Transcript Highlights:

• for managed care MA forecast payments for managed care MA capitation<00:22:06.400><c> payments</c><00
• :22:06.799><c> by</c> capitation payments by capitation payments by 0.1%<00:22:09.039><c> and</c><00:
• <00:25:00.400><c> rates</c> payment rates payment rates for<00:25:03.279><c> ambulances.
• </c><01:19:40.560><c> to</c> perenrollment incentive payments to perenrollment incentive payments to
• . reimbursement. reimbursement.

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• I would say we did receive approval for the reimbursement funding methodology later than typical.
• A lot of these state-directed payments, a lot of these supplemental payments, have just come under additional
• Florida's Directed Payment Program for Hospitals provides payments to hospitals for both inpatient and
• Meyer, I would say similar to essentially every supplemental payment program, state-directed payment
• supplemental payment models. Any other questions? See no debate.

Keywords: 999, senate, all

Transcript Highlights:

• And if you comply with the requirements of the program, you can also have some of your co-payments reimbursed
• And if you comply with the requirements of the program, you can also have some of your co-payments reimbursed
• We were asked to talk specifically about tuition reimbursement.
• Some agencies do support tuition reimbursement, others do not.
• It does not cover—it's not specifically tuition reimbursement—but it does include tuition reimbursement

Committee: Joint Employee Benefits Programs Committee

Summary: The Employee Benefits Committee met to hear presentations on state employee health insurance, compensation, leave policies, labor market conditions, and prevailing wage issues, then later took up committee rules and bill-draft jurisdiction. PERS reviewed the history and structure of the state health plan, noting the state has paid the full family premium since 1979, described cost-control and benefit-enhancement changes over time, and explained current plan options, wellness incentives, employer wellness discounts, and the upcoming bid process for the 2027-29 contract. HRMS then presented compensation comparisons showing state classified pay generally trails private and regional markets, with larger gaps at higher-level jobs, and reviewed benefits and leave policies, including the new enhanced annual leave and new-hire leave, the state’s unpaid family leave structure, and varying tuition reimbursement practices. Job Service reported on labor force trends, low unemployment, high labor force participation, job openings, and wage growth, and OMB said there are no state prevailing-wage requirements beyond federal Davis-Bacon rules for federally funded projects. The committee then considered a proposed amendment to Joint Rule 211 to better align the health insurance mandate review process with recent statutory changes. Members discussed how the rule should reference both the committee’s required actuarial reports and the Legislative Council cost-benefit analysis, and the amendment was adopted on a roll call vote. The committee also discussed how its jurisdiction decisions affect whether a bill draft receives actuarial analysis, with staff explaining that a decision not to take jurisdiction means the bill is not treated as impacting the relevant retirement or health plans for purposes of that analysis. After that, the committee began reviewing bill drafts for jurisdiction. The first draft, bill draft 33, would automatically renew pre-tax elections for dental and vision coverage during open enrollment instead of requiring annual re-election. Members debated whether it had any actuarial impact, noting the state does not pay those premiums directly, and the discussion was still underway when the transcript ended.

Transcript Highlights:

• Senate Bill 2399 from just last year required the department to amend the payment rates for, or the payment
• And the first transitions of payment mechanisms are painful.
• I mean, if we are reimbursing the PRTFs, that some of it comes from a Medicaid budget, If we are reimbursing
• Well, the payment goes to the provider. I know.
• We're going to hear DD Payment System Steering Committee. Reimbursement Project on Development Act.

Committee: Joint Human Services Committee

Summary: The committee first approved the February 11, 2026 minutes and then received an update from the North Dakota Housing Finance Agency on the interagency council on homelessness and continuum of care funding. Testimony described rising homelessness tied to tight housing markets, low incomes, aging homelessness, barriers to rental assistance and public benefits, and limited shelter and case-management capacity. Members discussed the need for more affordable housing, continued one-time funding for the North Dakota Homeless Grant and Housing Incentive Fund, better coordination with Health and Human Services on economic assistance and human service zones, landlord engagement, recovery housing, and reentry housing. The committee also heard that federal continuum of care funding remains uncertain, with possible shifts away from permanent supportive housing and housing-first models; members asked for a future update on the impact if federal rules reduce the share available for permanent housing. The committee then took testimony on accessibility of government services for people who are blind or visually impaired. Paul Olson of North Dakota Vision Services School for the Blind described current screening and service delivery, including infant referrals, regional staff, short-term programs, and collaboration with vocational rehabilitation. He said the targeted screening system is working, recommended maintaining the current model, and noted ongoing challenges with staffing, public awareness, and accessible state websites and documents. Public testimony from a visually impaired resident and a deaf resident emphasized barriers such as CAPTCHAs, inaccessible PDFs, employment forms that screen out applicants based on driver’s license status, shortages of interpreters, and the need for video remote interpreting and video relay services, along with training for users and agencies. Finally, the committee heard a final report on the study of child care provider licensing from HHS Early Childhood Director Kay Larson. The report summarized provider input and committee discussion on simplifying North Dakota’s child care licensing structure, reducing administrative burden, and balancing that with health and safety standards. Key topics included licensing categories, child care assistance eligibility, food program sponsorship, staff qualifications, training requirements, ratios and group size, age bands, and preschool exemptions. The committee’s recommendations included streamlining to three provider types plus a preschool designation, revising ratio and age-band rules, and carrying forward certain preschool outdoor-space exemptions. Larson noted that any changes would require statutory changes, rulemaking, and a transition period before new licensing rules could take effect.

Transcript Highlights:

• c><00:01:59.280><c> first</c><00:01:59.520><c> wave</c><00:01:59.759><c> of</c><00:01:59.920><c> payments
• </c><00:02:00.240><c> to</c> sending out a first wave of payments to sending out a first wave of payments
• </c> how claims would be um uh reimbursed how claims would be um uh reimbursed under<00:08:23.520><c>
• folks um as as much as reimburse folks um as as much as possible. possible. possible.
• So it doesn't reimbursed to the fund.

Keywords: 1183, house

Summary: The committee heard House File 4867, a bill from Representative Lee to make changes to the Consumer Protection Restitution Account created the prior year to help victims of fraud. The Attorney General’s Office testified that the fund has already received more than $4.5 million and is beginning its first distributions, including payments to victims of the closure of Woodbury Dental. The office said the bill would remove the current $5 million annual deposit cap and establish a more equitable distribution formula so large claims would not exhaust the fund and prevent other victims from receiving restitution. Public testimony strongly supported the bill. A Woodbury Dental victim described paying $25,000 upfront, losing her dental work when the clinic abruptly closed, and having to start over with another dentist; she said reimbursement would help her recover from the loss. An AARP Minnesota representative also supported the measure as a cleanup bill that improves the new restitution program. Members asked about how the bill would handle large claims, whether the Attorney General could still pursue defendants for additional recovery, and whether restitution payments would be taxable. The Attorney General’s Office said it would continue collection efforts and reimburse the fund if later recoveries are made, and Representative Lee said the bill includes a provision making payments non-taxable. The chair then moved that House File 4867 be laid over, and the bill was laid over without a vote on passage.

Transcript Highlights:

• Expenditures are pre-audited before a payment is made.
• We met with resistance, but it was eventually reimbursed.
• So we don't really get reimbursed by the state.
• You're required to have money in reserve to cover a payment.
• Key word is reimbursable.

Summary: The Intergovernmental Affairs Subcommittee met to review how county budgets are developed and how constitutional officers fit into that process. Davin Suggs of the Florida Association of Counties gave an overview of county budgeting, explaining the statutory framework, the role of property taxes and TRIM notices, the fiscal-year timeline, fund balances and reserves, and the Department of Revenue’s oversight. He emphasized that county budgets include the board’s budget plus the budgets of constitutional officers, and that relationships and communication are critical to resolving budget issues. A panel of constitutional officers then described their offices’ budget processes and responsibilities: Escambia County Sheriff Chip Simmons discussed law enforcement budgeting and the importance of negotiated agreements with county commissions; Alachua County Property Appraiser Aisha Solomon explained the June 1 budget deadline, valuation methods, and the appeal process for property assessments; Manatee County Clerk and Comptroller Angelina Coleniso outlined the clerk’s court and finance duties, the county-side budget process, and the clerk’s personal liability under section 129.09 for unlawful expenditures; Leon County Supervisor of Elections Mark Early described the cyclical nature of election costs, staffing, equipment, and the impact of turnout and election law changes; and Columbia County Tax Collector Kyle Keene explained that tax collectors’ budgets are reviewed by the Department of Revenue, with fee offices funding themselves through service charges and budget offices relying on county support. Members asked about personal liability for unlawful spending, conflicts between clerks and county commissions, property valuation and storm damage adjustments, reserve levels, and whether tax collectors can retain excess fees. Responses noted that clerks must refuse illegal expenditures, property appraisers use market-based assessments with VAB and court review available, counties should maintain healthy fund balances for cash flow and emergencies, and tax collectors generally must zero out year-end balances and distribute excess revenues to taxing authorities. The committee took no votes and adjourned after thanking the panelists for their testimony.

Transcript Highlights:

• We did receive approval for the reimbursement funding methodology later than typical.
• A lot of these state-directed payments, a lot of these supplemental payments, have just come under additional
• We want to make sure that the hospitals are reimbursed for that.
• Florida's Directed Payment Program for Hospitals provides payments to hospitals for both inpatient and
• I would say, similar to essentially every supplemental payment program, state-directed payment for 38.6

Summary: The Legislative Budget Commission met with a quorum present and considered two budget amendments for the Agency for Health Care Administration. The first, EOGB 2026-0831, authorized $2.1 billion in budget authority for the Low-Income Pool to support safety-net providers for uncompensated charity care. Members asked about the timing of CMS approval and whether the program addressed hospital shortfalls for insured patients and children; AHCA said the program is for uncompensated care and would follow up on specific questions. The amendment was adopted without objection. The second amendment, EOGB 2026-0875, placed $7.9 billion in reserve for Florida’s Directed Payment Program for hospitals, pending final CMS approval. Discussion focused on hospital attestations that no hold harmless agreements were in place, the meaning of those federal requirements, and whether any agreements had to be unwound; AHCA said attestations had been received from all hospitals and submitted to CMS. Members also asked about the approval timeline and whether another amendment would be needed after final approval, and AHCA said approval was hoped for soon but could not confirm the budget process. Representative Woodson raised concerns about cancer hospitals not participating in the DPP; AHCA responded that those hospitals participate instead in a separate Florida Cancer Hospital supplemental program, which had already been approved. This amendment was also adopted without objection, and the commission then adjourned.

Transcript Highlights:

• state-directed payment limits.
• ,</c> expansion enrollment, provider payments, expansion enrollment, provider payments, particularly<
• payments which are payments<00:09:20.720><c> to</c><00:09:21.040><c> providers</c><00:09:22.000><c>
• </c> Combined effects on provider payments Combined effects on provider payments are<00:13:51.440><c>
• </c> Medicaid state directed payment program. Medicaid state directed payment program.

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:

• The reimbursement rate to counties is reported to cost $250 per day per juvenile.
• within 60 days of receipt of complete reimbursement documentation.
• Once it's over, we then submit for reimbursement.
• For example, the average reimbursement payment to the Kirkland Fire Department took about nine months
• for local agencies that receive their reimbursement post emergencies.

Summary: The committee heard public hearings on several bills. HB 2675 would eliminate a number of state accounts and transfer remaining balances from two accounts to the general fund, while also changing how revenues in the Salary Insurance Contribution Increase Revolving Account are deposited; OFM testified in support and there was no public opposition. SHB 1903 would create a statewide low-income energy assistance program through the Department of Commerce, funded by the general fund and Climate Commitment Act revenues; supporters said it would address Washington’s underfunded and uneven energy assistance system, while utilities and rural co-ops raised concerns about cost, reporting burdens, utility authority, and implementation details. SHB 2384 would require actuarial reviews for certain continuing care retirement communities with prepaid life care contracts; residents and consumer advocates supported the added transparency, while providers opposed the added review costs and said they already pay for actuarial work. SHB 1982 would expand the ability of tribal members to vacate convictions tied to treaty rights, add OPD representation and a tribal liaison position, and then an amendment was described that would remove the liaison position and eliminate the fiscal impact; the sponsor and OPD supported the bill, and testimony emphasized correcting past treaty-rights convictions. The committee also heard SHB 2389, a broad juvenile justice bill that would expand suspended disposition options, create midpoint review hearings, reduce some robbery ranges, and address juvenile rehabilitation capacity and transfers. Supporters argued it would reduce racial disparities, favor community-based rehabilitation when safe, and improve outcomes, while prosecutors, sheriffs, counties, judges, cities, victim advocates, and some tribal law enforcement warned it would weaken accountability for serious violent offenses, increase court and local government burdens, and shift costs without funding. Several witnesses and the bill sponsor discussed proposed amendments, including removing presumptions and the mid-sentence review. The committee then heard SHB 2439, which would raise tobacco and vapor product license fees, create a responsible vendor program, add manufacturer certification and enforcement provisions, restrict certain products and sales practices, and redirect tobacco tax revenue to public health, cancer research, and youth prevention accounts; public health and prevention groups supported it, while retailers and industry representatives opposed the fee increases and some of the new restrictions. Finally, HB 2681 would sharply increase cannabis license fees and index them to inflation; OFM supported the change as aligning fees with program costs, while cannabis businesses and associations opposed or sought changes to the fee structure and CPI indexing. The committee also heard a briefing on SHB 2215, which would require the Caseload Forecast Council to forecast SNAP and state food assistance caseloads in light of upcoming federal cost-sharing changes; no questions were raised at the briefing.

Transcript Highlights:

• We can fix this by increasing reimbursement rates while simplifying payment structures and increasing
• We can fix this by increasing reimbursement rates while simplifying payment structures and increasing
• We can fix this by increasing reimbursement rates while simplifying payment structures and increasing
• reimbursement is getting worse.
• reimbursement is getting worse.

Committee: Senate Health and Human Services

Keywords: 1187, senate, all

Transcript Highlights:

• </c> resource um it states that co-payments resource um it states that co-payments co-<00:15:40.839><
• </c><00:19:26.840><c> from</c> people removes any co-payments from people removes any co-payments from
• </c> of rate exceptions rather that payment of rate exceptions rather that payment rates<00:48:22.440
• </c><00:57:26.839><c> rates</c> medical assistance reimbursement rates medical assistance reimbursement
• </c> thinking about the U the average payment thinking about the U the average payment you<01:06:22.880

Committee: House Human Services Finance and Policy

Keywords: 1183, house

Transcript Highlights:

• When the payment is received, a discount is calculated, and that is then taken off.
• to us in May. ...takes the time it takes for them to get the payment to us in May.
• The costs incurred at the local level would be reimbursed.
• The costs incurred at the local level would be reimbursed.
• Incurred at the local level would be reimbursed.

Summary: The subcommittee met with a quorum, approved the prior minutes, and focused primarily on property tax statement issues tied to the primary residence credit and the 5% early-payment discount. North Dakota Association of Counties representatives said the current special-session language creates problems because the discount is being applied even when no taxes are ultimately owed, and because the discount is calculated before the PRC funds are actually received. They recommended reverting to the prior law so the discount is applied after the PRC, and noted that all four programmers said they could revert the software to the earlier version if needed. The committee also reviewed a bill draft to remove the legislative tax relief line item from the required contents of the property tax statement. Members agreed the current line item is not especially accurate or useful on the statement, and several members said the committee should go further by adding clearer taxpayer education, such as a pie chart or other supplemental breakdown of where property taxes go. County officials said some counties already provide supplemental charts or explanatory material, but others would need help with printing, mailing, or formatting. To support that idea, staff presented a second bill draft creating a grant program, administered through the Association of Counties with OMB as a pass-through, to reimburse counties for supplemental property tax statement information and related administration. After discussion, the committee voted unanimously to combine the two bill drafts into one recommendation and forward it to the full Tax Reform and Relief Advisory Committee. The subcommittee then voted to adjourn after directing staff to prepare its summary and recommended bill draft for the interim report.

Transcript Highlights:

• them who's going government to reimburse them who's going to<00:15:26.839><c> reimburse</c><00:15:27.320
• them</c><00:15:30.360><c> if</c> formula who's going to reimburse them if formula who's going to reimburse
• </c><00:15:32.240><c> system</c> Elon Musk controls the payment system Elon Musk controls the payment
• </c> security clearances on our payment security clearances on our payment systems<00:15:42.519><c> the
• </c><00:16:20.360><c> for</c> isn't going to get reimbursed for isn't going to get reimbursed for special

Keywords: 1187, senate, all

Transcript Highlights:

• ensures safety net clinics are reimbursed based on a true cost of delivering comprehensive care.
• I'm going to ask how H.R. 1 affects the reimbursements and their federal funding for Medi-Cal.
• I'm going to ask how HR1 affects the reimbursements in their federal funding for Medi-Cal. the reimbursements
• The 2025 Budget Act eliminates the prospective payment system reimbursement for services provided to
• We see a down payment of $500 million to support those public hospitals.

Keywords: 988, house, all

Transcript Highlights:

• The first transitions of payment mechanisms are painful.
• So infant toddler bonus payments... January through April 2026.
• Well, the payment goes to the provider. Provider. I know.
• Well, the payment goes to the provider. Provider. I know.
• We're going to hear DD Payment System Steering Committee Reimbursement Project on Development Act.

Committees: Joint Human Services , Joint Human Services Committee

Keywords: 908, all

Transcript Highlights:

• can't speak to the why of what's in the bill, but I will point out that last biennium there were payments
• These payment arrangements allow states to direct specific MCO payments to providers and use permissible
• These payment arrangements allow states to direct specific MCO payments to providers and use permission
• the non-federal share of state-directed payments, including provider assessments.
• If and when the program is able to move forward, future Medicaid and Medicare reimbursement rates and

Summary: The House Appropriations Committee held public hearings on three bills. House Bill 2251, sponsored by Rep. Fitzgibbon, would reorganize Climate Commitment Act revenue accounts by repealing several existing accounts and creating new operating and capital accounts, changing how auction proceeds are distributed when revenues are above or below a set threshold, broadening some tribal and overburdened-community spending language, adding electric vehicles and certain housing uses, capping Ecology administrative costs, and moving some reporting from annual to every two years. Supporters said the bill would simplify a confusing account structure and improve predictability, while opponents criticized the reduced reporting frequency and said it could weaken accountability. No vote was taken. House Bill 2254 would adjust the funding model for the Partnership Access Line and related behavioral health consultation programs by allowing the cost of the third-party administrator to be included in the carrier assessment rather than paid from general funds. Committee staff said this would produce general fund savings, and testimony from HCA, UW Medicine, Seattle Children’s, and others supported the bill as a technical fix that would stabilize the programs and potentially free up funds to restore service levels. No vote was taken. House Bill 2385 would extend deadlines and the expiration date for the Medicaid Access Program created last session, after federal HR1 restrictions prevented implementation of the original program and provider assessment. The bill would push out CMS submission deadlines, update the rate-setting reference year, and extend the act’s sunset date. The sponsor and the Washington State Medical Association supported the bill as necessary to preserve the option of pursuing the program later. The committee took no action and adjourned after the hearings.

Transcript Highlights:

• what private insurance reimburses, but just what Medicare reimburses—it’s a Just to what Medicare reimburses—forget
• what private insurance reimburses—but just what Medicare reimburses is substantially less because you
• , higher payment rates with payers.
• State directive payments are another way that it can help.
• So most of the hospitals get reimbursed for that uncompensated care through those supplemental payments

Committee: House Health Care Affordability, Select

Keywords: 1184, house, all

Transcript Highlights:

• the remaining 20% are reimbursed by the state.
• You say they get a lesser reimbursement.
• Yes, they'll still be reimbursed. There is a reimbursement process that occurs.
• How are you improving that timeline and process for reimbursement?
• We are continuously working to improve the reimbursement processes.

Committee: House Legislative Health & Human Services Committee

Transcript Highlights:

• Doctors are just looking for a fair payment in a reasonable amount of time.
• They can't look at government payment rates.
• It provides additional reimbursement guidelines for pharmacy benefit managers.
• , or a professional dispensing fee, for calculating pharmacy reimbursements.
• It focuses strictly on reimbursement and payment terms, where states have clear authority.

Committee: House Insurance

Keywords: 965, house, all

Transcript Highlights:

• So we've had two main methods of payment for state-funded projects, which are advance payment or reimbursement
• Our community-based organizations with limited resources having a reimbursement payment method caused
• We turn it back as an award and send out that first payment so they can begin the work.
• You have all the information for reimbursement or a disbursement.
• on yourselves to make sure you're getting that payment out within a certain period?