Transcript Highlights:

• even as states continue to wait for CMS even as states continue to wait for CMS to<00:43:36.079>
• of the Medicaid portions of HR1 by not going further than what it calls for until we know more from CMS
• of the Medicaid portions of HR1 by not going further than what it calls for until we know more from CMS
• of the Medicaid portions of HR1 by not going further than what it calls for until we know more from CMS
• of the Medicaid portions of HR1 by not going further than what it calls for until we know more from CMS

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

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

Transcript Highlights:

• Um, CMS on the federal level, um, does provide parity protections, um, for those, uh, governmental, uh
• Um, but an audit found last year, an audit by US, uh, HHSOIG found that CMS is not correct, correctly
• So we have concerns that CMS is not getting the job done, um, on parity, uh, regulation and compliance

Bills: HB201, HB272

Keywords: disabled veteran, partially disabled veteran, veterans property tax exemption, homestead exemption, ad valorem tax, property tax relief, surviving spouse, appraisal district, Tax Code, local government revenue, homestead portability, service-connected disability, veteran benefits, Texas property tax, residence homestead, disability rating, disaster response, financial assistance, helicopter, municipalities

Transcript Highlights:

• CMS, on the federal level, does provide parity protections for those. uh, governmental, uh, employee
• HHS-OIG found that CMS is not correctly reviewing. Medicaid plans for parity compliance.
• So we have concerns that CMS is not getting the job done. on parity regulation and compliance for the

Bills: HB201, HB272, HB618, HB 1094, HB 1142, HB201, HB272

Keywords: financial crime, card fraud, motor fuel theft, law enforcement, criminal activity, skimmers, prevention, training, credit card fraud, debit card fraud, prosecution, illegal possession, state law, HB 618, Texas insurance code, IVF, in vitro fertilization, fertility treatment, infertility coverage, government employee health benefits

Transcript Highlights:

• The reason House Bill 707 talks about 10^-4 cm/s is because that's silty sand.
• The reason House Bill 707 talks about 10^-4 cm/s is because that's silty sand.
• The reason House Bill 707 talks about 10^-4 cm/s is because that's silty sand.
• The reason House Bill 707 talks about 10^-4 cm/s is because that's silty sand.
• The reason House Bill 707 talks about 10^-4 cm/s is because that's silty sand.

Keywords: 1191, senate, all

Transcript Highlights:

• previous concern was that the implementation of the bill would require a state plan amendment with CMS
• Representative Bliss's floor amendment in the House, which made coverage of the added services contingent on CMS
• previous concern was that the implementation of the bill would require a state plan amendment with CMS
• Representative Bliss's floor amendment in the House, which made coverage of the added services contingent on CMS
• President of Bliss's floor amendment in the House which made coverage of the added services contingent on CMS

Bills: HB2051, HB2114, HB2127, HB2134, HB2207, HB2574, HB2700, HB2800, HB2916

Keywords: AHCCCS, lactation care, breastfeeding, health services, healthcare access, motorcycle registration, safety fund, education, awareness programs, low-income scholarships, motorcycle training, special license plates, transportation, funding, nonprofits, charitable contributions, critical infrastructure, foreign adversaries, China, communications

Summary: The Committee on Appropriations met with all members present, approved the March 17, 2026 minutes, and announced its final hearing would be the following Tuesday at 8:30 a.m. The committee first heard HB 2134, the Arizona Critical Infrastructure Protection Act, which would bar state and critical infrastructure entities from contracting with Chinese companies for access to critical infrastructure, prohibit Chinese-produced software and equipment in certain systems, require annual certifications and reporting, and direct the Corporation Commission and DEMA to implement oversight and emergency communications measures. The sponsor and a witness argued the bill was a targeted national-security measure and a companion to federal efforts; concerns were raised about cost, overlap with federal law, and staffing, but the bill received a do-pass recommendation on a 6-4 vote. The committee then considered HB 2051, which would require AHCCCS contractors, subject to CMS approval, to provide breastfeeding and lactation care services in multiple settings. Testimony from lactation consultants, researchers, advocates, and tribal representatives emphasized maternal and infant health benefits, access gaps, and potential Medicaid savings; AHCCCS and ADHS were neutral, with AHCCCS estimating a $1.8 million general fund cost and ADHS saying it could not absorb implementation costs. The committee adopted a 15-page amendment creating a voluntary state certification for lactation care providers and a DHS advisory committee, then passed the bill as amended on a 9-0 vote. HB 2700, creating a technology-first study committee on assistive technology for people with disabilities, also passed unanimously after testimony from disability advocates and a proposed amendment to add minority-party appointments was discussed but not voted on. HB 2800, which increases the penalty for knowingly lending a vehicle to a person with a DUI-related driving restriction if that person causes serious injury or death, drew extensive debate over whether the felony penalty was appropriate when the lender may not know the eventual outcome; after testimony from the sponsor and the victim’s widow, the bill passed 9-1. HB 2114, which uses motorcycle safety fund money for scholarships for rural and low-income riders and requires ADOT to issue motorcycle registrations only when an owner has a class M license, passed 10-0 amid concerns that the license language may need clarification on the floor. The committee then began HB 2127, an omnibus special-plates bill with multiple amendments, but discussion centered on whether one amendment was hostile and whether a community-college plate should be offered later; no final action on HB 2127 was taken in the portion provided.

Transcript Highlights:

• We think that CMS might take administrative action to reduce those payments down to 100% of Medicare.
• However, we're very much still in negotiations about that with the federal government, and the federal CMS
• Then, $5 billion at CMS administrator's discretion.
• ready as soon as the guidance comes out, because we are expecting announcements in about a month from CMS
• We did receive a letter from the federal regulator at CMS basically saying, "You better get started.

Transcript Highlights:

• will have access to enough affordable EV options in the market to support the aggressive targets of CMS
• For reference, CMS set far more aggressive targets for EV use by rideshare platforms than the new sales
• latter program was recently put into question by the federal government, which could directly impact CMS
• We could fall short of the CMS target without better public and private investment.
• average in California per ride for insurance alone, post other government taxes and fees, including CMS

Summary: The hearing focused on transportation network companies in California, with the chair framing it as an informational hearing on the history, regulation, safety, climate, accessibility, and data issues surrounding Uber, Lyft, and smaller or autonomous TNC services. The CPUC described its decade-long regulatory role, including safety rules, background checks, insurance requirements, reporting obligations, and two major legislative programs from 2018: the Clean Miles Standard and the Access for All program. Members asked about complaint trends, data collection and disclosure, program implementation, and how the CPUC uses annual reports for policymaking, compliance, and program oversight. Uber and Lyft said the statewide framework has supported growth while providing safety and access benefits, but both companies emphasized that insurance is a major cost driver and argued that California’s UM/UIM requirement is unusually high compared with other vehicles. They said the Clean Miles Standard is pushing electrification but faces headwinds from EV affordability and charging infrastructure, while Access for All has expanded wheelchair-accessible service but still needs continued support. They also discussed transit partnerships, wildfire response, and the potential role of autonomous vehicles, with both companies saying human drivers will remain important and that future regulation should account for new technology. The final panel, including the San Francisco County Transportation Authority and UC Berkeley researchers, presented evidence that TNCs have increased congestion and reduced transit ridership, especially in dense urban areas. They described prior research showing TNCs contributed to congestion growth in San Francisco and noted that this work helped spur local taxes on ride-hailing trips to fund safety and transit improvements. The panel also discussed the CPUC’s evolving data-disclosure decisions, arguing that public access to TNC trip data is important for understanding transportation impacts and informing local policy.

Transcript Highlights:

• As you can see here for C, the state plan amendment is pending approval by CMS, but it has been submitted
• to CMS.
• Both of those approaches would require us to submit a waiver to CMS to implement those approaches, but
• But does every child participate in CMS?
• although at a lower rate than we would have expected based upon the appropriated amounts, with the CMS

Summary: The subcommittee held its first meeting of the 2025-2026 term, took attendance, confirmed a quorum, and heard introductory remarks from members and staff. Chair Anderson outlined the subcommittee’s jurisdiction over access and affordability issues, including health facility regulation, insurance, Medicaid, CHIP, and state employee health coverage. The main agenda item was an update on implementation of HB 391, which created a family home health aide program for medically fragile children. Representative Tramont, the bill sponsor, explained that the law was intended to let trained family caregivers be paid through Medicaid to care for their children, reduce reliance on private duty nursing, and relieve families. He and several members expressed frustration that implementation had taken nearly two years and that families still faced barriers. Deputy Secretary Brian Meyer of AHCA and Bridget Royce of DCF said the program was implemented October 1, 2024, with billing available, but no home health agencies had yet launched the required 80-hour training program and no claims had been paid. They described the program’s requirements, including agency employment, background screening, training, a $25-per-hour Medicaid rate paid to the agency, and an annual assessment report. A major issue discussed was that income earned by family caregivers counts toward Medicaid eligibility and could cause families to lose coverage. AHCA and DCF outlined two possible fixes that would require CMS approval: disregarding the income for eligibility purposes or treating the child as a family of one. Members and public witnesses strongly urged changes to avoid forcing families to choose between income and coverage. Several providers said they had begun preparing training programs, but asked for clearer approval processes and more patient-specific training requirements. The committee then heard extensive public testimony from parents and caregivers of medically fragile children, who described the financial, emotional, and logistical strain of caring for children with severe disabilities and argued that the bill should be expanded to include Florida KidCare families and others in the coverage gap. They also raised concerns about the eight-hour-per-day limit, low pay, and the need for simpler rules and direct support. Home health providers and associations supported the concept but asked for modifications, including more targeted training and clearer implementation guidance. The meeting then shifted to a second agenda item on the Andrew John Anderson Rapid Whole Genome Sequencing Program, which was funded in the 2023 budget. Deputy Secretary Meyer said the program has been implemented since January 1, 2024, but utilization has been lower than expected, with only about 60 claims paid and many denials occurring through managed care. Public testimony from a lab, a hospital, and a pediatric rare disease expert said the program is clinically valuable and cost-saving, but managed care billing barriers, prior authorization issues, and DRG-related denials are limiting access; they urged direct billing to Medicaid and possible expansion to all newborns.

Transcript Highlights:

• the agenda today is a rule to allow us to be exempt from the recovery audit contractor requirement of CMS
• CMS has agreed and approved this exemption because we have four other layers of program integrity in

Keywords: 1204, all

Summary: The committee met briefly, approved the January 7 minutes, and heard several Department of Human Services rules. DHS explained a rule allowing rehabilitative hospitals to open psychiatric units, provide acute psychiatric services, and receive Medicaid reimbursement, noting the service is needed and already being provided in Jefferson County. Members also reviewed a rule allowing DHS to participate in the CMS cell and gene therapy model for value-based payment agreements to treat sickle cell disorder with CGT therapy. A third DHS rule would exempt the state from the CMS recovery audit contractor requirement. DHS said recovery audit contractors typically work on contingency to identify fraud, waste, abuse, or overpayments, but Arkansas law prevents contingency arrangements, so the state uses other program-integrity layers instead. Those layers include internal retrospective reviews, an external payment integrity office, the Office of Medicaid Inspector General, and the Attorney General’s Medicaid Fraud Control Unit. Members asked for clarification on the contractor role, and DHS responded that the exemption has no cost and was approved by CMS. During new business, Representative Pilkington asked about a reported increase in uninsured postpartum cases in a DHS quarterly report. DHS representatives said they were not prepared to answer at the meeting and would follow up offline. Representative Johnson also asked about a handout related to program integrity and Arkansas Medicaid. With no further business, the committee adjourned.

Transcript Highlights:

• the agenda today is a rule to allow us to be exempt from the recovery audit contractor requirement of CMS
• CMS has agreed and approved this exemption because we have four other layers of program integrity in

Summary: The committee opened with prayer, approved the January 7 meeting minutes, and then reviewed several Department of Human Services rules. One rule would allow rehabilitative hospitals to open psychiatric units, provide acute psychiatric services, and receive Medicaid reimbursement, addressing a service gap, especially in Jefferson County. Another rule would let DHS participate in a CMS cell and gene therapy model to support value-based payment agreements for treating sickle cell disorder with CGT therapy. A third DHS rule would exempt the state from the CMS recovery audit contractor requirement. DHS explained that recovery audit contractors typically work on contingency to identify fraud, waste, abuse, or overpayments, but Arkansas law prohibits contingency arrangements of that kind. DHS said the state already has multiple other program integrity layers, including internal reviews, an external payment integrity office, the Office of Medicaid Inspector General, and the Attorney General’s Medicaid Fraud Control Unit. Members asked for clarification on the role of recovery audit contractors, and DHS responded that they perform post-payment audits and recoveries. All three DHS rules were reviewed without objection. Near the end of the meeting, Representative Pilkington asked about a reported increase in uninsured individuals in a DHS postpartum report, but DHS said it was not prepared to answer and would follow up offline. Representative Johnson also asked about a handout related to program integrity and Arkansas Medicaid. The committee then adjourned.

Transcript Highlights:

• WEEK AND I WILL NOTE IT DOES NOT MENTION THE F MAP SHARED AMOUNT THAT HAS ALREADY BEEN REPORTED TO CMS
• OR THE FACT THAT NO OTHER STATE NOR CMS ITSELF AGREES WITH THIS LEGAL INTERPRETATION.

Transcript Highlights:

• CMS right now limits us to $5,000 per facility that has an SNF, Skilled Nursing Facility, unit.
• , so they would have to be an SNF facility that is surveyed by us, by CMS.
• CMS is the Medicare program, so it's any long-term care facility that has a skilled nursing bed.
• so they would have to be an under CMS so they would have to be an SNF<02:09:15.880> facility<
• CMS what does CMS just saying it's not CMS what does CMS cover<02:10:00.599> then<02:10:00.719

Keywords: 912, senate, all

Summary: The joint Ways and Means and Health and Human Services committees heard Hawaii Health Systems Corporation’s biennium budget request, with testimony from HHSC leadership on the Hilo/Big Island region (HTH 212) and the Oahu region (HTH 215), plus discussion of capital improvement projects and systemwide partnerships. HHSC described its role as the rural healthcare safety net, serving a high share of Medicare, Medicaid/Quest, and uninsured patients, and said its costs are elevated by state employee fringe benefits, which it said are about 64% compared with roughly 30% in the private sector. HHSC also said pandemic-era federal aid, including relief funds and PPP loans totaling about $100 million, reduced the need for general fund support in prior years. For HTH 212, HHSC said its general fund request for fiscal years 2026 and 2027 was higher than the governor’s recommendation because of rising insurance, pharmaceutical, and contractor labor costs, and because it includes $13.2 million in FY 2026 and $2.3 million in FY 2027 for Epic electronic medical record implementation in East Hawaii. For HTH 215, HHSC said the requested general funds were aligned with the governor’s recommendation, in part because of increased Medicaid reimbursement rates for long-term care facilities under prior legislation. HHSC also said it was restoring a special fund ceiling so the region could spend its cash collections on operations. Members asked about the 64% fringe rate, and HHSC explained the difference was mainly due to defined-benefit pension and retiree health insurance costs, which private hospitals generally do not bear at the same level. Members also asked about the Daniel K. Akaka State Veterans Home, and HHSC said operations would be funded through the general fund corporation for the home when it opens, with management by Ohana Pacific, but no additional legislative operating funds were being requested at that time. Other questions focused on staffing and vacancies, including an abolished procurement position and an ongoing IT help desk recruitment need. HHSC highlighted several capital and partnership projects, including a $25 million state CIP request matched by $25 million from the Benioff family for the Benioff Health Center, an ER expansion and reconfiguration at Corner Community Hospital, and $7.5 million in each fiscal year for Kauai EMR capital funds to join the Epic platform. Testimony also described collaborations with Queen’s, the University of California San Francisco, Hawaii Pacific Health, the Hawaii Cancer Consortium, the Department of Health, and the state hospital to improve specialty access, clinical trials, behavioral health, and patient placement across the system.

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

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

Transcript Highlights:

• 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?
• Representative Beatty, just while we have the Secretary at the table, our state CMS plan maybe a year

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

Transcript Highlights:

• housing stabilization supports area, because the state had requested that the program be terminated and CMS
• Uh, because the state had requested that the program be terminated and CMS had approved that.
• that we're in compliance with what the department had requested for the program to be terminated, that CMS
• that we're in compliance with what the department had requested for the program to be terminated, that CMS

Keywords: 919, house, all

Summary: The committee took up House File 3379, a technical bill dealing with the housing stabilization supports program in human services. The bill’s author explained that the program had been terminated at the state’s request and approved by CMS, and the bill would remove it from statute so the legislature would have a role if the program is later brought back. The discussion quickly broadened into a debate over legislative versus executive authority in Medicaid and human services programs, with members arguing about whether the department should be able to terminate or redesign programs without legislative approval and how to protect vulnerable participants. Members discussed three amendments. The A1 amendment sought to require 30-day public comment periods for Medicaid waiver and state plan changes, require publication of comment text online, and prohibit the commissioner from terminating legislatively enacted Medicaid waivers or benefits or requesting federal assistance to do so without legislative involvement. The A3 amendment was offered as a modification to A1 to address concerns about requiring the legislature to be called back in during the interim; however, after debate over whether the amendment would give the commissioner too much authority and whether it could affect existing fraud-sanction procedures under section 256B.064, A1 was withdrawn and A3 was also set aside. A2, described as a technical cleanup amendment from nonpartisan staff, was then adopted. The committee then voted on the bill as amended. The motion to re-refer House File 3379 to the General Register passed on a voice vote, and the bill was recommended to be placed on the General Register. Throughout the discussion, members emphasized different priorities: some stressed oversight, public input, and legislative control over program changes, while others argued the department needed flexibility to address fraud and protect services for seniors, people with disabilities, and other vulnerable residents.

Transcript Highlights:

• committed to achieving the Clean Mile Standard goals. in the market to support the aggressive targets of CMS
• For reference, CMS set far more aggressive targets for EV use by rideshare platforms than the new sales
• the latter program was recently put into question by federal government, which could directly impact CMS
• Average in California per ride for insurance alone, plus other government taxes and fees, including CMS

Keywords: 988, house, all

Transcript Highlights:

• The act requires the Center for Medicare and Medicaid Services, CMS, to issue a regulation to identify
• And we're waiting for CMS to get the guidance on what that application includes. recipients on um on
• to get the we're waiting with from CMS to get the guidance<00:34:50.240> on<00:34:50.480>
• to be allocated by CMS with no guarantee<00:35:11.280> of<00:35:11.440> receipts<00:35
• So uh uh and I would bet that CMS is going to incorporate a number of uh reporting requirements on the

Keywords: Meeting Start 00:00:00 FY 2025 Budget Close Out 00:02:55 Impressions of H.R. – 119th Congress 00:28:15 SNAP Payment Error Rates 00:37:05, 958, all

Summary: The committee first established a quorum, approved the July minutes, and recognized Jennifer Hayes of the Department of State Budget Director for her retirement and long service. Secretary Hicks then presented a review of fiscal year 2025 closeout for the general fund and road fund, explaining that the general fund ended with a $313 million surplus and the road fund with a $61 million surplus. He attributed the general fund result to strong corporate income and LLC tax receipts, investment income, and lower-than-budgeted spending, while noting that individual income tax and sales tax underperformed estimates. He also described how the general fund surplus was allocated, with $62 million used for necessary government expenses and $251 million deposited into the budget reserve trust fund, which remained at historically strong levels. For the road fund, he said the surplus would be deposited into the Department of Highways construction account, and he highlighted record motor vehicle usage tax receipts despite lower motor fuels tax revenue due to a rate decline. Members asked questions about the pass-through entity tax, delayed filing deadlines, THC beverage sales, and income tax collection from undocumented workers. Hicks said the pass-through entity tax remains difficult to model because of timing issues and the first year’s unusual filing pattern, and that staff are still working with the Department of Revenue and other states to improve forecasting. He said the delayed filing deadline likely would not require a major restatement and that any related receipts would still be counted in fiscal 2026. On THC beverages, he said the issue would be considered in the next forecasting cycle. On the undocumented-worker question, he said withholding may capture some of the revenue but referred broader collection efforts to the Department of Revenue. The committee then shifted to an overview of the federal reconciliation act’s potential impact on the next biennial budget, with Hicks and Commissioner Lisa Dennis focusing on Medicaid and SNAP. Hicks said the Congressional Budget Office estimated roughly $900 billion in federal savings over 10 years, driven in part by work or community engagement requirements for the Medicaid expansion population and limits on state-directed payments. He emphasized that CMS still must issue regulations to define how the state-directed payment reductions will be calculated, making the exact fiscal impact uncertain. He referred members to a prior Medicaid Oversight Advisory Board presentation for more detail, and the discussion remained informational with no votes or formal actions taken on the federal changes.

Transcript Highlights:

• CMS categorizes provider types into three different categories, so there's a low-risk, moderate-risk,
• > um<00:29:16.960> assess<00:29:17.320> patterns<00:29:17.640> and through CMS
• um to um assess patterns and through CMS um to um assess patterns and where<00:29:17.919> there's
• Chair, final question for me, uh, Director, is there any CMS guidance that you're receiving on any of
• and working with other working with CMS and working with other states<01:05:35.160> to<01:05:

Keywords: 1183, house

Transcript Highlights:

• Workforce reductions contribute to higher deficiency rates and lower CMS star quality ratings, consistent
• long-term health care workforce go to the profits of private equity. to higher deficiency rates and lower CMS
• to higher deficiency rates and lower CMS star<00:13:27.040> quality<00:13:27.519> ratings,

Keywords: 1183, house

Summary: The committee took up two bills concerning health entity ownership and heard invited testimony before acting on them. Dr. Yasha Singh of Brown University testified about private equity in healthcare, describing how PE firms use debt-financed acquisitions, short investment horizons, and roll-up strategies that can avoid disclosure requirements. He said the lack of transparency makes it difficult to track ownership and outcomes, and cited research linking PE ownership to higher costs in outpatient care, more ancillary service use, workforce turnover, and worse outcomes in hospitals and nursing homes. He also noted Minnesota-specific concerns, including PE involvement in opioid treatment programs, and said the policy challenge is balancing needed capital investment with protections for patients and workers. Sam Brooks of the National Consumer Voice for Quality Long-Term Care testified in strong support of the legislation, focusing on nursing homes. He argued that private equity ownership is associated with worse resident outcomes, including higher mortality, more pressure ulcers, more hospitalizations, and more deficiencies, and said leverage buyouts divert money from staffing and care into debt service, management fees, and lease-back arrangements. Brooks said staffing levels and quality ratings decline under PE ownership and pointed to recent bankruptcies as examples of instability. He said the bills would add safeguards such as transparency, attorney general approval of acquisitions, and requirements that a large share of public funds go to direct resident care. The testimony framed the bills as responses to concerns about private equity ownership in healthcare and long-term care, especially the effects on quality, staffing, and financial stability. No vote or final committee action was described in the excerpt.

Transcript Highlights:

• be a rule introduced by June 1st by CMS be a rule introduced by June 1st by CMS to<00:26:36.559>
• In subsequent meetings<00:53:56.559> with<00:53:56.880> CMS<00:53:57.760> and<00
• So that's how we have been advised by CMS to think about medical frailty.
• So that's how we have been advised by CMS to think about medical frailty.
• So that's how we have been advised by CMS to think about medical frailty.

Keywords: 928, house, all

Summary: The committee first approved the draft minutes from its May 29 meeting and then received an informational update from the Commission for the Deaf and Hard of Hearing about the state’s ASL interpreter pipeline. Representative Woods and Associate Commissioner Ann Landry explained that the American Sign Language program at UNH Manchester, the nation’s first fully accredited program, is facing viability concerns because high tuition has left only two of a potential 20 students committed so far. They warned that if enrollment does not recover, the program could face a teachout and eventually be lost, which they said would be detrimental because many state services and legal proceedings require qualified interpreters. Members discussed possible alternatives, including whether community colleges could help, and asked for follow-up research and contact information for UNH officials. The committee also heard that interpreter demand across DHHS continues to rise and that the department must ensure compliance with civil rights and service-access requirements. The committee then turned to Medicaid policy changes tied to Senate Bill 134 and a new federal interim final rule on Medicaid community engagement, or work, requirements. DHHS officials Olivia May and Ann Landry explained that the state law and federal rule align in many areas, but the committee still needed to decide how to implement several remaining policy choices. The department recommended adopting all four short-term hardship exceptions because the federal rule requires states to take them all or none: inpatient or institutional care, federally declared emergencies, high-unemployment areas, and extensive out-of-state travel for serious medical care. Members generally supported the exceptions but raised concerns about how they would be defined and applied, especially the emergency and medical-travel categories. Several legislators asked for more clarity on terms like “extensively” and “serious or complex medical care,” and DHHS said the federal rule does not rigidly define them, though the state could refine implementation through rulemaking if authorized. The department also said the emergency exception would apply only to federally declared emergencies, not state declarations, and would be tied to the emergency event itself. No final vote on the Medicaid policy was recorded in the portion provided, but the discussion indicated the committee was reviewing the remaining decisions needed to implement Senate Bill 134 under the new federal framework.