Transcript Highlights:

• It's called the PERM audits, the Payment Error Rate Measurement audits that CMS conducted.
• That letter has been submitted to CMS.
• That letter has been submitted<00:54:12.400> to<00:54:12.640> CMS.
• We've been working with CMS. We have routine meetings with them.
• those requirements by CMS. those requirements by CMS.

Keywords: During the committee meeting live stream, portion of the video was lost due to network issues. There were also some technical difficulties with content and the incorrect background image being used. The lost footage was recovered from backup, and the other issues corrected in post production editing. 1. 00:00:41 Call to Order 2. 00:01:02 Roll Call 3. 00:02:54 Approval of Minutes 4. 00:05:06 Statutory Reports and Data Requests 5. 00:35:14 2025 and 2026 Session Update 6. 01:03:10 Board Structure Updates and Subcommittees 7. 01:05:20 Public Comment 8. 02:23:14 Adjournment, 958, all

Summary: The Medicaid Oversight Board meeting opened with quorum, approval of the March 9 and March 16, 2026 minutes, and a welcome to new member Representative Willner. The board then heard a presentation from the Department of Medicaid Services on several statutory reports: the quarterly budget analysis (LRC) report, the quarterly MCO report, the provider tax and assessment report, the enrollee demographic report, the annual behavioral health/substance use disorder utilization report, and the Medicaid pharmaceutical rebate fund. Commissioner Lisa Lee and CFO Steve Bechal explained the reports and answered questions. On spending, DMS said the quarterly budget analysis report should be read using the summary tabs because the first tab reflects only traditional Medicaid and does not include all populations. Lee said the first three quarters of fiscal year 2026 showed about $191 million more in waiver spending than the same period last year, about $250 million more in other categories such as nursing facilities, CCBHCs, and FQHCs, and roughly $450 million more in total fee-for-service spending. She also noted that Medicare Part D premiums are 100% state funds and estimated the state-fund increase at about $140 million. For managed care, DMS said pharmacy, inpatient hospital, and outpatient hospital spending made up about 66% of MCO payments so far this fiscal year. Members asked about administrative costs, provider tax impacts, citizenship-status categories, medical loss ratio, and whether the reports could be expanded to show recoupments and citizenship-based spending. DMS clarified that the spending figures discussed were benefit costs only, not administrative costs, and said administrative match rates vary. On the provider tax and directed payments report, Lee said the new CMS proposed rule would allow separate payment terms to continue through the grandfathering period, but that the impact would be substantial for providers even if the administrative effect was minimal. She also said DMS was still reviewing unusual citizenship categories such as “other” and “unspecified,” and would provide more information on medical loss ratio and recoupments if available. Auditor Ball raised concerns about alleged waste, duplicate Social Security numbers, ineligible enrollees, and high error rates in other programs. Lee responded that Medicaid focuses on fraud, waste, and abuse, but said the cited $800 million figure was not factual because it did not account for people enrolled in more than one Medicaid program at the same time. She said DMS is reviewing eligibility systems, including changes tied to community engagement requirements, and is working with the cabinet’s eligibility staff and ombudsman division on error rates. No additional votes or formal actions were taken beyond approving the minutes.

Transcript Highlights:

• He said his amendment makes sure the bill language aligns with CMS language, and that the goal is for
• federal requirements from CMS.
• So my amendment makes sure that the CMS.
• Uh and so is not a requirement from CMS.
• requirements from CMS requirements from CMS >> and<00:49:49.119> I<00:49:49.280>

Keywords: 919, house, all

Summary: The House first adopted non-controversial motions, then approved an urgency motion to suspend the rules so Senate File 4476, the human services program integrity package, could move quickly to conference committee before the end of session. The House then adopted a DE amendment to insert House language into the bill, and proceeded to debate several amendments focused on program integrity, fraud prevention, and reporting requirements in human services programs. Representative Schultz offered Amendment A5 to remove a sunset on the periodic data matching report requirement, arguing the report helps ensure only eligible people receive medical assistance and welfare benefits and should continue to be delivered annually. Supporters said the report had been inconsistently delivered, cited past findings of ineligible recipients, and framed the amendment as a low-cost accountability measure. Opponents, including Representative Nor, said the report had been sent to the chairs, that the issue should be handled through broader HR1-related changes and negotiations with the Senate, and that the amendment was not the right vehicle. After roll call, A5 failed on a 63-67 vote. Schultz then offered Amendment A6, which would require reporting on homelessness programs, including how many people are served, total costs, outcomes, and possible recoupment of funds if reporting is inadequate. Schultz said the state spends tens of millions on homelessness programs without clear results and that better data would help the legislature make decisions and protect taxpayers. Several members supported the idea of more accountability, while others said the state already receives reports, that homelessness work is being done in partnership with stakeholders, and that the amendment was not the best approach. The discussion continued with further comments on homelessness data and program oversight, but no final vote on A6 is shown in the transcript excerpt.

Transcript Highlights:

• CMS has stated that up to 30% of the nation's critical access hospitals are in jeopardy of closing in
• What I would say is this: CMS has identified that these hospitals are at a breaking point, um, and the
• and based of what I'm hearing from CMS and based of what I'm hearing from people<00:33:30.480> in
• CMS has proven that over and over and over again, and I don't have a dog in this fight, okay?
• <02:10:21.159> uh insurers and CMS uh insurers and CMS uh nationally<02:10:23.199> two<

Keywords: 1191, senate, all

Transcript Highlights:

• So, part of the study was just collecting that information they had already submitted to CMS.
• However, that didn't account for all CMS providers.
• However, that didn't account for to CMS.
• However, that didn't account for all<01:02:50.799> CMS<01:02:51.359> providers.
• So, what they did is all CMS providers.

Keywords: 1191, senate, all

Transcript Highlights:

• Senate Bill 739 fills that gap and makes reasonable adjustments to the CMS program, supported by a two-year
• But the current CMS framework is no longer economically or technically feasible.
• It provides CARB with the authority to recalibrate the CMS targets in light of existing market conditions
• But that's something they can already do right now under the existing CMS program.
• new standard that the CEMS program... ...amended version, this now becomes a new standard, that the CMS

Summary: The Assembly Transportation Committee heard several bills focused on active transportation, transit, road safety, and local enforcement. SB 569 would restrict removal or downgrading of bikeways built with state General Fund dollars for at least 20 years, require public hearings before major changes, and was supported by bicycle advocates and some local and environmental groups. The City of Encinitas opposed the bill, arguing it could limit needed safety fixes and should apply only to future projects; committee members discussed whether the bill still allowed safety-based modifications. The bill passed on a due pass vote to Appropriations. SB 741 would streamline the Low-Carbon Transit Operations Program by reducing administrative burden and giving transit agencies more flexibility to use funds for service improvements, fare programs, and other transit needs while maintaining oversight and disadvantaged community requirements. Transit agencies and advocacy groups supported the measure, saying it would help agencies respond to post-pandemic ridership and financial challenges. The committee approved the bill on a due pass as amended vote to Appropriations. The committee also heard SB 1167, which would tighten consumer protections by clarifying that high-powered e-motos and similar motor vehicles are not e-bikes, requiring clearer disclosures and labels, and improving crash reporting. Supporters said the bill would reduce confusion and improve safety for riders, pedestrians, and parents; the Motorcycle Industry Council opposed unless amended, arguing the term “e-bike” is used broadly and the bill could affect existing businesses. The bill passed to Appropriations. Later, SB 953, dealing with vehicular manslaughter cases dismissed through misdemeanor diversion, would add DMV points so fatal conduct remains reflected on driving records; the bill was supported by the victim’s family and safety advocates and passed to Appropriations. The committee then heard SB 1218, which would let local agencies boot vehicles tied to repeated unpaid illegal dumping citations instead of using DMV enforcement. Oakland officials and community groups supported the bill as a needed deterrent, while the ACLU opposed it as punitive debt collection without a sufficient nexus to the vehicle. The bill passed to Appropriations. Finally, SB 739 would revise the Clean Miles Standard for rideshare companies by allowing CARB and CPUC to adjust electric vehicle mileage targets in light of current market conditions; Uber and Lyft supported the flexibility, while clean air advocates began raising concerns about weakening climate goals as the transcript cut off.

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
• Yeah, $29 million for this year, $39 million for next year, and CMS has approved the rate increase, so

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

Transcript Highlights:

• pilot through our 9817 funds, the money we got around the American Rescue Act that came straight from CMS
• CMS will only let us use the money until September 30th. So we're going to have a lot of...
• CMS will only let us use the money until September 30th.

Summary: The subcommittee reviewed multiple methods of finance and construction items, including projects for Arkansas State University, Black River Technical College, UAMS, the University of Arkansas at Pine Bluff, and UCA. The UAPB Allied Health and Sciences Building appeared both as a method of finance and as an alternative delivery construction project, with East Harding Construction selected and AMR Architects as designer. Members approved the methods of finance, the alternative delivery project, and several discretionary grants, including Department of Health grants for a heart attack center designation and community health worker training, and DHS grants related to homeless services, behavioral health transition support, and an enabling technology pilot. The committee then reviewed service contracts, including RFQs, construction-related contracts, intergovernmental agreements, and a large number of out-of-state and in-state contracts. Testimony focused heavily on DHS staffing and state hospital contracts, the Arkansas State Police seatbelt survey, AEDC’s lithium supply chain analysis, and Shared Administrative Services’ new SuccessFactors performance-management contract. Members asked detailed questions about contract nursing costs, turnover, hiring timelines, and whether some contracts were being renewed or amended beyond their original projected costs. DHS and Veterans Affairs officials explained staffing shortages, retention incentives, and the use of contract labor as a supplement to state employees. Several contracts drew scrutiny and were held for further review. Representative Wardlaw raised concerns about projected costs and repeated amendments on the Department of Education security contract and on DHS staffing contracts, arguing that some had exceeded their original projected totals. The committee voted to hold contracts 5, 7, and 8 until Friday, while adopting the remaining contracts. The meeting ended after informational reports on service contract amendments without material change, executed contracts, and emergency procurements were presented, with no further business before adjournment.

Transcript Highlights:

• President, the House amended the bill by reducing the rate from 400 percent to the current CMS rate.
• President, the House amended the bill by reducing the rate from 400% to the current CMS rate of 200%.

Keywords: 994, senate, all

Summary: The Senate took up a series of House amendments and concurrence motions on several bills. Senate Bill 4 on crimes against public justice was amended to restore a cleaner definition of harassment and then passed 31-2. Senate Bill 59 on voter eligibility and residency requirements was amended with clarifying language on challenges to voter residency, passed 33-0, and made effective January 1, 2027. Senate Bill 104, providing raises for certain state mine inspectors, concurred in a House effective-date change and was made effective July 1, 2026. Senate Bill 200, increasing penalties and fines for assault on certain public service workers, law enforcement officers, and police animals, concurred in a technical House amendment and passed 33-0. Senate Bill 481 on elections concurred in a House effective-date change and was made effective from passage. Senate Bill 531, the First Amendment Preservation Act, was amended to add entities associated with foreign adversaries, passed 31-2, and was made effective July 1, 2026. The Senate also concurred in House amendments to Senate Bill 641 on above-ground storage tanks, which narrowed the bill by reducing the tank threshold and limiting covered fluids to brine water; it passed 25-8. Senate Bill 645 on surprise billing for ground emergency medical services was amended to reduce the rate from 400% to the current CMS rate of 200% and remove some balance-billing prohibitions; it passed 29-4. Senate Bill 800 on jury service policy was amended to allow certain people with expunged or pardoned convictions to serve on juries and passed 31-2. Senate Bill 878 creating an Office of Entrepreneurship within the Secretary of State’s office had House amendments removing redundant language and increasing flexibility; it passed 30-4 and was made effective July 1, 2026. The chamber also received a Rules Committee report recommending passage of Engrossed Committee Substitute for House Bill 5381, which concerns developing a comprehensive state energy development policy and plan for the Office of Energy. The bill was advanced to third reading with the right to amend. The Senate then moved through announcements and adjourned until the next day at 11 a.m.

Transcript Highlights:

• <00:12:53.160> draw<00:12:53.440> Downs<00:12:53.720> the<00:12:53.839> CMS
• 64 report is the the draw Downs the CMS 64 report is a<00:12:55.760> quarterly<00:12:56.320><
• um basically take direction from CMS um basically take direction from CMS from<03:05:34.439>
• <03:05:35.920> to from the regional office of CMS to from the regional office of CMS to perform
• where CMS says they need to go in that day.

Keywords: 1189, house, all

Summary: House Finance Division III convened a work session on the DHHS budget, with the chair noting there would be no votes and that the committee would spend the day hearing from the commissioner’s office. Nathan White, DHHS Chief Financial Officer, opened with the Division of Finance/Office of Business Operations, explaining that the unit supports the department through daily financial management, AP/AR, audit work, expense projections, transfers, and procurement functions such as contracts, amendments, RFPs/RFAs, and grants management. He also described the division’s revenue and reporting work, including federal draws, CMS-64 reporting, and the public assistance cost allocation plan, and said the department had centralized rate-setting work and a small team handling Medicaid rate analysis and nursing facility rebase work. Members asked about vacancies, turnover, and budget changes. White said the division had 18 positions unfunded in the governor’s budget, reducing personal services from about $10.8 million to $9.9 million, and estimated the division’s vacancy rate at about 11 percent, below the department average. He said turnover was relatively low, with one retirement at the manager level and higher turnover mainly at lower AP-level positions. He also explained that some budget lines reflected reallocations rather than new spending, including fringe benefits centralized elsewhere and an EBT card contract moved into this unit because the staff member overseeing it works in Finance. When asked about a rent/lease increase, he said it was due to higher copier leasing costs under a statewide DAS contract. White highlighted several management and technology improvements. He said a business intelligence tool procured in 2022, using Salesforce and Excel-based data, helped DHHS better track federal revenue and maintenance-of-effort spending, reducing FY24 General Fund lapse by about 70 percent and federal/other revenue lapse by 88 percent compared with FY23; he warned that the tool is not funded in the current budget. He also described Lean Six Sigma efforts in the contracts team, training for vendors and nonprofits on procurement and indirect cost rules, and a Finance Academy to standardize policies and procedures. On the contracts side, he said the department uses Smartsheet for project management and DocuSign for electronic signatures, which cut contract execution time dramatically, but noted DocuSign is also not funded in the governor’s budget. The session ended as the committee prepared to move on to the Employee Assistance Program presentation.

Transcript Highlights:

• Uh, in the next week or so we will be in engagement with CMS, and it's an open discussion time where
• And it's really getting down to the brass tacks with CMS of um what that budget is going to look like
• week or so we will be in<00:08:14.560> engagement<00:08:15.120> with<00:08:15.360> CMS
• of um what to the brass tax with CMS of um what that<00:08:41.680> budget<00:08:42.000> is
• We're very excited that it represents the voice of New Hampshire, and we'll see what CMS allows from

Keywords: 928, house, all

Summary: The committee first handled routine business, approving the prior meeting minutes with one abstention from a member who had been absent. It then received an update from DHHS Commissioner Lori Weaver on the department’s rural health transformation grant submission. Weaver said the grant was submitted ahead of the deadline, reflected input from communities and providers statewide, and would now enter a CMS review and negotiation phase. She explained that the governor’s office will oversee the grant with DHHS, that some proposals may be limited by federal parameters, and that the department may need to hire some staff to administer the grant, within the grant’s administrative cap. Members also discussed DHHS budget pressures and staffing. The department’s CFO, Nathan White, reviewed the agency’s budget mix, noting that DHHS accounts for a large share of the state’s operating and general fund budgets, and explained projected general fund lapse estimates, which he said are currently just under $20 million for the department. He also described why lapse projections are difficult to predict in DHHS because many costs are driven by utilization and because some funds are statutorily non-lapsing. White reported that vacancy rates have risen, citing about 400 unfunded positions in the current biennium and the department’s hiring freeze, while emphasizing that direct-care positions are being prioritized. Committee members raised concerns that back-of-the-budget cuts and weak revenue collections could affect the department’s ability to manage lapse projections. The committee then heard from Division of Public Health Director Ian Watt on vaccine policy and federal changes. Watt said New Hampshire continues to support access to safe and effective vaccines, including through the universal purchase program and seasonal respiratory virus guidance. He explained a recent CDC change regarding the MMRV vaccine, which now discourages the combined shot for the first dose in children under four because of febrile seizure risk, while still allowing it for the second dose. Watt said New Hampshire’s school and child care vaccine mandates remain stable, with nine vaccines required for schoolchildren and 10 for child care, and that the state continues to review federal recommendations cautiously. He also said there have been no supply or funding disruptions affecting vaccine access, and that childhood vaccine funding through commercial insurers remains intact. Finally, the Permanent Subcommittee on Alzheimer’s Disease and Other Related Dementias presented its annual report. The subcommittee said it met about six times, heard presentations on state services, silver alerts, brain health awareness, and palliative/hospice care, and began work on updating the state’s Alzheimer’s plan, which had last been updated in 2015-2016. To gather more direct input, the subcommittee formed a needs-assessment work group to develop a survey for people living with dementia, caregivers, and service providers. It recommended integrating Alzheimer’s and dementia materials into chronic disease, aging, and public health outreach; embedding cognitive health into systems of care and the state health improvement plan; adding cognitive health measures to BRFSS; and continuing partnerships with aging and advocacy organizations. Members praised the report and suggested it should clearly identify the subcommittee and include page numbers in future versions.

Transcript Highlights:

• technology subscription fees in addition to, and we'll talk about this with the update with the big CMS
• technology subscription fees in addition to, and we'll talk about this with the update with the big CMS
• technology subscription fees in addition to, and we'll talk about this with the update with the big CMS
• technology subscription fees in addition to, and we'll talk about this with the update with the big CMS
• With the update with the big CMS implementation.

Keywords: 958, all

Summary: The Interim Joint Budget Review Subcommittee on Justice and Judiciary met without a quorum and heard an update from the Administrative Office of the Courts on the judicial branch budget. AOC Director Zach Ramsey and budget director Carol Henderson outlined the branch’s current funding structure, noting that fiscal year 2026 general fund support is about 2.77% of the state general fund, below the National Center for State Courts’ typical 2% to 4% range. They emphasized Kentucky’s unusual responsibility for courthouse facilities, with the judicial branch directly involved in construction, maintenance, and operations across 229 facilities in all 120 counties. AOC said nearly 91% of its general fund is spent on personnel and other non-discretionary costs, and that the branch has long relied on agency revenue, restricted fund carryforwards, and vacancy credits to balance court operations. Members were told that Senate Bill 25 required a $34.5 million transfer into a reserve account, part of which was used to purchase the Chamberlain Avenue building in Frankfort. AOC reported that only $11.9 million remains in restricted funds, while it projects needing about $13.5 million to cover fiscal year 2026 obligations, not including roughly $9 million in flood-related remediation costs for Hardin and Franklin counties, much of which it expects to recover through insurance and FEMA. Looking ahead to the next biennium, AOC said it will seek full funding of court operations at $341 million annually, a $13.5 million increase to bring current services into the base appropriation rather than relying on reserves. It also previewed additional requests, including a 15% across-the-board pay parity plan for Kentucky Court of Justice personnel, replacement of declining master commissioner fee revenue tied to 141 deputy circuit court clerk positions, funding for technology subscription and case management system costs, JAV audiovisual system upgrades, AEDs and medical kits for courthouses, and other staffing and operational needs. Senator Funky Frommeyer asked whether the 15% salary proposal was included in the $13.5 million increase; AOC said it was not, and that it would be an additional request. No votes or formal actions were taken.

Transcript Highlights:

• Steve said the state is obligated to make payments in a compliant manner that CMS would allow.
• :17:38.919> compliant<00:17:39.600> manner<00:17:40.160> that<00:17:40.360> CMS
• payments in a compliant manner that CMS payments in a compliant manner that CMS would<00:17:41.240
• rules they have to be allocated the CMS rules they have to be allocated based<00:42:25.559> on
• But we were able to propose to CMS doing an additional, if you were a border hospital within, I think

Keywords: 1191, senate, all

Transcript Highlights:

• To the first question, CMS does have a process for updating the Essential Health Benefit benchmark plans
• ><00:21:06.080> first<00:21:06.360> question<00:21:07.320> uh<00:21:07.440> CMS
• you um so to the first question uh CMS you um so to the first question uh CMS does<00:21:08.440>
• But on this piece of mandates, this is the list that CMS has on file for Minnesota's state mandates.
• has on file for Minnesota's that CMS has on file for Minnesota's State<01:17:19.719> mandates

Keywords: 1183, house

Transcript Highlights:

• And then also the Centers for Medicare and Medicaid Services, CMS, finalized a rule that removes gender-affirming
• would be withdrawing, but we're actively trying to figure this out to understand the impacts of the CMS
• We need to come back to this as we're sort of figuring out what this final CMS rule means.
• We need to come back to this as we're sort of figuring out what this final CMS rule means.

Keywords: 995, all

Summary: The Senate first adopted three congratulatory resolutions recognizing the retirements of Dolores Hayes, Lisa Audet, and Kate Fitzpatrick. It then handled several procedural matters, including suspending Joint Rule 12 to refer a sick leave bank bill for a Suffolk County Sheriff’s Office employee to the Committee on Public Service and referring House petitions to their respective committees. The chamber also adopted a conference report on the joint rules for the 2025-2026 session after remarks from Senators Creem, Tarr, Lovely, and Fattman emphasizing transparency, public access, recorded votes, longer notice for hearings and conference reports, remote participation, and periodic review of the rules. The report was accepted by a 40-0 roll call. The Senate then took up the bill strengthening health care protections in the Commonwealth, Senate No. 2538, commonly described as Shield Act 2.0. Senator Friedman and others argued the bill was needed to protect reproductive and gender-affirming care from out-of-state and federal interference, to limit disclosure of sensitive information, to create a state-level EMTALA-style protection for emergency care and active labor, and to strengthen privacy and licensing protections for providers and institutions. Senators Cyr, Lovely, and Fattman also spoke in support, framing the bill as a response to recent federal and state threats and as an extension of Massachusetts’ prior shield-law work. The chamber considered numerous amendments. Several were rejected, including amendments by Senators Finegold and Keenan and multiple Tarr amendments on topics such as medical records, consistency with existing law, and public health data collection. Some amendments were adopted, including a Montigny amendment on health-connected data disclosure, a Brownsberger amendment further protecting privacy for reproductive and gender-affirming care, a Rauch amendment clarifying protections for patients in active labor, a Tarr amendment removing an exemption for data from personal tracking devices, and a Rodrigues corrective amendment. After the amendments, the Ways and Means substitute was adopted, the bill was ordered to a third reading, and it then passed to be engrossed by a 37-3 roll call. At the end of the session, the Senate adopted a memorial adjournment in honor of former Senate Majority Leader Louis P. Bertinazi. The Governor also filed a message submitting a bill to build resilience for Massachusetts communities, authorizing future capital spending for energy and environmental affairs, which was referred to the Committee on Environment and Natural Resources. The Senate then adopted an order to meet again the following Monday at 1 p.m. and adjourned.

Transcript Highlights:

• licensed by the Office of Long-Term Care on behalf of the Centers for Medicare and Medicaid Services, or CMS
• So CMS, but in real time, in practice at the facility, it's the professional staff.
• almost all of them, 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 the October 8, 2025 minutes and then held an extended hearing on the death of Zachary Moore at the Southeast Arkansas Human Development Center. DHS officials Lori McDonald, Jennifer Brise, and Melissa Weatherton described the HDC system, staffing and resident needs, and said Moore died after being held in a prone restraint for about 13 minutes, followed by a delayed chemical restraint and delayed CPR. They said the family settled a wrongful death claim for $725,000, 13 staff were terminated, the facility leadership was changed, and at least five staff had been criminally charged, with the death certificate later described as homicide and the cause of death as physiologic stress associated with struggle and prone restraint. Members pressed DHS on why the family was not kept informed, whether there was a written restraint protocol, how staff are trained, and why the agency did not have more complete information ready for the hearing. DHS said staff receive CPI restraint training, annual restraint training is mandatory, and a consultant is reviewing policies, retraining staff, and conducting a root cause analysis under a directed plan of correction from the Office of Long-Term Care. Legislators also raised broader concerns about low pay, staffing shortages, use of float and contract staff, and a waiting list of about 2,000 people for home- and community-based care. DHS said it is working on a retention and recruitment plan and a rate report for certain PASS services, but that the PASS rate study does not cover CNA pay. Several members said the incident reflected both a failure of restraint practice and a broader staffing and oversight problem. DHS acknowledged that prone restraint should not have been used, that the chemical restraint was given at the wrong time, and that multiple breakdowns occurred in supervision, communication, and equipment use. The committee also discussed whether there should be more regular independent audits of HDC policies, and DHS said it does not currently have a separate annual policy audit beyond existing oversight. At the end of the meeting, the committee asked DHS to keep it updated on recruitment, consultant reports, and to contact Moore’s mother about the communication she had been promised. The meeting adjourned without any additional formal action beyond approving the minutes.

Transcript Highlights:

• licensed by the Office of Long-Term Care on behalf of the Centers for Medicare and Medicaid Services, or CMS
• So CMS, but in real time, in practice at the facility, it's the professional staff.
• almost all of them, relate back to policies specifically around what the Office of Long-Term Care and CMS
• And they're out all the time, so the survey, the CMS OLTC surveyors...

Keywords: 1204, all

Summary: The Joint State Agencies committee met to approve the October 8, 2025 minutes and then held an extended oversight discussion with the Department of Human Services about the death of Zachary Moore at the Southeast Arkansas Human Development Center (later clarified in testimony as the Warren facility). DHS officials described Moore’s background, said he died after being restrained in a prone position for about 13 minutes, and reported that a nurse later administered a chemical restraint before CPR was attempted. They said the agency settled with the family for $725,000, terminated 13 staff members, changed facility leadership, and brought in consultants under a directed plan of correction from the Office of Long-Term Care to review policies, retrain staff, and conduct a root-cause analysis. Later testimony clarified that the death certificate listed the manner of death as homicide and the cause as physiologic stress associated with struggle and prone restraint; committee members also noted that six people had been charged with manslaughter and neglect of a vulnerable person. Members focused on restraint policy, staff training, chain of command during emergencies, family communication, and whether warning signs had been missed. DHS said it has written restraint protocols, annual restraint training, and a mortality review process, but acknowledged that the Warren facility had multiple failures, including use of a prone restraint, improper chemical restraint, poor supervision, inadequate communication, and problems with equipment and behavior plans. Officials said they were revising policies, creating clearer crisis-team roles, and retraining staff, and that the consultant work would be shared across the other human development centers. Several members pressed DHS on why the family had not been kept informed, why the agency was not prepared with basic facts, and whether a more formal independent audit of facilities should exist. The committee also discussed broader staffing and funding issues across the human development centers. DHS said CNAs start at about $39,000 a year, that the centers rely heavily on float and contract staff, and that there are about 2,000 people on a waiting list for services. Members argued that low pay, turnover, and rural staffing shortages contribute to risk and asked for recruitment and retention plans, possible regional pay differentials, and more legislative support. DHS said it is drafting a systemwide retention and recruitment plan and expects to bring it to ALC, while also implementing a separate rate study for certain PASS program services in January 2027. The meeting ended after comments from Zachary Moore’s mother, Angela Stevens, who said money cannot replace her son and urged the state to ensure no other family experiences the same loss; the committee asked DHS to keep members and Ms. Stevens updated on consultant reports and recruitment efforts before adjourning.

Transcript Highlights:

• This information was all sent in May of last year to the governor's office, to the director of CMS, Dr
• Oz, and... ...to the director of CMS, Dr.
• In the proposal to CMS, Access indicated they were... Okay?
• In the proposal to CMS, Access indicated they would pay out year one payments ahead of time to help fund

Keywords: 1182, all

Summary: The Senate Committee on Health and Human Services held a fourth hearing in its ongoing review of alleged fraud, waste, and abuse involving AHCCCS/Access and DHS, with a major focus on Medicaid eligibility verification for the aged, blind, and disabled (ABD) population, behavioral health and sober living oversight, and payment delays to providers. Senator Shamp presented findings she said showed major gaps in ABD asset verification, including claims that only a fraction of enrollees were checked and that many ineligible members may remain on the rolls. She urged referrals to law enforcement, tighter verification requirements, better PARIS data sharing, and legislative changes to close what she described as a compliance and taxpayer-risk gap. Reva Stewart also testified that patient brokering and fraudulent recruitment of vulnerable people, including Native Americans, continues through social media and other channels, and she called for stronger enforcement and transparency. Heather Dukes, representing behavioral health and sober living operators, argued that the state’s response to fraud has become overly punitive toward legitimate providers. She said ADHS often sends technical paperwork deficiencies straight to enforcement instead of allowing plans of correction, that zoning approvals are being questioned despite not being within ADHS authority, and that long Access approval timelines are creating licensing and billing delays. ADHS Deputy Assistant Director Tiffany Slater said the department has seen a large volume of unlicensed complaints, that it is trying to improve staffing and data systems, and that some enforcement tools have been expanded for sober living homes. She also said many sober living operators are in recovery themselves and provide low-cost housing and support rather than direct billing to Access. Access Director Virginia Roundtree said the agency is trying to balance fraud prevention with support for legitimate providers. She reported steps such as daily internal huddles, live dashboards, added project management support, an outside review of the Division of Fee-for-Service Management, and a new external claims vendor to help reduce backlogs. Senators pressed her on a specific provider’s long-delayed payments and prepayment review, and she said the agency would provide answers early the following week. Access staff also described provider resolution roundtables and said unadjudicated claims had been reduced to zero, though members questioned whether that was due to denials rather than resolution. The hearing ended with the chair announcing legislation to preserve the American Indian Health Plan as a fee-for-service option while requiring Access to contract administrative and care management functions to another entity, citing structural failures in Access’s ability to operate the plan safely and effectively.

Transcript Highlights:

• The bill directs the Department for Medicaid Services to seek approval from CMS and, upon approval, to
• and upon approval to approval from CMS and upon approval to implement<00:04:03.680> the<00:04
• Also, we just received a letter from CMS about redeterminations. As you know, it's one year.
• And as you heard in Miss which is CMS.
• Uh, we updated based on the guidance that CMS submitted.

Keywords: 00:00:00 - Call to Order/Roll Call 00:02:20 - Discussion of 26RS HB 689 00:13:13 - Discussion of 26RS SB 201 00:27:45 - Discussion of 26RS HB 583 00:46:37 - Discussion of 26RS HB 488 00:48:13 - Discussion of 26RS HB 2 01:14:34 - Discussion of Kentucky State Plan Amendment (SPA) 26:0001: School-based Medicaid Services Program 01:18:24 - Public Comment, 958, all

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:

• And the CMS first gave us our first component of the 1115 waiver was the substance use disorder waiver
• uh Centers for is a new um item that CMS uh Centers for Medicaid<00:21:23.039> Medicare<00:21
• As well as, CMS will cover—the federal government will cover—up to a 30-day supply of medications.
• :10.320> federal<00:25:10.559> government CMS will cover, the federal government CMS will
• So you'll hear folks refer to the CMS core set measures as well as the HEDIS measures.

Keywords: 928, house, all

Summary: The committee first handled roll call and approved the prior meeting minutes. Members discussed attendance and substitutions, then moved to the DHS commissioner’s update, which focused on New Hampshire’s Medicaid 1115 waiver and the new community re-entry initiative for people leaving correctional facilities. The presenter explained that the waiver lets the state cover certain services not normally covered under Medicaid, including substance use disorder treatment, serious mental illness services, adult dental benefits, and the new community re-entry component. She also noted that a separate youth re-entry component is federally required, with youth defined up to age 21 and foster-care-related coverage extending to age 26. The update described how the adult re-entry program works for incarcerated individuals with behavioral health needs, providing up to 45 days of pre-release services, care coordination with managed care organizations and DOC staff, telemedicine assessments, discharge prescriptions, insurance cards, and connections to community mental health, primary care, and substance use providers. For youth, the program includes more intensive case management, 30 days of pre-release services, and 30 days of post-release care coordination, with a stronger emphasis on screening, diagnosis, and holistic assessment. The presenter said New Hampshire received the adult waiver in July 2024, has implemented the program in state correctional facilities, and is beginning work at the youth center. Members and the presenter discussed why the program is structured as a waiver rather than a standard Medicaid benefit, with the explanation that CMS is allowing this as a newer policy area and that states generally pursue waivers for certain services. The chair and others emphasized the need for real cost and outcome data, and the presenter said an independent evaluator and evaluation plan are required under the 1115 waiver. Early results cited included 30 adults enrolled so far, 10 released, five youth enrolled with one released, and anecdotal early successes such as housing, employment, and better continuity of medication and treatment. The committee did not take any additional votes or formal actions beyond approving the minutes.

Transcript Highlights:

• an outlier, but the other states are doing it successfully and haven't had any negative impact from CMS
• an outlier, but the other states are doing it successfully and haven't had any negative impact from CMS
• an outlier, but the other states are doing it successfully and haven't had any negative impact from CMS
• an outlier, but the other states are doing it successfully and haven't had any negative impact from CMS
• an outlier, but the other states are doing it successfully and haven't had any negative impact from CMS

Keywords: Meeting Start 00:00:00 Roll Call 00:00:10 HB 2 Discussion 00:01:00 HB 2 Vote 00:04:00 HB 544 Discussion 00:05:05 HB 544 Vote 00:06:15 HB 552 Discussion 00:07:00 HB 552 Vote 00:08:40 HB 605 Discussion 00:09:35 HB 605 Vote 00:11:35 HB 606 Discussion 00:12:10 HB 606 Vote 00:15:40 HB 695 Discussion 00:16:25 HB 695 Vote 00:34:05, 958, all

Summary: The Appropriations and Revenue Committee took up several House bills and committee substitutes. House Bill 2, as amended by Senate Committee Substitute 1, was described by Rep. T.J. Roberts as restoring a tax exemption enacted in 2024 by providing refunds with interest to those improperly taxed and creating a cause of action; the substitute also aligned state filing deadlines for certain flood-disaster counties with the federal November 15 deadline. The committee adopted the substitute and then passed the bill with favorable expression. The committee also adopted a title amendment for House Bill 544, which Rep. Jason Petrie said was part of the state’s flood-relief discussion and would allow the guard cap to be used over the biennium rather than annually, effectively increasing the cap from $50 million per year to $100 million over two years; the measure passed with favorable expression. House Bill 552, handled by Rep. Josh Bray after Rep. Kim King’s absence, was described as simplifying tourist commission appointments. The committee substitute added creation of the Kentucky-Ireland Trade Commission and changed marina licensing agreements by exempting private contractors from the model procurement code. The committee adopted the substitute, approved a title amendment, and passed the bill with favorable expression. House Bill 605, sponsored by Rep. Kim King, clarified which grants qualify for a grant program and allowed cities or counties to apply on behalf of water districts or other entities not directly affiliated with them; Rebecca Hearts of Grant Ready Kentucky said the program had matched $103 million of the $200 million allocation, generating about $469.98 million in total project value. The committee adopted the title amendment and passed the bill with favorable expression. House Bill 606, by Rep. Wade Williams, added a capital-oversight reporting requirement for school district general obligation bonds that had been omitted from prior legislation. The committee substitute also made several budget and program adjustments, including moving Regional Training Center funds, accelerating funding for the Grand Lyric Theater, correcting water funding language, removing Odyssey Inc. language from a treatment-related item, fixing a double appropriation to LifeWorks Transition Academy, clarifying carry-forward language, allowing SRO reimbursements for public and non-public schools, and authorizing an additional $10 million in agency bonds for Western Kentucky University athletic facilities. The committee adopted the substitute, approved a title amendment, and passed the bill with favorable expression. The committee then spent the most time on House Bill 695, a Medicaid-related bill. Rep. Adam Bowling said the bill was intended to stabilize Medicaid, create oversight and advisory mechanisms, and address growth in the program. Cabinet for Health and Family Services Secretary Eric Friedlander and Medicaid CFO Steve Beckle said they were generally supportive of the transparency and reporting changes but flagged risks, including federal compliance concerns, budget growth from changing the drug rebate treatment, administrative costs tied to MCO rebidding and a managed long-term services study, and some data-collection challenges. Representatives from the Kentucky Association of Healthcare Facilities opposed the section calling for a managed long-term care reimbursement study, arguing it would be costly, duplicative, and likely ineffective, and they warned against managed care models for long-term care. Despite the concerns, the committee adopted the committee substitute by voice vote and moved the bill forward with favorable expression.