-age-five programs into a cabinet-level department, expanded pre-K to a longer day, and uses a cost model to set reimbursement rates intended to cover true provider costs, including wages, benefits, occupancy, food, and reserves. She also said the state created an Early Childhood Trust Fund and secured a constitutional amendment to dedicate 0.60% of the land grant permanent fund to early care and education, with the department’s budget growing from about $400 million in 2021 to just under $1 billion this year. Gragensky said families can begin applying for universal child care on November 1, with participation voluntary for both families and providers. She reported that New Mexico is aiming to expand capacity by adding 1,000 registered home providers, 120 group homes, and about 55 more centers, supported in part by a $13 million low-interest loan fund and a request for an additional $20 million. She said the state has seen growth in early childhood professionals, including a 64% increase over the last three to four years, and pointed to reported outcomes such as a 21% increase in literacy and a 75% kindergarten readiness rate, while noting that some measures are new and baseline comparisons are still being developed. Members asked about the funding sources, provider profitability, workforce development, and measurable outcomes. Gragensky said the program is designed to support provider sustainability through rates tied to true cost and includes allowances for sick leave, vacation, benefits, and reserves. She also said maternal labor force participation is 10% higher than the national rate and attributed that in part to child care access. The committee then moved to a separate presentation by Department for Community Based Services Commissioner Lisa Dennis and Division of Family Support Director Roger McCann on anticipated cuts to TANF and SNAP, beginning with an overview of TANF as a federal block grant with a fixed annual Kentucky allocation of about $180.7 million.

Transcript Highlights:

• Um this facility payment system changes.
• standards would only be the payments upfront so long as the operating payment rate limits were in place
• to</c> establishes stipen payments to establishes stipen payments to bargaining<00:54:16.000><c> unit
• ><c> eligibility</c> fund payment and eligibility fund payment and eligibility determination<01:02:03.640
• </c> fund payments. Um, a note that um, Mr. fund payments. Um, a note that um, Mr.

Transcript Highlights:

• And I think the last bit of information is the tail payments, more detail on those tail payments if you
• And I think the last bit of information is the tail payments, more detail on those tail payments if you
• And I think the last bit of information is the tail payments, more detail on those tail payments if you
• And I think the last bit of information is the tail payments, more detail on those tail payments if you
• </c> getting those payments getting those payments out<01:51:09.320><c> um</c><01:51:09.679><c> the</

Summary: The Finance Committee Division II met with the New Hampshire Department of Education to review school nutrition programs and related funding. Department staff Melissa White and Kelly Rambo walked through a packet covering the National School Lunch Program, Fresh Fruit and Vegetable Program, Community Eligibility (CEP), After School Snack Program, Child and Adult Care Food Program, and Summer Food Service Program, explaining that these are federally funded USDA programs, with some state supplemental funding in certain areas. They also reviewed reimbursement rates for lunch, breakfast, child/adult care, and summer meals, noting that summer rates follow calendar-year timing while most others follow the state fiscal year. Members asked several questions about how the funding works, especially the difference between federal reimbursements and the state match. Staff explained that the state lunch line in the budget is a fixed match amount tied to federal participation, while breakfast funding is broken out by meal type and reimbursement category. They also discussed why FY 2022 federal spending was much higher during COVID, when USDA covered meals at the free rate for all students, and why FY 2023 and FY 2024 dropped as normal income-eligibility rules returned. A committee member also asked about the “severe need lunch” two-cent rate, and staff said they did not know USDA’s formula. A substantial portion of the meeting focused on summer meals and the distinction between the Summer Food Service Program and Summer EBT. Staff explained that SFSP provides meals at approved sites, which can be open or closed sites, while Summer EBT is a separate DHHS-operated benefit program that provides funds to families. They said some schools or sites may not qualify under USDA rules, but eligible children can often use another nearby open site, and the department posts an interactive map and phone line to help families find locations. The committee also discussed the Community Eligibility Provision. Staff said New Hampshire currently has three CEP schools, that the eligibility threshold had recently been lowered from 40% to 25% identified students, and that the program allows participating schools to offer free meals to all students while the local district covers the non-federal share. Members asked whether any districts in the 25% to 40% range had joined; staff said no. The department offered to provide the eligibility report in Excel and noted that the CEP intent is to reduce application burden, though the lower threshold can make the local cost share harder for some districts to absorb.

Transcript Highlights:

• So, I just came back this payment rate.
• </c> Medicaid quality incentive payment Medicaid quality incentive payment program<00:32:21.760><c> and
• <00:40:18.640><c> programs</c><00:40:19.680><c> are</c> payment programs are payment programs are &gt
• The second concern you heard was what happens to their ProShare and their MQUIP payments.
• There may be some ways MQUIP payments.

Summary: The committee to study long-term managed care met to approve the prior meeting minutes, with a clarification that “OB3” referred to the “one big beautiful bill.” The minutes were then approved. Chair Jim Kofalt outlined the day’s agenda, which included testimony from the Granite State Home Health and Hospice Association, the New Hampshire Association of Counties, and later DHHS. He also noted that future meetings were expected soon and that the meetings were being livestreamed on YouTube. Granite State Home Health and Hospice Association, represented by Kellyanne Totten and Amy Moore, urged inclusive planning and a cautious, phased approach if managed care is considered. They emphasized that home care providers are not uniform, with different licensing and service models, and said any pilot should include varied provider types, rural and southern regions, and agencies of different sizes. They warned that workforce shortages, inflation, and a possible 9% CMS cut to Medicare home health payments could force agencies to reduce service areas or service types. They also said the 2023 Medicaid CFI rate increase has begun to lose its effect. In response to questions, they said the rural health transformation fund may help with planning and telehealth but likely cannot be used directly for rates or recruitment/retention. They also described the New England Home Care Nurse Residency Program, a Department of Labor grant, as a way to bring new registered nurses into home care with added training and school partnerships. The New Hampshire Association of Counties, through county nursing home administrators Craig Labore and David Ross, revisited the earlier Step Two managed care discussions from 2016-2018. They said prior consultants found the long-term services and supports system was underfunded and needed investment to stabilize providers and expand community-based care. They argued the same concerns remain today and said a managed model would jeopardize the Medicaid quality incentive payment program and, for county nursing homes, the proportionate share payment program. Their testimony was generally opposed to moving forward with managed long-term services and supports without significant additional funding and safeguards.

Transcript Highlights:

• These really took over them, but the majority of the model at the time, which is direct payment from
• The MCOs had demanded a whole set of increases from the state in their per member per month payments,
• As you all know, under the Patient Protection and Affordable Care Act, there was a bump in payment to
• , or denial of payments to clinicians.
• Delayed payments to the physicians.

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• The bill also makes it a crime for building contractors who have already received payment for completed
• only concerns or issues that we have relate to line 489 on the bill with reference to contractor payments
• . ...with reference to contractor payments.
• You have state government prompt payment that we work under, you have public works projects prompt payment
• Our contractors tell us that typically their payments are net 30 or net 45 days.

Committee: Senate Agriculture

Summary: The Senate Committee on Agriculture received a presentation from Florida Forest Service Director Rick Dolan on the agency’s wildfire response, forest management, and emergency support roles. He described the service’s four regions and 14 districts, its year-round wildfire response, use of bulldozers, helicopters, and drones, and the current high fire danger due to drought conditions. Dolan also highlighted prescribed burning, fuels mitigation, state forest management, the pine seedling nursery, and the agency’s role in hurricane response and incident management. Members asked about equipment loans and whether more prescribed burning could reduce wildfire impacts; Dolan said Florida already leads the nation in prescribed fire and emphasized public education and fuels reduction. The committee then considered and unanimously reported favorably Senate Bill 386, which creates a farm-equipment consumer protection process similar to a lemon law, allowing purchasers to seek repair or replacement of defective major farm equipment at no cost. The committee also took up Senate Bill 290, the Agriculture and Consumer Services omnibus bill. The bill would modernize fair association rules, preempt local bans on gas- and diesel-powered farm and landscape equipment, allow surplus of certain state-owned lands for bona fide agricultural use while excluding parks, forests, and wildlife lands, create a veterinary loan repayment program, make Farmers Feeding Florida permanent, expand Forest Service training opportunities, criminalize signal-jamming devices, increase penalties for CDL and English-proficiency exam cheating, restrict certain door-to-door solicitation, protect food safety inspectors, clarify biosolids rules, and add criminal and vendor-list penalties for contractors who fail to pay subcontractors. The committee adopted three amendments to align dates and technical language and to authorize native seed research and marketing through the Florida Wildlife Foundation. Testimony on SB 290 included support from several industry groups, concerns from the Home Builders Association about the new contractor-payment criminal penalties, and opposition from a citizen worried about the new surplus-land process for conservation lands. Despite concerns, CS/SB 290 was reported favorably. Finally, the committee unanimously recommended confirmation of the appointees listed on tabs 4 and 5, and then adjourned.

Transcript Highlights:

• SB 6103 relates to payments for rural emergency hospitals.
• SB 6103 relates to payments for rural emergency hospitals.
• system rate for Medicare patients. 105% of the outpatient prospective payment system rate for Medicare
• patients, but payments for Medicaid clients are up to the state.
• Senate Bill 6103 makes payments for medical assistance program services by a rural hospital designated

Bills: SB6103

Committee: House Appropriations

Keywords: rural healthcare, emergency services, hospital payments, state appropriation, public health

Transcript Highlights:

• Yes, it's intended to be in the base, not a supplemental payment. Follow up. Thank you, Mr.
• President, I understand that some of those payments were contracted and part of the mandated payments
• I think what I'm looking at is ETPS payments, so outcomes-based payments that is actually part...
• I'm looking at it's ETPS payments, so outcomes-based payments that is actually part of our contract and
• payments for already provided work by Community Behavioral Health Centers for their outcomes.

Bills: HB3418 , HB3985 , HB3463 , HB3002 , HB4303 , HB3919 , HB3416 , HB3417 , HB3415 , HB2206 , HB3414 , HB3265 , HB3310 , HB3413 , HB4486 , HB1219 , SR39 , SB1177 , HB3298 , HB2696 , HB3941 , HB3970 , HB3264 , HB3321 , HB2650 , HB3497 , HB3980 , HB3981 , HB4421 , HB3177 , HB3322 , HB3499 , HB3500 , HB3845 , HB3742 , HB3622 , HB1250 , HB2710 , HB3831 , HB4408 , HB1002 , HB3008 , HB3086 , HB3595 , HB3678 , HB4107 , HB3695 , HB3315 , HB3590 , HB3006 , HB3151 , HB2959 , HB2398 , HB3026 , HB3467 , HB4268 , HB3372 , HB2210 , HB4359 , HB4427

Summary: The Senate convened with a quorum, offered prayer, and recognized the Doctor and Nurse of the Day, along with several visiting groups in the galleries, including the Goldsby Volunteer Fire Department and families honoring fallen firefighters Todd Pendleton and Brian Jenkins, the Sapulpa Elks Antlers, the Grove Chamber of Commerce, and northeastern Oklahoma cattlemen. The chamber adopted Senate Resolution 39, celebrating the 100th anniversary of U.S. Route 70 and its economic importance to southern Oklahoma communities. The main item of business was the Joint Committee Report for Senate Bill 1177, the General Appropriation Bill for the State of Oklahoma. Senators questioned the budget’s overall size, the use of gross production tax revenues, the new sovereign/endowment trust fund, Medicaid and Health Care Authority funding, mental health appropriations, child care subsidy funding, school security, career tech, tourism, the Commissioners of the Land Office, textbook allocations, and several other agency lines. The chair explained that the budget included about $1.5 billion in cash and sweeps, a $250 million base appropriation for the Health Care Authority, $200 million for the endowment trust fund, $31 million for PREP projects, $25 million for the Governor’s Quick Action Closing Fund, and other agency-specific appropriations and supplements. Several members debated the report before adoption. Supporters argued the budget addressed agency needs and future savings, while opponents criticized it as a flat or spending-heavy budget that favored special projects and well-connected interests over core services such as child care, mental health, water infrastructure, and county needs. After debate, the Joint Committee Report for SB 1177 was adopted, and the Senate moved through the budget discussion with no recorded roll-call vote in the transcript provided.

Transcript Highlights:

• They do have the option to pay in two payments without penalty.
• I do not believe we have the automatic payments set up.
• The payment would be received by February 15th.
• I mean, the payment by February 15th for our software doesn't... ...really matter.
• So we will be shorted as far as that payment.

Summary: The subcommittee of the Tax Reform and Relief Committee met with a quorum to begin its study of whether the content of North Dakota real estate tax statements should be revised to improve transparency. Legislative Council staff reviewed the background for the study, including House Bill 1176, current statutory requirements for tax statements, and recent changes such as separate line items for bonded debt, primary residence credit, and legacy fund-related amounts. The Tax Department then explained the current statement format and noted that the form is prescribed and approved by the tax commissioner, with changes typically driven by statute and implemented collaboratively with counties and vendors. County officials from the North Dakota Association of Counties described the full annual process for preparing budgets, setting levies, calculating taxable values, and issuing notices and tax statements. They said counties spend significant time coordinating with taxing districts, neighboring counties, and software vendors, and that the new budget hearing notices and valuation notices have not generated much public response. Members raised concerns about the usefulness and clarity of certain line items, especially the legislative tax relief calculation and the primary residence credit, and discussed whether the current statement creates confusion rather than transparency. Testimony also addressed the 3% cap, mill levy worksheets, assessment cycles, and the role of county auditors and tax directors in maintaining accurate values. The committee also heard from software vendors CPT and Tyler Technologies about how legislative changes are programmed into tax systems and how online taxpayer portals can provide more detailed breakdowns of tax bills. Vendors said changes required by law are generally absorbed in contracts rather than billed directly to counties, and they demonstrated web tools and pie-chart style breakdowns that show where tax dollars go. NDACO presented a survey of eight counties estimating tax statement preparation and mailing costs, concluding that outsourced printing tends to be cheaper on average and that total statewide tax statement costs may be roughly $600,000, though the estimate was based on limited data. No votes were taken; the meeting was informational and focused on gathering testimony and identifying issues for possible future recommendations or bill drafts.

Transcript Highlights:

• </c><00:04:08.640><c> for</c> the 1st, 2026 with retro payments for the 1st, 2026 with retro payments
• </c> for existing statedirected payment for existing statedirected payment programs.<00:04:34.400><c>
• </c><00:04:59.600><c> for</c> receive enhanced Medicaid payments for receive enhanced Medicaid payments
• ><c> federal</c><00:05:10.000><c> law</c> Payments would comply with federal law Payments would comply
• </c><00:12:21.440><c> is</c> payment rate in Medicaid. is payment rate in Medicaid. is substantially<

Summary: The Medicaid Oversight Board met on March 9 with a quorum present and no minutes to approve. The chair reordered the agenda to hear House Bill 689 first. Representative Amy Neighbors presented HB 689, which would authorize Kentucky to seek CMS approval for a Medicaid state-directed payment program for physician and non-physician professional services delivered through qualifying hospital-affiliated groups, beginning January 1, 2026, with retroactive payments for that year. She said the bill is intended to improve access to care in rural and underserved areas, support workforce retention, and generate about $29 million annually in federal Medicaid funds without using general fund dollars. Representatives from Owensboro Health and St. Elizabeth Healthcare testified in support, describing staffing and subsidy pressures, lower Medicaid and Medicare reimbursement, and the importance of the program for maintaining access and quality in rural and safety-net settings. Committee members noted the bill had already passed the House Health Services Committee unanimously and discussed broader concerns about Kentucky’s low reimbursement rates and the need to consider other systems not covered by the proposal. The board then heard Senate Bill 2011 from Senator Donald Douglas and Cody Hunt of the Kentucky Medical Association. The bill would address a Medicaid coding issue by ensuring that coverage limits do not reduce payment to fewer than two evaluation and management service units per provider, per patient, per day. Douglas argued the current one-visit, one-issue limitation forces multiple visits, increases no-shows, and prevents providers from treating the whole patient. Hunt explained that the bill is meant to correct a longstanding regulation that limited E&M services to one per physician per recipient per date of service, which can prevent providers from coding additional medically necessary work during the same visit. He said DMS has already filed a regulatory amendment to fix the problem, but a statutory change is still needed to prevent the issue from returning. He also said the bill is not intended to change reimbursement policy, only coding rules, and that MCO payment practices vary. Members generally supported the concept. Senator Berg asked about fiscal impact and private-payer billing; Hunt said there should be no fiscal impact because the bill does not change payment policy, only coding. Representative Moore said the proposal could reduce costs and improve convenience by avoiding extra visits. Chairman Meredith said the bill illustrated problems with fee-for-service care and supported moving toward a more holistic delivery model. Dr. Schuster raised a drafting concern about the bill summary language, and Hunt responded that the regulatory amendment should address the issue generally for providers. No votes were taken on either bill during this portion of the meeting.

Transcript Highlights:

• The House takes the payment program.
• </c> with uh relative foster care payments. with uh relative foster care payments.
• </c> compensation support payments compensation support payments program.<00:17:47.360><c> Uh</c><00:
• Secondly, the Great Start Compensation Support Payment Program provides payments to thousands of child
• Secondly, the Great Start Compensation Support Payment Program provides payments to thousands of child

Bills: HF2436

Committee: House Children and Families Finance and Policy

Transcript Highlights:

• </c><00:40:41.920><c> to</c> where we will transfer that payment to where we will transfer that payment
• We do occasionally, advanced payments.
• ,</c> in which we make an advanced payment, in which we make an advanced payment, but<01:06:59.599><c
• </c> recovering overp payments recovering overp payments administratively,<01:15:48.000><c> but</c><01
• So when you're SNAP benefit payments.

Summary: The committee chair opened by explaining that the committee has expanded from a traditional audit-follow-up role into an oversight role focused on whether audit recommendations are implemented and whether controls are in place to detect fraud. He said the committee was concerned about fraud uncovered in social service programs in other states and wanted to understand New Hampshire’s safeguards, especially around major contracts and program performance. Charles Buchanan, director of the New Hampshire Medicaid Fraud Control Unit, and investigator Tim Brackett described the unit’s structure and mission. Buchanan said the unit, housed in the Attorney General’s Criminal Justice Bureau, investigates and prosecutes fraud by health care providers serving Medicaid beneficiaries, as well as abuse, neglect, and financial exploitation of residents in health care facilities. He outlined common Medicaid fraud schemes such as billing for services not rendered, upcoding, using unqualified staff, drug substitution, kickbacks, supplemental charges, and inflated customary charges. He also described resident abuse/neglect and drug diversion in hospitals, nursing homes, and assisted living settings. Brackett said his role is financial investigator/auditor and noted the unit is grant-funded and must include a prosecutor, investigator, and auditor. The witnesses then explained how cases reach the unit and how they are handled. Most referrals come from the state Department of Health and Human Services’ program integrity unit and from managed care organizations’ special investigations units, which look for fraud, waste, and abuse and refer credible allegations. Other sources include qui tam whistleblower actions, the national Medicaid Fraud Control Units association, citizen complaints, provider referrals, adult protective services law-enforcement referrals, local law enforcement, and federal agencies. Once a referral is received, the unit can accept or deny it; accepted matters may be investigated criminally or civilly, while nonviable matters can be referred back to HHS or other agencies for administrative action, including repayment demands and reimbursement offsets. No votes or formal committee actions were taken in the portion provided.

Transcript Highlights:

• Was there another entity like Road and Bridge that made those payments?
• Or was it through a special district that these payments, overpayments, were made?
• . invoices, payments, etc.
• other payments that are made by this county.
• Transparency exists in payments of government entities to to in payments of government entities to vendors

Committee: Joint Management Audit Committee

Transcript Highlights:

• performance audit follow-up report identified the lack of board approval on some additional duty payments
• then DES approves those payments.
• At this time, we expanded our scope and pulled all 126 payments for that provider.
• At this time, we expanded our scope and pulled all 126 payments for that provider. expanded our scope
• Did they have... ...payments. Did they have all of the required elements that were required?

Committee: Joint Joint Legislative Audit Committee

Summary: The committee first heard an update on Topok Elementary School District’s long-running noncompliance with Arizona’s Uniform System of Financial Records. The Auditor General’s office explained the USFR noncompliance process and reported that Topok had made substantial progress, correcting many deficiencies in areas such as open meeting law, procurement, payroll, attendance reporting, property control, and information technology. The district’s superintendent and staff described the corrective actions they had taken, the use of outside consultants, and their plan to maintain compliance through stronger leadership, training, and consistent procedures. Members praised the district’s progress and asked about the remaining deficiencies and the status of the 3% state-aid withholding, which the Auditor General said would be addressed by the State Board of Education. The committee then considered a request for a fourth school safety special audit, tied to concerns raised by Representative Martinez about Phoenix Union High School District and school violence response practices. The Auditor General said the proposed audit would be a new topic focused on policies and procedures for responding to credible threats of violence and allegations of staff misconduct affecting student safety, and could include Phoenix Union in the sample. Representative Martinez described a fatal 2024 shooting, weapons incidents, and concerns about district oversight. The committee approved the motion 10-0. Next, staff presented the fiscal years 2027-2028 school district performance audit schedule, describing 26 randomly selected school districts and career and technical education districts, plus 84 planned follow-ups. The Auditor General said the schedule is intended to shorten the average time between audits and that the school audits division is now fully staffed. Members asked about county coverage and the inclusion of ESA accountability, but the schedule was ultimately presented for review rather than approval. The committee also heard a detailed federal compliance audit presentation on the Child Care and Development Fund (CCDF) administered by DES. The Auditor General reported repeated findings involving missing provider documentation, questioned costs, and FFATA reporting errors, including a 2024 sample that led to questioning $2.88 million in costs. The office recommended stronger documentation, record retention, reporting procedures, and staff training; DES concurred and said it would correct the findings in 2026. Members discussed the limits of the single-audit scope, the possibility of a broader special audit, and the federal government’s recent actions on CCDF oversight in other states. Finally, the committee considered and discussed a special audit request for CCDF that would broaden review to provider oversight, licensing, site visits, and billing accuracy across multiple state agencies, with estimated costs of $547,000 to $625,000 and a projected report date of July 31, 2027.

Transcript Highlights:

• SB 6103 relates to payments for rural emergency hospitals.
• SB 6103 relates to payments for rural emergency hospitals.
• Under federal regulations, rural emergency hospitals are paid at 105% of the outpatient prospective payment
• system rate for Medicare patients, but payments for Medicaid clients are up to the state.
• Senate Bill 6103 makes payments for medical assistance program services by a rural hospital designated

Summary: The House Appropriations Committee held a public hearing on Senate Bill 6103, which would make Medicaid payments for services provided by rural emergency hospitals subject to appropriation. Committee staff explained that rural emergency hospitals are a federal Medicare provider type created in 2020, that they may provide emergency and limited outpatient services but not general inpatient care, and that Washington currently has no designated rural emergency hospitals. The bill would update state law so these facilities can be recognized in the Medicaid statute; staff said the fiscal note showed no fiscal impact. Public testimony was entirely in support. Lisa Thatcher of the Washington State Hospital Association said the bill is needed to align state law with the federal designation, allow cost-based reimbursement similar to critical access hospitals, and preserve eligibility for SNAP-related payment treatment. Todd Nida, CEO of East Adams Rural Health Care, said his facility is seeking to become the first rural emergency hospital in Washington and warned that without the bill, conversion would reduce reimbursement and threaten financial viability. No opposition was presented, and the chair closed the public hearing on SB 6103. The committee then announced upcoming budget release, hearing, amendment, and executive action dates, and adjourned.

Transcript Highlights:

• ,</c><00:01:45.280><c> not</c> managing their claims payments, not managing their claims payments, not
• </c><00:06:47.680><c> We</c> small monthly payment for that. We small monthly payment for that.
• system toward a model sick care payment system toward a model of<00:29:21.600><c> payment</c><00:29:
• </c><00:34:20.560><c> program</c> Healthcare's directed payment program Healthcare's directed payment
• </c> People cannot afford a down payment People cannot afford a down payment anymore.<01:59:12.960><c

Committee: Senate Health and Human Services

Transcript Highlights:

• These changes have brought and employment eligibility criteria and increased benefits payments, allowing
• These eligible adopted adoptive parents could receive initially an incentive payment of up to $10,000
• Law enforcement officers became eligible for a one-time lump 6 months payment of up to $25,000.
• The remainder of the eligible populations continue to receive the previously established payments of
• If the applicant is now employed by a different qualifying agency, their payment will be issued through