Transcript Highlights:

• There's a number of different programs that come down with federal dollars. Right.
• There are other mechanisms of getting block grant dollars down to the states.
• The next day, it closes down, everybody can look at it.
• And he pulled his glasses down and said, it may be time for you to join the club.
• That's down from the current 7,000 hours. Okay. And that's for the apprentice.

Bills: HR115, HR116, HR117, HR118, HR112, HR113, HR114, HCR51, HCR52, SCR18, SCR20, SB14, SB76, SB118, SB142, SB156, SB170, SB197, SB234, SB258, SB287, SB288, SB313, SB315, SB393, SB396, SB426, SB427, HCR7, HB76, HB84, HB132, HB181, HB210, HB250, HB265, HB275, HB291, HB322, HB342, HB457, HB475, HB477, HB486, HB616, HB635, HB639, HB690, HB740, HB757, HB761, HB766, HB774, HB808, HB855, HB866, HB872, HB883, HB886, HB903, HB949, HB962, HB996, HB1003, HB1036, HB1054, HB1071, HB1076, HB1078, HB1113, HB1132, HB1146, HB1232, HB1233, HR15, HR20, HCR14, HCR6, HCR19, HCR10, HR74, HCR26, HCR35, HB98, HB108, HB131, HB151, HB161, HB288, HB294, HB305, HB310, HB320, HB336, HB380, HB392, HB403, HB420, HB459, HB476, HB540, HB615, HB631, HB637, HB648, HB665, HB682, HB789, HB813, HB815, HB835, HB870, HB905, HB915, HB933, HB938, HB987, HB1040, HB51, HB82, HB143, HB145, HB160, HB180, HB192, HB393, HB430, HB445, HB506, HB515, HB521, HB565, HB590, HB614, HB638, HB670, HB672, HB685, HB692, HB752, HB773, HB781, HB799, HB860, HB874, HB887, HB917, HB937, HB956, HB965, HB972, HB977, HB982, HB1006, HB1010, HB1044, HB1072, HB1088, HB1179, HB1200, HB81, HB400, HB154, HB410, HB463, HB827, HB868, HB952, HB953, HB140, HB750, HB911, HB52, HB961, HB399, HB401, HB901, HB9, HB58, HB193, HB284, HB570, HB577, HB582, HB605, HB733

Keywords: Kappa Alpha Psi, fraternity, Louisiana, commemoration, community engagement, recognition, state championship, basketball, sports achievement, school commendation, commendation, athletics, team sports, youth, community recognition, water utility, tax credit, excessive rates, residential service, subcommittee

Transcript Highlights:

• Who was not in awe by the starship launches down in South Texas recently?
• We'll refer them to work group chairs if you get down in the weeds when needed.
• I can't go help the church down the road or whom...
• And the fund pays for itself because of the interest payments, the low interest payments that are coming
• To pull down the amendment, the rider at this time.

Bills: SCR8, SCR25, SB1, SB14, SB24, SB213, SB251, SB315, SB371, SB378, SB379, SB406, SB413, SB472, SB487, SB502, SB502, SB509, SB513, SB513, SB565, SB565, SB583, SB608, SB621, SB650, SB686, SB686, SB707, SB710, SB710, SB761, SB761, SB810, SB815, SB840, SB856, SB875, SB875, SB896, SB896, SB916, SB925, SB958, SB958, SB961, SB965, SB965, SB973, SB973, SB987, SB990, SB995, SB1018, SB1019, SB1146, SB1146, SB1198, SB1252, SB1252, SB1253, SB1253, SB1330, SB1343, SB1362, SB1499, SB1499, SB1532, SB1532, SB1547, SB1547, SB1555, SB1596, SB1596, SJR36, SJR12, SJR57, SCR25, SCR22, SCR12, SCR8, SB565, SB765, SB62, SB666, SB707, SB888, SB687, SB847, SB1248, SB14, SB1006, SB504, SB925, SB995, SB857, SB305, SB296, SB284, SB815, SB1379, SB1497, SB1499, SB1498, SB241, SB304, SB621, SB1023, SB1024, SB686, SB112, SB371, SB204, SB609, SB670, SB502, SB850, SB854, SB413, SB1555, SB1362, SB1346, SB1033, SB1220, SB1073, SB810, SB987, SB1539, SB447, SB875, SB406, SB985, SB965, SB1119, SB1505, SB24, SB1194, SB1253, SB1215, SB1532, SB1302, SB856, SB650, SB583, SB673, SB213, SB681, SB1172, SB1252, SB378, SB1343, SB608, SB487, SB955, SB957, SB988, SB990, SB1019, SB1021, SB1120, SB251, SB958, SB761, SB1, SB541, SB315, SB379, SB1018, SB1737, SB266, SB1415, SB1527, SB125, SB599, SB1330, SB53, SB916, SB896, SB1352, SB973, SB785, SB710, SB472, SB1450, SB1502, SB1566, SB414, SB1062, SB1547, SB961, SB1038, SB513, SB578, SB711, SB746, SB942, SB1404, SB1448, SB1738, SB108, SB8, SB318, SB507, SB533, SB689, SB1026, SB1349, SB1355, SB1433, SB1434, SB1596, SB1403, SB1198, SB1146, SB763, SB667, SB1059, SB617, SB1567, SB503, SB1, SB1555, SR233, SR307, SR310, SR318, SR319, SCR25, SJR72, SJR73, SJR75, SJR77, SJR79, SJR80, SJR81, SJR82, SB2198, SB2201, SB2202, SB2203, SB2204, SB2205, SB2206, SB2207, SB2208, SB2209, SB2210, SB2211, SB2213, SB2214, SB2215, SB2216, SB2217, SB2218, SB2219, SB2220, SB2221, SB2222, SB2223, SB2224, SB2225, SB2226, SB2227, SB2228, SB2229, SB2231, SB2232, SB2233, SB2234, SB2235, SB2236, SB2237, SB2238, SB2239, SB2240, SB2241, SB2242, SB2243, SB2244, SB2245, SB2246, SB2247, SB2248, SB2249, SB2250, SB2251, SB2252, SB2253, SB2254, SB2255, SB2256, SB2257, SB2258, SB2259, SB2260, SB2261, SB2262, SB2263, SB2264, SB2265, SB2266, SB2267, SB2268, SB2269, SB2270, SB2271, SB2272, SB2273, SB2274, SB2275, SB2276, SB2277, SB2278, SB2279, SB2280, SB2281, SB2282, SB2283, SB2284, SB2285, SB2286, SB2287, SB2288, SB2289, SB2290, SB2291, SB2292, SB2293, SB2294, SB2295, SB2296, SB2297, SB2298, SB2299, SB2300, SB2301, SB2302, SB2303, SB2304, SB2305, SB2306, SB2307, SB2308, SB2309, SB2310, SB2311, SB2313, SB2314, SB2315, SB2316, SB2317, SB2318, SB2319, SB2320, SB2321, SB2322, SB2323, SB2324, SB2325, SB2326, SB2327, SB2328, SB2329, SB2330, SB2331, SB2333, SB2334, SB2335, SB2336, SB2337, SB2338, SB2339, SB2340, SB2341, SB2342, SB2343, SB2344, SB2346, SB2347, SB2348, SB2349, SB2350, SB2351, SB2352, SB2353, SB2354, SB2355, SB2356, SB2357, SB2358, SB2359, SB2360, SB2361, SB2362, SB2363, SB2364, SB2365, SB2366, SB2367, SB2368, SB2369, SB2370, SB2371, SB2372, SB2373, SB2374, SB2375, SB2376, SB2377, SB2378, SB2379, SB2380, SB2381, SB2382, SB2383, SB2384, SB2385, SB2386, SB2387, SB2388, SB2389, SB2390, SB2391, SB2393, SB2394, SB2395, SB2396, SB2397, SB2398, SB2399, SB2400, SB2401, SB2402, SB2403, SB2404, SB2405, SB2406, SB2410, SB2411, SB2412, SB2413, SB2414, SB2415, SB2416, SB2417, SB2418, SB2419, SB2420, SB2421, SB2422, SB2423, SB2424, SB2426, SB2427, SB2428, SB2429, SB2430, SB2431, SB2432, SB2433, SB2434, SB2435, SB2436, SB2437, SB2438, SB2439, SB2440, SB2441, SB2442, SB2443, SB2444, SB2445, SB2446, SB2447, SB2448, SB2449, SB2450, SB2451, SB2452, SB2453, SB2454, SB2455, SB2456, SB2457, SB2458, SB2459, SB2460, SJR72, SJR73, SJR75, SJR77, SJR79, SJR80, SJR81, SJR82, SB2198, SB2201, SB2202, SB2203, SB2204, SB2205, SB2206, SB2207, SB2208, SB2209, SB2210, SB2211, SB2213, SB2214, SB2215, SB2216, SB2217, SB2218, SB2219, SB2220, SB2221, SB2222, SB2223, SB2224, SB2225, SB2226, SB2227, SB2228, SB2229, SB2231, SB2232, SB2233, SB2234, SB2235, SB2236, SB2237, SB2238, SB2239, SB2240, SB2241, SB2242, SB2243, SB2244, SB2245, SB2246, SB2247, SB2248, SB2249, SB2250, SB2251, SB2252, SB2253, SB2254, SB2255, SB2256, SB2257, SB2258, SB2259, SB2260, SB2261, SB2262, SB2263, SB2264, SB2265, SB2266, SB2267, SB2268, SB2269, SB2270, SB2271, SB2272, SB2273, SB2274, SB2275, SB2276, SB2277, SB2278, SB2279, SB2280, SB2281, SB2282, SB2283, SB2284, SB2285, SB2286, SB2287, SB2288, SB2289, SB2290, SB2291, SB2292, SB2293, SB2294, SB2295, SB2296, SB2297, SB2298, SB2299, SB2300, SB2301, SB2302, SB2303, SB2304, SB2305, SB2306, SB2307, SB2308, SB2309, SB2310, SB2311, SB2313, SB2314, SB2315, SB2316, SB2317, SB2318, SB2319, SB2320, SB2321, SB2322, SB2323, SB2324, SB2325, SB2326, SB2327, SB2328, SB2329, SB2330, SB2331, SB2333, SB2334, SB2335, SB2336, SB2337, SB2338, SB2339, SB2340, SB2341, SB2342, SB2343, SB2344, SB2346, SB2347, SB2348, SB2349, SB2350, SB2351, SB2352, SB2353, SB2354, SB2355, SB2356, SB2357, SB2358, SB2359, SB2360, SB2361, SB2362, SB2363, SB2364, SB2365, SB2366, SB2367, SB2368, SB2369, SB2370, SB2371, SB2372, SB2373, SB2374, SB2375, SB2376, SB2377, SB2378, SB2379, SB2380, SB2381, SB2382, SB2383, SB2384, SB2385, SB2386, SB2387, SB2388, SB2389, SB2390, SB2391, SB2393, SB2394, SB2395, SB2396, SB2397, SB2398, SB2399, SB2400, SB2401, SB2402, SB2403, SB2404, SB2405, SB2406, SB2410, SB2411, SB2412, SB2413, SB2414, SB2415, SB2416, SB2417, SB2418, SB2419, SB2420, SB2421, SB2422, SB2423, SB2424, SB2426, SB2427, SB2428, SB2429, SB2430, SB2431, SB2432, SB2433, SB2434, SB2435, SB2436, SB2437, SB2438, SB2439, SB2440, SB2441, SB2442, SB2443, SB2444, SB2445, SB2446, SB2447, SB2448, SB2449, SB2450, SB2451, SB2452, SB2453, SB2454, SB2455, SB2456, SB2457, SB2458, SB2459, SB2460

Keywords: central bank digital currency, CBDC, Federal Reserve, digital dollar, digital currency, cashless payments, financial privacy, cybersecurity, government surveillance, financial surveillance, money laundering, terrorism financing, illicit finance, banking policy, monetary policy, payments system, commercial banks, Texas Legislature, concurrent resolution, federal reserve digital currency

Transcript Highlights:

• of Health to require enhanced reporting and legislative oversight of the Medicaid Care Incentive Payment
• Members, this is seeking some enhanced reporting concerning managed care incentive payment plans.

Bills: SR146, SCR12, HB378, HB509, HB1090, HB221, HCR85, HCR100, HCR105, HCR107, HCR114, HCR58, HB723, SB4, SB52, SB57, SB83, SB131, SB143, SB145, SB152, SB194, SB251, SB254, SB279, SB283, SB333, SB353, SB367, SB384, SB389, SB398, SB408, SB431, SB448, SB450, SB465, SB468, SB469, SB484, SB495, SB496, SB509, SB56, SCR9, SCR58, SB35, SB65, SB215, SB246, SB249, SB269, SB282, SB296, SB323, SB363, SB369, SB474, SB490, SB492, SB500, SB514, HCR32, HB59, HB89, HB153, HB243, HB335, HB342, HB407, HB451, HB513, HB595, HB682, HB688, HB690, HB730, HB762, HB802, HB816, HB940, HB1003, HB1011, HB1029, HB1053, HB1058, HB1062, HB1064, HB1079, HB1084, HB1098, HB1161, HB1189, HB1203, HB1215, HB1247, HB1248, HB1251, HB1253, HB1257, HB1258, HB17, HB27, HB36, HB41, HB73, HB140, HB166, HB181, HB205, HB211, HB223, HB226, HB259, HB271, HB308, HB337, HB399, HB410, HB487, HB626, HB712, HB740, HB750, HB759, HB775, HB812, HB844, HB906, HB966, HB968, HB979, HB1006, HB1009, HB1018, HB1036, HB1038, HB1081, HB1086, HB1107, HB1112, HB1155, HB1220, HB1242, HB1252, HB1256, SB42, SB208, SB217, SB274, SB300, SB341, SB379, SB382, SB387, SB401, SB449, SB487, HB74, HB119, HB134, HB210, HB258, HB468, HB784, HB870, HB953, HB956, HB1117, HB1236, SB29, SB43, SB78, SB149, SB441, HB359

Keywords: SR146, Senate Resolution 146, Louis Thomas Nelson, Thomas Nelson, condolences, memorial resolution, tribute, obituary, public service, St. Martinville, Cade, St. Martin Parish, police juror, mayor, community center, water system, school bus driver, school board, Louisiana Senate, sympathy

Summary: The Senate convened with a quorum, heard a guest prayer by Pastor Lee Shipp, and conducted routine opening business including journal adoption, receipt of confirmation appointments, and House messages naming conferees on several Senate bill disagreements. The chamber also adopted or recognized several personal privilege resolutions and commendations, including honors for Grady Hazel, the Acadiana Veterans Hockey of Louisiana national championship team, Grambling State University’s 125th anniversary and related athletics/band centennials, the 2026 Governor’s Fellows, and a brief address by special guest Ms. Benson. Members then acted on a series of resolutions and concurrent resolutions. The Senate adopted measures creating or requesting study task forces on child permanency, medical malpractice review panels, driving school fees, the Minimum Foundation Program, and earthquake activity in north Louisiana, and it concurred in House resolutions on illegal dumping, gaming board review, behavioral health crisis center reimbursement, Medicaid incentive payment reporting, and a physician review panel study. Several condolence and commendation resolutions also passed, including those honoring Lewis Thomas Nelson and Josephine Ruth Kennedy, and the Senate adopted a resolution urging local governments to consider generator requirements for unlicensed senior and disability residential facilities. The chamber also took up House Bill 723, a motorcycle traffic-signal bill allowing certain two- and three-wheeled vehicles to proceed through malfunctioning vehicle-actuated signals under specified circumstances; after debate about safety and enforcement, it passed 33-3. The Senate then considered numerous House amendments to Senate bills, concurring in most, including bills on fluoridation/local opt-out, public assistance, nutrition, human trafficking training, bulletproof vests, adult residential care generators, cell-cultured food products, public benefits eligibility, attorney-fee limits in disciplinary proceedings, critical infrastructure protections, debit card surcharges, bank stock certificates, child welfare proceedings, digital student IDs, watershed restoration funding, innovation hubs, sports agent registration, and manufactured housing regulation. It rejected House amendments to SB 283 and SB 408 for further negotiation. The session ended with announcements for committee meetings and a recess until 2 p.m.

Transcript Highlights:

• Kim Smiley is the executive director of Down of the Down Syndrome Partnership of North Texas and Lauren
• of all people with Down syndrome.
• of North Texas, the Down Syndrome Partnership of Central Texas, the Down Syndrome Partnership of South
• Not one to take that line down.
• And part of my concern is, in that narrowing down, you can almost tailor the matrix down to the actual

Bills: SCR5, SCR13, SB3, SB6, SB10, SB12, SB13, SB15, SB17, SB18, SB19, SB24, SB35, SB57, SB65, SB112, SB284, SB290, SB388, SB400, SB402, SB412, SB495, SB499, SB502, SB509, SB621, SB706, SB740, SB815, SB842, SB854, SB875, SB893, SB917, SB974, SB1025, SB1061, SB1073, SB1106, SB1268, SB1281, SB1300, SB1362, SB1379, SB1447, SB1451, SB1555, SB1902, SJR36, SJR12, SCR13, SCR25, SCR5, SCR22, SCR12, SCR24, SB495, SB412, SB10, SB18, SB565, SB372, SB842, SB765, SB62, SB19, SB666, SB707, SB888, SB687, SB706, SB847, SB290, SB13, SB1248, SB740, SB14, SB1006, SB504, SB917, SB925, SB388, SB1902, SB1121, SB995, SB857, SB305, SB296, SB284, SB35, SB6, SB815, SB3, SB1281, SB1379, SB1300, SB1497, SB1499, SB1498, SB1451, SB1061, SB15, SB65, SB241, SB304, SB402, SB499, SB621, SB974, SB1023, SB1024, SB1025, SB1106, SB686, SB112, SB371, SB204, SB400, SB609, SB1447, SB670, SB502, SB427, SB850, SB854, SB413, SB1555, SB1362, SB1346, SB1033, SB1220, SB1073, SB810, SB987, SB1539, SB893, SB447, SB875, SB406, SB509, SB985, SB965, SB17, SB1119, SB1505, SB12, SB24, SB57, SB1194, SB1253, SB1215, SB1532, SB1268, SB1302, SB856, SB650, SB583, SB673, SB840, SJR57, SCR8, SB213, SB681, SB1172, SB1252, SB378, SB610, SB918, SB1343, SB608, SB487, SB955, SB957, SB988, SB990, SB1019, SB1021, SB1120, SB251, SB958, SB535, SB761, SB1, SB541, SB315, SB379, SB1018, SB1737, SB266, SB1415

Keywords: SCR 5, Senate Concurrent Resolution 5, Texas School for the Deaf, TSD, Robert Rives, gymnasium naming, building naming, honorary resolution, commemorative resolution, deaf education, hard of hearing, Gallaudet University, alumni hall of fame, football coach, school facility naming, education K-16, State Affairs, Texas Legislature, public school tribute, water rights

Transcript Highlights:

• But I would venture Texans do not want religion crammed down their throat by their government.
• Texans don't even want their own religion crammed down their throat by their government.
• The legislation requires the use of a specific translation of the Ten Commandments down to individual

Bills: SCR5, SCR13, SB3, SB6, SB10, SB12, SB13, SB15, SB17, SB18, SB19, SB24, SB35, SB57, SB65, SB112, SB284, SB290, SB388, SB400, SB402, SB412, SB495, SB499, SB502, SB509, SB621, SB706, SB740, SB815, SB842, SB854, SB875, SB893, SB917, SB974, SB1025, SB1061, SB1073, SB1106, SB1268, SB1281, SB1300, SB1362, SB1379, SB1447, SB1451, SB1555, SB1902, SJR36, SJR12, SCR13, SCR25, SCR5, SCR22, SCR12, SCR24, SB495, SB412, SB10, SB18, SB565, SB372, SB842, SB765, SB62, SB19, SB666, SB707, SB888, SB687, SB706, SB847, SB290, SB13, SB1248, SB740, SB14, SB1006, SB504, SB917, SB925, SB388, SB1902, SB1121, SB995, SB857, SB305, SB296, SB284, SB35, SB6, SB815, SB3, SB1281, SB1379, SB1300, SB1497, SB1499, SB1498, SB1451, SB1061, SB15, SB65, SB241, SB304, SB402, SB499, SB621, SB974, SB1023, SB1024, SB1025, SB1106, SB686, SB112, SB371, SB204, SB400, SB609, SB1447, SB670, SB502, SB427, SB850, SB854, SB413, SB1555, SB1362, SB1346, SB1033, SB1220, SB1073, SB810, SB987, SB1539, SB893, SB447, SB875, SB406, SB509, SB985, SB965, SB17, SB1119, SB1505, SB12, SB24, SB57, SB1194, SB1253, SB1215, SB1532, SB1268, SB1302, SB856, SB650, SB583, SB673, SB840, SJR57, SCR8, SB213, SB681, SB1172, SB1252, SB378, SB610, SB918, SB1343, SB608, SB487, SB955, SB957, SB988, SB990, SB1019, SB1021, SB1120, SB251, SB958, SB535, SB761, SB1, SB541, SB315, SB379, SB1018, SB1737, SB266, SB1415

Keywords: SCR 5, Senate Concurrent Resolution 5, Texas School for the Deaf, TSD, Robert Rives, gymnasium naming, building naming, honorary resolution, commemorative resolution, deaf education, hard of hearing, Gallaudet University, alumni hall of fame, football coach, school facility naming, education K-16, State Affairs, Texas Legislature, public school tribute, water rights

Transcript Highlights:

• program payment, DSH payment, the UPL payment, GME, outpatient APC opt-outs, and EHR payments.
• You also see the dish payments go down.
• So as those payments go up or down and taxes go up or down, we can see these shifts within the model.
• So, as those payments go up or down and taxes go up or down, we can see these shifts within the model
• So, they are inherently upside down in our tax model and our payment model just because they're getting

Keywords: Medicaid - Room 216, 4 February, 2026; 2:00 PM, 925, all

Summary: The committee heard presentations on several Medicaid-related topics. First, a pharmacy representative discussed nonopioid pain medications as a way to reduce opioid dependence and overdose risk, emphasizing that options such as acetaminophen, NSAIDs, and topical diclofenac can be useful for pain management. She cautioned that nonopioids can still have risks and said any policy should avoid requiring patients to step through opioids before accessing safer alternatives, while still allowing reasonable step therapy among nonopioid options. The presenter said the goal is to keep patients from being pushed toward opioids by cost or insurance design. The committee also heard emotional testimony from parents of a child with Prader-Willi syndrome, who described the condition as a rare genetic disorder that causes severe, lifelong hyperphagia and requires rigid supervision and ongoing treatment. They argued that alternative funding programs can disrupt access to medically necessary drugs such as human growth hormone, forcing families into costly and uncertain coverage gaps. They asked lawmakers to ensure insurance coverage remains stable for rare disease patients and thanked Senator Blackwell for prior support of rare disease legislation. Next, a Livanova representative urged the committee to support higher Medicaid reimbursement for vagus nerve stimulator surgery for drug-resistant epilepsy. He said inadequate hospital reimbursement has reduced access in Mississippi, causing patients to travel long distances or go without treatment, and argued that better reimbursement would improve outcomes and save money over time. He cited studies showing seizure reductions, lower ER use, and a projected $2.8 million in five-year savings for Medicaid based on 40 patients, and asked that hospitals be reimbursed at 100% of Medicare rates for the procedure codes. Finally, a Medicaid official gave a broad overview of hospital payment structure, including fee-for-service, managed care, MHAP, DSH, UPL, provider taxes, and related funding mechanisms. She explained that hospital payments are interrelated and have shifted over time, with major changes tied to managed care, MHAP/UPL increases, and provider taxes. At the end of the discussion, the committee was running short on time and asked her to skip ahead to the provider tax component; no votes or formal actions were taken in the portion provided.

Transcript Highlights:

• And as your call, the state director payment programs consist of the various supplemental payment programs
• That is state director payments that are above 110% of Medicare will need to be step down 10% each year
• on each of these supplemental payment program, state-directed payment programs.
• If if the physician supplemental payment program and then hospital directed payment program, if it's
• So that's the information that drives the low income pool payments and then for the DPP payments that

Transcript Highlights:

• . down. down.
• Um, but starting in 2028, those grandfathered payments are reduced by 10% annually down to the 100% of
• Um, but starting in 2028, those grandfathered payments are reduced by 10% annually down to the 100% of
• Um, but starting in 2028, those grandfathered payments are reduced by 10% annually down to the 100% of
• Um, but starting in 2028, those grandfathered payments are reduced by 10% annually down to the 100% of

Keywords: 00:00:22 - Call to Order and Roll Call 00:03:00 – Approval of June 25, 2025 Minutes 00:03:22 - Update on Federal Changes to the Medicaid Program 01:03:44 - State Directed Payments, Provider Taxes, and the Rural Health Transformation Fund: How Medicaid Changes Could Impact Kentucky Hospitals 01:29:42 – Public Comments 01:45:25 – Announcements 01:46:19 - Adjournment, 958, all

Summary: The Medicaid Oversight and Advisory Board met on July 30, 2025, approved the June 25 minutes, and received a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid provisions in H.R. 1. The presentation outlined more than 20 Medicaid-related provisions, emphasizing that the largest federal savings come from work/community engagement requirements, changes to provider taxes, limits on state-directed payments, more frequent eligibility redeterminations for expansion populations, and related eligibility/enrollment changes. She said the fiscal effects are backloaded, with most reductions occurring in the later years of the 10-year window, and noted potential significant impacts on hospital payments and state financing. She also described new funding opportunities, including a $50 billion rural health transformation fund and a new home and community-based services waiver with associated grants. A substantial portion of the discussion focused on Kentucky’s pending community engagement 1115 waiver and how it would interact with the new federal requirements. Board members asked whether the waiver had been approved, what the cabinet’s contingency plan would be if CMS does not approve it, and what the timeline is for compliance. Cabinet representatives said the waiver has not yet been approved by CMS, remains under public comment, and that the state will wait for CMS guidance before moving forward; if needed, the state would amend the waiver or submit a new one. They said the work requirement must be in place by January 1, 2027, with a possible extension to 2028. Castanza also explained that expansion adults with incomes between 100% and 138% of the federal poverty level would face new cost-sharing requirements beginning October 1, 2028, and that eligibility redeterminations would move from annual to every six months starting January 1, 2027. She then walked through provider tax changes, including a moratorium on new provider taxes beginning October 1, 2026, and a phased reduction in the hold-harmless threshold for existing taxes beginning January 1, 2028, with exemptions for nursing facilities and ICF/IID providers. Board members questioned the timing and likely impact on Kentucky, and Castanza responded that the effect would depend on each tax’s current rate and would phase in over time.

Transcript Highlights:

• They if they can't pay the entire balance, which often they cannot, um, it might require a down payment
• <00:04:27.360> payment<00:04:27.600> of um, it might require a down payment of um,
• it might require a down payment of some<00:04:28.000> kind.
• Reconnection fees for non-payment. Reconnection fees for non-payment.
• receive funds to help gas gap payments receive funds to help pay<00:15:04.320> down<00:15:04.480

Keywords: 1183, house

Summary: The committee heard House File 3912, as amended, and the author moved that the bill be laid over for consideration in a future omnibus bill. The amendment was adopted without objection. Representative Holland described the bill as an energy affordability measure that would bar utilities from charging certain fees during the cold weather rule for customers above 50% of state median income, prohibit reconnection fees after shutoff for nonpayment, and create a framework for regulating late fees. He argued that late fees are often high, compound monthly, and disproportionately burden low-income households, citing utility debt and disconnection figures and noting that the need for relief is concentrated in greater Minnesota. Annie Levenson Faulk of the Citizens Utility Board supported the bill, saying reconnection fees and late fees fall on households already struggling to pay for essential service. She said reconnection fees should be treated as part of the cost of doing business and that late fees should be limited to a reasonable approximation of actual carrying costs, with protections for low-income customers. She also said the issue is already being considered in utility rate cases before the Public Utilities Commission, but that legislative action is still appropriate. Nick Martin of Xcel Energy and Katherine O'Donnell of CenterPoint Energy opposed the bill in its current form while emphasizing their companies’ commitment to affordability and customer assistance. Xcel said the bill would shift reconnection costs to other customers and could undermine a proposed arrears management program funded by late payment charges; Xcel also noted that the PUC is already reviewing these issues in its rate case. CenterPoint said it already offers extensive outreach, payment plans, and assistance programs, does not charge late fees once a customer is on a payment plan, and that its reconnection fee does not fully cover costs. After testimony and brief discussion, the chair noted the helpful information from utilities, the author said he was open to further work on the bill, and the bill was laid over.

Transcript Highlights:

• payment programs that are above 110% that are that are we'll need to be step down.
• But about 9 billion and supplemental payments associated with these 5 state directed payments.
• is payments under Medicaid.
• and stepping those down.
• So not only with accept them down 210% but also may limit the amount of direct payments that could happen

Transcript Highlights:

• Uh extends the [clears throat] down Uh extends the [clears throat] down payment<00:39:07.760>
• buyers come up with a down payment. buyers come up with a down payment.
• Um Um Um If If I can speak from experience, um, the ideal for down payment is 20%.
• payment else, coming up with a 20% down payment is<00:39:51.440> very<00:39:51.800> difficult
• down payment can be very difficult. down payment can be very difficult. 20<00:39:57.480> is

Keywords: 927, senate, all

Transcript Highlights:

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

Keywords: 958, all

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:

• It is a state-specific rate of payment operations.
• The payment system works the exact same way.
• or other participants in the payment system.
• We are down the road.
• All right, so hit it down good.

Keywords: 995, all

Summary: The Special Commission on the future of payments and sales transactions by credit card heard extensive testimony from credit union, banking, retail, restaurant, and payments-industry representatives about proposals to limit interchange fees, especially on the tax and tip portions of transactions. Several witnesses opposed state-level restrictions, arguing they would create a patchwork of rules, burden state-chartered institutions, raise compliance complexity, and ultimately reduce resources for fraud prevention, cybersecurity, rewards, and access to credit. Others, including retail and merchant advocates, said swipe fees are a significant and growing cost for small businesses and that states should consider reforms such as limiting fees on taxes and tips, allowing surcharging, improving transparency in merchant contracts, and studying collection costs more closely. Witnesses also discussed recent legal and regulatory developments, including Illinois’s interchange-fee law, OCC and NCUA interim rules, and the ongoing Visa/Mastercard antitrust settlement. Industry representatives said the Illinois law has been delayed and is likely preempted for most transactions, while merchant advocates argued the state efforts and court rulings show that networks and banks do not set fees competitively. The proposed antitrust settlement was described by some as a meaningful but limited merchant victory, with temporary fee reductions and expanded surcharge/steering rights, while others said it still falls short of structural reform. The commission members pressed witnesses on the practical effects of fees, the cost of cash, whether merchants can pass costs through, and whether small businesses are actually seeing benefits from the current system. Members repeatedly emphasized the need for a fair middle ground that protects both small businesses and the payment system. No substantive votes or policy actions were taken beyond accepting testimony, and the meeting ended with adjournment after all scheduled witnesses had spoken.

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.

Keywords: 1204, all

Transcript Highlights:

• And in addition to the regular fee-for-service payments, we do make hospital access payments.
• 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.
• So the hospitals fund their upper payment limit payments.

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:

• Credit card fees, mobile payments, buy now, pay later financing, and other aspects of the payments industry
• And second, the limits on the global payment electronic payment system.
• country, not a top-down approach.
• It doesn't impact the electronic payment system at all. No impact on the electronic payment system.
• But the retailer or the restaurant knows because they have to then break that down and remit their payment

Keywords: 995, all

Summary: The Special Legislative Commission on the Future of Payments and Sales Transactions by Credit Card and the Impacts for Small Businesses held a public hearing focused on interchange fees, sales tax and tip processing, chargebacks, fraud, surcharging, and the broader future of payment systems. Chair Paul Feeney and co-chair Rep. Jamie Murphy opened by explaining the commission’s charge and inviting testimony from small businesses, industry groups, banks, and policy experts. Representative Sean Garballey testified first, arguing that Massachusetts tourism depends on universal card acceptance and stable interchange, and urging the commission not to disrupt the current system ahead of major events expected to bring millions of visitors to the Commonwealth. A large portion of the hearing featured independent restaurant owners and advocates describing thin margins and the burden of paying percentage-based processing fees on sales tax and tips that are not business revenue. Jen Ziskin, Kristen Canty, Nancy Cushman, Kerry Colzer, and others said restaurants often operate on very small profits and that processing fees on taxes and gratuities can amount to tens or hundreds of thousands of dollars annually. Ryan Lotz also urged reforms to chargebacks, including refunding chargeback fees when merchants prevail, requiring consumers to contact businesses before disputing charges, and limiting repeat abuse. Commission members pressed witnesses on whether tax and tip amounts could be separated at the point of sale, and several witnesses said current consumer card systems do not transmit that level of detail. Testimony from credit union, banking, and payments representatives largely opposed state-level changes that would carve out taxes or tips from interchange, warning of compliance burdens, higher costs, reduced rewards, and possible effects on fraud protection and access to credit. Alex Verine of America’s Credit Unions and Deb Peters and Keely McEwen of the Electronic Payments Coalition said the payment system is complex, that interchange funds fraud prevention and network infrastructure, and that new state mandates could create operational and legal uncertainty. Dan Swanson argued states have authority to act and pointed to Illinois litigation and federal court rulings, while Julian Morris and Brad Popolado emphasized the benefits of card acceptance, the decline of cash, and the need to consider other payment methods and check fraud as well. Several witnesses discussed international payment systems, instant payments, and QR standards as possible future directions. The chairs and members engaged in extended back-and-forth with witnesses about whether Massachusetts could exempt sales tax from swipe fees, whether surcharging should be revisited, and whether vendor compensation or other targeted relief might be more workable than broad changes to interchange. No votes were taken. At the close of the hearing, the chairs said the commission would hold one additional public hearing date to be determined, after which members would begin developing next steps and a report.

Transcript Highlights:

• And lastly, down payment foreclosure.
• :57.840> payment<00:21:58.159> assistance buyer community down payment assistance buyer
• down payment assistance will that their down payment assistance will be<00:22:36.000> there<00
• essential that we pair it with down essential that we pair it with down payment<00:25:31.440>
• <00:30:30.480> payment in first generation down payment in first generation down payment assistance

Keywords: 1183, house

Transcript Highlights:

• How quickly does it help us accelerate the down payment on those extending, outstanding loans?
• How quickly does it help us accelerate the down payment on those outstanding loans?
• are paying down the principal.
• are paying down the principal.
• So we have to use the monies as these other mandated payments are going down because of the responsible

Keywords: 987, senate, all

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.

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:

• They're also looking at phasing down payments, particularly to hospitals through the reconciliation bill
• down to 100% of Medicare.
• That is the program that will be phased down back down to 100% of Medicare, which takes us back to where
• Chair, Vice Chair, those are changes. ...that we could make now to bring down the payment error rate
• The enrollment will go down and those provider payment rates might go down.