Transcript Highlights:

• If you are pregnant, you qualify for Medicaid.
• say it took 2 months, and so you were maybe 3 months into your pregnancy when you got approved for Medicaid
• could go back and... but anyway you could go back and file for what you had already done, and the Medicaid

Bills: HB52, HB89, HB141, HB52, HB89, HB141

Keywords: income tax, CHOOSE Act, education funding, ABLE account, tax credits, poverty threshold, legislative funding, HB89, Medicaid, pregnant women, pregnancy, prenatal care, ambulatory prenatal care, presumptive eligibility, temporary Medicaid coverage, Alabama Medicaid Agency, maternal health, low-income women, health coverage, eligibility determination

Transcript Highlights:

• Medicaid waiver services. So that's Medicaid waiver services.
• evaluating effectiveness of the Medicaid evaluating effectiveness of the Medicaid program,<00:16
• know, 1.4 million people on Medicaid. know, 1.4 million people on Medicaid.
• services to Medicaid enrolles. services to Medicaid enrolles.
• care services are covered by Medicaid. care services are covered by Medicaid.

Keywords: Call to Order and Roll Call – 00:00:00 Introduction of Board Members – 00:02:04 Overview of the Purpose and Goals of the Medicaid Oversight and Advisory Board – 00:12:46 Medicaid Legislative Update - 00:20:26 Discussion of Next Steps and Future Meeting Dates – 01:04:06 Adjournment – 01:06:37, 958, all

Summary: The first meeting of the Medicaid Oversight Advisory Board opened with Chair Ken Fleming and Co-Chair Rocky Adams welcoming members, explaining the board’s purpose, and introducing the diverse membership of legislators, providers, advocates, and state officials. Fleming said the board would meet monthly, allow public comment at the end of meetings, and operate transparently with materials posted online and distributed in advance. Both chairs emphasized that the board’s work would focus on improving Medicaid outcomes, efficiency, and oversight, while preparing for possible federal changes and avoiding premature assumptions about what Congress may do. Members then gave brief introductions describing their backgrounds in medicine, nursing, hospital administration, behavioral health, insurance, budgeting, pharmacy, and Medicaid administration. Several noted direct experience with Medicaid populations or managed care, including the Department for Medicaid Services commissioner, health plan representatives, hospital and clinic leaders, and legislators with health care backgrounds. The board also heard from Stephanie Bates of the LRC Office of Health Data Analytics, who said her office supports the General Assembly with health-related data, policy, and research and would serve as a resource to the board. Bates then began a presentation on Medicaid basics, explaining that House Bill 695 created the board and that the presentation would cover eligibility, enrollment, covered benefits, waivers, managed care, the budget, and the federal reconciliation bill. She described Medicaid eligibility as complex, noted that Kentucky had more than 1.4 million enrollees, and explained enrollment churn and the unwinding of pandemic-era continuous coverage. She also outlined mandatory and optional Medicaid benefits, the requirement that services be medically necessary and provided by enrolled providers, and the main waiver types used in Kentucky, including 1115, 1915(b), and 1915(c) waivers. No votes or formal actions were taken at this meeting beyond organizational setup and receiving the initial informational presentation.

Transcript Highlights:

• The House Committee that oversees Medicaid and Medicaid is responsible for funding 880 billion dollars
• Medicaid covers almost 40 million children.
• put that hospital in financial peril to lose Medicaid.
• We'll spend a trillion dollars this year on Medicaid.
• And he said the same thing about Medicaid.

Keywords: Social Security, Medicaid, Frank Bisignano, Elon Musk, benefit processing, office closures, public testimony, administration policies, health care, vulnerable populations

Summary: The committee meeting focused heavily on the nomination of Frank Bisignano as the Commissioner of the Social Security Administration, with intense discussions around the current state of Social Security and its management under the current administration. Members voiced significant concerns regarding potential changes to Social Security and Medicaid, specifically addressing issues such as office closures, delays in benefit processing, and the perceived policies from Elon Musk's association with the administration. Public testimonies highlighted fears that these changes would severely impact the accessibility of benefits for seniors and vulnerable individuals, resulting in a chaotic environment at the SSA. Members expressed a unified opposition to the notion of dismantling these critical programs, emphasizing the long-term implications on their constituents' well-being.

Transcript Highlights:

• So there will be two options depending on what the individuals who lose Medicaid do or do not qualify
• So there will be two options depending on what the individuals who lose Medicaid do or do not qualify

Bills: HB1546

Keywords: Medicaid, health insurance, healthcare access, insurance subsidies, pilot program, affordable care, preventive services, low-income, community engagement, 910, house, all

Summary: The committee heard testimony on HB 2083, which would add homeless shelters to Hawaii’s drug-free/safe-zone protections. The City and County prosecutor’s office strongly supported the bill, saying service providers asked for the change because drug activity near shelters can undermine recovery efforts. The Office of the Public Defender opposed the measure, focusing on a possible notice problem because many shelters are not readily identifiable and the bill’s 750-foot distance requirement could be difficult to apply. The Drug Policy Forum of Hawaii also opposed the bill, arguing it would expand criminalization of poverty and drug use and that drug-free zone laws are ineffective and disproportionately harmful. The prosecutor’s office said it would do more research on the notice concern. The committee then moved on without taking a vote in the transcript provided. The committee next discussed HB 2087, which would change the treatment of abuse of family or household member cases by ending the deferred-acceptance pilot and returning to the prior statute. The prosecutor’s office supported the bill, saying the pilot had not reduced backlog as intended and that domestic violence cases should remain petty misdemeanors without deferral. The Hawaii State Coalition Against Domestic Violence and the Public Defender’s Office both opposed HB 2087, instead urging extension of the pilot for another five years so the legislature can better evaluate how deferred acceptance is working. They said deferrals can be a useful incentive for behavior change and that more data is needed before ending the program. Committee members questioned the prosecutor about why Hawaii should differ from other counties and whether repeat offenders could keep receiving deferrals; the prosecutor said the deferral is available only once and reiterated support for returning to the old statute. The committee then heard HB 2096 on aggravated circumstances in child protective proceedings. The family court and Attorney General’s Office supported the bill, saying current law limits aggravated-circumstances findings to the early return hearing, which can prevent findings in the most serious abuse cases when key evidence is not yet available. They said the bill would allow such findings later in the case and, with proposed amendments, would let the court consolidate aggravated-circumstances and termination-of-parental-rights hearings to reduce delay and appeals. The Libertarian Party of Hawaii opposed the measure, arguing it would expand state power in family matters and could worsen outcomes for parents and children. Committee questions focused on the amended language, including what “another court of competent jurisdiction” means and whether a charge alone would be enough; the judiciary responded that criminal courts are included, but a hearing and opportunity to defend would still be required. Finally, the committee took up HB 1959, another domestic violence measure. The Hawaii State Coalition Against Domestic Violence, the Public Defender’s Office, the Crime Victim Compensation Commission, the Hawaii State Commission on the Status of Women, and county prosecuting offices testified in support. Supporters said the bill would extend the pilot program while keeping deferred acceptance of guilty pleas in place, giving more time to evaluate whether the program is working and whether a more formal diversion model should be developed. The coalition also suggested technical fixes to ensure judiciary data reporting continues and that the deferred-acceptance statute is not inadvertently repealed. No vote or final action was taken in the transcript before the committee moved on to the next bill.

Transcript Highlights:

• Medicaid program.
• Medicaid Services. Medicaid Services.
• to our Medicaid uh managed care system. to our Medicaid uh managed care system.
• accept new Medicaid patients. accept new Medicaid patients.
• provider but don't accept Medicaid. provider but don't accept Medicaid.

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:36 Department for Medicaid Services 00:01:44, 958, all

Summary: The House Budget Review Subcommittee on Health and Family Services met for an overview of the Department for Medicaid Services budget. Commissioner Lisa Lee and CFO Steve Beal described Kentucky Medicaid enrollment at about 1.4 million members, including more than 600,000 children, and said the agency’s 2025 total budget was $20.6 billion. They reviewed enrollment trends before, during, and after the COVID-19 public health emergency, noting that redeterminations begun in 2023 reduced enrollment from its peak but that total membership remains above pre-COVID levels. They also explained the difference between the fee-for-service population, which includes long-term care and waiver members, and managed care members, and gave examples of the kinds of services and diagnoses seen in each group. A major focus was the governor’s recommended Medicaid budget and the department’s forecast process. Lee said the budget is split into benefits and administration, with benefits covering fee-for-service services, managed care capitation, transportation, and Medicare premiums, while administration covers contracts, personnel, operating costs, and IT-related advanced planning documents. She said the department uses a consensus forecasting group and actuary input, and that its forecasts have been within 1% of actual spending in recent years. The department also said the governor’s budget includes new waiver slots to address waiting lists, a 2% staff COLA, and a 10% phase-down on state-directed payments beginning in January 2028. Much of the discussion centered on House Resolution 1 and the funding needed to implement its Medicaid-related provisions, including community engagement requirements, six-month redeterminations, and future cost sharing. Lee said the department requested about $35 million in total funds for fiscal 2027, including about $8.2 million in general funds for system changes to the integrated eligibility system, claims processing, notices, and monitoring; and about $11 million in fiscal 2028 for ongoing maintenance, with about $1.6 million in general funds. She said the department expects to seek federal APD matching funds for the IT work. In response to questions, she explained that community engagement would apply to Medicaid expansion members, with qualifying activities including work, school, volunteering, or equivalent income, and that certain groups such as pregnant women, children, caretaker relatives, and some people with chronic disease or substance use disorder would be excluded. She said the department identified roughly 70,000 expansion members who could be subject to the requirement. No votes or formal actions were taken.

Transcript Highlights:

• Okay. the federal changes to the Medicaid the federal changes to the Medicaid program.
• Medicaid state directed payment program. Medicaid state directed payment program.
• necessary changes to Medicaid. necessary changes to Medicaid.
• Medicaid. Medicaid.
• , a few years later, Medicaid.

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.

Bills: HB0003, HB0004

Keywords: pregnancy centers, abortion, pro-life, healthcare, women's rights, state regulation, civil rights, freedom of speech, medical assistance, birthing centers, Medicaid, Wyoming, 916, all

Transcript Highlights:

• 4, birthing cent's Medicaid coverage. 4, birthing cent's Medicaid coverage.
• Jesse Springer, the state Medicaid agent, responded that Medicaid reimburses approximately $7,000 for
• 30% of our clients are Medicaid.
• > to<01:37:45.199> the<01:37:45.600> Medicaid Medicaid clients going to the Medicaid
• The Medicaid client in the state.

Bills: HB0003, HB0004

Keywords: pregnancy centers, abortion, pro-life, healthcare, women's rights, state regulation, civil rights, freedom of speech, medical assistance, birthing centers, Medicaid, Wyoming, 916, all

Transcript Highlights:

• General's office in fighting Medicaid General's office in fighting Medicaid fraud<00:43:08.000><
• that administers the Medicaid program. that administers the Medicaid program.
• our Medicaid fraud control unit.
• expand the definition of Medicaid fraud. expand the definition of Medicaid fraud.
• confirms that services build to Medicaid confirms that services build to Medicaid assistance<01:

Bills: HF3423, HF2354, HF3634

Keywords: healthcare, provider enrollment, medical assistance, legislation, state funds, fraud prevention, subpoena authority, criminal penalties, consumer protection, service verification, Medicaid, human services, electronic documentation, 1183, house

Transcript Highlights:

• could trim federal support for Medicaid could trim federal support for Medicaid by<00:50:55.520>
• Um, but we just wanted to emphasize the point that our Medicaid program, our state Medicaid...
• Our Medicaid program, our state Medicaid program, is going to require hundreds of millions of dollars
• lose my Medicaid. lose my Medicaid.
• money without losing Medicaid services. money without losing Medicaid services.

Bills: HB2488, HB2456

Keywords: disability, communication access, deaf, hard-of-hearing, deaf-blind, healthcare, sign language interpreters, auxiliary aids, weight loss, GLP-1 drugs, obesity, Medicaid, healthcare costs, 910, house, all

Summary: The committee heard testimony on HP 1972, which would create a nonrefundable family caregiver tax credit, and on a related tax measure to increase the existing dependent care tax credit. Supporters of HP 1972, including AARP, the Executive Office on Aging, the Hawaii Public Health Institute, Hawaii Children’s Action Network, and others, said unpaid caregivers are essential to keeping kūpuna and other loved ones at home and described significant out-of-pocket costs. The Department of Taxation and the Tax Foundation raised technical concerns, including the need to avoid overlap with existing credits and to prevent double-dipping. The department said taxpayers can claim credits to the extent allowed, but recommended explicit language barring the same costs from being claimed under more than one credit. No vote was taken in the excerpt, and the chair moved the bill along after questions. The committee then heard HP 1975, which would repeal the sunset on the state rent supplement program for kūpuna. AARP, Catholic Charities Hawaii, the Executive Office on Aging, and others supported making the program permanent, saying it helps low-income older adults avoid eviction and homelessness and allows them to remain in affordable housing. Catholic Charities described clients who were paying unsustainable shares of income for rent before receiving the supplement. Members also shared a constituent example of an elderly retiree who needed the subsidy to stay housed. Written support was noted from additional organizations and individuals. Next, the committee took up HB 1706, which would expand Medicaid prospective payment reimbursement to include mental health services furnished in federally qualified health centers and rural health clinics by mental health professionals under supervision. The Office of Hawaiian Affairs supported the bill, and DHS said it appreciated the intent to address workforce shortages and expand training, but cautioned that unlicensed professionals cannot currently bill Medicaid and that a state plan amendment would be needed, with limited precedent for approval. Members asked about the likelihood and timing of federal approval and whether the bill could help rural areas; DHS said approval is uncertain and the process can take time, though it saw possible alignment with the state’s rural health transformation efforts. The committee also discussed HB 546, a three-year health coverage continuity pilot program for people losing Medicaid coverage. DHS, the Attorney General’s office, DCCA, Catholic Charities, the University of Hawaii, and others testified, with DHS warning that federal changes could increase uninsured rates and that the state may need to act quickly. Catholic Charities and others emphasized the risk to Medicaid recipients, including homeless and near-elderly residents, while DHS explained the state’s existing premium assistance program for certain immigrants and compared it to the proposed pilot. The excerpt ends during discussion of that comparison, with no vote shown.

Bills: HB304, HB285, HB312, HB311, SB60

Keywords: impoundment, driver licenses, vehicle redemption, local identification cards, law enforcement, HB285, TJ's Law, traffic infraction, traffic ticket, uniform traffic ticket and complaint, minor driver, juvenile driver, parent notification, guardian notification, emergency contact, citing agency, traffic citation, driver safety, youth safety, Alabama traffic law

Bills: HB1845, HB2192, HB2438, HB2529, HB2607, HB2658, HB3348, HB3505, HB3305

Keywords: rural prosecution, salary assistance, staffing grant, legal support, criminal justice, fireworks, permit requirements, sale, county regulations, public safety, hospital district, administration, elections, director qualifications, public contracts, salary supplement, county judges, judicial functions, state law, government compensation

Transcript Highlights:

• It is specific to palliative care and hospice care for children in our state under Medicaid.
• And are you telling me there's no Medicaid benefit to put that young child?
• And are you telling me there's no Medicaid benefit to put that young child?
• Medicaid benefit to put that young child, son or daughter in hospice care or palliative care?
• Medicaid doesn't cover that cost?

Bills: SJR1, SM2

Keywords: school elections, partisan elections, voting rights, constitutional amendment, New Mexico, elector registration, pediatric palliative care, pediatric hospice, Medicaid, state plan amendment, Health Care Authority, children with serious illness, life-limiting conditions, complex medical conditions, curative care, concurrent care, family-centered care, hospice services, managed care, pain management

Bills: HB288, HB403, HB420, HB783, HB815, HB915, HB927, HB933, HB944, HB962, HB971, HR74, SCR3, SCR20, SB5, SB34, SB37, SB190, SB255, SB270, SB273, SB314, SB415

Keywords: medical terminology, documentation, miscarriage, spontaneous abortion, healthcare, medical records, billing, homemade food, food safety, small business, exemption, regulation, Department of Children and Family Services, background checks, child welfare, employee screening, safety regulations, criminal history, non-lactational dairy, labeling requirements

Transcript Highlights:

• Medicaid and mental health were both reduced by 5 million each.
• I was looking at the Medicaid information and I was trying to understand, I guess you just mentioned
• ..assessment and Medicaid funding program extended for fiscal year 2028.
• Is this different than what we do now in consultation with the Alabama Medicaid agency?
• State match, $2 million for the Medicaid State match, $2 million for the Medicaid State match, $2 million

Bills: HB186, HB185, HB184, HB183, HB181, HB312, HB405, HB182, HB460

Keywords: Alabama budget, general fund appropriations, fiscal year 2026, state budget, appropriations act, HB186, executive branch funding, legislative branch funding, judicial branch funding, debt service, capital outlay, corrections, Medicaid, public health, mental health, transportation, education, law enforcement, tourism, veterans affairs

Transcript Highlights:

• So, Madam Chair, was that the Medicaid director who spoke here behind us?
• There's a new Medicaid director. Not the Secretary of the Medicaid Director.
• No, I don't see the Medicaid director. Okay. No, I don't see the Medicaid director. Okay.
• . ...rules are for Medicaid.
• We use our Medicare and Medicaid reimbursements to pay for the GME program.

Bills: SB4, SB7, SB9, SB17

Keywords: Medicaid, healthcare, medical education, salaries, graduate education, clinician pay, health sciences, education funding, faculty salary, University of New Mexico, healthcare funding, general fund, state budget, New Mexico legislation, gun control, firearm safety, dealer regulation, illegal trade, background checks, 996

Transcript Highlights:

• Just a snapshot of our me Medicaid Just a snapshot of our me Medicaid program<01:18:32.159> in
• > first know, when Medicaid was first know, when Medicaid was first established,<01:21:29.600>
• , of DHS's programs including Medicaid, of DHS's programs including Medicaid, Minnesota<01:31:18.719
• <01:35:21.440> So<01:35:21.679> effective certain Medicaid enrolles.
• So effective certain Medicaid enrolles.

Bills: HF4609, HF4401

Keywords: infertility, fertility treatment, fertility preservation, IVF, assisted reproductive technology, ART, oocyte retrieval, embryo transfer, egg freezing, sperm freezing, reproductive health, maternity coverage, health insurance mandate, health plan benefits, Medical Assistance, Medicaid, MinnesotaCare, family planning, oncology fertility preservation, chemotherapy

Bills: SB43, SB50, SB145, SM2

Keywords: parole, life imprisonment, rehabilitation, criminal justice, victim rights, law enforcement, training requirements, mental health, domestic abuse, child abuse, public safety, crisis intervention, auditing, financial reporting, state auditor, public agencies, capital outlay, compliance, federal audits, pediatric palliative care

Bills: SB43, SB50, SB145, SM2

Keywords: parole, life imprisonment, rehabilitation, criminal justice, victim rights, law enforcement, training requirements, mental health, domestic abuse, child abuse, public safety, crisis intervention, auditing, financial reporting, state auditor, public agencies, capital outlay, compliance, federal audits, pediatric palliative care

Transcript Highlights:

• Department of Education. to update its plan for maximizing to update its plan for maximizing Medicaid
• Medicaid reimbursements. Medicaid reimbursements.
• SB 3324 SD 1, which is increasing rates for our Medicaid home- and community-based care.
• Next up we have SB 3325 SD 1 HD 1, which is looking at increasing Medicaid reimbursement within the DOE
• Thank you very much and we are adjourned. increasing uh Medicaid reimbursement increasing uh Medicaid

Bills: SB2479, SB2557, SB2861, SB3204, SB3324, SB3325

Keywords: criminal procedure, family violence, dating violence, child abuse, evidence admissibility, reduced sentencing, homelessness, reporting requirements, statewide office, housing solutions, kauhale projects, public oversight, SB2861, Hawaii, Office of Wellness and Resilience, OWR, Department of Human Services, DHS, Kakou Pilot Program, Kakou

Summary: The committee heard testimony on several measures related to criminal procedure, homelessness, family resilience, Medicaid-funded services, and school Medicaid reimbursement. On SB 2479 SD2, the Judiciary testified in neutral opposition with concerns that the bill could require imprisonment even for probation-eligible defendants, expand sentence reconsideration in ways that could undermine finality for victims, conflict with existing sentencing statutes, and require additional judicial resources. The Office of the Public Defender supported the bill’s intent but asked for language changes so people serving sentences could raise the new evidence in Rule 40 petitions and so probation would remain available in appropriate felony cases. Written testimony also included opposition from several county prosecutors and police, and support from the Office of Hawaiian Affairs. The chair later deferred SB 2479 SD2, citing unintended consequences and problems with the bill. For SB 2557 SD1, which would require annual reporting by the State Office on Homelessness and Housing Solutions, the office said it supported the intent but noted it already produces annual and quarterly reports, that some requested data is already available, and that staffing and cost constraints could make the new reporting burdensome. The State Council on Mental Health supported the measure and suggested narrowing the reporting language to data on individuals with serious mental illness or co-occurring behavioral health conditions, to the extent practicable and in collaboration with relevant agencies. A committee member asked about the availability of point-in-time count data, and the office explained that some figures may not be available every year and may need to be generated through HMIS. Dr. Jack Lewin testified in support, saying the data would be useful for understanding health care costs. The committee passed SB 2557 SD1 with amendments, including a deferral of the effective date. The committee also heard SB 2861 SD2 and SB 3204 SD1, both family resilience pilot program measures. For SB 2861 SD2, the Office of Wellness and Resilience and DHS supported the bill but requested amendments to clarify that the office’s role is planning and advisory, that DHS is a key partner, and that federal compliance safeguards are included. The chair raised concerns about overlap with DHS’s existing Ka Ohana program and asked for language to avoid redundancy while allowing the bill to cover other at-risk children; decision-making was deferred to the next hearing. For SB 3204 SD1, which would create a peer-navigator-based family resilience pilot, the Office of Wellness and Resilience and DHS supported the measure, with the office requesting a two-year pilot period, and both agencies and several advocacy groups submitted support. The committee discussed funding, the proposed five peer navigators, and whether the pilot should be limited to one or two geographic areas; no final action was taken in the portion provided. The committee also heard and supported SB 3324 SD1 on Medicaid home and community-based services, with the Department of Health emphasizing caregiver shortages and the cost-effectiveness of community care, and SB 3325 SD1 HD1 on public school Medicaid reimbursement, where DOE and the Attorney General requested clarifying amendments to reporting language and position titles.