Transcript Highlights:

• payments.
• payments.
• payments.
• payments.
• payments.

Summary: The Budget Review Subcommittee on Health and Family Services heard a presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults with serious mental illness who do not qualify for nursing home care but need structured support, medication assistance, meals, housekeeping, transportation, and supervision. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and rely on a state supplementation rate of about $50.70 per day, which they argued no longer covers operating costs because of rising food, labor, insurance, and maintenance expenses. The presenters said the sector has shrunk significantly over time, citing a drop from 64 homes in 2002 to 34 today among the homes serving this population, with 30 closures over 23 years and two more closures since August. They argued that the closures have contributed to homelessness, hospital overcrowding, and longer stays in psychiatric hospitals, and they gave examples of residents who had spent many months in hospitals before stabilizing in a personal care home. One provider also described spending more than $800,000 on capital improvements after acquiring Kentucky facilities and said reimbursement is too low to sustain safe operations. They asked for an incremental reimbursement increase over two years and said they have also proposed an assisted-living model for people with mental illness. Members asked about staffing, reimbursement, and the number of people still needing placement. The presenters said there is no requirement for licensed or certified staff in these facilities, though some homes use medication technicians and occasional LPNs. They estimated they are currently serving about 2,000 residents and said they receive roughly 30 referrals for every one person admitted, with many referrals involving people whose needs exceed the personal care home level. Senator Meredith and Representative Fleming said any funding request would need documentation of savings and corresponding budget offsets, while Representative Duval expressed support and asked about possible staffing and program improvements. The witnesses also compared Kentucky’s flat-rate reimbursement to a more individualized reimbursement model in Minnesota, saying a needs-based system would better match staffing and reduce hospitalizations.

Transcript Highlights:

• And in addition to the regular fee-for-service payments, we do make hospital access payments.
• Our UPL payment, or upper payment limit payment, is $473 million for state fiscal year 25.
• upper payment limit payments.
• That sets your upper payment limit.
• So the hospitals fund their upper payment limit payments.

Committee: All ALC-HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE

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:

• In addition to the regular fee-for-service payments, we do make hospital access payments and cost settlements
• Our UPL payment, or upper payment limit payment, is $473 million for state fiscal year 25.
• upper payment limit payments.
• Medicare is considered the upper payment. So the difference is the total payment that can be paid.
• So the hospitals fund their upper payment limit payments.

Committee: All ALC-HOSPITAL, MEDICAID, & DEVELOPMENTAL DISABILITIES STUDY SUBCOMMITTEE

Transcript Highlights:

• What we're doing is we're trying to not allow the PBMs to delay the payments to the pharmacist.
• Senate Bill 2007 is a PBM bill that basically says that if a pharmacist acquires a drug and is reimbursed
• , then they shall be reimbursed for the actual cost. ...and that going forward, the PBM shall reimburse
• And for the last... reimbursed, that they shall be reimbursed for the actual cost, and that going forward
• , the PBM shall reimburse at that cost going forward.

Bills: SB206 , SB640 , SB667 , SB1344 , SB1380 , SB1423 , SB1425 , SB1436 , SB1484 , SB1500 , SB1502 , SB1503 , SB1557 , SB1562 , SB1572 , SB1644 , SB1645 , SB1794 , SB1796 , SB1806 , SB1849 , SB1984 , SB2007 , SB2074

Committee: House Health and Human Services Oversight

Keywords: SB206, emergency medical services, EMS, ambulance, 911 response, emergency response, essential services, federal funding, grant funding, public health, health care facility, municipality, county, ambulance service district, tribal entity, public entity, contract ambulance service, Oklahoma, 63 O.S. 2021 Section 1-2502, emergency clause

Transcript Highlights:

• </c> we have among the lowest reimbursement we have among the lowest reimbursement rates<00:08:28.400
• So, as the Medicaid reimbursements.
• </c> in reimbursements. in reimbursements.
• </c> for and amalgam is actually reimbursed for and amalgam is actually reimbursed at<00:24:53.120><c
• </c><01:08:42.400><c> for</c> payments uh double payments made for payments uh double payments made for

Summary: The Medicaid Oversight and Advisory Board meeting began with a roll call and approval of the October 7 meeting minutes. The chair then reordered the agenda to hear the item on Medicaid reimbursement rates and network adequacy first because of scheduling issues. Dr. Steve Robertson of the Kentucky Dental Association was sworn in and testified at length about Kentucky’s dental Medicaid program, arguing that reimbursement rates are unsustainably low, have been largely flat for decades, and are often below the cost of providing care. He said Kentucky ranks near the bottom nationally in oral health, dental Medicaid rates are often 60% or less of commercial rates, and the program’s share of the Medicaid budget has effectively remained around 2% despite growth in enrollment and services. Dr. Robertson said the low rates are contributing to provider losses, rural access gaps, longer wait times, dental deserts, and greater use of emergency rooms for preventable dental problems. He cited examples of office costs exceeding reimbursement for basic procedures, noted that many dentists are small private businesses, and said the state is struggling to recruit and retain dentists because of low payment levels and high student debt. He also pointed to disparities with neighboring states and said recent increases in some oral surgery and cleaning codes were not enough to address the broader problem. His recommendations included completing the rebasing study, increasing dental reimbursement in the upcoming budget, tying future reviews to inflation and cost data, aligning benchmarks, and prioritizing preventive and restorative care to improve workforce stability and access. Board members asked about the size of the needed increase, the effect of private insurance on dental practice finances, and what a new dentist might expect to earn. Dr. Robertson said the association is working on an appropriations request and that private insurance pressures are part of the problem as well, since many plans are HMOs or PPOs with limited provider control over rates. He also said the association can no longer conduct reimbursement surveys because of FTC restrictions, but would try to obtain current ADA data. In response to questions about the future of the program, he warned that without significant changes it could become unsustainable and cited Ohio and Missouri as examples where higher reimbursement improved provider participation and access. The board then heard from Mr. Bowman of Baldwin Consulting, who discussed outpatient behavioral health providers, including ABA therapy and mental health/substance use disorder services. He said these providers face similar issues of rising costs, flat reimbursement, and access problems. He reviewed Kentucky’s network adequacy standards, including travel-time standards, 30-day appointment limits, and newer federal requirements that will require services within 10 business days by 2029. He said wait times for outpatient behavioral health, especially children’s services and ABA, have grown substantially, sometimes to more than a year, and emphasized that the Medicaid department must enforce these standards.

Transcript Highlights:

• After making that payment, the insurer may pursue reimbursement from the at-fault party's insurer through
• This issue arises when, after those payments and reimbursements occur, the same damages are later presented
• They were not reimbursed by the other insurance company.
• Would they reimburse by the other insurance company?
• She gets a $35,000 payment from the other company.

Committee: House Insurance and Banking

Summary: The Insurance Committee first established a quorum and then went into executive session, where it voted House Bill 1615 and House Bill 2071 “do pass” with 11 ayes and no opposition on each bill, with one member present on the roll call. After returning to public session, the committee opened a hearing on House Bill 1647, sponsored by Representative Overcast, which was described as a fairness measure intended to prevent double recovery when insurance payments have already satisfied part of a claim. The sponsor and supporters said the bill was aimed at property damage claims and intercompany arbitration between insurers, though several members questioned whether the bill’s language was actually limited to property damage or instead reached broader collateral source issues and evidence rules. Committee members, especially Representatives Butts, Zimmerman, and Castile, pressed the sponsor on how the bill would work in practice, whether it would reduce a plaintiff’s recovery or instead affect insurer subrogation rights, and why arbitration was being addressed in an evidentiary statute. Supporters from the Missouri Insurance Coalition and other industry groups said the bill would clarify offset rules, preserve voluntary insurer-to-insurer arbitration, and prevent inconsistent court treatment of prior payments. Opponents, including attorney Blake Heath, argued the bill was drafted too broadly, did not stay confined to property damage, and was placed in the wrong statutory section because these issues are usually handled through insurer subrogation rather than in a lawsuit by the injured party. Additional support came from the Missouri State Medical Association, Associated Industries of Missouri, and the National Association of Mutual Insurance Companies, though some supporters also acknowledged the bill might need narrowing if the intent was property damage only. No vote was taken on House Bill 1647 during the hearing, and the committee adjourned after testimony concluded.

Transcript Highlights:

• After making that payment, the insurer may pursue reimbursement from the at-fault party's insurer through
• This issue arises when, after those payments and reimbursements occur, the same damages are later presented
• They were not reimbursed by the other insurance company.
• They were not reimbursed by the other insurance company.
• She gets a $35,000 payment from the other company.

Committees: House Insurance , House Insurance and Banking

Transcript Highlights:

• is the base payment plus the supplemental payment—is capped at the average commercial insurance rate
• On the disbursement side, CMS requires that Medicaid reimbursements be reimbursed based on volume.
• As for Medicaid, it hurts us on the Medicare reimbursement rate, but for Medicaid reimbursement on the
• Now, this is a Medicare reimbursement, not a Medicare reimbursement.
• Reimbursement to Chair Solis.

Committee: House Federal Funding Stabilization Subcommittee

Transcript Highlights:

• program payment, DSH payment, the UPL payment, GME, outpatient APC opt-outs, and EHR payments.
• structure. payment, uh the UPL payment, GME payment, uh the UPL payment, GME outpatient<00:30:34.880>
• </c> reimbursement for that hospital stay. reimbursement for that hospital stay.
• </c> product of the impact payments going up. product of the impact payments going up.
• You got paid in a dish payment. patient. You got paid in a dish payment.

Committee: Joint Medicaid

Transcript Highlights:

• But about 9 billion and supplemental payments associated with these 5 state directed payments.
• is payments under Medicaid.
• Every 3 years we have a payment.
• Supplemental payment is at 213%.
• genome sequencing to be reimbursed outside of of the drg separate reimbursement for this.

Bills: SB5223 , SB5831 , SB5928 , SB6183 , SB6071 , SB5995 , SB5966 , SB5841 , SB5840 , SB6061 , SB6058 , SB5931 , SB5944 , SB5520 , SB6011 , SB6087 , SB6076 , SB5916 , SB6016 , SB5936 , SB6137 , SB5956 , SB6025 , SB6009 , SB5833 , SB6161 , SB6188 , SB5890 , SB5917 , SB5820 , SB5973 , SJM8015 , SB5816 , SB6136 , SB6091 , SB6024 , SB5053 , SB5249 , SB5536 , SB5834 , SB5837 , SB5872 , SB5879 , SB5899 , SB5925 , SB6019 , SB6148 , SB6184 , SB6190 , SB6237 , SB6086 , SB5574 , SB5873 , SB5992 , SB5924 , SB6134 , SB6263 , SB5395 , SB6282 , SB5905 , SB6302 , SB5950 , SB6074 , SB6226 , SB6096 , SB5970 , SB6269

Keywords: criminal offense, fingerprinting, law enforcement, state regulations, public safety, mortgage modification, uniform regulations, homeowners, financial stability, foreclosure prevention, wildfire risk, disclosure, safety, environmental policy, risk assessment, SB 6183, HIV, antiviral drugs, antiretroviral therapy, AIDS

Transcript Highlights:

• I mean, are you getting reimbursed what you need to be reimbursed?
• So that's why that payment.
• So those payments are well above.
• For grandfathered payments...
• the Medicare payment rate.

Committee: House Federal Funding Stabilization Subcommittee

Transcript Highlights:

• with other child care payments.
• payments on top of our prior reimbursement rates.
• that they get that reimbursement back.
• that they get that reimbursement back.
• that they get that reimbursement back.

Transcript Highlights:

• These reimbursement rules have us moving expenses from one area where we could get some payment to an
• These reimbursement rules have us moving expenses from one area where we could get some payment to an
• </c> the move towards Fair reimbursement the move towards Fair reimbursement ensuring<00:53:24.720><c
• </c> directed payment directed payment programs<01:09:49.159><c> directed</c><01:09:49.679><c> payment
• payment gaps.

Committee: House Health Finance and Policy

Transcript Highlights:

• And even the payment models or the per-pupil payment at the time was just over $9,000.
• And even the payment models or the per-pupil payment at the time was just over $9,000.
• And even the payment models or the per-pupil payment at the time was just over $9,000.
• payment?
• reimburse.

Summary: The committee first approved the minutes and then received a lengthy DPI presentation from Stanley Schauer on statewide reading and math assessment data for students with and without disabilities. He explained the assessment systems used over time, the absence of 2019-20 data, and how North Dakota’s standards are set by educators. Members asked about alternate assessments, cohort trends, the apparent drop in proficiency in higher grades, and the new NDA+ assessment. Schauer emphasized that the biggest pattern in the data was the relative stability of students with disabilities, the post-pandemic drop and partial recovery, and the need to focus on reducing the novice category. He also said the state plans to revisit high school standard setting and that future data could be broken out by program, disability category, and schools using science-of-math or other initiatives. Public testimony from special education staff suggested that the flat performance of students with disabilities during COVID likely reflected continued services and intensive supports, and committee members discussed whether the current disparity goal is realistic and whether growth measures would be more useful than simple proficiency buckets. After the presentation, the committee took a short break and then moved into discussion of special education funding models. Chair Richter said members should contact Schauer directly with ideas for additional data views and noted that the committee would continue its work on funding and possible model changes. Brandon Bomback of Grand Forks Public Schools began a presentation arguing that the special education funding formula, especially the weighting factor, should be reconsidered if the committee wants a system that better reflects accountability and student needs. He said his comments were based on the perspective of a larger district and focused on the special education weighting factor rather than other parts of the formula. The remainder of his presentation was not included in the excerpt.

Transcript Highlights:

• We found that employee reimbursements and vendor payments were frequently inaccurate.
• expense reimbursements we tested contained errors that led to inaccurate payments.
• We also found that requests for reimbursements did not always match the payments that were made.
• , employee reimbursements, and payments, employee reimbursements, and purchasing<00:12:37.760><c> card
• Finding nine had to do with inaccurate reimbursements to employees and payments to vendors.

Transcript Highlights:

• That payment often just goes uncompensated.
• Disproportionate share hospital payments are payments that hospitals receive for uncompensated care,
• Red, um, DSH payments, disproportionate share, so that's a payment that only a handful of our hospitals
• reimbursement, what the Medicare program would have reimbursed for the same service. >> Co-Chairman
• And bundling payments is a great way to do... Bundling payments is a great way to do that.

Committee: Joint Health Insurance Affordability Task Force

Transcript Highlights:

• For example, the average reimbursement payment to the Kirkland Fire Department took about nine months
• lot of also of reimbursement of those agencies.
• There's a priority payment process.
• We also reimburse for equipment.
• Seeing long delays in reimbursement causes a shortfall of money.

Summary: The committee first met in executive session on several technology and economic development bills. Staff briefed proposed substitutes and amendments for House Bill 2157 on high-risk AI, House Bill 2225 on AI companion chatbots, House Bill 2351 on emergency responder protections, and House Bill 2186 on federal fund acquisition for economic development. Members discussed the competing approaches in the two proposed substitutes for HB 2225, including enforcement, disclosures, minor protections, and crisis-response requirements. The committee then voted to adopt the proposed substitute for HB 2225 and report it out with a due pass recommendation, with a 7-3 vote and three excused. It also passed HB 2186 out of committee with a unanimous due pass recommendation after discussion about reducing fiscal impact. The committee then held a public hearing on House Bill 2397, which would require timely reimbursement within 60 days for state agencies and local jurisdictions mobilized under the Washington State Fire Services mobilization plan. Fire officials and fire finance staff testified in support, describing reimbursement delays of six to ten months that strain local budgets and can discourage participation in wildfire deployments. Testifiers said the bill would improve cash flow and staffing stability, while also noting the need for technical clarification on when the 60-day clock starts and possible staffing needs at the State Patrol. No one testified in opposition. The final public hearing was on House Bill 2417, which would add victim-rights protections to the Washington Code of Military Justice, aligning state military justice procedures with the federal Uniform Code of Military Justice. The prime sponsor and military legal experts testified that the bill closes a gap so victims serving in the Washington National Guard receive the same notice, participation, and fairness protections regardless of whether they are in state or federal status. Veterans’ advocates also supported the bill, saying it would improve trust, reporting, and accountability. The bill was scheduled for future executive action, and the meeting adjourned after the hearings.

Transcript Highlights:

• And so as a result of— exactly how those payments will be exactly how those payments will be split.<00
• </c> there are some costs that are reimbursed there are some costs that are reimbursed 100%<00:13:36.160
• or add additional reimbursable expenses.
• ,</c><00:26:19.760><c> if</c> weren't allowable for reimbursement, if weren't allowable for reimbursement
• It's not to reimburse other expenses.

Committee: Senate Finance

Transcript Highlights:

• DCFS to see if there are any late child support payments.
• Arrears just means non-payment, right?
• The bill creates a clear reimbursement formula.
• We do agree with the reimbursing, but I do want to make clear it is contingent on our belief of reimbursing
• We do agree with the reimbursing, but I do want to make clear it is contingent our belief of reimbursing

Committee: Senate Insurance

Summary: The Senate Committee on Insurance met on May 6, 2026, and first reported HB 1241 favorably. That bill, by Chairman Furman, requires insurers to check with DCFS before paying certain insurance settlements to determine whether the recipient owes delinquent child support, and to withhold and remit arrears if found. DCFS explained that Louisiana already has intercepts and other collection tools, but no current mechanism for insurance settlements. Senators raised concerns about notice to obligors and about liability if insurers fail to withhold, but the bill was advanced without objection. The committee then heard HB 870, which would require health insurers and PBMs to cover lower-cost generic or biosimilar drugs when available and to use utilization management no more restrictively on those drugs. Supporters said the bill would improve access and lower patient costs by using wholesale acquisition cost as the comparison point. Opponents, including Louisiana Blue and the AFL-CIO, argued that WAC ignores rebates and net cost, could force plans to cover higher-cost biosimilars first, and could increase premiums and disrupt ERISA and fully insured plan design. The committee adopted a technical amendment set and then a second amendment set that added notice and reporting requirements tied to net cost calculations, and HB 870 was reported favorably as amended. Several other bills were moved with little or no opposition. HB 1176, concerning Medicare Advantage coverage for integrative cancer treatments such as cold cap therapy, cryotherapy, and acupuncture, was amended to change the effective date and then reported favorably. HB 1196, dealing with colorectal cancer screening follow-up colonoscopies, was also amended and reported favorably. HB 1162, a consumer protection bill requiring DOI to verify that a contractor named on a first-party property damage check is licensed in Louisiana, was amended and reported favorably. HB 826, which modernizes insurance referral rules to allow referrals by email or website address, was reported favorably. The committee also heard HB 1151 on insurer investment limits and solvency protections, and HB 1236 on pharmacy reimbursement and copay maximizer programs; both drew substantial testimony and concern, especially over retroactivity, PBM cost allocation, and whether copay maximizers shift costs to patients, but the transcript cuts off before final action on HB 1236.