Transcript Highlights:

• Actually, we have a call at 4:30 this afternoon with CMS, trying to figure out whether we can zig or
• 00:32:04.799> this<00:32:05.120> afternoon<00:32:06.000> with<00:32:06.320> CMS
• 4:30 this afternoon with CMS 4:30 this afternoon with CMS uh<00:32:08.559> trying<00:32:08.799

Keywords: Government Structure - Room 409, 12 January, 2026; 2:00 P.M., 925, all

Summary: The committee held its first meeting under its new Government Structure Committee name and began by electing Senator Chris Johnson as secretary. The chair explained the committee’s purpose as improving efficiency, effectiveness, and stewardship of taxpayer dollars, and said members had asked statewide officials and agencies for ideas on streamlining government and reducing costs. Commissioner of Agriculture and Commerce Andy Gibson testified at length about ways his agency has found efficiencies, especially after the COVID-era consolidation of three agencies into one. He said state procurement and construction rules can add major time and cost to projects, citing a proposed $300,000 building that grew to about $1 million through the state process. He recommended raising repair and quote thresholds, streamlining construction procedures, reconsidering restrictions on payments between state agencies, and allowing more flexibility for agencies to help one another when authorized. Members questioned Gibson about the repair caps, the construction cost increase, Ticketmaster and other technology/vendor arrangements, and whether agencies should have more decentralized control over contracts. The chair and several senators agreed the committee should examine red tape, vendor relationships, and procurement rules, and Gibson said he would provide more information and work with the committee. No formal legislation was acted on in the portion provided. The transcript then shifted to testimony from the Insurance Commissioner, who said his department is heavily affected by IT and board structure issues and oversees 17 boards. He urged consolidation of some boards, criticized the effects of SB 2362 on special-fund agencies, and said the State Fire Academy and other operations have been constrained by general-fund treatment and limited authority. He also discussed insurance-rate pressures, including projected premium increases, wind pool rate concerns on the Gulf Coast, and the need for mitigation to stabilize costs.

Transcript Highlights:

• providers if there is a need for additional service availability as determined by ACCA and federal CMS
• providers if there is a need for additional service availability as determined by ACCA and federal CMS
• CMS. That is the bill, Mr. Speaker. Questions of the sponsor? Is there debate?
• CMS. That is the bill, Mr. Speaker. Questions of the sponsor? Is there debate?

Summary: The House met on the final day of session, swore in Representatives Boyles and Hodgers, and observed a moment of silence for the Minnesota House Speaker Melissa Hortman and her husband, as well as for Representative Rosenwald’s father. The chamber then moved into final budget work, with leaders outlining the plan to take up H.J.R. 5019, HB 7031, HB 5017, HB 5015, and then the general appropriations act once the Senate transmitted it. H.J.R. 5019, a proposed constitutional amendment to expand the budget stabilization fund, was explained and amended to raise the rainy day fund cap, require annual deposits, and allow withdrawals for critical state needs by a two-thirds vote; it passed 100-1. The House then adopted the conference report on HB 7031, the tax package. The bill repeals the business rent tax and aviation fuel tax, delays the natural gas fuel tax, creates or expands several sales tax holidays and exemptions, including permanent exemptions for disaster-preparedness items, hunting/fishing/camping items, and ammunition and firearms-related purchases, and makes changes to property, corporate income, local tax, and economic development provisions. Members debated the removal of recurring housing trust fund and transit-related revenue streams, the new ammunition exemption, and the data center tax changes; supporters argued the package reduces taxes and preserves annual budget flexibility, while opponents raised concerns about housing, transportation, and gun violence. The conference report passed 93-7. HB 5017, creating a debt reduction program funded by a recurring transfer to retire state bonds early, passed unanimously. HB 5015, the state group insurance conforming bill, which directs DMS to develop a formulary management plan and codifies the administrative health insurance assessment, also passed. The House then began explanation and questions on the fiscal year 2025-26 general appropriations act, described as a $115.1 billion budget that is down $3.8 billion from the current year and includes more than $12 billion in reserves. Subcommittee chairs summarized major spending areas, including pre-K-12 funding increases, health care funding for Medicaid, KidCare, nursing homes, opioid treatment, and mental health, transportation and economic development funding, environmental and water projects, higher education, state administration, justice, and information technology. Questions focused on school vouchers, inflationary pressures on school districts, and the adequacy of funding for housing, transportation, and other priorities.

Transcript Highlights:

• aligning statute with guidance for time-based codes from the Minnesota Department of Health's rule and the CMS
• aligning statute with guidance for time-based codes from the Minnesota Department of Health's rule and the CMS
• aligning statute with guidance for time-based codes from the Minnesota Department of Health's rule and the CMS
• Aligning statute with guidance for time-based codes from the Minnesota Department of Health's rule and the CMS

Keywords: 1183, house

Transcript Highlights:

• CMS over Medicaid is a little bit more flexible.
• care, they have some initiatives. about behavioral health that do not match with what the feds and CMS
• It is what is used to do to determine the quality metrics for the five-star rating system with CMS. quality
• CMS oversees the quality, measures the quality, and measures it on a scale of one to five.

Bills: HB150, HB869, HB876, HB 1043, HB1494, HB1522, HB150

Keywords: cybersecurity, state command, information resources, data protection, incident response, information technology, classification officer, job descriptions, state positions, competency-based, information sharing, government efficiency, public sector, private sector, distributed ledger, title registry, real estate, property liens, pilot program, healthcare

Transcript Highlights:

• that in New Hampshire we have a mandatory community re-entry benefit for Medicaid that federal DHHS, CMS
• that in New Hampshire we have a mandatory community re-entry benefit for Medicaid that federal DHHS, CMS
• that in New Hampshire we have a mandatory community re-entry benefit for Medicaid that federal DHHS, CMS
• c> In New Hampshire, we have a mandatory community re-entry benefit for Medicaid that federal DHHS, CMS

Keywords: 1191, senate, all

Transcript Highlights:

• statewide issue as well that we'd like to address with this legislation, and it just mirrors aligning to CMS
• statewide issue as well that we'd like to address with this legislation, and it just mirrors aligning to CMS
• statewide issue as well that we'd like to address with this legislation, and it just mirrors aligning to CMS
• statewide issue as well that we'd like to address with this legislation, and it just mirrors aligning to CMS

Keywords: 912, senate, all

Summary: The Health and Human Services Committee heard testimony on several measures related to child welfare, health care access, overdose response, disability services, and waste management. For SB 710 on child welfare, the Department of Human Services, the Office of Wellness and Resilience, the Attorney General’s office, and multiple advocacy groups testified in support, with the Governor’s office noting support but deferring to the Attorney General on implementation because of separation-of-powers concerns. For SB 952 on child welfare services, DHS, the Governor’s office, and child- and trauma-informed care advocates supported the bill, saying it would help families access services, provide basic material support, and reduce strain on the child welfare system. SB 954 on a home health services rate study also drew support, including from DHS, the Hawaii Healthcare Association, and a public testifier who said the study would help ensure funds reach low-income, disabled, and kupuna recipients. SB 957 on overdose prevention received support from the Department of Health and the Attorney General, who said overdose prevention centers are evidence-based but raised federal-law concerns and recommended amendments; the Hawaii Health and Harm Reduction Center and others also testified in support. The committee then moved to the 1:00 regular calendar and heard SB 850 on disability health disparity, which was supported by the Executive Office on Aging, the Hawaii State Council on Developmental Disabilities, the Hawaii Disability Rights Center, self-advocates, and others. Testimony emphasized that a disparity study could improve workforce development, training, and services for people with disabilities. SB 838 on continuous glucose monitoring drew support from health agencies and advocates, with testimony stressing that monitors can be critical for some diabetes patients. SB 829 on health care was supported by the Department of Health and health care stakeholders, who said it would help rotating physicians serve neighbor islands without local hospital privileges and align with CMS rules. SB 446 on waste management drew mixed testimony: the Department of Health and several public entities provided comments, the County of Maui opposed, and environmental advocates urged stronger aquifer protections and limits on ash reuse. During decision making, the committee adopted recommendations to pass SB 298, SB 322, SB 299, SB 450, SB 451, SB 949, SB 710, SB 957, SB 69, and SD 952 with various amendments, including technical changes, blank appropriations, and defective dates. SB 323, SB 324, SB 712, SB 950, SB 954, and SB 959 were deferred, largely because companion House measures were moving or similar Senate measures had already passed. The chair also announced recesses to find quorum and noted that some bills from the earlier Monday calendar were being deferred to avoid duplication.

Transcript Highlights:

• Timothy Lyons, subcontractors CM E2, is in support.
• Timothy Lyons, subcontractors CM E2, is in support.
• Timothy Lyons, subcontractors CM E2, is in support.
• Timothy Lyons, subcontractors CM E2, is in support.

Keywords: 912, senate, all

Summary: The committee opened its first hearing of 2025 and announced that all measures heard that day would be deferred to the next committee hearing for decision-making on Thursday, January 30. The agenda centered largely on procurement and government-operations bills, with testimony generally split between state agencies and local governments. On procurement measures, SB 254 and SB 383 would raise small-purchase thresholds; the State Procurement Office opposed both, while county officials, the City and County of Honolulu, the state librarian, and others supported them. SB 382, which would bar disclosure of a competing offeror’s proposal or evaluation score, and SB 462, which would require performance incentive contracts to specify pricing bases, goals, and formulas, drew mostly written comments and some support from agencies such as the Department of Transportation and Department of Education. SB 615, which would treat certain large change orders as new contracts, received opposition from the Comptroller and engineering interests. The committee also heard several bills on vacancies, appointments, and legislative oversight. SB 5 on state legislative vacancies had one supporting testifier, while SB 300 on deadlines for filling certain Senate vacancies drew opposition from several individuals and support from one late testifier. SB 1081, which would create a legislative budget office to provide fiscal analysis and reports on bills, received broad support from advocacy groups, civic organizations, and individuals. SB 711, requiring Senate advice and consent for certain executive-branch appointments, drew written opposition from the Governor’s Office and support from one individual. SB 375, establishing a select commission on government restructuring, had one written supporter. SB 418, which would require the Attorney General’s office to review a portion of administrative rules each year, prompted extended discussion about outdated rules, the difficulty of repealing or amending rules, and whether the bill should be refined; the AG’s office indicated the process is burdensome and could be streamlined. The committee then took up transparency and access measures. SB 55, requiring agency rules to be posted online in a digitally accessible format, received support from several advocacy and civic groups and written comment from the Lieutenant Governor’s Office. SB 870 would direct the comptroller to identify state office buildings that could provide equitable telecom access for remote participation in hearings, especially for residents with disabilities; the Comptroller supported the concept, and members discussed using libraries, DAGS facilities, county facilities, and other public buildings, with concerns raised about staffing, bandwidth, and competing public use. SB 270, a sunshine-law measure allowing board members to attend informational meetings and presentations, drew opposition from the Public First Law Center, which argued it would create a broad loophole and should be narrowed to existing county-council provisions. SB 45, concerning neighborhood board meetings and third-party presentations, prompted discussion about whether it actually addressed neighborhood boards’ Sunshine Law concerns; the committee was told it was not the right vehicle for that issue. SB 406, which would cap copying fees for government records at 5 cents per page with exceptions, drew support from media and transparency groups but opposition from DAGS, which said its actual per-page cost is much higher; members discussed possible electronic-copy alternatives and asked for more cost information before the next hearing.

Transcript Highlights:

• It's a CMS questionnaire that we are going through with our patients to identify housing insecurity,
• that's the qu that's 25 questions<00:42:49.520> it's<00:42:49.680> a<00:42:49.800> CMS
• <00:42:50.440> questionnaire<00:42:51.440> that questions it's a CMS questionnaire
• that questions it's a CMS questionnaire that we<00:42:51.800> are<00:42:52.119> going<00

Keywords: 00:00 Call to Order/Roll Call 00:16 Consideration of Referred Administrative Regulations 25:49 Discussion of Hospital Rate Improvement Plan 58:50 Adjournment, 958, all

Summary: The committee began by reviewing a large slate of administrative regulations and explaining that it does not approve regulations but can find them deficient and send them back for further work. Members then asked questions on several items, including EMS reciprocity, dental hygienist licensure, and interpreter licensure. The EMS board explained that reciprocity would extend to applicants from any state, not just contiguous states, because the underlying statute had been amended. On the dental regulation, staff said the changes mainly clarified licensure requirements, reinstatement fees, and that dental hygienists administering local anesthetic must do so under direct dentist supervision. The most extended discussion involved the Board of Interpreters for the Deaf and Hard of Hearing. The board chair said the main concern was that the EIPA is an educational specialty assessment, not a nationally recognized certification, yet the regulation would allow it to support full licensure. Members discussed whether that could let educational interpreters work outside their intended scope and whether a separate educational license or statutory change would be more appropriate. The board said it did not think the regulation could be fixed further at this point and suggested a statute could create a narrower educational interpreter license. After discussion, the committee voted to defer both related interpreter regulations, 201 KAR 39:030 and the companion regulation, for further work. The committee then took up two community mental health regulations, 907 KAR 1:044 and 907 KAR 5:005, which had been found deficient in Administrative Regulations. Department for Medicaid Services staff said the rules would expand and rename the mental health associate role as a behavioral health associate, making the role available in many more facilities, but would also require additional coursework or progress toward licensure. Some members and providers raised access-to-care concerns, especially for rural areas and unlicensed staff already working in the field. Staff said the proposal had been revised through work with CMHCs and licensing boards, but the committee ultimately voted to defer both regulations as well. After finishing the regulation review, the committee heard a presentation from the Kentucky Hospital Association on the ATRIP hospital rate improvement program. Hospital representatives said ATRIP is a Medicaid state-directed payment program funded through a provider tax and federal matching dollars, allowing hospitals to receive payments tied to quality measures. They reported improvements including lower Medicaid readmissions, high sepsis screening rates, reduced infections and opioid prescribing, expanded postpartum depression and suicide screening, and training for more than 1,000 people. They said the program has helped hospitals invest in staffing and quality improvement and warned that without it, many hospitals would face severe financial strain.

Transcript Highlights:

• large body of evidence backing the intervention, two team-based billing codes for CSC were approved by CMS
• CMS has approved two billing codes for this, as you've heard, and it was endorsed by Don Berwick, the

Keywords: 995, all

Summary: The committee held a hearing on a large group of behavioral health and insurance-related bills. Topics included expanding access to mental health services by allowing physician assistants to authorize Section 12 emergency holds and be recognized as licensed mental health professionals (H. 1131/S. 773); improving coverage for community behavioral health centers so commercial insurance matches MassHealth’s bundled outpatient and crisis services (H. 1276/S. 703); eliminating cost sharing for certain behavioral health services (S. 718); extending detox and clinical stabilization coverage from 14 to 30 days and adding transitional support services (H. 1319/S. 772); requiring coverage for dual-diagnosis treatment in psychiatric facilities (H. 1277/S. 771); and preserving access to treatment for serious mental illness through coverage of coordinated specialty care and assertive community treatment (H. 1135/S. 709). The committee also heard bills on preventive behavioral health services for children (H. 1228/S. 802) and post-pregnancy mental health care, including postpartum depression and pregnancy loss-related care (H. 1314/S. 823).

Transcript Highlights:

• the key things that we have to go through, and some of the processes that I noted earlier, is federal CMS
• That's part of what the corrective action plan with CMS includes.

Transcript Highlights:

• find that Ironic that he could make that statement, seeing 72.6% of CVS and Caremark's patients are CMS
• beneficiaries and CMS requires minimum access standards, so His job is access.

Bills: HB3552, HB2984, HB4124, HB3934, HB3448, HB3131, HB4200, HB4201, HB3011, HB1912, HB3380, HB3881, HB3538, HB3851, HB3907, HB4430, HB4431, HB4457

Keywords: childcare, differential pricing, Department of Human Services, child care subsidy, licensed providers, emergency legislation, child care, subsidy program, annual report, program integrity, overpayments, ivermectin, over-the-counter medication, pharmacy immunity, healthcare access, FDA approval, prescription, public health, dentistry, licensing

Transcript Highlights:

• Madam Chair and Leader, yeah, the process for our state's Medicaid program is they must put that in the CMS
• CMS is the Centers for Medicare and Medicaid Services.

Bills: HB99, HB38, HB165, HB127, HB72, HB151, SB40, SB104, SB136, SB164

Keywords: medical malpractice, malpractice reform, patient's compensation fund, PCF, health care liability, tort reform, damage caps, punitive damages, hospital liability, physician liability, nurse practitioner, certified nurse-midwife, outpatient facility, ambulatory surgical center, urgent care, free-standing emergency room, insurance surcharge, superintendent of insurance, New Mexico hospitals, medical review process

Transcript Highlights:

• Hospitals operate under oversight from multiple entities beyond the Board of Pharmacy, including CMS,
• CMS, CDPH, and the Joint Commission.

Summary: The joint Assembly and Senate business committees held a sunset review hearing on the California State Board of Pharmacy, with board leadership describing the board’s consumer-protection role and its priorities around access, enforcement, and updating pharmacy law. The board emphasized a proposed shift toward a standard-of-care model for pharmacists, arguing it would reduce rigid protocol requirements and improve access to services such as HIV PrEP/PEP, contraception, and naloxone. Board representatives also discussed pharmacy deserts, possible fee waivers for pharmacies in underserved areas, concerns about payer practices contributing to closures, continuing education audits, and a request to restore more flexibility in licensure decisions and probationary monitoring for applicants with certain criminal histories. A major focus of the hearing was the board’s ongoing compounding regulations, especially the treatment of sterile versus nonsterile compounding and substances such as glutathione and methylcobalamin. The board said the proposal was not a ban on those substances and described the rulemaking as grounded in federal law, USP standards, and public comment, noting the process had gone through multiple modified texts and hearings. Testimony from stakeholders was sharply divided: pharmacists, veterinarians, firefighters, naturopathic doctors, and patient advocates warned the rules were restricting access to compounded medications and harming patients and first responders, while the California Medical Association, psychiatric physicians, and PhRMA raised concerns that the board’s proposals could expand pharmacist authority beyond training, affect physician practice, or create safety risks. Other public comments addressed pharmacy technician ratios, remote processing, flavoring medications, hospital-specific regulation, budget and enforcement transparency, and whether the board should add members with community compounding or pharmacy technician expertise. Committee members also asked about the board’s oversight priorities and the rationale for its standard-of-care proposal. Board staff explained that consumer protection includes education, licensing, policy, and enforcement, with the highest-priority enforcement cases being those posing imminent public harm. After public testimony concluded, the chairs thanked participants and adjourned the sunset review hearing, announcing an immediate transition to the joint informational hearing on the Department of Cannabis Control.

Transcript Highlights:

• a lot more favorable, and we were able to get much lower rates of what we had to pay per member. >> CMS
• And by the way, here it is. >> That's worse than the power bill. inflation reduction act and CMS the
• inflation reduction act and CMS the funding<00:13:21.120> formula<00:13:22.000> was<00:
• > code<00:13:31.440> for<00:13:31.680> the >> CMS that's that's uh code for
• the >> CMS that's that's uh code for the federal<00:13:32.240> government,<00:13:32.639

Keywords: 924, joint, all

Transcript Highlights:

• Specifically, what are you asking CMS to do?
• So we're not asking CMS as much as we are asking DHS to basically file and basically start the process
• Is that an approval for this from CMS? I'm just trying to figure out.
• Using layman's terms, you have to basically get approval from CMS if you if we wanted to do this statewide
• Looking for is a state plan amendment is what we have to apply for at CMS.

Bills: SB1687, HB1687, HB4431, HB2894, HB2979, HB3262, HB3298, HB3369, HB3431, HB3462, SB1226, SB1876, SB1916, SB1920, HB3467, HB3498, HB3500, HB3521, HB3581, HB3650, HB3673, HB3764, HB3767, HB3781, HB3800, HB3831, HB3834, HB3941, HB2749, HB3970, HB3972, HB3979, HB3980, HB3981, HB3996, HB4095, HB4104, HB4191, HB4248, HB4298, HB4338, HB4427, HB4428, HJR1023, HB3660, HB3718, HB4326, HB3443, HB3880, HB3649, HB3000, SB1651, SB504, SB372, SB1326, SB1633, SB248, SB1242, SB1238, SB423, SB1989, SB1286, SB904, SB1213, SB1216, SB1827, SB65, SB1390, SB259, SB1944, SB540, SB2139, SB346, SB1595, SB1400, SB1555, SB1209, SB2110, SB1670, SB1061, SB2104, HR1057, SB1946, SB1734, SB1316, SB1360, SB1557, SB1684, SB2049, SB1410, SB2011, SB1437, SB1204, SB1732, SB1775, SB2084, SB1380, SB1572, SB1772, SB1224, SB710, SB1338, SB1266, SB1303, SB1307, SB1562, SB1794, SB1191, SB1983, SB1832, SB1448, SB1534, SB1593, SB1597, SB1630, SB1489, SB1726, SB1796, SB1806, SB1877, SB1451, SB1553, SB1632, SB1423, SB1425, SB1502, SB2180, SB1725, SB2182, HB3003, HB3004, HB4434, HB4324, HB4342, HB2137, HB4432, SJR50, SJR52, SJR53

Keywords: driver licenses, exam proctor, Service Oklahoma, commercial training, background checks, advance directive, advance health care directive, health care proxy, medical power of attorney, durable power of attorney for health care, living will, surrogate decision-maker, default surrogate, health care agent, capacity determination, supported decision making, mental health directive, psychiatric advance directive, end-of-life care, life-sustaining treatment

Transcript Highlights:

• I know CMS does stars, so it's like how many stars you get and that's sort of how they get rated.
• Years ago, I believe DHS sort of linked into the CMS system and did those stars.
• Since then, I believe CMS has also done a moratorium on new home health agencies.

Keywords: 1182, all

Transcript Highlights:

• So, I mean, I know like CMS does stars, and so it's like how many, you know, whether you're, you know
• We haven't, years ago I believe DHS sort of linked into the CMS system and did those stars.
• Now, since then, I believe CMS has also done a moratorium on new home health agencies, but before they

Summary: The Committee on Director Nominations met with four members present and approved the prior minutes without objection. Chair Jay Kaufman outlined the committee’s role in reviewing executive nominations and explained the hearing process for three nominees: Mary Foote for the Office of Economic Opportunity, Debbie Johnston for the Department of Health Services, and Chuck Bassett. Foote did not appear for her hearing, and members discussed her absence and alleged omissions in her disclosure materials, including prior service with Planned Parenthood-related organizations. The committee then moved to reject her nomination, and the motion passed 3-2, recommending that the full Senate reject Mary Foote. Debbie Johnston, nominee to lead the Department of Health Services, appeared and gave an opening statement describing her Arizona background, prior Senate staff work, and more than 20 years with the Arizona Hospital and Health Care Association. She said her priorities at ADHS include rebuilding trust in public health licensing, improving stakeholder engagement, standardizing rulemaking communication, addressing alleged religious discrimination and retaliation concerns in licensing, and using technology and AI to improve efficiency. In questioning, senators pressed her on her management style, conflict-of-interest safeguards given her prior industry role, enforcement priorities, budget pressures, behavioral health and assisted living oversight, and the department’s response to COVID-19. Johnston said she would follow statutes, recuse herself from enforcement matters involving former contacts, and resign if directed to carry out an unlawful policy. She also said the department does not regulate therapy itself, only facilities, and that it would rely on legal counsel regarding the governor’s conversion-therapy executive order and related federal civil-rights allegations. Several senators focused on public health trust and the department’s pandemic response, with Johnston acknowledging concerns about closures, data collection, and communication during COVID-19 while saying she would review past after-action materials and be better prepared in the future. Public testimony from stakeholders in aging services and health care strongly supported her confirmation, praising her accessibility, responsiveness, and collaborative approach. After testimony, the vice chair moved to recommend Johnston’s confirmation to the full Senate. The roll call was underway when the transcript ended, with several members voting aye and one member expressing reservations about her not reviewing the pandemic after-action report before another crisis occurs.

Transcript Highlights:

• Would we be more comfortable with, like, when we talk about health care issues, we lean to our CMS.
• We don't make health care policies in the state that would, at some point, conflict with CMS.
• These regulations which are in place... ...conflict with CMS.

Bills: HB387, HB673, HB947, HB975, HB1102, HB1228, HB1229, HCR66, SB102, SB165, SB280, SB291, SB326, SB521

Keywords: engineering, land surveying, construction, state fire marshal, plan review, security cameras, abandoned property, blighted structures, property management, digital assets, abandonment, custodian, escheatment, blockchain, cryptocurrency, unclaimed property, state treasurer, Department of Public Service, statutory entities, public administration

Transcript Highlights:

• of the Medicaid portions of HR1 by not going further than what it calls for until we know more from CMS
• We want to be sure that we keep our error rate below the 3% threshold set by CMS.
• When CMS audits states, the most common reason for errors by far is case worker documentation.

Keywords: 958, all

Summary: The committee met with a quorum to consider the Senate Committee Substitute for House Bill 2, a major Medicaid bill. Members first adopted the substitute and then adopted Amendment 9770. The bill was described as a lengthy rewrite aimed at aligning Kentucky Medicaid policy with federal requirements under HR 1, while also preserving program integrity and addressing due process concerns. Senators and staff repeatedly emphasized that the measure was the product of extensive meetings with providers, associations, and work groups. The sponsor’s section-by-section summary highlighted several key changes: delaying and reducing cost-sharing requirements; pushing eligibility redetermination deadlines to the federal date; restoring some flexibility for hardship waivers; allowing self-attestation as a last resort; modifying MCO audit provisions; clarifying non-emergency medical transport GPS costs; expanding waiver attestation authority to nurse practitioners and licensed psychologists; adding qualified aliens to waiver eligibility to comply with federal law; requiring Medicaid data sharing with the oversight board; limiting changes to Medicaid benefits without General Assembly authorization; narrowing the prescription drug exclusion to drugs prescribed primarily for weight loss; and delaying the dental ASO transition until 2029. The substitute also deleted a proposed auditor review requirement and retained an emergency clause. Committee discussion focused heavily on the policy and fiscal implications of the cost-sharing and recertification provisions. Senators raised concerns about whether the co-pays would be effective or simply shift costs to providers, whether the recertification process would burden the Cabinet and cause eligible people to lose coverage, and how the bill would affect people transitioning from Medicaid into work. Supporters said the lower cost-sharing amounts were intended to encourage appropriate use of care, protect providers, and comply with federal law, and they noted that the Medicaid Oversight and Advisory Board would help shape future changes. A public witness, Maggie Chisholm, gave emotional testimony about her daughter’s experience with a Medicaid waiver and argued that policy delays and administrative disconnects can harm vulnerable families. No final vote on the bill itself was recorded in the excerpt, but the substitute and amendment were adopted and testimony continued.

Transcript Highlights:

• is related to actions taken by the Centers for Medicare and Medicaid Services, also referred to as CMS
• On January 6th, CMS indicated their intent to withhold $515 million per quarter from the state's MA reimbursement
• And now, just earlier this week, we received additional notice from CMS that they would defer $260 million

Keywords: 1183, house

Summary: Minnesota Management and Budget officials presented the February 2026 budget and economic forecast, saying the state remains in a strong financial position but faces continued structural imbalance and significant uncertainty. Commissioner Aaron Campbell said the FY 2026-27 balance is now projected at more than $3.7 billion, up about $1.3 billion from November, and the FY 2028-29 planning period is projected to end with a $377 million positive balance. He emphasized that the improvement comes largely from higher projected revenues, especially individual income and corporate franchise taxes, but warned that the state is increasingly reliant on more volatile sources such as capital gains, interest income, and corporate profits. State Economist Dr. Anthony Becker said the national outlook improved slightly, with stronger projected GDP, consumer spending, and investment, but weaker payroll growth and ongoing trade-policy uncertainty. He noted that the forecast was complicated by missing federal data because of the federal shutdown, and that tariffs, immigration policy, equity markets, and possible AI-related shifts all present risks. Revenue projections were raised for the current biennium, including individual income tax receipts, sales tax revenue, corporate franchise tax revenue, and other revenues, while Becker stressed that federal funding threats, especially involving Medicaid and other entitlement programs, could materially alter the outlook. State Budget Director Anna Mingi said general fund spending in the current biennium is projected to be $68 million lower than previously estimated, but planning-year spending is up $152 million. The biggest spending changes came from education, where special education costs rose sharply after updated local spending data, and from human services, where a new prepayment review process for certain Medicaid benefits reduced projected spending by $133 million this biennium and $105 million in the next. She also said discretionary inflation is now estimated at $1.04 billion, up $104 million from November. Campbell closed by saying the state’s reserve remains at a record $3.8 billion and that Minnesota’s AAA bond rating and reserve policy help protect against downturns. He cautioned, however, that the long-term structural imbalance remains about $3.4 billion in the planning years, or $2.3 billion excluding discretionary inflation, and urged policymakers to offset any new spending with reductions. No votes or formal actions were taken; the meeting was a presentation and question-and-answer session on the forecast.