Transcript Highlights:

• direct payments by Medicaid.
• direct payments by Medicaid.
• The payment structure I certainly understand.
• Although other states have increased payments for commercially insured primary care, none linked payments
• to monthly prospective payment.

Committee: Joint Joint Committee on Health Care Financing

Summary: The Joint Committee on Health Care Financing held a public hearing on a large docket focused on primary care, workforce development, and medical debt. Chairs Cindy Friedman and John Lawn outlined hearing procedures and noted that testimony would be taken on 17 matters. The committee first heard testimony on bills to establish a community health center nurse practitioner residency program and to strengthen mental health centers. Senator Keenan, Rep. Keefe, and health center leaders described the Worcester nurse practitioner residency as a successful pipeline and retention strategy, citing workforce shortages, training needs in community health centers, and the cost of the program. Rep. O’Day also supported the mental health centers bill, saying it would raise payment rates, improve reimbursement for behavioral health services, and help clinics retain staff and expand access. The committee then took testimony on bills to address medical debt through hospital financial assistance reform. The Attorney General’s Office, Health Care for All, Health Law Advocates, the Leukemia and Lymphoma Society, and individual patients supported the measure, arguing that hospital financial assistance policies are inconsistent, hard to find, and difficult to navigate. Witnesses said the bill would standardize eligibility criteria, create a uniform application, improve notice requirements, and expand access to discounted care up to 400% of the federal poverty level. Several personal stories described medical bills being sent to collections, confusion over insurance billing, and the burden of debt on low-income and chronically ill patients. Committee members asked about hospital concerns, the role of the health safety net, and whether the bill addressed root causes of medical debt; testimony emphasized that the proposal was meant to improve transparency and access rather than replace broader insurance reforms. The hearing also focused heavily on “Primary Care for You” legislation, H. 1370 and S. 867, which would increase primary care investment and create a new payment model. Rep. Haggerty, physicians, a patient, community health center leaders, and the Massachusetts League of Community Health Centers described a primary care crisis marked by low reimbursement, staffing shortages, long waits, burnout, and difficulty recruiting clinicians. Supporters said the bills would shift spending toward preventive, team-based care, improve access and equity, and reduce long-term costs. The Massachusetts Association of Health Plans said it was directionally supportive of increased primary care investment but warned that any new spending must stay within the cost growth benchmark and preserve existing contracting structures. The hearing ended with additional testimony on a community health center workforce and loan repayment grant bill from Rep. Stanley, and with further discussion from Dr. Alan Garo about the need for payment reform in primary care.

Transcript Highlights:

• It's about state-directed payments and the phase-out under OB3.
• It's about state-directed payments and the phase-out under OB3.
• payments are expressly Supplemental payments are expressly prohibited<00:12:37.920><c> by</c><00:12:
• </c><00:14:14.000><c> Okay,</c> the input payments. Okay, the input payments.
• </c><00:14:32.000><c> and</c> It's about state directed payments and It's about state directed payments

Summary: The Committee to Study Long-Term Managed Care approved the prior meeting minutes as amended after correcting the first paragraph. The chair then outlined the committee’s plan to produce a preliminary report by October 1, with additional meetings to follow, since some questions remain about the federal One Big Beautiful Bill (OB3) and its effects on Medicaid financing and managed care. The main discussion focused on New Hampshire nursing home funding and how ProShare and MQUIP work. Members reviewed Medicaid rates, supplemental payments, intergovernmental transfers, and the role of federal matching funds. The chair and Mr. Litman concluded that OB3’s phase-down of payments above the Medicare rate likely would not directly eliminate ProShare or MQUIP in New Hampshire, but uncertainty remains about intergovernmental transfers and about how these payments would function if the state moved nursing facilities into managed care. Mr. Litman said managed care would likely require waivers for supplemental payments, and Texas was cited as an example of a state operating under such waivers. The committee also discussed dual eligibles, DNIP, PACE, and the possibility of carving out HCBS from nursing facility services. DHS said its managed care contract would allow the state to use MCOs for DNIP, with the goal of better coordination between Medicaid and Medicare, while PACE would likely require more study and might be more feasible in populated counties. Members also reviewed OB3’s new presumptive eligibility provisions and a state waiver request modeled on Washington’s approach, plus a separate grant for transitioning people from facilities back to the community. The rural health transformation fund was discussed as a possible source for workforce, telehealth, mobile integrated health, and other support investments, but not for direct construction or major building renovation. County representatives emphasized that any county role in PACE or DNIP would require significant vetting, infrastructure, capital investment, and a realistic timeline. The meeting ended with the chair saying the draft report would outline issues and possible alternatives, but not recommendations yet, and the committee adjourned without taking further action.

Transcript Highlights:

• If America had instituted real-time payments when England did.
• This is about the kind of payment system we're going to have in our country.
• To be clear, the HCU's responsibility is for making the payments, always drives...
• The payment process.
• From accessing the payment system, and that chart puts my hair on fire.

Committee: Senate Banking, Housing, and Urban Affairs Committee

Transcript Highlights:

• The federal match for DISH payments is 50% and is up to 90% for rates and directed payments.
• > to</c> directed payments and dish payments to directed payments and dish payments to um<01:31:01.199
• </c> those tax payments April 15th. those tax payments April 15th.
• The small their uh dish payments.
• . payments. payments.

Summary: The Ways and Means Committee held a public hearing on Senate Bill 291, which would update religious land-use and property tax exemption rules for church-owned parsonages, parish houses, and similar properties. Senator Tim Lang, speaking for the sponsor, said the bill was intended to address situations where former parsonages are no longer occupied by clergy and are instead used for church-related purposes such as housing staff, religious education, or congregate living tied to ministry, including addiction recovery. He emphasized that the bill was not meant to create commercial rental housing and that it also preserves reasonable zoning and environmental regulations. Committee members pressed the sponsor on how the bill would be applied, especially the meaning of “religious purposes,” the six-unit limit, the “same lot” language, and whether churches could use the exemption to rent units for revenue. The sponsor said the six-unit cap was added to prevent large-scale commercial rental use, that congregate housing would be limited and defined, and that the bill was meant to cover uses like substance abuse recovery, homes for unwed mothers, and religious education, but not apartments converted for ordinary rental. He also said churches would still file annual exemption paperwork and towns could challenge claims they believed were commercial. Questions also raised concerns about whether the bill treated religious and nonreligious housing trusts differently; the sponsor responded that the bill was aimed at church-owned property used in pursuit of a religious mission. Several witnesses testified in support. Representative Mark Pearson, an active clergyman, said the bill would not remove additional property from the tax rolls because clergy housing allowances typically lead clergy to buy taxable homes elsewhere, while the church-owned parsonage remains exempt. Nick Taylor of Housing Action New Hampshire supported the bill as a modest expansion that could help create more attainable housing by allowing better use of existing religious land and structures, though he noted his organization would support even broader use. The hearing ended without a vote or final action, and the chair closed questions after the testimony.

Transcript Highlights:

• Those payments totaled $2.1 million. Those payments totaled $2.1 million.
• </c> and 790 days after final payment. and 790 days after final payment.
• I will note that um there was one payment uh for a project. It was an advanced payment.
• I will note that um there was one payment uh for a project. It was an advanced payment.
• . payment. payment.

Bills: HF3564

Committee: House Legacy Finance

Transcript Highlights:

• </c> rental assistance and Utility payments rental assistance and Utility payments this<00:09:23.000>
• </c> mortgage lending and down payment mortgage lending and down payment assistance<01:02:55.839><c>
• </c> Community it's a mouthful down payment Community it's a mouthful down payment assistance assistance
• but the down payment is home available but the down payment is the<01:18:29.199><c> is</c><01:18:29.560
• </c><01:25:06.679><c> it</c> opportunity to put a down payment it opportunity to put a down payment it

Committee: House Housing Finance and Policy

Transcript Highlights:

• They failed to ever make that payment, it automatically defaults in.
• It will reflect those payments. Thank you, ma'am. Okay.
• Who approved the payment is what I...
• The receipt books in which these payments were recorded could not be located.
• The town council minutes indicated Ordinance No. 1001 was adopted to authorize these payments.

Committee: All LEGISLATIVE JOINT AUDITING-COUNTIES AND MUNICIPALITIES

Summary: The committee first heard updates on delinquent private water and sewer reports. For reports due as of December 31, 2012, staff said five additional 2024 reports had been received since the December meeting, bringing the total of released escrow funds to 17 and leaving 26 still escrowed. For reports delinquent as of December 31, 2023, two more reports were received, bringing 59 of the original 64 into compliance and leaving five outstanding. Both update reports were filed without objection. The committee then discussed Act 709 of 2021 and the town of Daisy’s repayment of street turnback funds. Staff said Daisy had made improper payments to a nonprofit, used restricted street funds for fire truck and fire department building costs, and had not adopted the required repayment ordinance or obtained approval for a reduced repayment percentage. Mayor Lisa Cogburn said the city council had not approved repayment because members disputed the amount, though she said the city had funds to pay. After questions from members and staff explaining the audit calculations, the committee adopted a motion requiring Daisy to repay 10% of unrestricted general fund revenues under the statute and to withhold turnback funds if the city fails to comply. The report was then filed. The committee reviewed numerous deferred and current audit findings from cities, counties, and water systems. Several local officials appeared and described corrective steps, including Harrison district court, Carroll County airport, Izard County treasurer, Alexander district court, Town of 56 officials, Bull Shoals, Lone Oak County, Beaver, Central City, Gravette, Ralston Water Department, Thornton Waterworks, Ozan, and Lee County. Findings included missing or inaccurate reconciliations, unsupported credit card charges, payroll and compensation issues, improper use of public funds, missing receipts, and budget overruns. Some matters were referred to the prosecuting attorney and Attorney General, including Bull Shoals and Lone Oak County, while others were filed or deferred as appropriate. The committee also deferred two private water and sewer reports for lack of proper responses, filed 19 reports with resolved findings, and filed 53 reports with no findings. Before adjourning, the committee set its next meeting for February 12, 2026.

Transcript Highlights:

• is made and then for advanced payment is made and then for advanced payments<00:20:04.559><c> and</c
• </c> sent to try to recover those payments sent to try to recover those payments our<00:32:24.159><c>
• </c> have asked us why don't we stop payment have asked us why don't we stop payment as<00:57:09.760>
• </c> one next slide if we had stopped payment one next slide if we had stopped payment immediately<00
• </c> if the invoicing being sent for payment if the invoicing being sent for payment is<01:08:38.080>

Committee: Senate Human Services

Transcript Highlights:

• You know, $250 a month can be a car payment.
• About payment error rates.
• The first is the SNAP payment error rate.
• It's really clear that it's not for payment rates.
• To address the payment error rate.

Transcript Highlights:

• It updates the loan structure to not require payments or interest over the 5-year forgivable period.
• </c><00:11:10.920><c> assistance</c> generation down payment assistance generation down payment assistance
• </c><00:15:26.199><c> programs</c> distinction most down payment programs distinction most down payment
• </c><00:21:30.960><c> assistance</c> generation down payment assistance generation down payment assistance
• The median PITI payment statewide in Minnesota right now is $2,551 per month.

Committee: Senate Housing and Homelessness Prevention

Transcript Highlights:

• And this limits the reduction in bus depreciation payments for the grants and rebates to the 2025-26
• the reduction, and normal payments would resume thereafter.
• and may not reduce a depreciation payment for a school year below zero.
• The payments must be distributed by the county treasurer in the same way as property tax revenues.
• it's property tax or whether they pay payments in lieu of taxes to the county.

Summary: The House Appropriations Committee met in executive session on three bills. For Second Substitute Senate Bill 6182, staff explained it would create an abortion savings program funded by a new assessment on health carriers to support grants for abortion clinical care access. Representative Marshall offered amendments to limit grants to Washington residents, expand eligibility to IVF and fertility providers, prioritize medically underserved areas, and add a 2031 sunset; all were rejected or withdrawn. The committee then voted 18-10 to report the bill out with a do pass recommendation. For Engrossed Substitute Senate Bill 6260, staff briefed a striking amendment that would reduce savings in K-12 spending by changing local effort assistance and Running Start limits, prioritizing some transition-to-kindergarten funding, and eliminating inflation increases for National Board bonuses. Members debated a series of amendments on bus depreciation, charter school LEA payments, transition-to-kindergarten funding, and Running Start. Some amendments were adopted, including a bus depreciation change and a Running Start adjustment, while others were rejected. The committee then adopted the striker as amended and reported the bill out 17-12 with a due pass recommendation. For Substitute Senate Bill 6355, which would establish the Washington Electric Transmission Authority and related board and advisory structures, members considered amendments on rural land-use expertise, eastern Washington board representation, corridor review standards, tribal workgroup removal, and payments in lieu of taxes for transmission facilities. One amendment was withdrawn and the others were rejected except for a landowner/rural expertise amendment that passed. The committee then reported the bill out 18-11 with a due pass recommendation. At the end of the meeting, members exchanged closing remarks thanking staff and colleagues, and the committee adjourned.

Transcript Highlights:

• </c><00:08:50.040><c> partial</c><00:08:50.440><c> payments</c><00:08:50.760><c> on</c> so partial payments
• partial payments on so partial payments partial payments on invoices<00:08:52.800><c> we</c><00:08:53.279
• </c><00:09:10.360><c> so</c> able to pay those partial payments so able to pay those partial payments
• </c> existing statute around late payments existing statute around late payments and<00:10:19.880><c>
• ><c> the</c><00:10:22.040><c> um</c> and prompt payments and then the um and prompt payments and then

Summary: The committee first reconsidered House Joint Resolution 53, which concerns releasing previously appropriated funds for Kentucky State University. Kentucky State University President Kofi Aapo testified in support, describing significant enrollment growth, a balanced budget, and a $5 million fund balance since his arrival, and asking for continued support. Members praised his leadership while noting the institution still has work to do. The motion to reconsider passed, and the resolution then received favorable expression by a 9-2 vote. The committee next took up House Bill 622, a compromise bill involving the Kentucky Nonprofit Network and the Finance and Administration Cabinet. Testimony explained that the bill is intended to improve prompt payment practices for grants and contracts, including partial payments on undisputed invoice items within 30 days and a process for disputed items. The bill also included several appropriation-related corrections and adjustments, including a fix to an allocation for Elizabethtown water and sewer projects, a change in an economic development recipient, revisions to school resource officer language, and additional contingency authority for the Capitol renovation. The committee adopted a title amendment and passed the bill with favorable expression by a 10-1 vote. House Bill 775 was then discussed as a broad tax and economic development measure. The bill covers TIF districts, electronic filing for craft brewers, pipeline property tax treatment, bourbon barrel tax cleanup, staged income tax reductions, extension of the Metropolitan College incentive, tourism and lodging incentives, reauthorization of an expired TIF, taxation and licensing of cannabis-infused beverages, alternative fuels and jet fuel tax credit review, entertainment event incentives, the selling farmer tax credit, IRC conformity, data center incentives, the first audit of the Kentucky Horse Racing and Gaming Corporation, and limits on additional electronic charity gaming locations until regulations are adopted. Members raised questions about the beverage tax structure, TIF impacts, and the income tax reduction provisions; some expressed concern about making future tax cuts easier, while others supported the bill’s TIF and agriculture provisions. The bill passed with favorable expression by a 7-2 vote with two pass votes, and the committee then adjourned.

Transcript Highlights:

• If the state's payment error rate is below 6%, there is no state share of benefits.
• A payment error rate between 6% and 7.99% means the state share of benefits would be 5%.
• The federal requirement is that the state's payment error rate is to be below 6%.
• The federal requirement is that the state's payment error rate is to be below 6%.
• The federal fiscal year 2024 payment error rate is 15.13%.

Summary: The Human Services Subcommittee met to receive implementation briefings on House Bill 1267, which was enacted to address benefit cliffs and help public assistance recipients move toward economic self-sufficiency. The Department of Children and Families reviewed SNAP, Temporary Cash Assistance (TCA), and Medicaid-related eligibility and work requirements, including who must participate in work activities, the role of Florida Commerce and CareerSource Florida, and the new standardized intake and exit surveys required by the law. Members also discussed the TCA program’s household-based structure, the 48-month adult limit, and how work requirements differ for SNAP and TCA participants. Florida Commerce and CareerSource Florida then reported on implementation of HB 1267, including the CLIFF financial forecasting tool, case management changes, and survey data collected from welfare transition participants. They said intake surveys showed common barriers such as child care, transportation, and flexible work schedules, while exit surveys showed many participants were employed or had gained credentials, though response rates were low because the surveys are voluntary. A local workforce board, CareerSource Tampa Bay, described using CLIFF in case management and shared a success story about a participant who completed training, earned certifications, and moved into employment. The committee also heard a separate DCF briefing on the federal One Big Beautiful Bill Act and its impact on SNAP. DCF said the law expands able-bodied adult without dependents requirements, changes non-citizen eligibility, ends future SNAP-Ed funding, increases state administrative cost sharing, and may require states to share in benefit costs if payment error rates remain above federal thresholds. Members focused heavily on Florida’s SNAP payment error rate, which DCF said was 15.13% for federal fiscal year 2024 and 12.60% for 2023, with the state currently on a corrective action plan. DCF described steps to reduce errors, including more verification of rent and utility expenses, improved income matching, staff training, and system modernization. No votes were taken, and the meeting adjourned after questions concluded.

Transcript Highlights:

• And then we did make some bigger changes on the payments during appeal after hearing input.
• This allows counties to get away from doing payments under protest.
• They can pay a partial payment, which is last year's amount.
• Then they make the rest of that payment within 30 days of it being resolved.
• And then, lastly, if you either didn't make the first payment or didn't make the final payment within

Committee: House Special Committee on Property Tax Reform

Transcript Highlights:

• Instead, board staff processed applications and credit card payments manually, including one employee
• 40-hour work week manually processing credit card payments.
• As for the amount of that incentive payment, I...
• And as of federal fiscal year 2024, the department's improper payment rate was approximately 8.8%.
• So, as a result, reducing the department's payment... ...the highest match rate of 15%.

Committee: House House Health & Human Services Committee of Reference

Transcript Highlights:

• That is due to directed payments, the growth in state-directed payments, the additional directed payments
• </c> We've just paid one quarter's payment. We've just paid one quarter's payment.
• </c><00:53:20.880><c> So</c> quarters worth of that payment. So quarters worth of that payment.
• We've expanded directed payments.
• We've expanded directed payments.

Summary: The Health and Family Services committee heard an informational 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, often with serious mental illness, who do not meet nursing home criteria but need structured supervision, medication assistance, meals, and daily support. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and are supported largely through state supplementation payments and residents’ SSI income. The presenters argued that the current reimbursement rate of about $50.70 per day is no longer sufficient to cover staffing, food, insurance, utilities, maintenance, and other costs, and said the sector has shrunk significantly over time. They cited figures showing a decline from 64 to 34 homes serving the seriously mentally ill since 2002, with 30 closures over 23 years, and said the loss of beds contributes to homelessness, hospital overcrowding, and longer psychiatric stays. They also gave examples of residents who had spent many months in hospitals before being successfully placed in personal care homes, which they said can prevent more costly institutional care. Committee members asked about staffing credentials, fraud controls, referral processes, and how reimbursement works in other states. The presenters said Kentucky does not require licensed or certified staff in these facilities, though some homes use certified medication technicians or an LPN, and they described a county case-manager-based assessment process used to set individualized rates in other states such as Minnesota. Members expressed support for the work but emphasized the need for documentation of savings and budget offsets. The presenters said they are seeking an incremental reimbursement increase over two years, roughly 25% to 50% in the first year and another 50% after that, and urged the committee to support the homes to prevent further closures.

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
• And bundling payments is a great way to do... Bundling payments is a great way to do that.
• Um, and I am speaking... ...payment agreement.

Committee: Joint Health Insurance Affordability Task Force

Transcript Highlights:

• We can't make those payments.
• Our primary concern has to do with the definition of payment for anesthesia services on how the units
• and payment are calculated.
• It's specifically about a concern that there be some limitation on the payment of the agreed rates.
• Concern because it's the definition that's proposed for payment of services that says you have to use

Committee: House Health and Mental Health

Summary: The committee first heard public testimony on House Bill 2570, which would prohibit health insurers from limiting payment for anesthesia services based on the length of a surgical procedure. The bill sponsor said the measure was prompted by a prior Anthem policy that would not cover all anesthesia time if a surgery ran long, and argued that insurers should not create pressure to stop or rush procedures. Supporters from physician and nurse anesthetist groups said the bill would protect patients and providers from unfair time-based payment limits. An insurance industry witness raised concerns about unclear definitions, possible internal contradictions in the bill’s language, the use of time-based billing formulas, and whether dental anesthesia should be excluded; the sponsor responded that the bill was aimed at medical, not dental, anesthesia and that any wording issues could be worked out later. After the hearing, the committee moved into executive session on a combined committee substitute for House Bills 1945 and 2570. Members discussed an amendment rolling HB 2570 into the larger substitute and noted minor changes to the anesthesia language, including adding modifiers and clarifying billing terms, while also adjusting unrelated pathology language to make it workable with the department and possible Medicaid waiver requirements. Questions from members focused on whether the insurance industry’s concerns were addressed and whether dental anesthesia should be exempted; the sponsor said some concerns could be handled later and that dental situations involving separate anesthesia providers might still need careful drafting. The committee adopted the amendment and substitute and then voted the combined committee substitute do pass by roll call, with the motion approved unanimously by those present.

Transcript Highlights:

• We can't make those payments.
• Our primary concern has to do with the definition of payment for anesthesia services.
• What is included is a formula. on how the units and payment are calculated.
• It's specifically about a concern that there be some limitation on the payment of the agreed rates.
• And again, if the language that mandates the definition of payment of anesthesia services is altered

Committee: House Health and Mental Health

Transcript Highlights:

• </c> are also established in statute payment are also established in statute payment rates<00:02:16.959
• </c><00:08:26.759><c> that</c> serving and um the the payments that serving and um the the payments that
• Managed care payments are also growing.
• </c> imds they were not and so those payments imds they were not and so those payments have<00:34:00.320
• robots making payments each month.

Committee: House Human Services Finance and Policy