Transcript Highlights:

• A reduction in FMAP for emergency Medi-Cal.
• Instead, states will receive their regular FMAP, which is 50-50, for all emergency Medicaid services.
• Planned Parenthood is not receiving reimbursement at all without those FMAP dollars.
• members are doing right now, given the potential impacts of H.R. 1, the reduction of the MCO tax, the FMAP

Summary: The joint informational hearing focused on the impacts of H.R. 1 on California’s Medi-Cal program and on community health effects from recent immigration enforcement actions. Committee leaders said H.R. 1 would sharply reduce federal funding, increase administrative burdens, and worsen access to care, especially for Medi-Cal enrollees, immigrant families, rural communities, and reproductive health patients. The second half of the hearing examined how ICE raids and related federal actions are creating fear, reducing clinic and emergency department use, and disrupting children’s access to schools and early childhood education. Department of Health Care Services Director Michelle Bass outlined the main H.R. 1 provisions affecting Medi-Cal: work requirements, semiannual eligibility redeterminations, shorter retroactive coverage, new cost-sharing, limits on provider taxes and state-directed payments, reduced federal support for emergency and lawful immigrant coverage, and a one-year ban on Medicaid funding for prohibited abortion providers. She estimated millions could lose coverage, with tens of billions of dollars in federal funding at risk. Planned Parenthood Affiliates of California warned the defunding provision could force clinic closures, service reductions, and loss of access to family planning, STI testing, and cancer screenings. The California Hospital Association said the financing changes could cut hospital revenue by tens of billions over 10 years and threaten access, especially for rural and safety-net hospitals. The Western Center on Law and Poverty argued the law would increase churn, paperwork, and uninsured rates, disproportionately harming working adults and people experiencing homelessness. Committee members asked about implementation timelines, notification systems, administrative costs, the effect on immigrant eligibility, and whether California could delay or mitigate some provisions. Bass said the state was still assessing federal guidance, planning county and provider outreach, and exploring a possible delay for work requirements and a transition period for provider-tax changes. Members also discussed how state budget actions may need to be revisited in light of H.R. 1, and how California might preserve access through state-only funding or other policy changes. In the second panel, CHIRLA, Los Angeles County Department of Health Services, and the Children’s Partnership described the health consequences of immigration enforcement. Speakers said raids and data-sharing fears are causing anxiety, trauma, and avoidance of care, with Los Angeles County reporting declines in emergency, urgent care, and clinic visits after enforcement actions. The Children’s Partnership said school and early childhood absences are rising in some communities and that enforcement is undermining children’s emotional well-being and access to education. Members asked for more data and discussed possible state protections, telehealth, mobile care, and legal and policy responses to reduce fear and preserve access to health and education services.

Transcript Highlights:

• and then ACCA would be able to draw down that authority to match the dollars based on the current FMAP
• Yes, so we had said it would be approximately 1.3 billion, and it would be whatever the current FMAP
• Yes, so we had said it would be approximately 1.3 billion and um, it would be whatever the current FMAP

Summary: The Health Care Budget Subcommittee took up two bills and then continued oversight discussions with APD and AHCA. CS/HB 27, the Social Work Licensure Interstate Compact, was presented as a way to let Florida social workers practice in other compact states and vice versa; AARP, the Florida Chamber, and NASW Florida supported it, and the bill passed favorably. HB 1127, a child welfare bill, would create a treatment foster care pilot for children with high behavioral needs, improve DCF data collection on commercially sexually exploited children, and expand recruitment for protective investigators and case managers; the bill also passed favorably after brief supportive testimony. The committee then questioned APD at length about the iBudget waiver waitlist, enrollment pace, spending projections, and provider capacity. APD said it had sent more than 1,100 interest letters in categories 3, 4, and 5, enrolled 1,124 people so far this year, and expects to spend about 96.4% of its waiver appropriation, leaving roughly $82 million unspent. Members pressed APD on why prior discussions suggested more reserve was needed, how long the SANS process takes, whether category 6 could be expanded, and whether the agency has enough waiver support coordinators and direct support providers. APD said it has about 1,061 waiver support coordinators statewide, adequate capacity for current enrollees, but would need further analysis if the legislature directed a much larger enrollment increase. Members also asked about outreach, annual maintenance of the waitlist, portability for military families, and whether communication efforts should be privatized. Finally, AHCA walked the committee through the 2023 Achieved Savings Rebate (ASR) report for Aetna and explained how the report is used for financial monitoring, rebate calculations, and transparency. AHCA said the ASR is separate from the medical loss ratio (MLR) calculation, though both are reviewed, and that Florida uses the ASR mechanism rather than an MLR remittance requirement to recover funds from plans. Members asked about related-party disclosures, CVS/Caremark relationships, expanded benefits, encounter data, network adequacy penalties, denials and appeals reporting, interest earned on capitation payments, and whether rate increases were reaching providers. AHCA and the outside auditors said they review the plans’ reported data, reconcile it to underlying records, and can assess liquidated damages for network adequacy violations; several members requested follow-up data on rebates, interest, provider capacity, and related-party reporting.

Transcript Highlights:

• If you're referring to the FMAP that changes every October 1, we do have a tentative number for that,
• tool for that revenue as it relates to either the beginning of the fiscal year, the change in the FMAP

Summary: The committee met with a quorum, opened with a prayer recognizing the death of Reverend Jesse Jackson, and then worked through a series of appropriation and transfer requests. In Section B, it approved a $273,000 temporary appropriation for the Department of Labor and Licensing. In Section C, it approved two Infrastructure Investment and Jobs Act requests: $280 million for the Department of Transportation and $195 million for the State Broadband Office to support Arkansas BEAD broadband grants, including an extra help position. Members questioned the broadband awards, provider amendments, buildout timelines, accountability, and the status of unawarded locations; the broadband director said no provider had requested speed changes, awards would be monitored with milestone-based payments, and remaining locations would be addressed later as federal guidance is received. The committee also approved transfers in Section D, including $458,000 for the Department of Correction, $25 million for Department of Education programs such as declining enrollment and teacher incentive funding, and $229,000 for Shared Administrative Services project management support. In Section E, the committee considered a $4.7 million budget stabilization trust fund loan for the Office of State Technology to implement ServiceNow and related IT modernization, cybersecurity, and governance tools. Members pressed agency officials on repayment, cost savings, and whether the loan would simply roll over existing costs; officials said repayment would come through agency rates over a five-year period and that the new payment would be lower than the current loan being retired. The committee voted to give favorable advice to the Governor on the loan request. In Section F, the committee reviewed cash fund requests for wage and hour claims, unclaimed property, and a heritage grant; in Section G, it reviewed a $1.1 million federal grant to expand college and career coaching in rural districts; in Section H, it reviewed pay plan and performance fund requests totaling millions across multiple agencies; and in Section I, it reviewed budget manual formatting changes. The latter part of the meeting focused on reports, especially the Medicaid trust fund. DHS and DFA officials reported the fund balance had declined from prior years and was down to about $394 million after seven months, with further decline expected by year-end. Senators and representatives asked about the appropriate reserve level, the impact of pending Medicaid rules and legislation, FMAP changes, and whether additional funding would be needed in the upcoming budget. Officials said projections are updated regularly, more than 10 rule packages remain pending with CMS, and the governor and legislative leaders will discuss additional capital needs during budget development. Members also discussed the importance of balancing Medicaid spending with new federal funding and maintaining flexibility for critical areas such as labor and delivery. The committee then adjourned without further action on the reports.

Transcript Highlights:

• is kind of to Senator, the Vice Chairman, Senator Matthew, Maddering, as if we start looking at our FMAP
• We start looking at utilizing that FMAP, what it was intended for, it should be intended for, is coming
• services for our own tribal members and Indians resident in the state, and it provides for a 100% FMAP
• federal government steps forward to take care of, you know, their portion of things with the 100% FMAP

Keywords: 908, all

Transcript Highlights:

• it is kind of to Senator, the Vice Chairman, Senator Matthew Mathern, as if we start looking at our FMAP
• It does not come back to the tribes that we start looking and utilizing that FMAP, what it was intended
• provide services for our own tribal members and Indians resident in the state, and it provides for 100% FMAP
• federal government steps forward to take care of, you know, their portion of things with the 100% FMAP

Summary: The committee met at Spirit Lake Tribe and heard an extended discussion with Spirit Lake tribal leaders and program directors about government-to-government relations with the state. Chairwoman Street and others outlined a number of concerns and requests, including taxation of tribal and trust lands, state school support for non-beneficiary students, homelessness services, Indian-managed health care, gaming/e-tabs, the Feather Alert system, industrial farming near waterways, tourism and cultural issues, and the need for more consistent tribal consultation. Committee members responded that many of these issues had previously been passed along without direct action, and several members emphasized the committee’s role in education, communication, and preparing possible legislation or resolutions for the next session. Tribal representatives also offered to provide training on treaties, IHS 638, and compact services to help legislators better understand tribal jurisdiction and billing issues. A major portion of the meeting focused on Spirit Lake Fish and Wildlife concerns, especially jurisdictional “gray areas” around hunting and fishing on the reservation, recognition of tribal licenses, and the boundary of the reservation around Spirit Lake/Devils Lake. Tribal officials said they wanted a co-stewardship agreement or MOU with the state to clarify jurisdiction, improve cooperation, and address invasive species and aquatic nuisance species. Committee members discussed whether to draft legislation or a resolution directing the executive branch and state agencies to negotiate such an agreement, and they asked for further input from the North Dakota Game and Fish Department at a future meeting. The committee also discussed county involvement in land status changes and trust land issues, with Spirit Lake leaders describing a past Benson County resolution that tried to block fee-to-trust transfers and saying it was later rescinded. The committee then heard from Benson County tax equalization director Randy Thompson, who explained how the county values land and handles tax-exempt, inundated, and fee-to-trust parcels. Members asked about the impact of tax-exempt lands on county services and discussed prior legislation that helped counties with large tax-exempt bases. The committee also received a presentation from Dr. Steven Smith of Sisseton Wahpeton College, who described the college’s programs, economic impact, and funding needs, including support for non-beneficiary students and workforce training. Members asked about expanding tribal college education into correctional settings, and Smith said the idea was worth exploring through the tribal college system. Finally, HHS interim medical services director Christoph Framing presented remotely on 1115 Medicaid waivers and the IMD exclusion, explaining current state funding mechanisms for inpatient and residential behavioral health services and the bill draft directing HHS to pursue a waiver for IMD payments.

Transcript Highlights:

• is kind of to Senator, the Vice Chairman, Senator Matthew, Maddering, as if we start looking at our FMAP
• We start looking at utilizing that FMAP, what it was intended for, it should be intended for, is coming
• for our own tribal members and Indians resident in the state, and it provides for a hundred percent FMAP
• federal government steps forward to take care of, you know, their portion of things with the 100% FMAP

Summary: The committee met at Spirit Lake Tribe and first heard welcoming remarks and introductions from tribal leaders and program directors. Chairwoman Street and other tribal representatives outlined a range of concerns and requests for state action, including taxation of reservation lands, support for non-beneficiary students at the tribal school, homelessness funding, Indian-managed health care, gaming and e-tabs, Feather Alert improvements, industrial farming near waterways, tourism, and better state-tribal consultation. Committee members responded that the meeting was intended to improve understanding and communication, and several members suggested future legislation or resolutions could be used to advance some of the issues. The tribe also offered to provide training on treaties, IHS 638, and compact services to legislators and staff. A major portion of the discussion focused on Spirit Lake fish and wildlife jurisdiction and the lake boundary. Tribal representatives asked for an MOU or co-stewardship agreement with the state to clarify hunting and fishing rights, recognize tribal licenses, and reduce recurring disputes over “gray areas” on the reservation and lake. Committee members discussed whether to draft a bill or resolution directing the executive branch and state agencies to negotiate such an agreement, and asked that North Dakota Game and Fish be invited to a future meeting. Related concerns included aquatic nuisance species prevention, with both sides agreeing that more aggressive boat inspection and cleaning measures would be beneficial. The committee also discussed taxation and county relations. Tribal leaders raised concerns about county resistance to fee-to-trust transfers and about property and vehicle taxation affecting members living on or near reservation lands. Committee members and tribal counsel reviewed federal treaty principles and court cases, and one member noted that the committee had previously taken no formal action on similar issues. Later, Benson County’s tax equalization director explained how the county values taxable land, handles inundated land applications, and tracks land coming off the tax rolls when the tribe repurchases acreage. The discussion ended with a presentation from the president of Sisseton Wahpeton College, who described the college’s programs, economic impact, and funding needs, followed by an HHS presentation on 1115 Medicaid waivers and the IMD exclusion as the committee moved to its next topic.

Transcript Highlights:

• the most important things here is on that third bullet: the blended rate accounts for the different FMAP
• In the end, though, they ended up not changing the FMAPs for reconciliation, so this isn't a concern
• If you go back to the FMAP table on page 8, you'll see that traditional base population, and that's the

Transcript Highlights:

• waivers, we have to separate the nurses from the other staff for the waiver because we get a higher FMAP
• 48.760> a<00:34:48.800> higher<00:34:49.399> um get a higher um get a higher um FMAP
• > higher<00:34:51.000> reimbursement<00:34:51.639> rate<00:34:51.919> for FMAP
• , a higher reimbursement rate for FMAP, a higher reimbursement rate for Medicaid<00:34:53.560> uh<

Keywords: 958, all

Summary: The committee first approved a motion and then deferred a large batch of 246 contracts totaling about $187.8 million until the April 2026 meeting. It then moved through the agenda and reviewed several pulled items, beginning with four Attorney General contingent-fee contracts. Committee members questioned why the contracts were new, what the $20 million maximums meant, and how the fees would work; the AG’s office explained they were new awards from a September RFP, that the $20 million was an outside estimate tied to a full recovery, and that one contract would require a $380 million recovery to pay out the maximum. The committee voted to consider those contracts reviewed without objection. The Department of Highways then explained an “alternative delivery support” contract, describing it as a procurement method different from the usual design-bid-build model and noting it can help with innovation, speed, timeliness, or cost reduction. After that explanation, the committee again voted to consider the contract reviewed without objection. The Kentucky Horse Park/Kentucky Horse Racing and Gaming Corporation presented eight legal services contracts; members focused on differing hourly rates and retroactive approval. The corporation said it had selected four firms through an RFP to maintain flexibility and avoid conflicts, would use in-house counsel first, and did not expect to use the maximum rates. Senator Thomas argued the committee’s statutory hourly rate cap is outdated and should be revisited. The committee then approved the contracts. One Transportation Office of the Secretary contract was deferred to the April meeting, consistent with the agency’s prior request. The committee then reviewed Cabinet for Health and Family Services items from the Department of Community Based Services: three contract amendments and one memorandum of agreement. Members asked about funding sources, service outcomes, and whether the programs reduce future need; the agency said one amendment was a $55,000 increase offset by reductions elsewhere, that the total contract amount with the agency did not change, and that follow-up data show over 90% of children remain in the home after services. The committee approved those items. Finally, the committee reviewed a LIHEAP contract amendment from the Division of Family Support, which the agency said used federal funds, not state general funds, to add newly appropriated federal money for low-income home energy assistance and crisis heating support. Members asked about future funding and were told that continuation depends on Congress. The committee approved that item. It then began reviewing Behavioral Health, Developmental and Intellectual Disabilities memoranda of agreement tied to Kentucky Correctional Psychiatric Center staffing; members asked for a count of personnel, and the agency said it would provide that information, after which the discussion continued.

Transcript Highlights:

• facilities, we cannot draw down the full federal funds due to the declining census and the reduction in the FMAP
• So if you look at over the last five years, the FMAP has been reduced 10.6 percent.

Summary: The Appropriations Committee on Health and Human Services heard a presentation on the governor’s proposed fiscal year 2026-27 budget for the health and human services silo, which totals $48.5 billion. Agency leaders outlined major requests for AHCA, APD, DCF, DOEA, DOH, and the Department of Veterans’ Affairs, including behavioral health redesign, Medicaid rate changes, developmental disability services, child welfare and opioid programs, senior services, cancer research, public health initiatives, and veterans’ facility and technology needs. The committee also received an overview of the overall state budget, which was described as $117.4 billion, up 1.1% from the current year. AHCA’s presentation focused on $71.6 million for a Medicaid behavioral health redesign, including funding for residential treatment, a serious mental illness waiver, and higher inpatient psychiatric rates for youth, plus $7.1 million to raise private duty nursing reimbursement in fee-for-service Medicaid, $2.5 million for the background screening clearinghouse, and $124.4 million for the Health Care Connection System (FX). APD requested funding to continue moving people off the pre-enrollment list and to support developmental disability centers, a new forensic facility, an electronic health record system, and higher operating costs. DCF highlighted $81.9 million for eligibility and system integrity, $187.5 million for opioid prevention and treatment, $35.5 million for community-based care lead agencies, and $72.7 million to expand behavioral health bed capacity, including 474 new beds at state hospitals. DOEA sought additional funding for Alzheimer’s services, home care, and community care for the elderly. DOH emphasized $278 million for cancer research and innovation, $5 million for food and product safety testing, $5 million for the Florida FIRST blood-on-ambulance initiative, and $5.7 million for a public lab feasibility study. Veterans Affairs requested funds for facility improvements, cybersecurity, and medication management equipment. Members asked detailed questions about several items, especially the proposed changes to the AIDS Drug Assistance Program (ADAP), which would reduce eligibility and the number of people served. Senators and public witnesses criticized the lack of transparency and urged the department to pause the changes and work with stakeholders; the Surgeon General said the issue was driven by funding constraints and federal changes, not a legal barrier, and that the agency was exploring alternatives. Questions also addressed the Office of Minority Health and Health Equity, the Kids Care/CHIP expansion implementation, the cancer research funding structure, and the timeline and cost of the FX system. Public testimony focused heavily on ADAP, with speakers warning that thousands could lose medication access and calling for community involvement and a review of the program’s finances. The committee adjourned after the presentations and questions, with no votes taken on the budget items during this meeting.

Transcript Highlights:

• facilities, we cannot draw down the full federal funds due to the declining census and the reduction in the FMAP
• So if you look at over the last five years, the FMAP has been reduced 10.6 percent.

Summary: The Appropriations Committee on Health and Human Services heard presentations on the governor’s proposed fiscal year 2026-2027 budget for the health and human services agencies. Kendall Kelly outlined the overall HHS budget at $48.5 billion, with AHCA accounting for the largest share, and agency heads then highlighted major proposals for Medicaid behavioral health redesign, APD waiver enrollment and facility needs, DCF child welfare, opioid, and mental health investments, DOEA funding for Alzheimer’s, home care, and community services, DOH funding for cancer research, public health initiatives, and lab capacity, and VA funding for facility improvements, cybersecurity, and medication management. Several members praised specific proposals, including increased reimbursement for private duty nursing, Alzheimer’s supports, and the Florida FIRST blood-in-ambulance initiative. Senators also questioned the proposed changes to the AIDS Drug Assistance Program (ADAP), with the Surgeon General explaining that the department expects a reduction in covered patients from about 30,000 to about 20,000 because of funding pressures tied to rebates, federal changes, and premium tax credit issues. Public testimony strongly criticized the ADAP changes, citing lack of transparency and warning that many patients could lose access to medications. Other questions focused on the Office of Minority Health and Health Equity, DCF’s substance abuse and mental health data dashboard, Kids Care/CHIP expansion implementation, APD bed and facility planning, and the FX Medicaid technology project. DCF said about $7 million is set aside for the dashboard system, and AHCA said the governor’s budget includes $124.4 million for FX maintenance and continued module development, with $13.5 million to begin claims processing work. The committee did not take a substantive vote on the budget presentations and adjourned after questions and public testimony.

Transcript Highlights:

• happening, so that the state won't have to utilize our general funds, but they can pull their full FMAP
• Thank you. to utilize our general funds, but they can pull their full FMAP, also a new acronym that I
• The waivers would maximize the 100% FMAP for tribal and IHS facilities received for services provided

Bills: HB2049, HB2050, HB2051, HB2072, HB2082, HB2085, HB2177, HB2178, HB2179, HB2183, HB2195

Keywords: radiation therapy, particle accelerator, critical access hospitals, patient care, rural healthcare, AHCCCS, lactation care, breastfeeding, health services, healthcare access, Cesar Chavez, public holiday, state law, holiday repeal, Arizona Revised Statutes, childhood cancer, rare diseases, research funding, healthcare, clinical trials

Summary: The committee opened with attendance and member introductions, then heard a series of health-related bills, many focused on access to care in rural and underserved communities. HB 2049 would allow particle accelerators for radiation therapy in critical access hospitals and counties under 400,000 population under general supervision; sponsors and rural oncology witnesses said it would reduce travel burdens for cancer patients while maintaining safety protocols. HB 2050 updated radiologic technologist statutes to align with current national standards, adjust accreditation and clinical-hour requirements, and allow radiologist assistants to work under supervision rather than direct supervision; an amendment also added registered nurses to the list of professionals not needing a separate license to use diagnostic X-ray machines. Both bills were supported by testimony about workforce shortages and access, though one member voted no on HB 2050 over concerns about oversight and board authority. Both measures received do-pass recommendations, with HB 2050 amended. The committee then unanimously advanced HB 2082, which creates a Childhood Cancer and Rare Childhood Disease Research Commission to award grants for phase-one pediatric cancer and rare disease trials. Testimony came from families affected by pediatric brain cancer, including a parent who described traveling internationally for treatment and a college student currently undergoing treatment who urged the state to invest in research. Members expressed strong sympathy and support, and the bill passed 12-0. Next, HB 2015 would require Access to cover breastfeeding and lactation services in multiple settings; the sponsor and medical witnesses described breastfeeding as preventive care with benefits for infants and mothers, while Access testified neutral and noted a fiscal estimate was being developed and that the amendment would protect the state if CMS does not approve the services. The bill, as amended, also received a unanimous do-pass recommendation. The committee also approved HB 2177, which directs Access to seek CMS waivers so tribal and Indian Health Service facilities can be reimbursed for certain covered services, including dental care, for American Indian and Alaska Native members. The sponsor and a Sage Memorial Hospital representative said the bill would help rural tribal facilities keep services local and maximize federal matching funds; it passed unanimously as amended. HB 2178, requiring a state agency medical chief officer to hold an active medical or osteopathic license, was described as a cleanup measure after a lapse in licensure exposed a statutory gap, and it also passed unanimously. HB 2179, which clarifies definitions separating air ambulance from ground ambulance regulation, was supported as a technical clarification to avoid unintended consequences and likewise received unanimous approval. Finally, the committee advanced HB 2183, which creates an emergency medicine study committee to examine Arizona’s EMS system, including rural and urban capacity, workforce burnout, uncompensated care, and emergency department utilization. The sponsor said the study would help the state understand system pressures and identify policy solutions; firefighters, health care advocates, and an emergency medicine nurse practitioner testified in support, emphasizing the ER’s role as the safety net and the strain from staffing shortages, rural closures, and high volumes. The bill was still under discussion at the end of the transcript, with testimony continuing after the initial supporters spoke.

Transcript Highlights:

• <00:39:13.440> u<00:39:14.079> what's There's also a portion where what's called the FMAP
• they know they have to send back to the federal Medicaid program to make them whole as part of that FMAP
• program to make them whole as part of program to make them whole as part of that<00:41:12.160> FMAP
• that FMAP that's required. that FMAP that's required.

Keywords: 1189, house, all

Summary: The committee chair opened by explaining that the committee has expanded from a traditional audit-follow-up role into an oversight role focused on whether audit recommendations are implemented and whether controls are in place to detect fraud. He said the committee was concerned about fraud uncovered in social service programs in other states and wanted to understand New Hampshire’s safeguards, especially around major contracts and program performance. Charles Buchanan, director of the New Hampshire Medicaid Fraud Control Unit, and investigator Tim Brackett described the unit’s structure and mission. Buchanan said the unit, housed in the Attorney General’s Criminal Justice Bureau, investigates and prosecutes fraud by health care providers serving Medicaid beneficiaries, as well as abuse, neglect, and financial exploitation of residents in health care facilities. He outlined common Medicaid fraud schemes such as billing for services not rendered, upcoding, using unqualified staff, drug substitution, kickbacks, supplemental charges, and inflated customary charges. He also described resident abuse/neglect and drug diversion in hospitals, nursing homes, and assisted living settings. Brackett said his role is financial investigator/auditor and noted the unit is grant-funded and must include a prosecutor, investigator, and auditor. The witnesses then explained how cases reach the unit and how they are handled. Most referrals come from the state Department of Health and Human Services’ program integrity unit and from managed care organizations’ special investigations units, which look for fraud, waste, and abuse and refer credible allegations. Other sources include qui tam whistleblower actions, the national Medicaid Fraud Control Units association, citizen complaints, provider referrals, adult protective services law-enforcement referrals, local law enforcement, and federal agencies. Once a referral is received, the unit can accept or deny it; accepted matters may be investigated criminally or civilly, while nonviable matters can be referred back to HHS or other agencies for administrative action, including repayment demands and reimbursement offsets. No votes or formal committee actions were taken in the portion provided.

Transcript Highlights:

• but it's hard for me to predict with the federal government relative to directed payments, 340B, all FMAP
• But what the General Assembly did during the COVID pandemic was the FMAP rate.
• payments<01:28:10.280> 340b<01:28:11.280> all<01:28:11.679> uh<01:28:11.880> fmap
• <01:28:12.440> all directed payments 340b all uh fmap all directed payments 340b all uh fmap

Keywords: Meeting start 00:06:05 Roll Call 00:06:33 HB 152 Discussion 00:07:55 HB 152 PHS 2 Vote 00:10:12 HB 545 Discussion HB 545 PHS 1 Vote 00:13:47 HB 606 Discussion 00:15:15 HB 606 Vote 00:16:32 HJR 30 Discussion HJR Vote 00:19:07 HJR 32 Discussion 00:20:25 HJR 32 PHS 1 Vote 00:23:11 HJR 34 Discussion 00:25:04 HJR 34 PHS 1 Vote 00:28:50 HJR 46 Discussion 00:30:09 HJR 46 Vote 00:34:15 HJR 53 Discussion 00:35:40 HJR 53 Vote 00:38:55 HJR 54 Discussion 00:40:15 HJR 54 Vote 00:40:50 HB 546 Discussion 00:42:15 HB 546 PHS 1 Vote 00:46:15 HB 605 Discussion 00:47:38 HB 605 PHS 1 Vote 00:52:10 HB 694 Discussion 00:53:46 HB 694 Vote 01:07:47 HB 695 Discussion Only 01:10:20, 958, all

Summary: The House Standing Committee on Appropriations and Revenue met on February 25 and considered a series of bills and joint resolutions, mostly involving appropriations, capital projects, and local infrastructure funding. The committee first adopted PHS 2 and passed House Bill 152, which creates a Medicaid supplemental payment program for public ground ambulance providers; the sponsor said the substitute ensures no state general fund dollars will be used and that local agencies must identify a funding source for any required match. HB 152 was reported favorably on a 20-0 vote. The committee also passed House Bill 545, the annual claims bill, after members confirmed all executive-branch claims were included; it was reported favorably on a 21-0 vote. House Bill 606, requiring reporting for general obligation bonds, also passed unanimously and was reported favorably. The committee then took up several joint resolutions tied to capital and infrastructure spending. House Joint Resolution 30, concerning water projects, was described as implementing ranked projects under the Waters program administered by KIA and was reported favorably on a 21-0 vote. House Joint Resolution 32, concerning school facilities construction, was amended by PHS 1 and advanced after discussion referencing the Auditor’s report and questions about a Johnson County Schools expenditure; it also passed 21-0. House Joint Resolution 34, relating to contingent appropriations for KCTCS, was amended by PHS 1 and advanced after testimony outlining three projects in Somerset, Jefferson Community and Technical College, and Glasgow; it passed 21-0. House Joint Resolution 46, for local road projects, was described as funding the highest-scoring local road requests from a larger pool of applications and passed 21-0. The committee also advanced House Joint Resolution 53, authorizing release of funds for KSU’s Health Sciences Center project, after KSU officials said the building is needed for nursing and allied health programs and promised a business plan report by November 1, 2025; it passed 21-0. House Joint Resolution 54, authorizing funds related to the State Fair Board, also passed unanimously. Later, the committee considered House Bill 546, which revises the local roads and streets program by adding a DOT-developed scoring system, monthly reporting, a match requirement, and a $500,000 project cap; members asked about the cap and were told larger projects should be handled through other mechanisms. HB 546 was reported favorably on a 21-0 vote. Finally, House Bill 605, a technical corrections and update bill for the local economic relief grant program, was amended by PHS 1 and discussed as expanding eligibility, including to the Delta Regional Authority and certain local-affiliated applicants; the transcript cuts off before the final vote on HB 605.

Transcript Highlights:

• First of all, for the FMAP for fiscal year 2027, we were estimating a 52.52% FMAP.

Keywords: 908, all

Summary: The Budget Section Leadership Division met with a quorum and approved the March 18 minutes. The committee first heard an update from the Petroleum Council on oil and gas activity in North Dakota. Ron Ness said production is expected to remain relatively flat at just under 1.2 million barrels per day, with efficiency gains and longer laterals helping offset lower rig counts. He discussed oil and gas prices, gas taxation, flaring concerns, northward movement of drilling activity, and the importance of new infrastructure and enhanced oil recovery (EOR) pilots. Members asked about gas taxation, natural gas liquids, pipeline impacts, and the outlook for Continental and other operators. Ness said the industry is likely to remain steady rather than see a major ramp-up or decline. Matt Pearl of the State Tax Department then explained the federal “big beautiful bill” and its effect on North Dakota income tax collections. He said the law extends or makes permanent several federal provisions and creates temporary deductions for seniors, tips, overtime, and auto loan interest, with the biggest state impact coming from the standard deduction increase and business tax changes. He revised earlier estimates downward, saying the net cash impact on state collections is likely in the $30 million to $35 million range after accounting for business prepayments and one-time FY25 oilfield transaction effects. Committee members asked which provisions apply to standard versus itemized returns. OMB staff gave a detailed update on major capital projects and facility funding. Topics included Capitol grounds improvements such as 18th-floor renovations, wayfinding, seating, lighting, tree management, and restroom and lobby upgrades; security work at the governor’s residence, which has been delayed by the discovery of human remains; and space reconfiguration efforts in Bismarck-Mandan to reduce leases and create shared offices and conference rooms. They also reported on the State Facility Maintenance Fund, including roof, window, boiler, and kitchen projects at state facilities, and on the state hospital project in Jamestown, which remains on budget and on schedule for substantial completion in winter 2027 and opening in spring 2028. OMB also updated the committee on the Minot North Central State Office Building, the use of federal State Fiscal Recovery Funds, and the status of legislative intent and trust fund reports, including school aid turnback, the school construction loan program, the Foundation Aid Stabilization Fund, the Legacy Fund, and the Strategic Investment and Improvements Fund. The committee ended by discussing future agenda items, including government efficiency, cash management, Bank of North Dakota lines of credit, and the rural health transformation program, and then adjourned.

Transcript Highlights:

• First of all, for the FMAP for fiscal year 2027, we were estimating a 52.52% FMAP.

Summary: The Budget Section Leadership Division met with a quorum present and approved the March 18 minutes. The committee first heard an update from the Petroleum Council on oil and gas activity, which described North Dakota production as holding steady around 1.1 to 1.2 million barrels per day despite lower prices and market volatility. The presentation emphasized that efficiency gains, longer laterals, and improved completion technology are allowing operators to sustain output while activity shifts north in the Bakken. Members asked about gas taxation, natural gas liquids, flaring, and enhanced oil recovery; the witness said gas is taxed by volume, most liquids are handled through oil lines or gas processing, and the state’s EOR pilot projects and new gas infrastructure are intended to help hold production flat and expand future recovery. The committee then received a presentation from the Tax Department on the federal “big beautiful bill” and its effect on North Dakota income tax collections. The department explained that most of the federal changes were extensions of existing Tax Cuts and Jobs Act provisions, but several items — including the larger standard deduction, senior deduction, tip and overtime exclusions, auto loan interest deduction, and business expensing changes — affect state collections. Revised estimates showed a smaller-than-expected impact on individual income tax, with the department suggesting a net cash effect in the range of roughly $30 million to $35 million when business and individual effects are combined, plus a possible one-time distortion from large oil-field transactions in fiscal year 2025. Members asked which provisions apply to standard versus itemized returns, and the department clarified that most of the individual provisions apply broadly, while the SALT-related item is itemizer-specific. OMB then reported on major capital projects and facility funding. Updates included Capitol grounds improvements such as 18th-floor renovations, wayfinding, augmented reality displays for the Rough Rider Hall of Fame, tree management and lighting studies, and restroom and parking reconfiguration in the tower. OMB also described security upgrades at the governor’s residence, where human remains were discovered on site and are being handled with historical and legal review. The state hospital project in Jamestown remains on schedule for substantial completion in winter 2027 and opening in spring 2028, with costs currently estimated a little over $292 million and a line of credit expected to be drawn in April 2027. The North Central State Office Building in Minot is under construction, with a $5.6 million line of credit already accessed. OMB also reported on the State Facility Maintenance Fund, noting about $1.1 million spent so far on projects such as the Liberty Memorial Building roof and foundation work, Capitol window replacement, boiler replacement, and kitchen remodeling. Finally, Legislative Council staff reviewed the interim compliance report on legislative intent and state trust funds. The report highlighted the status of multiple lines of credit, including those for the state hospital and Minot office building, and noted that the executive budget will likely need to include repayment planning for about $350 million of expected outstanding balances. Other updates included the Bank of North Dakota profit transfer schedule, litigation pool spending, the new Office of Guardianship and Conservatorship, the Missouri River Correctional Center planning effort, HHS items such as FMAP and child care assistance, Job Service’s unemployment insurance modernization project, and DPI school aid turnback estimates. No formal votes were taken beyond approval of the minutes.

Transcript Highlights:

• It's a 50-50 match; it's the standard FMAP for Medicaid.
• Is what... match it's the the standard fmap for match it's the the standard fmap for Medicaid Medicaid
• So we did, you know, during the enhanced FMAP get additional funding that is slowly running out in that
• So we did, you know, during the enhanced FMAP get additional funding that is slowly running out in that
• The enhanced FMAP got additional funding that is slowly running out in that grant account, and we have

Keywords: 1183, house

Transcript Highlights:

• Now, the federal portion of covering those Medicaid services is called the FMAP, the Federal Medical
• Now, the federal portion of covering those Medicaid services is called the FMAP, the Federal Medical
• <00:19:44.679> is<00:19:44.840> called<00:19:45.039> the<00:19:45.159> fmap
• <00:19:45.720> the services is cons is called the fmap the services is cons is called the
• early legislation as a result of the public health emergency during the early days of COVID, that FMAP

Keywords: 1189, house, all

Bills: HB4440, HJR1067, HJR1087, HB4426, HB3704, HB4311, HB3044, HB4191, HB3465, HB3972, HB3759, HB3625, HB1411, HB2980, HB3015, HB3147, HB3277, HB3323, HB3443, HB3882, HB3406, HB2975, HB3977, HB3263, HB2988, HB3404, HB1770

Keywords: Medicaid, low-income adults, healthcare, eligibility restrictions, constitutional amendment, Medicaid expansion, SoonerCare, health coverage, federal matching funds, FMAP, Article XXV-A, state question, special election, Title 63, public assistance, healthcare funding, federal-state match, Medicaid eligibility, Oklahoma Constitution, ad valorem

Transcript Highlights:

• First of all, for the FMAP for fiscal year 2027, we were estimating a 52.52% FMAP.

Summary: The Budget Section Leadership Division met with a quorum and approved the March 18 minutes before hearing a series of informational updates. The Petroleum Council reported that North Dakota oil production is expected to remain relatively flat at just under 1.2 million barrels per day, with activity shifting northward in the Bakken as technology improves and three- and four-mile laterals boost well performance. The presentation also discussed oil and gas prices, gas taxation, flaring concerns, the importance of pipelines and other linear infrastructure, and enhanced oil recovery pilot projects supported by state and federal funding. Members asked questions about gas production taxes, natural gas liquids, and the outlook for drilling rigs and future production. The Office of State Tax Commissioner then reviewed the federal “big beautiful bill” and its estimated effect on North Dakota individual and business income tax collections. Staff explained that most of the individual income tax impact comes from the permanent increase in the standard deduction, while temporary provisions such as senior deductions, tip and overtime exclusions, and auto loan interest deductions have smaller or limited-term effects. They also noted that business tax changes, especially depreciation and expensing provisions, create a larger near-term cash impact, and that some FY25 collections likely reflected one-time oil field transactions that may have inflated the baseline used in earlier estimates. OMB provided updates on major capital projects and facility funding. For Capitol grounds improvements, officials described plans for 18th-floor renovations, wayfinding upgrades, public seating, lighting, tree management, and possible restroom and lobby reconfiguration, while also noting the governor’s residence security project and the discovery of human remains on the Capitol grounds. OMB and its consultants also reported on the state facility maintenance fund, including window replacement, boiler work, roof and foundation repairs, and a new facility conditions assessment covering more state buildings. Updates were also given on the new state hospital in Jamestown, the Minot state office building, and the use of federal state fiscal recovery funds, including possible future reallocations to the Department of Corrections. Finally, Legislative Council staff summarized the interim compliance report on legislative intent and trust fund activity, highlighting the status of lines of credit, Bank of North Dakota profit transfers, the statewide litigation pool, the new Office of Guardianship and Conservatorship, corrections planning, HHS program updates, and a likely future general fund request for the unemployment insurance modernization project. No formal votes were taken beyond approval of the minutes; the meeting was primarily informational, with members asking clarifying questions throughout.

Transcript Highlights:

• Is that tied into the FMAP? I don't know. I'm still trying to understand it.
• Is that tied into the FMAP? I don't know. I'm still trying to understand it. Okay.

Summary: The Legislative Joint Auditing Committee met on June 5 and first adopted prior minutes and several committee reports. The executive committee report noted adoption of its minutes, staff updates on scheduled audits, approval of an annual financial audit for the City of Horseshoe Bend, and an update on the intern program. The Counties and Municipalities report covered delinquent private water and sewer audits, compliance follow-up with towns including Denning, Gum Springs, Omer, Fargo, Jericho, and Haynes, and review of current and deferred reports; the committee filed most current reports but deferred several and referred some matters to prosecutors and the Attorney General. The Educational Institutions report said 103 education audits were reviewed, most with no findings, while several school districts had findings and one Booneville School District finding was referred to law enforcement. The State Agencies report included findings at the Department of Finance and Administration and a deferred Department of Health report, and the committee filed 13 reports. The committee then received lengthy presentations on the State of Arkansas annual comprehensive financial report and the state single audit for fiscal year ended June 30, 2025. Legislative Audit issued unmodified opinions on the state financial statements, but identified two material weaknesses: insufficient internal controls at the Office of State Technology to monitor threats and unauthorized access, and improper methodology changes and documentation issues at the Division of Workforce Services affecting year-end estimates for unemployment-related accounts. The single audit covered $12.4 billion in federal awards across 469 programs, with 16 major programs reviewed. Auditors reported 33 findings overall, including 31 federal findings, $12.9 million in outstanding questioned costs, and qualified opinions for the Summer Electronic Benefit Transfer program, the Coronavirus Capital Projects Fund, and the Child Care Development Fund cluster. Committee members questioned DHS, the broadband office, OST, DFA, Education, and Workforce Services about the findings, corrective actions, cyber protections, federal drawdowns, child care reporting, and accounting methodology changes. Several agencies described corrective steps. DHS said it had changed how it draws Summer EBT funds, addressed provider revalidation and incarceration-related Medicaid issues, and updated internal processes and staffing. The broadband office said the questioned costs reflected invoice documentation disputes rather than missing payments and expected Treasury review to resolve the issue. OST said it was expanding logging, endpoint detection, and enterprise monitoring, and described broader cybersecurity investments, training, and a roadmap. DFA and Workforce Services addressed the workers’ compensation and unemployment accounting issues, with Workforce Services saying it had updated its policy and submitted the methodology to DFA. After discussion, the committee voted to hold the two statewide audit reports over until the August meeting, with members asked to submit specific questions in advance so only needed agencies would return. The final item was a special report on the Hot Spring County Solid Waste Authority for January 1, 2023 through June 30, 2025. The audit reviewed compliance with laws, board procedures, bidding, payroll, permits, inspections, and cash handling. It noted prior private audit findings on segregation of duties, that recent private audit reports had not been obtained for 2023 through 2025, and that the current administrator said prior office staff and bookkeeping contractors resigned when he was hired. The authority’s operations and revenue sources were described, and the report was presented for committee review.