Transcript Highlights:

• and that is under review at CMS. and that is under review at CMS.
• <00:39:51.440> required encounters and that's a CMS required encounters and that's a CMS required
• It would have to be reviewed by CMS.
• , how CMS would see a potential change.
• <00:44:19.200> a um and what CMS how CMS would see a um and what CMS how CMS would see a potential

Keywords: Medicaid - Room 216, 4 February, 2026; 2:00 PM, 925, all

Summary: The committee heard presentations on several Medicaid-related topics. First, a pharmacy representative discussed nonopioid pain medications as a way to reduce opioid dependence and overdose risk, emphasizing that options such as acetaminophen, NSAIDs, and topical diclofenac can be useful for pain management. She cautioned that nonopioids can still have risks and said any policy should avoid requiring patients to step through opioids before accessing safer alternatives, while still allowing reasonable step therapy among nonopioid options. The presenter said the goal is to keep patients from being pushed toward opioids by cost or insurance design. The committee also heard emotional testimony from parents of a child with Prader-Willi syndrome, who described the condition as a rare genetic disorder that causes severe, lifelong hyperphagia and requires rigid supervision and ongoing treatment. They argued that alternative funding programs can disrupt access to medically necessary drugs such as human growth hormone, forcing families into costly and uncertain coverage gaps. They asked lawmakers to ensure insurance coverage remains stable for rare disease patients and thanked Senator Blackwell for prior support of rare disease legislation. Next, a Livanova representative urged the committee to support higher Medicaid reimbursement for vagus nerve stimulator surgery for drug-resistant epilepsy. He said inadequate hospital reimbursement has reduced access in Mississippi, causing patients to travel long distances or go without treatment, and argued that better reimbursement would improve outcomes and save money over time. He cited studies showing seizure reductions, lower ER use, and a projected $2.8 million in five-year savings for Medicaid based on 40 patients, and asked that hospitals be reimbursed at 100% of Medicare rates for the procedure codes. Finally, a Medicaid official gave a broad overview of hospital payment structure, including fee-for-service, managed care, MHAP, DSH, UPL, provider taxes, and related funding mechanisms. She explained that hospital payments are interrelated and have shifted over time, with major changes tied to managed care, MHAP/UPL increases, and provider taxes. At the end of the discussion, the committee was running short on time and asked her to skip ahead to the provider tax component; no votes or formal actions were taken in the portion provided.

Transcript Highlights:

• The CMS-64 reports are quarterly expenditure reports that are filed by DHS with the federal grantor.
• United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, or CMS
• is a public portal through which CMS, the federal grantor, receives these findings and follows up with
• It is a state and federal partnership, and we work with the CMS, as described earlier, to have a state
• CMS provides 75 beneficiaries, CMS provides 75% of our funding, and so we are obviously bound to some

Summary: The Medicaid Subcommittee of the Legislative Joint Auditing Committee met to receive a primer on the subcommittee’s history and on how Medicaid oversight works in Arkansas. Legislative audit staff reviewed the subcommittee’s origins in response to earlier Medicaid audit concerns and explained that Medicaid is audited every year in the statewide single audit because it is a high-risk, large federal program. Staff summarized recent audit findings, including issues with eligibility controls, data matching, contractor charging, incarcerated juveniles’ coverage handling, provider eligibility support, and the state’s Medicaid recovery audit contractor exception request. They also noted a DHS departmental audit finding involving employees who improperly received benefits, which was referred for possible prosecution. The Department of Human Services gave an overview of the Medicaid program, describing eligibility groups, delivery systems (fee-for-service, managed care/PASSE, and premium assistance for expansion adults), the size of the program, and the agency’s budget and provider base. DHS also outlined the difference between state plan amendments and waivers and said other committee materials would be sent to members. The Office of Medicaid Inspector General described its role in detecting and preventing fraud, waste, and abuse, explaining that it investigates suspected intentional fraud, suspends providers when there is a credible allegation of fraud, recovers improper payments in mistake cases, and recommends policy changes when trends are identified. The Attorney General’s Medicaid Fraud Control Unit explained that it prosecutes provider fraud criminally and civilly, handles neglect, abuse, and exploitation cases in long-term care settings, and works with DHS, OMIG, and federal partners. Members asked about where cases are filed, how provider suspensions work, whether beneficiary fraud is investigated, and how education is provided to providers. DHS confirmed that beneficiary fraud cases are referred to local prosecutors and said the expansion population will move toward community engagement/work requirements under federal changes, with a soft launch planned before full implementation. The meeting ended with no formal votes beyond adoption of the prior minutes and no other committee actions.

Transcript Highlights:

• By CMS to support performance improvement in this area.
• We were recently selected by CMS again to help improve that measure.
• We were recently selected by CMS again to help improve that measure.
• We're part, again, of the CMS Oral Health Affinity Group.
• This is called the CMS 416 report.

Keywords: 962, all

Summary: The MAPOC Women and Children’s Health Subcommittee heard a presentation from Kate Parker Riley, executive director of the Connecticut Dental Health Partnership, on the Husky Dental Program and efforts to improve oral health during pregnancy. She reviewed the structure of Connecticut’s Medicaid dental benefit, the ASO model, provider network, utilization trends, and member barriers to care. She noted that children’s dental measures remain above the national median, but adult utilization is lower and the dental provider network has been shrinking, with longer wait times in rural areas. A major focus was the state’s goal to raise the rate of oral evaluation during pregnancy from about 17.5% to 25% by 2030. Riley described planned outreach to OB/GYN practices using a draft “snapshot” report showing each practice’s pregnancy oral-health rate compared with the state average, along with education materials based on ACOG and AAP guidance. Committee members and guests discussed barriers such as lack of provider training, workflow burden, access to dentists who will see pregnant patients, and the need for stronger referral bridges. Suggestions included adding simple oral-health screening questions in OB settings, using human support to make appointments, and exploring co-located dental hygienists or other embedded models. Riley also highlighted partnerships with DSS, DCF, Head Start, WIC, Read to Grow, YMCA programs, refugee resettlement agencies, and school-based and hospital partners, as well as data-sharing and navigation efforts. She said pregnant members newly identified through HUSKY will now receive outreach and navigation support. DSS dental director Carolyn MacArthur introduced herself and said she supports the initiative, noting the literature linking untreated maternal dental disease to poor child oral-health outcomes. No votes were taken; the meeting ended with thanks and a preview of upcoming July presentations on integrated behavioral health and home visitation programs.

Transcript Highlights:

• DIRECTED TO CREATE A NEW DESIGNATION SO, A NEW HOSPITAL DESIGNATION OR CLASSIFICATION IN RESPONSE TO CMS
• THAT IS WHERE WE STAND NOW WITH RESPECT TO OUR 1115 WORKFORCE DEMONSTRATION WAIVER THAT IS THE CMS WE
• CMS LEADERSHIP.
• WHICH HAS BEEN WHAT I LITIGATION WAS ABOUT BASED ON CMS INTERPRETATION.
• WE HAVE HAD CONVERSATIONS WITH CMS AS WELL AND THE HIGHER LEVELS OF CMS SO THEY ARE AWARE OF THIS ISSUE

Keywords: 999, senate, all

Transcript Highlights:

• <00:13:18.680> does they don't take the full the CMS does they don't take the full the CMS
• What you know, what she just said in terms of defining what the CMS... >> I don't want to speak for CMS
• What you know, what she just said in terms of defining what the CMS... >> I don't want to speak for CMS
• What you know, what she just said in terms of defining what the CMS... >> I don't want to speak for CMS
• What you know, what she just said in terms of defining what the CMS... >> I don't want to speak for CMS

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on September 24, 2025, approved the minutes from the September 9 meeting, and then continued its discussion of Medicaid waivers with Leslie Hoffman and Carmen Hancock from the Department for Medicaid Services. Members asked for updates on the 2024 waiver waitlist management assessment recommendations, including aligning waiver policies, standardizing applications and waitlist placement, and modernizing data systems. DMS said that work is being done jointly with Aging and Independent Living and Behavioral Health/Developmental and Intellectual Disabilities through task forces, that ARPA spending delayed action, and that implementation timelines extend through March 2027. The board also reviewed per-member waiver cost averages for fiscal years 2023 through 2025 for ABI, ABI long-term care, HCBS, Model II, Michelle P, and SCL. DMS emphasized these figures were benefit-only averages based on paid claims, not full waiver costs, and explained that true budget neutrality is calculated on an aggregate basis against institutional care comparisons approved by CMS. DMS said all six waivers remain in compliance with budget neutrality and that the most recent 18-month lag review for FY 2022 and FY 2023 found costs at or below institutional care. Members also asked about unused waiver slots; DMS said slots generally cannot be reallocated mid-year if they have been used, except in cases such as death or reserved capacity, because CMS treats participants as unduplicated for the waiver year. A major portion of the meeting focused on the new child waiver created under House Bill 6. Legislators questioned whether the waiver’s design, including the exclusion of participant-directed services and the emphasis on high-acuity children with behavioral health, DCBS, or juvenile justice involvement, matched the bill’s intent to keep children at home. DMS said it used the $14.7 million appropriated for FY 2026 to develop the program, that there is no priority list, and that the waiver is intended to serve the highest-acuity children while also addressing residential needs for those sleeping in offices or placed out of state. Members also raised concerns about the rapid growth of the HCBS waiting list and asked for more detail on age and timing patterns, which DMS said it would provide later. Finally, DMS gave average processing times from application to eligibility determination and from approval to service start, and said the overall average from application to services beginning was about 80 days, while members requested follow-up information on the Carewise assessment contract and related costs.

Transcript Highlights:

• While CMS approves these standards, they can vary slightly from CMS requirements.
• While CMS approves these standards, they can vary slightly from CMS requirements.
• I mean, does CMS also go in and inspect? I mean, there's a number.
• I mean to CMS also It's not the only inspection. Is that correct?
• I mean, does CMS also go in and they inspect? I mean, there's a number.

Summary: The committee heard a JLARC presentation on the Department of Health’s oversight of hospital inspections, complaints, and reporting. JLARC said DOH was late on 72% of acute care hospital inspections as of December 2024, had not verified that third-party accrediting standards were substantially equivalent to state standards, did not consistently require proof of those inspections, did not review adverse health event corrective plans, and could make hospital data more accessible. JLARC also raised a possible language-access barrier in the complaint system. Members asked about complaint filing by staff, the meaning of adverse health events, inspection outcomes, and whether the audit compared DOH to other agencies. JLARC said it had not reviewed inspection results or cross-agency comparisons, but noted inspectors were dedicated and working long hours. DOH later said it concurred with the recommendations and outlined a strategic plan with target dates for improving timeliness, verifying accreditation standards, expanding language access, reviewing adverse event laws, and improving public data access, with annual reporting to the Legislature expected. The committee then heard a Department of Health presentation on certificate of need modernization. DOH described the current certificate of need process, which reviews need, financial feasibility, quality, and cost containment for certain facility changes and new services, and said the program has not been modernized since the 1980s. DOH proposed 10 statutory modernization recommendations, including clarifying the program’s purpose, creating a planning entity, adding flexibility, reducing legal costs, updating access-to-care standards, expanding oversight to freestanding emergency departments and urgent care, addressing equity, improving cost control coordination, strengthening long-term funding, and using better data systems. Members asked about oversight of freestanding urgent care and EDs, funding sources, and whether the process could be streamlined or made more responsive to complaints or other triggers. A third panel discussed artificial intelligence in health care. Lucy O’Rourke of the Coalition for Health AI described CHAI’s work on responsible AI principles, technical standards, model cards or “nutrition labels,” testing and governance tools, and educational resources for providers. She said the group is focused on trust, transparency, fairness, safety, security, and privacy, and noted Washington’s AI-related policy work as among the more progressive in the country. No questions were asked. The final portion focused on the financial impact of federal and state health care policy changes. The Washington State Hospital Association said hospitals are facing low or negative operating margins, service reductions, layoffs, and closures, and that state cuts and taxes enacted in 2025, combined with federal HR1 changes, will significantly worsen finances. Providence Swedish leaders described staffing reductions, service cuts, delayed capital investments, and pressure from denials, tariffs, and reimbursement changes, while emphasizing that frontline staffing cuts are tied to service reductions rather than nurse-to-patient ratio changes. The Washington Health Benefit Exchange then began a presentation on expiring federal ACA premium tax credits, state Cascade Care Savings assistance, and eligibility changes affecting lawfully present non-citizens, with examples showing large premium increases for customers if federal subsidies expire.

Transcript Highlights:

• the minimum reimbursement rate shall be 200% of the Medicare ambulance fee schedule as published by CMS
• as published by CMS rate in effect<00:05:09.680> on<00:05:09.919> October<00:05:10.400
• The applicable rate will be approximately 245% of the CMS reimbursement rate, and that rate will apply
• be approximately 245% of the CMS be approximately 245% of the CMS reimbursement<00:05:44.000>
• published by CMS published by CMS section<00:16:18.959> two.

Bills: SB9, HB400, SB9, HB400

Keywords: Alabama Athletic Commission, Attorney General, criminal penalties, unarmed combat, regulation, boxing, mixed martial arts, civil fines, dental insurance, benefit rollover, healthcare, insurance policy, annual maximum, smoking ban, vaping, public health, indoor air quality, clean air, ambulance services, health insurance

Transcript Highlights:

• As recently as last week, I’ve had conversations with CMS about this.
• This program provides supplemental payments to two cancer hospitals who meet certain CMS requirements
• So it does seem like there's a backlog in the federal CMS approval process.
• So CMS is making progress on clearing the backlog on a lot of these state-directed payments that were
• submitted to CMS.

Summary: The Legislative Budget Commission considered 21 budget amendments, most of them routine authority adjustments tied to federal grants, Medicaid payment programs, and trust fund realignments. The Department of Education received $14.751 million for a Preschool Development Grant to support early learning system improvements, workforce credentialing and training, IT modernization, and related early childhood certification work. The Department of Veterans Affairs shifted $2.2 million within its trust fund to cover higher nursing home occupancy, replace contract nursing with OPS staff, and meet rising operating costs. The Department of Health moved about $9.1 million to support Disability Determinations, where roughly 140,000 cases were pending or in process, and said the change would help reduce backlog and avoid a deficit. The Agency for Health Care Administration presented multiple amendments for Medicaid-related programs, including $766 million for indirect medical education, $1.9 million for managed care network adequacy audits, $209 million for the Rural Health Transformation Program, and several large supplemental payment programs for hospitals and physicians; members asked about CMS approval delays, provider access, and how rural funds would be distributed. The commission also adopted an amendment realigning KidCare funds, placing a $32.1 million surplus into reserve, though several members objected that the state had not yet implemented the 2023 KidCare expansion and that children remained on a wait list. Another Medicaid amendment placed a $376 million surplus into reserve after updated estimating conference projections. Other agencies also received approvals. FDLE received $16.26 million to buy counter-unmanned aircraft systems equipment such as radar and RF sensors to detect and mitigate drone threats. The Department of Juvenile Justice received $1.6 million for the Florida Scholars Academy and a Social Services Block Grant realignment, with staff confirming corrective action had been taken after prior audit findings about allowable SSBG spending. The Division of Emergency Management received federal pass-through authority for FIFA World Cup security and counter-UAS funds, both controlled by the Miami host committee, and members noted the state had little direct oversight over how those local grants would be used. The Department of Commerce received $148.4 million for Community Development Block Grant Disaster Recovery work, with questions focused on the split between housing, infrastructure, and administrative costs. The Department of State received $408,377 for arts and culture federal grant obligations. All amendments were adopted, generally without objection, after brief questioning and no public testimony.

Transcript Highlights:

• We received additional notice from CMS that they would defer $260 million of our Medicaid reimbursements
• > their<00:01:07.360> intent January 6th, CMS indicated their intent January 6th, CMS indicated
• 01:20.480> additional<00:01:21.040> notice<00:01:21.520> from<00:01:21.720> CMS
• <00:01:22.200> that received additional notice from CMS that received additional notice from
• CMS that they<00:01:22.520> would<00:01:22.720> defer<00:01:23.480> $260<00:01:

Keywords: 918, senate, all

Summary: Minnesota Management and Budget’s February forecast reported that the state’s projected deficit has turned into a surplus, with an estimated $3.7 billion balance for fiscal years 2026-27 and a projected $377 million positive balance for FY28-29. Officials said the improved outlook is driven by a slightly stronger national economy and higher forecast revenues, but they cautioned that the state remains in a strong yet not secure position. A major concern discussed was federal funding uncertainty. CMS has indicated it may withhold $515 million per quarter in Medicaid Assistance reimbursement, and separately notified the state it would defer $260 million in Medicaid reimbursements pending further information. Those potential losses are not included in the forecast, but lawmakers were told federal funds account for about one-third of state agency spending and that budget flexibility may be needed if cuts occur. Speakers also noted that Minnesota still faces a structural budget imbalance despite progress made last session. Current biennium spending is projected to be $68 million lower than earlier estimates, but planning estimates are up $152 million since the last forecast. Several lawmakers emphasized affordability concerns for residents, citing rising delinquency rates, increasing unemployment, flat wages, and the need to focus on tax conformity, vehicle tab fees, and property taxes. Members from both parties said they want to continue working together on budget solutions and spending restraint.

Transcript Highlights:

• Um CMS has approved hand side.
• CMS's Center for CMS has approved.
• year means there's five years that a CMS year means there's five years that a CMS will<01:09:34.080
• <01:10:32.080> has and budget appropriation and CMS has and budget appropriation and CMS has
• <01:25:32.719> We CMS until April of this year. We CMS until April of this year.

Keywords: 958, all

Summary: The Health and Family Services committee heard an informational presentation on Kentucky personal care homes from representatives of the Kentucky Association of Healthcare Facilities, Management Systems of Kentucky, and Elder Care Partners. Witnesses described personal care homes as a lower-cost, 24/7 residential option for adults, often with serious mental illness, who do not meet nursing home criteria but need structured supervision, medication assistance, meals, and daily support. They said the homes are regulated by the Cabinet for Health and Family Services, are not Medicaid-funded, and are supported largely through state supplementation payments and residents’ SSI income. The presenters argued that the current reimbursement rate of about $50.70 per day is no longer sufficient to cover staffing, food, insurance, utilities, maintenance, and other costs, and said the sector has shrunk significantly over time. They cited figures showing a decline from 64 to 34 homes serving the seriously mentally ill since 2002, with 30 closures over 23 years, and said the loss of beds contributes to homelessness, hospital overcrowding, and longer psychiatric stays. They also gave examples of residents who had spent many months in hospitals before being successfully placed in personal care homes, which they said can prevent more costly institutional care. Committee members asked about staffing credentials, fraud controls, referral processes, and how reimbursement works in other states. The presenters said Kentucky does not require licensed or certified staff in these facilities, though some homes use certified medication technicians or an LPN, and they described a county case-manager-based assessment process used to set individualized rates in other states such as Minnesota. Members expressed support for the work but emphasized the need for documentation of savings and budget offsets. The presenters said they are seeking an incremental reimbursement increase over two years, roughly 25% to 50% in the first year and another 50% after that, and urged the committee to support the homes to prevent further closures.

Transcript Highlights:

• CMS will be<00:20:52.320> based<00:20:52.640> on<00:20:52.880> that.
• approximately 142% of the CMS rate. approximately 142% of the CMS rate.
• <00:23:45.200> So approximately 245% of the CMS rate.
• So approximately 245% of the CMS rate.
• So, we're not super receiving whatever CMS calls. Okay. Thank you. >> All right.

Bills: SB294, HB296, HB300, SB269

Keywords: public officers, bonding, risk management, notification, delinquency, consumer protection, rental home, marketplace guarantees, insurance, commissioner of insurance, healthcare, breast cancer screening, insurance coverage, deductible, copayment, emergency medical services, ambulance reimbursement, health care insurers, balance billing, provider networks

Transcript Highlights:

• We are expecting additional guidance from CMS.
• :28:27.919> bulletin CMS has published anformational bulletin CMS has published anformational
• Um and in terms of whether we from CMS.
• We also need additional guidance from CMS.
• CMS.

Bills: HR1

Keywords: January 6 insurrection, pardon, law enforcement, violent crimes, public safety, justice system, political accountability, 1183, house

Transcript Highlights:

• And so we have a ticketing system, and if an agency has an issue with CMS, they can put in a ticket.
• I took over in March of 2022, following the CMS remediation.
• Amendment 7 was about that pause and CMS remediation.
• We had more of an agile approach to the CMS wave, which resulted in CMS remediation being required by
• CMS is the Centers for Medicare and Medicaid Services, our federal cognizant agency.

Summary: The subcommittee heard updates on several major technology modernization efforts, beginning with the Department of Financial Services’ Florida PALM project, which is replacing the state’s decades-old FLAIR accounting system. DFS described PALM as a statewide effort affecting all three branches of government, with cash management already live and the remaining financial management, payroll, and data warehouse components still in development. Officials said the project began in 2014, was restructured after a 2022 legislative pause, and is now being recommended for a go-live delay from January 2026 to July 2026. Members asked about governance, staffing, contract structure, cost growth, and maintenance costs; DFS said the contract is deliverable-based, the current amendment would add a net $2.2 million, and post-go-live maintenance is expected to be about $13 million annually under the current contract through July 2027. The Agency for Health Care Administration then updated the committee on the FX Medicaid enterprise modernization program. AHCA explained that federal CMS directed states to move from monolithic Medicaid systems to a modular approach, leading Florida to procure separate vendors for integration services, data warehouse, unified operations, provider services, and claims processing, with pharmacy benefits still to be procured. Officials said the project has spent about $334 million to date, with most costs federally matched, and requested $189.95 million for the upcoming year. They also highlighted a 2024 special assessment that produced 81 recommendations, most tied to staffing shortages, and said the Legislature added 47 FTEs, with 17 currently filled or being filled. Members asked about governance changes, production status, data access, and future technology maintenance; AHCA said some components are operational, the data warehouse is nearing certification, and the agency is working to keep the system adaptable and nonproprietary. The Department of Children and Families presented its Access modernization project, which is replacing a mainframe-based eligibility system used for SNAP, TANF, Medicaid assistance, and related programs. DCF said the six-year, $205 million project is in its third year and has already delivered a new customer portal with mobile access, multi-factor authentication, and fraud protections, while also building a worker portal, document management, community partner tools, and workload management functions. The agency said it is requesting $36.625 million for the next fiscal year, the same as last year, and emphasized that the project has remained on schedule and on budget by breaking work into smaller modules and using strong vendor and staff support. Members praised the project’s progress and asked about cybersecurity testing and the long delay before modernization began; DCF said security requirements were built in from the outset and that the remaining work will focus on moving staff off the legacy mainframe and modernizing notices and back-end processes.

Transcript Highlights:

• fall and what has been approved by CMS at this point.
• c><00:13:39.120> was<00:13:39.360> submitted<00:13:39.760> to<00:13:40.000> CMS
• <00:13:40.639> by<00:13:40.959> the reflect what was submitted to CMS by the reflect
• <00:13:46.560> Uh<00:13:46.880> and approved uh by CMS at this point.
• Uh and approved uh by CMS at this point.

Bills: SB367, SB368, SB350, SB351

Keywords: rural health, healthcare access, state funding, health transformation, appropriations, fiscal policy, healthcare funding, economic development, mental health, maternal health, antitrust, competition, market regulation, business practices, consumer protection, anaphylaxis, epinephrine, auto-injector, public health, school safety

Transcript Highlights:

• So the concept of Independence Plus even being recognized at the CMS level, it is no longer valid.
• And again, the Independence Plus designation is no longer one that's recognized by CMS.
• So that was our comparison that we gave to CMS, is that these are those kids.
• was our comparison that we gave to CMS was our comparison that we gave to CMS is<00:37:44.360>
• >> We would have to go back to CMS. >> We would have to go back to CMS.

Keywords: 0:06 - Roll Call 0:30 - Approval of Minutes 0:45 - OFFICE OF THE ATTORNEY GENERAL 2:08 - FINANCE AND ADMINISTRATION CABINET - OFFICE OF THE CONTROLLER 2:55 - BOARD OF DENTISTRY 5:30 - BOARD OF OPHTHALMIC DISPENSERS 7:30 - BOARD OF NURSING 8:32 - BOARD OF EMERGENCY MEDICAL SERVICES 9:30 - EDUCATION AND LABOR CABINET - DEPARTMENT OF EDUCATION, OFFICE OF DISTRICT SUPPORT SERVICES 15:35 - CABINET FOR HEALTH AND FAMILY SERVICES, DEPARTMENT FOR PUBLIC HEALTH 18:44 - CABINET FOR HEALTH AND FAMILY SERVICES, OFFICE OF THE INSPECTOR GENERAL, HEALTH SERVICES AND FACILITIES 23:39 - CABINET FOR HEALTH AND FAMILY SERVICES, DEPARTMENT FOR MEDICAID SERVICES 1:01:46 - CABINET FOR HEALTH AND FAMILY SERVICES, DEPARTMENT FOR PUBLIC HEALTH, OFFICE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS 1:03:46 - Next meeting/adjournment, 958, all

Summary: The committee first approved the minutes and then took up a series of administrative regulations from several agencies. Early items included Attorney General consumer protection rules on removal sales, health spas, liquidation sales, and nonresident sellers of visual aid glasses; Finance and Administration Controller rules on clearinghouse validation and fraud prevention; and Board of Dentistry rules updating exam requirements, controlled substance prescribing, training for neuromodulators and dermal fillers, infection control, sedation/anesthesia continuing education, and required education on pediatric abusive head trauma and controlled substance ingestion prevention. The committee also approved staff amendments on these items, generally to conform to KRS Chapter 13A, and members asked a brief question about the dentistry controlled-substances changes, which was answered as an alignment with statute. The committee next approved regulations for the Board of Ophthalmic Dispensers, Board of Nursing, and Board of Emergency Medical Services. The ophthalmic dispensers package would revise meeting and recordkeeping language, raise renewal fees, set reinstatement and apprentice-license rules, add complaint and hearing procedures, and repeal a duplicative regulation. The nursing regulations would streamline approval of training programs and require notice and documentation of site visits and deficiencies. EMS rules would create five EMS medical director certifications, set expiration and renewal requirements, require publication of disciplinary sanctions, and exempt currently approved directors before October 1, 2026. Staff amendments were adopted without objection on each set. The Education and Labor Cabinet’s school transportation regulation drew extended discussion. The agency explained the changes were intended to implement Senate Bill 46 and update references affected by later legislation, including an oral amendment to delete a subsection reference tied to KRS 160.380. The committee adopted both the agency and oral amendments without objection after brief questions about the scope of the bill changes and van transportation for students. The committee then heard a lengthy package from the Department for Public Health on WIC and related nutrition program regulations, including updates to infant and child certification periods, documentation requirements, vendor criteria, sanctions, hearing procedures, and high-risk vendor standards. Staff amendments were adopted without objection. Finally, the committee considered the Inspector General’s regulation for freestanding birthing centers, which included both staff and agency amendments. The agency changes would require two neonatal resuscitation program-certified staff, set rules for medical director vacancies and appeals, revise facility and staffing terminology, adjust transfer-agreement requirements, and allow waivers when agreements cannot be secured. Mary Katherine DeLodder of the Kentucky Birth Coalition testified in support, saying the parties had worked through concerns and were ready to move forward. The committee then moved on to Medicaid’s 1915C child waiver regulations, where staff amendments were adopted, but Lucy Heskins of Kentucky Protection and Advocacy testified against the package because it did not include person-directed services, which she said are required by Kentucky law and important for families using the waiver.

Transcript Highlights:

• and so, we want to make sure that CMS and so, we want to make sure that CMS gets<01:08:24.359>
• university to make sure that CMS university to make sure that CMS continue<01:10:48.120> to
• So, but that's the CMS. Correct.
• <01:23:02.000> So, Now, But that's the CMS. Correct. So, Now, But that's the CMS.
• organization created CMS organization created CMS and<01:30:29.800> it<01:30:29.960> was

Keywords: 912, senate, all

Summary: The committee heard several gubernatorial nominations for confirmation, beginning with GM 788 for Karen Knudsen to the Hawaii Sister State and International Partnerships Commission. DBEDT strongly supported her nomination, describing her decades of Asia-Pacific and East-West Center experience. Senators asked about the new commission structure, confirming that the old committee was abolished and replaced by a five-voting-member commission with two governor appointees before the Senate, other ex officio and legislative appointees, and one OHA vacancy still pending. Knudsen said the commission would help review new sister-state and international partnership proposals, while existing relationships would remain in place. Members also discussed the commission’s lack of a separate budget and its use of DBEDT international relations funding. The committee then moved to GM 789 for Wesley Fong to the same commission; DBEDT supported him based on his military, legal, and international trade background. A concern was raised that he also served on the State Ethics Commission, and Fong stated he had resigned from that post effective the 20th of the month to avoid a conflict. Senators questioned his reasons for leaving ethics, and he explained that his term was ending and he wanted to continue public service in a role aligned with his background in international agreements, education, and Indo-Pacific relations. No votes were taken in the portion provided. The committee next considered GM 769 for Patrick Branco to the State Foundation on Culture and the Arts. The foundation and the Hawaii Regional Council of Carpenters both testified in strong support. Branco appeared by Zoom and said he was currently on temporary military orders on the East Coast, but had prior experience in public diplomacy as cultural attaché in Caracas and had worked on Fulbright and cultural exchange efforts. The committee then took up GM 770 for Makanani Salā to the same board. The State Foundation on Culture and the Arts supported her nomination, and Noe Wong-Wilson testified in person, citing Salā’s work at Windward Community College and her role in organizing the Best Fest festival, saying she would bring Hawaiian cultural perspective to the foundation. Salā said her county experience included arts, culture, and sister-city work, and that she would emphasize public-private partnerships and helping other agencies use the foundation’s expertise. Members briefly discussed FESTPAC and its rotating international location. Finally, the committee heard GM 767 for Miles Miyatso to the Land Use Commission. The Land Use Commission and the Hawaii Regional Council of Carpenters both supported the nomination, and Avalon Development Company was listed but did not appear on Zoom. The discussion in the provided transcript ended during this item, with no vote or final action shown for the nominations covered.

Transcript Highlights:

• change on the CMS side.
• reporting back to CMS throughout those five<00:08:33.839> years.
• We'll be providing ongoing CMS.
• CMS has required a resubmission of plans to match awards.
• CMS has required a resubmission of plans to match awards.

Bills: HF1925

Keywords: nurse licensure, multistate license, healthcare, public safety, interstate compact, nursing regulation, 1183, house

Transcript Highlights:

• THE CMS ADULT AND CHILD CORSETS ESTABLISHED AND MAINTAINED BY OUR FEDERAL PARTNERS AT THE MEDICARE AND
• NEXT WE HAVE OUR CMS 416 REPORT OR ANNUAL PERIODIC SCREENING DIAGNOSTIC TESTING.
• THIS IS A FEDERALLY REQUIRED REPORT TO SUBMIT TO OUR FEDERAL CMS ANNUALLY AND DOES INCLUDE SCREENING
• CMS CALCULATES THE CHILD COURSE SET MEASURE BEFORE ON BEHALF OF ALL STATES USING THE DATA CMS CALCULATES
• LIKE THE PREVIOUS METRICS CMS CALCULATES THE MEASURE ON BEHALF OF ALL STATES USING THE DATA SUBMITTED

Transcript Highlights:

• Next, we have the CMS adult and child core sets.
• , which is federally required for states to submit to CMS annually.
• He just measures and the CMS for 16 metrics.
• Dental performance measures, some of which have been incorporated into the CMS child course.
• And we validate them using our each arrow and CMS standard profit protocols.

Transcript Highlights:

• Um, this comes from CMS. They really are looking for systems transformation.
• Um, this comes from CMS. They really are looking for systems transformation.
• Um, this comes from CMS. They really are looking for systems transformation.
• You can't play clinician salaries, although CMS is now working to clarify that.
• <01:08:48.400> administrator, points with the um CMS administrator, points with the um CMS

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:20 CRISP Shared Services 00:01:39 Rural Health Transformation Plan 00:30:55, 958, all

Summary: The Budget Review Subcommittee on Health and Family Services opened its first meeting of the 2026 interim session, took roll, and moved directly into presentations. The main presentation was from Ryan Bramble of Crisp Shared Services, who described the organization’s health information exchange and health data utility model in Kentucky and other states. He emphasized that Crisp is a nonprofit, that data ownership remains with providers, and that governance is local. He also outlined the technical infrastructure, including a master patient index, cloud-based data lake, support for modern standards like FHIR and USCDI as well as older formats, and data quality tools used to normalize and standardize information. Bramble said the model is intended to reduce duplication, lower costs, and support rural providers and future use cases such as reporting, analytics, and AI-enabled decision support. Members asked how the state can ensure the data is actually used and who should drive priorities for health care improvement. Bramble said Crisp can provide tools, expertise, and examples from other states, but local teams such as KHI and state stakeholders must tailor and lead utilization efforts. In response to questions about ownership and coordination, he stressed that successful HIE governance requires a multistakeholder body that includes hospitals, health plans, government, and other interests, with a unified approach rather than multiple competing directives. He also said the Commonwealth has an opportunity to convene those stakeholders and set clear priorities. A senator raised concerns that responsibility for Medicaid and broader health policy has become fragmented and suggested a stronger central role for the state, possibly through the Department of Public Health, to coordinate health priorities. Bramble agreed that a single convening authority and multistakeholder governance are important, and noted that local governance should determine what data is shared and how it is used. No votes or formal actions were taken during this portion of the meeting. After Bramble’s presentation and questions, the committee was told that Secretary Stack from the cabinet would testify next on the rural health transformation plan.