Transcript Highlights:

• From the Department of Human Services on their CMS and revalidation update with Director Grom.
• Oz and others at CMS that if the corrective action plan was approved by CMS, that they would end the
• We will be in conversation with CMS.
• Oz and others at CMS that um that if Dr.
• So, we're pleased involvement with CMS.

Bills: HF729

Keywords: human services, provider enrollment, medical assistance, healthcare, housing stabilization, substance use disorder, vulnerable adults, fraud prevention, 1183, house

Transcript Highlights:

• CMS. CMS.
• No, CMS is heavily involved in this.
• No, CMS is heavily involved in this.
• don't yet have final approval from CMS. don't yet have final approval from CMS.
• and and working with with CMS. and and working with with CMS.

Bills: HB2246, HB2119, HB1929, HB1953, HB1572, HB2549, HB2594, HB2551, HB2595, HB2548, HB2459, HB1931, HB1604, HB1616, HB1736, HB2233, HB2241, HB1891, HB1803, HB2567, HB2534, HB2399, HB2172, HB1595, HB1811, HB2168, HB1780, HB1781, HB1785, HB2122, HB2012, HB2398, HB1779, HB2296, HB1894, HB1925, HB2019, HB1896, HB2294, HB2298, HB2300, HB2344, HB2345, HB2391, HB2037, HB2201, HB1941, HB1635, HB1943, HB2325, HB1926, HB2490, HB1710, HB2545, HB1976, HB2173, HB1804, HB1563, HB2015, HB1619, HB2475, HB1889, HB2367, HB2187, HB1765, HB1452, HB2231, HB1700, HB1705, HB1626, HB1897, HB1642, HB1523, HB2593, HB815, HB1655, HB1596, HB1732, HB1842, HB2476, HB2478, HB2022, HB1588, HB2575, HB1163, HB2153, HB772, HB1519, HB2050, HB2309, HB2147, HB2329, HB2274, HB2280, HB2547, HB2275, HB2452, HB2306, HB2148, HB2088, HB1764, HB2438, HB2117, HB1860, HB2604, HB2118, HB2017, HB2155, HB1832, HB2216, HB1601, HB1934, HB2297, HB2397, HB1893, HB2533, HB1890, HB2454, HB2004, HB2427, HB2207, HB1810, HB1840, HB1644, HB1645, HB1946, HB1648, HB2324, HB2323, HB1509, HB1514, HB1515, HB2164, HB2165, HB2283, HB1691, HB2386, HB2423, HB2121, HB1984, HB1593, HB1671, HB2619, HB1481, HB2314, HB2319, HB1643, HB2558, HB1864, HB1898, HB2214, HB2167, HB2488, HB2009, HB2007, HB322, HB1964, HB2218, HB2616, HB1535, HB1574, HB1977, HB2054, HB2046, HB146, HB2094, HB2181, HB2250, HB2515, HB2444, HB2385, HB1740, HB1724, HB1733, HB1799, HB1725, HB2049, HB2161, HB1970, HB2519, HB1790, HB2416, HB1873, HB2001, HB2151, HB1603, HB1880, HB1753, HB2198, HB1511, HB1991, HB2546, HB1615, HB1939, HB2140, HB2429, HB1870, HB1850, HB1782, HB2137

Keywords: agriculture, federal grants, Hawaii, grant administration, revolving fund, department of agriculture and biosecurity, grant compliance, financial support, coffee, pest control, subsidy program, coffee berry borer, coffee leaf rust, economy, biosecurity, invasive species, Molokai, advisory board, quarantine, environmental protection

Transcript Highlights:

• CMS. CMS.
• No, CMS is heavily involved in this, and part of the reason we don't have slides is because CMS is still
• five years of rural service, uh CMS five years of rural service, uh CMS expects<00:42:56.200>
• with uh with CMS. with uh with CMS.
• CMS may demand what's restrictions.

Bills: HB20, HB276, HB644, HB812, HB816, HB916, HB1131, HB1247, HB1518, HB1525, HB1537, HB1541, HB1546, HB1553, HB1562, HB1565, HB1566, HB1576, HB1577, HB1591, HB1605, HB1612, HB1613, HB1614, HB1618, HB1620, HB1650, HB1656, HB1658, HB1661, HB1664, HB1668, HB1676, HB1707, HB1711, HB1713, HB1715, HB1718, HB1727, HB1749, HB1756, HB1774, HB1776, HB1801, HB1802, HB1805, HB1813, HB1815, HB1831, HB1838, HB1853, HB1854, HB1859, HB1863, HB1871, HB1872, HB1918, HB1920, HB1952, HB1965, HB1966, HB1967, HB1969, HB1972, HB1973, HB1974, HB1975, HB1980, HB1985, HB2005, HB2023, HB2031, HB2033, HB2062, HB2113, HB2114, HB2116, HB2138, HB2139, HB2156, HB2158, HB2159, HB2171, HB2208, HB2268, HB2270, HB2272, HB2273, HB2276, HB2289, HB2310, HB2315, HB2335, HB2338, HB2339, HB2340, HB2343, HB2361, HB2384, HB2387, SB2338, SB2431, SB2438, SB2593, SB2907, SB2671, SB2321, SB3084, SB2401, SB3033, SB2972, SB3032, SB2806, SB3014, SB2108, SB2981, SB2973, SB2423, SB2078, SB2322, SB2397, SB2896, SB2088, SB2347, SB2408, SB2970, SB2851, SB2713, SB2697, SB2312, SB2192, SB2363, SB2530, SB3028, SB2024, SB3007, SB2599, SB2596, SB2662, SB2930, SB3334, SB2378, SB3019, SB3231, SB2240, SB2372, SB2175, SB2046, SB2298, SB2922, SB2835, SB3263, SB2174, SB2128, SB2006, SB2489, SB3134, SB2982, SB2425, SB2849, SB2797, SB2795, SB2575, SB2521, SB2765, SB2386, SB2852, SB2022, SB2117, SB2277, SB2387, SB2688, SB2885, SB3132, SB3219, SB2169, SB2591, SB2090, SB2983, SB888, SB3249, SB2611, SB2429, SB2463, SB3154, SB3131, SB3152, SB3315, SB2448, SB2054, SB2140, SB2520, SB2377, SB2986, SB2010, SB2189, SB2026, SB3010, SB2818, SB2002

Keywords: lava insurance, homeowners, insurance market, subsidy, Hawaii, condominiums, annual report, filing fee, real estate, developer, residency, property regime, PFAS, single-use plastics, environmental health, food ware, pollution reduction, local produce, agriculture, Hawaii Revised Statutes

Transcript Highlights:

• That was submitted as a SPA and approved by CMS.
• We did submit that to CMS.
• And I guess through CMS is really the question.
• If we do, we would want to make sure we line that all up with CMS before.
• If we do, we would want to make sure we line that all up with CMS before.

Summary: The Arkansas Administrative Rules Subcommittee met to review a large slate of agency rules and related reports. The chair announced that several items were stricken from the agenda and that the maternal health providers and remote monitoring rules were pulled by the agency. The committee filed reports on emergency rules, ALC subcommittee rule reviews, and administrative directives, then moved through agency rules from the Department of Agriculture, Department of Commerce/Insurance, Department of Corrections, and multiple divisions of the Department of Human Services. Most rules were explained as technical updates or implementations of 2025 legislation and were approved without objection. Examples included repeal of obsolete equine ID-chip rules, updates to agriculture financing and pesticide rules, removal of duplicative workers’ compensation plan language, a unified visitation rule for correctional facilities, DHS marketing rules for PASS programs, a comprehensive DCFS policy manual revision, Medicaid-related changes for fictive kin, ABLE accounts, presumptive eligibility for pregnant women, SNAP work requirements and alien eligibility, coverage for certain incarcerated youth, nurse aide training updates, and permanent rules for state employee insurance and procurement. The committee also approved requests to exclude the Insurance Department from rulemaking requirements for Act 772 on forced organ harvesting and for restorative reproductive medicine, with the department saying it would issue rules later when more guidance is available. The most extended discussion concerned DHS’s dental Medicaid rate rule under Act 1025. Members and witnesses debated whether the statute’s language covered only oral surgeons or also general dentists performing oral surgery procedures, and whether the rate increase should apply more broadly to the services rather than the provider title. DHS said it was following the black-letter language of the law and could not confirm a broader interpretation without further approvals and funding, while legislators and a Dental Association representative said the intent was to increase payment for the services, especially in rural areas. Members also discussed the possibility of fixing the language in a future session or through a new rule if approvals and CMS review allow. Despite the concerns, the committee approved the rule. The meeting ended with approval of rule review reports and monthly updates, and the committee adjourned.

Transcript Highlights:

• Those capitation payments are required by CMS to be actuarially sound.
• This is what the guidance we have from CMS states.
• Us is what the guidance we have from CMS states.
• The legislation does not provide funding until 30 days after CMS approval.
• The legislation does not provide funding until 30 days after CMS approval.

Keywords: 1183, house

Transcript Highlights:

• This was an evolution and that that that CMS developed as part of the 2016 managed care rule to really
• And Lee by CMS, it's a different authorities for 38.6 authority under under Cfr.
• And CMS.
• We have a pending document authority document but with CMS to increase that to 7.8 billion.
• I think that that we need additional information from CMS.

Transcript Highlights:

• We're not anticipating... ...from CMS yet for what we're required to do.
• We are under a CMS compliance non-MAGI alignment.
• But we since July have just not been sending any claims for federal money to CMS.
• CMS has their definitions.
• CMS has their definitions. Other states have already put into law. CMS has their definitions.

Summary: The Ways and Means Committee held a work session to review how H.R. 1 (the One Big Beautiful Bill Act) could affect Washington’s Medicaid, long-term care, developmental disabilities, and food assistance programs, with a focus on implementation challenges, fiscal impacts, and likely coverage losses. Staff and agency officials explained Washington’s Medicaid financing structure, eligibility categories, caseload trends, and the role of the Health Care Authority and DSHS in administering Apple Health and related services. They also described how Medicaid expansion increased access to behavioral health services and how H.R. 1’s provisions are expected to affect the expansion population most directly. Health Care Authority and DSHS officials outlined several major H.R. 1 changes: new work and community engagement requirements for the Medicaid expansion population, six-month redeterminations instead of annual renewals, changes to immigrant eligibility, limits on provider taxes and state-directed payments, new cost-sharing requirements, reduced retroactive coverage, and changes affecting long-term care eligibility. They said Washington is still awaiting federal guidance on many details, but estimated that about 620,000 Apple Health expansion enrollees could be subject to work requirements, that roughly 30,000 immigrants could lose Medicaid eligibility under the new definition of qualified alien, and that some long-term care and developmental disability clients could be indirectly affected. Officials also said the state is working with other agencies to build shared verification systems and may seek a delay waiver, though they do not expect broad federal flexibility. The committee also heard that H.R. 1 immediately blocks Medicaid reimbursement for Planned Parenthood services for one year, with the state planning to backfill about $11 million to preserve access. In addition, officials warned that the law could reduce federal Medicaid revenue by billions over time and strain hospitals and emergency rooms as more people become uninsured. They noted that Washington’s rural health transformation grant application is due November 5 and could bring some funding, but not to offset coverage losses. No votes were taken; the session was informational only. The committee then heard a separate presentation on food assistance, where staff and DSHS described H.R. 1’s SNAP changes, including expanded work requirements, immigrant eligibility restrictions, higher state administrative costs, and a possible future state share of benefit costs tied to payment error rates. DSHS estimated a four-year fiscal impact of about $750 million for food assistance changes and said the state is working on system and policy changes across agencies before the new requirements take effect.

Transcript Highlights:

• But CMS has access to all information through. Tmz is reporting and they'll be increased reporting.
• Cms has noted up.
• Cms has been put out a lot of guys as to what that exactly looks like.
• And that last bill, like and that's for CMS to implement the section.
• Once the CMS pricing information becomes available and then that will take us to 941 codes.

Transcript Highlights:

• Additionally, CMS has approved this SPA, and I'm happy to take any questions.
• That was submitted as a SPA and approved by CMS.
• We did submit that to CMS.
• And I guess through CMS is really the question.
• If we do, we would want to make sure we line that all up with CMS before...

Keywords: 1204, all

Transcript Highlights:

• front of CMS. Next slide, please. front of CMS. Next slide, please.
• CMS.
• We just want to make clear that CMS CMS.
• to CMS. to CMS.
• what CMS is holding us accountable for. what CMS is holding us accountable for.

Keywords: 918, senate, all

Summary: The Select Subcommittee first took up adoption of three previously prepared nonpartisan committee summary reports dated October 15, November 13, and November 21. Senator Rasmusson objected to the lack of advance notice about the day’s testifiers and criticized the practice of having nonpartisan staff summarize what he described as a partisan agenda. The chair responded that the committee’s purpose is to gather information, not hear bills, and that the summaries were intended as neutral resources for the Senate. Senator Coopek moved adoption, the motion was opposed by Rasmusson and another member, and the motion passed. The committee then turned to the day’s hearing on federal impacts on Minnesota, with the chair focusing on federal funding threats and the effect of congressional budget actions on health care, especially in greater Minnesota. The first presentation came from the Minnesota Department of Health on the state’s rural health transformation work. Assistant Commissioner Carol Broom introduced the team and described the rural hospital transformation program as a major opportunity to invest in rural health, while acknowledging longstanding challenges such as demographics, transportation barriers, and the financing of care. Nitha Moibi outlined the state’s rural health chart book and data showing an aging population, workforce shortages, and many health professional shortage areas, and described proposed strategies including workforce pipelines, bridge payments for low-volume birth hospitals, telehealth access points, mental health urgent care, and chronic disease prevention. Acting Assistant Commissioner Anna Ashby of the Minnesota Management and Budget office explained the state’s application to CMS for the Rural Health Transformation Program, which was created in federal law and awarded Minnesota just over $193 million for federal fiscal year 2026. She said the application was shaped by public comments, stakeholder meetings, and legislative outreach, and included initiatives on preventive care, workforce, care access, behavioral health, and provider financial stability. She also reviewed implementation constraints, including a January 30 revised budget deadline, limits on administrative spending, restrictions on using funds to offset Medicaid losses, and the need to show measurable progress to remain eligible for future funding. The presentation noted that most year-one funding would go to rural hospitals, with additional support for federally qualified health centers, community mental health centers, tribal partners, and technical assistance.

Transcript Highlights:

• guidance from CMS once it's received. guidance from CMS once it's received.
• want to remind remind the body that CMS want to remind remind the body that CMS has<00:35:26.000
• Um CMS was expansion for enrolles.
• subject to an approval process by CMS. subject to an approval process by CMS.
• haven't communicated directly with CMS. haven't communicated directly with CMS.

Bills: HF3439, HF3763

Keywords: Medical Assistance, Medicaid, MNsure, MinnesotaCare, disability determination, expedited eligibility, state medical review team, compassionate allowance, rare disease, home and community-based services, long-term care, managed care, county-based purchasing, eligibility redetermination, periodic data matching, death master file, Social Security Administration, program integrity, income eligibility, asset test

Summary: The House Health Finance and Policy Committee met on March 4, 2026, approved the minutes from its February 25 and March 2 meetings, and then heard a presentation from Katherine Castanza of the National Conference of State Legislatures on Medicaid eligibility changes in the federal One Big Beautiful Bill Act (HR1/OB3). The presentation focused on provisions affecting Medicaid expansion adults ages 19 to 64, including new work and community engagement requirements, changes to retroactive eligibility, quarterly death master file checks, address verification requirements, six-month redeterminations for expansion enrollees, and new limits on some lawful permanent residents and other immigrant groups. Castanza also discussed state implementation issues, including the need for new data-sharing systems, system modernization, outreach, and options for helping people transition to other coverage if they lose eligibility. She said the work and community engagement rules take effect January 1, 2027, with states given flexibility on look-back periods, consecutive versus nonconsecutive months, and optional hardship exemptions, and noted that CMS guidance is not expected until June 2026. She also described federal support for implementation, including $200 million in grants and a 90% federal match for eligibility system work, while warning that the fast timeline could lead to coverage losses, churn, and challenges for special populations such as caregivers, people with behavioral health conditions, incarcerated individuals, and rural residents. She further explained that an erroneous payment provision could expose states to federal recoupment later if eligibility errors increase. During member questions, Representative Beerman asked about the overall size of the Medicaid cuts and the cumulative national impact; Castanza said estimates vary by state and cited KFF analysis suggesting states could lose 4% to 19% of federal Medicaid revenue, with a newer RAND analysis recently released. Beerman also asked about the history and effectiveness of state work requirements, but that discussion was not completed in the excerpt. Representative Elkins noted the presentation was not initially posted on the committee website, and the chair said it had since been posted.

Transcript Highlights:

• CMS is the share of Medicaid funding.
• engagement has not been approved by CMS. engagement has not been approved by CMS.
• Um although I defer to any from CMS.
• Um, we are waiting on CMS guidance.
• Um we are waiting on CMS guidance. Um we are waiting on CMS guidance.

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

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

Transcript Highlights:

• little bit, in the process, every year, the Medicare Advantage plans have to go and negotiate with CMS
• awaiting the final responses through the final rate-setting exercise that United Health Care is doing with CMS
• coverage gap from manufacturers, now called discount from manufacturers, and the other piece is from CMS
• And so CMS recognizes there's a big difference between those. So when they put this in 2025...
• So we, we Segal, don't have a CMS...

Summary: The committee received an update from Grant Wallace on the state employee Medicare Advantage group plan and the ongoing rebid with UnitedHealthcare. Wallace said the agency is exploring “decoupling” the medical and pharmacy portions of the plan, and that preliminary estimates suggested potential savings of about $100 to $200 per participant per month. He said the final CMS rate-setting process would conclude in April, with a revised contract amendment likely to come before the committee in May or June after review by the EBD Advisory Commission and State Board of Finance. He also clarified that the plan covers post-65 teacher and state employee retirees, including retirees from state agencies and K-12 public schools. Representatives from Segal Consulting then gave a broader presentation on Medicare Advantage and Part D market trends, reviewing Arkansas’s prior decision to adopt a Medicare Advantage prescription drug plan and the savings generated since the 2023 RFP. They explained that the Inflation Reduction Act significantly changed Part D financing by shifting more federal support into a direct subsidy tied to risk scores, which makes accurate risk adjustment more important and creates a larger difference between Medicare Advantage prescription drug plans and standalone Part D plans. They said this has led to a growing divergence in funding, especially for standalone Part D, and is the main reason decoupling medical and pharmacy coverage is being considered. Committee members asked about how the risk-score changes affect costs and members. Segal said the new structure has reduced member out-of-pocket costs, with the annual cap now at $2,000 and many members reaching it after roughly $600 to $800 in spending, but that the plan absorbs more of the cost. They also said the market appears to be adjusting through annual bids, and that a decoupled structure could allow the state to capture more favorable funding on the Part D side. No votes were taken, and the committee adjourned after being told to expect further information once the April rate notice and renewal proposal are available.

Transcript Highlights:

• Um, the requirements are CMS has these requirements.
• Um, the requirements are CMS has these requirements.
• these requirements that you know CMS these requirements that you know CMS would<00:52:44.400>
• And CMS requires the effective date.
• CMS approval for those programs.

Keywords: 958, all

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

Transcript Highlights:

• CMS oversees the process, but the funds remain in the state.
• has in place if it goes through us CMS has in place if it goes through us then<00:37:17.839> CMS<
• It's not the CMS process. I was going to say this is..."
• contract is based on toolkits created by CMS.
• price is a reasonable price CMS price is a reasonable price CMS evaluates<00:45:26.400> the

Keywords: This meeting will take place upon adjournment of both chambers today. There is not an exact time, there for the live stream has been created with a place holder time of 4:00 PM est., 958, all

Summary: Chairman Hart called the meeting to order, confirmed a quorum, welcomed Representative Rachel Roarx, and the committee approved the February 11 minutes. The committee then moved through its agenda of PSC and related contract items, including a motion to consider the reviewed contracts without objection. One Department of Highways item was deferred when the virtual representatives were not yet available. The committee first took up Kentucky Housing Corporation contracts. Members questioned outside legal services for foreclosures and bankruptcies, why the work was not handled entirely in-house, and how much of the workload and cost it represented. Witnesses said the agency’s need was largely geographic rather than a lack of expertise, that less than 1% of the loan portfolio is referred out for foreclosures, and that many fees are reimbursable through FHA. Both Kentucky Housing Corporation items were approved. The committee then considered a Department for Community Based Services contract tied to a protest and a temporary renewal with PCG. Witnesses said the contract increase was needed to bridge the gap while the protest and RFP process were unresolved, and that the initial vendor received no funds. The committee approved the item, with Senator Douglas explaining his vote as a preference for straightforward answers. The committee also heard a Northern Kentucky University contract for a Workday ERP replacement, including implementation consulting and separate license fees. University officials explained the move from SAP to Workday, the complexity of the systems, and the need for a consulting partner; they said the total effort would span 10 years and that the contract was priced below comparable institutions. After extensive questioning about cost, budget, and value, the vote ended 4-4 and the chair noted the contract would move forward through the Finance Committee if no disapproval motion was made. Finally, the Office of Inspector General presented a contract for culture change training in nursing facilities funded by civil monetary penalties; witnesses said the goal was to improve staff satisfaction, communication, and resident outcomes, and that the CMP fund balance was about $38 million. Discussion also covered survey backlogs and CMS restrictions on the funds, with the item still under review as the transcript ended.

Transcript Highlights:

• On June 1st, HHS CMS issued an interim final rule, 400 pages, that we are working through.
• CMS guidance is really looking at it quite differently.
• Does DSS plan on submitting comments to... ...plan on submitting comments to CMS?
• And the other thing is, I will say, that CMS does intend to issue more guidance, I think, pretty soon
• And as Bill pointed out, CMS itself still has more information to share.

Keywords: 962, all

Summary: The Care Management Committee met to receive a status update on the DSS/CHN PCMH program and to discuss implementation of HR1, especially the new medical frailty requirements. CHN reported the PCMH program remained steady at 124 practices and 553 sites, with 54.6% of the HUSKY population attributed to PCMH providers, and noted ongoing recruitment, provider turnover, and recent practice consolidations/acquisitions that will shift some sites to Yale and Hartford HealthCare. CHN also reported strong quality improvement engagement for 2026, with 83% of contacted PCMHs engaged, and said preliminary 2025 results showed improvement across measures. The bulk of the meeting focused on DSS’s response to the June 1 CMS interim final rule on HR1. DSS explained that it had been building a medical frailty definition based on diagnosis codes and comparisons with other states’ approaches, but the new federal rule adds a requirement that the condition significantly impair a person’s ability to work or comply with community engagement requirements. DSS said it is still evaluating how to combine claims-based data with the new federal overlay, may submit comments to CMS during the open comment period through July 31, and is considering options such as self-attestation, especially given CMS’s allowance of self-attestation for calendar year 2027. Committee members raised concerns about the rule’s complexity, possible legal challenges, the need for a good-faith waiver or implementation delay, and the risk of noncompliance if the state gets the process wrong. Members also pressed DSS for broader outreach, clearer public communication, training, and better reporting on implementation impacts and costs. DSS said it is developing a website, webinars, and a communications plan, and is working with community-based organizations, community health workers, and administrative services organizations to reach potentially affected members. DSS said it is also building a Medicaid pre-screener to help people determine whether they may be subject to work requirements. In the PCMH Plus discussion, DSS said it was not yet ready to present the 2024 quality data but would try to bring the Wave 3, Year 5 results and related quality/shared savings information to the July 8 meeting, along with the regular PCMH update and another HR1 update. The committee also discussed future agenda items including community health worker reimbursement, peer support services, and the inmate medical program.

Transcript Highlights:

• Because we did not have policies that CMS could see directly passed by the legislature on those four
• At the bottom of the first page, there are all those areas that CMS said they wanted us to look at.
• do, CMS may not approve some of these grant awards.
• And we'd like to get CMS to approve sort of a template in advance.
• There'll be changes in the decision makers at CMS. There'll be change in administration.

Keywords: 908, all

Summary: Legislative Management met with a quorum, approved the July 11, 2025 minutes, and then considered recommendations from the Legislative Procedures and Arrangements Committee. Beth Dittes explained proposed special session rule changes, which largely mirror prior special session rules and are intended to speed floor action. The changes would allow faster second readings and transmission between chambers, replace regular standing committees with two joint committees for the special session—Joint Appropriations and Joint Policy—and limit bill introduction methods. The package also included delayed-effective-date changes for the next regular session, such as moving the agency and Supreme Court prefile deadline earlier and advancing several resolution deadlines. Liz Fordall then reviewed revisions to the legislative workplace harassment policy, including clarified definitions, longer intake and review deadlines, an option for informal resolution before a review panel, and clearer disclosure rules. The committee adopted the report and forwarded the rules and policy changes. The committee also approved tentative first-day special session agendas for both chambers, with a Speaker-requested revision to allow time to swear in new House members. Megan Gordon outlined the schedule: early Rules Committee meetings, morning floor sessions, a joint session for the governor’s State of the State, then meetings of the joint appropriations and policy committees, with optional later floor and committee time. Members discussed how the joint committees would handle bills and confirmed the process would mirror the prior special session. The agendas were adopted. Chairman Bekkedahl then reported for the Rural Health Transformation Committee, which had completed its work and recommended five bill drafts for the special session: a Presidential Physical Fitness Test requirement for schools, a nutrition component for physician continuing education, joining a physician assistant licensure compact, expanding pharmacist scope for lab testing and prescribing, and a two-year appropriations bill to cover the program through the next regular session. He explained the federal rural health transformation grant, the state’s application, funding restrictions, and the need to keep the bills aligned with CMS requirements to avoid funding reductions or clawbacks. DHS officials said the department would measure outcomes through required metrics, use templates for awards, and set up an Office of Health Transformation to track long-term impacts. The committee adopted the rural health report and forwarded the bills. Finally, members discussed special-session logistics. Legislative staff said employment committees would approve a limited number of staff, Legislative Management would serve as the delayed-bills committee, and a letter would be sent to legislators explaining the process and a suggested Friday noon drafting deadline for bills to be considered at the January 20 meeting. The committee also discussed how many bills might be introduced and how to assign the rural health bills to the House or Senate for origin. No formal vote was taken on those logistics, and the meeting adjourned with plans to reconvene on January 20.

Transcript Highlights:

• Second, the letter uses speculative fears about CMS disapproval and potential loss of Medicaid funding
• despite the fact that no actual CMS guidance or precedent is cited.
• I'm not the one who deals with it, but the CMS lawyers do look at these things, and I think some of the
• lawyers um do look at these things CMS lawyers um do look at these things and<00:25:40.400> and
• they have a chance to make sure that CMS they have a chance to make sure that CMS does<00:25:55.600

Keywords: 1187, senate, all

Transcript Highlights:

• Can you tell us when AHCA submitted the model to CMS and provide some details as to why it was so late
• attestations, we have received attestations from all the hospitals, and those have been submitted to CMS
• But it sounds as if that was a big concern for CMS.
• forward, exactly what is your understanding of what may have created any kind of that holdup at the CMS
• So CMS, I believe, is just pursuing their review of these with additional levels of review and scrutiny

Keywords: 999, senate, all

Transcript Highlights:

• :26:16.320> bulletin CMS has published anformational bulletin CMS has published anformational
• <00:31:16.799> guidance Um CMS has released preliminary guidance Um CMS has released preliminary
• are um we are allowed to work with CMS are um we are allowed to work with CMS in<00:32:26.720>
• Um CMS can wave threshold is exceeded.
• It also allows CMS to apply threshold.

Keywords: 919, house, all

Summary: The Department of Human Services briefed the committee on how the federal HR1 law will affect Minnesota Medicaid and related programs. Budget Director Elise Bailey said the 900-page bill makes sweeping changes that will reduce coverage, increase administrative complexity for counties and tribal governments, raise uncompensated care for providers, and reduce federal funding. She reviewed current Medicaid spending and enrollment, emphasizing that the largest impacts will fall on the adult expansion group (adults ages 21-64 without children), which currently receives a 90% federal match. Bailey walked through several major provisions: work and community engagement requirements for the adult expansion group beginning January 1, 2027; six-month renewals for that same group; shorter retroactive coverage periods; new cost-sharing requirements for expansion enrollees above 100% of poverty; narrower Medicaid eligibility for certain lawful noncitizens; limits on provider taxes and state-directed payments; a reduced federal match for emergency medical assistance; and tighter federal rules on payment error penalties. She said many provisions require state law changes and additional federal guidance, and she cited research from Georgia suggesting work requirements increased administrative burden and caused coverage losses without increasing employment. The department estimated fiscal effects including reduced Medicaid spending in some areas but higher state costs in others, such as MinnesotaCare, emergency medical assistance, administrative systems, and provider uncompensated care. Bailey said the immigration-status changes would shift some people from Medical Assistance to MinnesotaCare, and that provider-tax and state-directed-payment changes could reduce future funding to hospitals and other providers. No votes or formal committee actions were taken in the portion provided; the presentation was informational and the department indicated it would return with proposed state-law language as needed.