Transcript Highlights:

• Now that's part of the FMAP, so 63.4% of that money comes from the federal government.

Keywords: 1182, all

Summary: The Senate Committee on Health and Human Services held a fourth hearing in its ongoing review of alleged fraud, waste, and abuse involving AHCCCS/Access and DHS, with a major focus on Medicaid eligibility verification for the aged, blind, and disabled (ABD) population, behavioral health and sober living oversight, and payment delays to providers. Senator Shamp presented findings she said showed major gaps in ABD asset verification, including claims that only a fraction of enrollees were checked and that many ineligible members may remain on the rolls. She urged referrals to law enforcement, tighter verification requirements, better PARIS data sharing, and legislative changes to close what she described as a compliance and taxpayer-risk gap. Reva Stewart also testified that patient brokering and fraudulent recruitment of vulnerable people, including Native Americans, continues through social media and other channels, and she called for stronger enforcement and transparency. Heather Dukes, representing behavioral health and sober living operators, argued that the state’s response to fraud has become overly punitive toward legitimate providers. She said ADHS often sends technical paperwork deficiencies straight to enforcement instead of allowing plans of correction, that zoning approvals are being questioned despite not being within ADHS authority, and that long Access approval timelines are creating licensing and billing delays. ADHS Deputy Assistant Director Tiffany Slater said the department has seen a large volume of unlicensed complaints, that it is trying to improve staffing and data systems, and that some enforcement tools have been expanded for sober living homes. She also said many sober living operators are in recovery themselves and provide low-cost housing and support rather than direct billing to Access. Access Director Virginia Roundtree said the agency is trying to balance fraud prevention with support for legitimate providers. She reported steps such as daily internal huddles, live dashboards, added project management support, an outside review of the Division of Fee-for-Service Management, and a new external claims vendor to help reduce backlogs. Senators pressed her on a specific provider’s long-delayed payments and prepayment review, and she said the agency would provide answers early the following week. Access staff also described provider resolution roundtables and said unadjudicated claims had been reduced to zero, though members questioned whether that was due to denials rather than resolution. The hearing ended with the chair announcing legislation to preserve the American Indian Health Plan as a fee-for-service option while requiring Access to contract administrative and care management functions to another entity, citing structural failures in Access’s ability to operate the plan safely and effectively.

Transcript Highlights:

• There were changes in the FMAP rate and things like that over the course of implementation.

Summary: The subcommittee heard a lengthy presentation on the Agency for Persons with Disabilities’ I-Connect system, based on an ILAB assessment of the platform’s performance and requirements. ILAB said the system provides useful centralized records, reporting, compliance support, and audit trails, but users described it as cumbersome, outdated, and inefficient, with excessive manual entry, weak navigation, limited notifications, no mobile app, poor printing/export options, and performance issues. ILAB also said the original 2013-era requirements were too high-level and that only a portion of the requirements could be verified, with some features de-scoped or never implemented. Their recommendations included better integration with electronic health record systems, improved performance monitoring, electronic signatures, OCR, and more modern export and verification tools. Public testimony from providers and advocates echoed those concerns. A support coordination provider said the system is nicknamed “I Disconnect,” described problems with EVV/GPS sign-ins, lengthy support plans, lack of a phone app, and possible HIPAA concerns. Another advocate said the system should have preserved family access to records and criticized the need for providers to use workarounds and additional software. APD staff said the agency has spent about $19.7 million through FY 2023-24, has regular build updates under the current contract with WellSky, and uses an internal help desk and vendor ticketing process to triage bugs versus enhancement requests. They said some issues are handled case-by-case, critical tickets have SLAs, and the agency is working on interoperability and other requested improvements. Members questioned whether the system should be fixed or replaced, whether the original contract and SaaS arrangement were sufficient, and whether the state received value for the money spent. APD said the system went live in phases and that all functionality was in place by June 2024, while ILAB and members noted significant technical debt and unresolved gaps. The committee also discussed record retention, provider access to records after a consumer changes providers, and whether federal funding or compliance could be affected. The meeting ended with broader budget remarks emphasizing completion over expansion, stronger upfront planning for technology projects, and more accountability before funding new systems or major enhancements.

Transcript Highlights:

• states have with in order for, I believe everybody knows, but if they don't know, the state gets 100% FMAP

Keywords: 1182, all

Summary: The Senate opened with prayer and the Pledge of Allegiance, recorded attendance, approved the journal, and welcomed several guest groups, including the City of Maricopa Youth Council, students from Alpha School in Scottsdale, Brianna Andrew, and students from Gilbert Edu-Prize. The chamber also adopted a proposed amendment to Senate Rule 7A and then adopted the rules of the 57th Legislature, and the President announced a temporary committee appointment for Senator Shamp and a request to adjourn after Wednesday’s session until Monday, March 16. The floor then considered a long list of bills, with several third-reading votes. Measures that passed included SB 1654 on elections funding, SB 1711 on school safety-related information, SB 1743 on campaign contribution address disclosure, SB 1747 on access technology content, SB 1284 on moving violations, SB 1336 on State Land Department issues, SB 1365 on property tax exemptions for veterans, SB 1655 on juror summons/poll worker service, SB 1662 on probation, SB 1803 on Department of Veterans’ Services claims assistance, SB 1494, SB 1497 on school insurance, SB 1503 on pension benefit plans, SB 1584 on Department of Corrections recruitment, SB 1632 on DES, SB 1723 on bail, SB 1206 on insurance claims, and SB 1827 on aviation. Several bills failed, including SCR 1047 on marijuana establishment licenses, SB 1134 on political signs before reconsideration, SB 1544 on probation, and SB 1585 on sex offender monitoring. SB 1134 was later reconsidered and passed. Many of these votes featured debate over elections administration, privacy, health care access, veterans’ benefits, probation, and public safety. The Senate then resolved into the Committee of the Whole for Calendar One and later Calendar Two. In Committee of the Whole, members adopted amendments and recommended do pass on SB 1009, SB 1050, SB 1054, SB 1071, SB 1086, SB 1317, SB 1461, and SB 1672, with discussion focusing on school training standards, veterans’ park passes, local measures, Arizona Rangers oversight, AHCCCS provider reimbursement, reentry programming, allied health workforce development, and anti-psychotic drug authorization. On Calendar Two, the committee also advanced SB 1173, SB 1234, SB 1295, SB 1611, and SCR 1022 after amendments and extended debate, especially on AHCCCS fraud, juvenile court proceedings, inmate medical release, and the American Indian Health Program. The Committee of the Whole report was adopted, the bills were properly assigned, and committee announcements were made for the next day’s meetings.

Transcript Highlights:

• As you see the line going upward, you can see that that's when we were receiving the increased FMAP.

Keywords: 924, joint, all

Transcript Highlights:

• And the problem is, you know, as the federal dollars decline, Medicaid and the FMAP match...
• ><02:18:20.240> Medicaid<02:18:20.719> and<02:18:20.960> the<02:18:21.120> FMAP
• <02:18:22.080> uh<02:18:22.639> match you know, Medicaid and the FMAP uh match you
• know, Medicaid and the FMAP uh match just just just >> I<02:18:23.920> remember<02:18:24.080

Keywords: 920, all

Summary: The Alabama Senate convened with prayer, the pledge, and a roll call establishing a quorum. The chamber approved routine motions to excuse absent senators, dispense with the previous day’s journal, and allow introduction of bills and committee reports throughout the day. The Senate also received several House messages referring bills to committee, including local constitutional amendments for Limestone, Blount, and Mobile counties, a human cloning bill, a Fair Campaign Practices Act bill, a public education bill, a court fees bill, and a physician assistance bill. Committee reports were then taken up. The Finance and Taxation General Fund, Confirmations, State Governmental Affairs, County and Municipal Government, Education Policy, Banking and Insurance, Fiscal Responsibility and Economic Development, Transportation and Energy, and Local Legislation committees all reported a number of bills favorably, many with amendments or substitutes. Several measures were advanced to the calendar for the next legislative day, and the Senate confirmed multiple appointments, including Eileen Meyer and Tiffany Martin to the Alabama Board of Midwifery, Jennifer Ag, Jerry Gross, and Edgar Hower II to the University of West Alabama Board of Trustees, Patricia Sims, Tony Cochran, and Sandy Stimson to the Alabama State Port Authority Board of Directors. The Senate then adopted a special order calendar under Senate Resolution 34, setting the order of business for the 10th legislative day. The main floor debate centered on House Bill 161, the App Store Accountability Act, which was described as a child-protection measure requiring parental permission, age verification by app stores, accurate app age ratings, and limits on minors entering contracts through app downloads. Senators speaking in support said the bill was needed to protect children from harmful online content and preserve parental control, and they discussed an amendment clarifying the meaning of “act” and preserving compliance with other state age-verification laws. The debate was ongoing in the portion provided, and no final vote on HB 161 appears in this excerpt.

Transcript Highlights:

• Representative Noe: So the question is, the FMAP percentage that we get as a state, it keeps on fluctuating
• Representative Noe: So the question is, the FMAP percentage that we get as a state, it keeps on fluctuating
• that fluctuates lowest end almost if that fluctuates does Representative Noe: So the question is, the FMAP

Keywords: 1183, house

Transcript Highlights:

• The other thing is we like to show you all the blended FMAPs that we assume.
• The other thing is we like to show you all the blended FMAPs that we assume.

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

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

Transcript Highlights:

• example of this, where standard Medicaid we get 50-50% matching federal funds, often referred to as FMAP
• The CEO of New Hampshire Hospital will be presenting later today. federal often often referred to as FMAP
• federal often often referred to as FMAP is<01:01:36.160> the<01:01:36.319> acronym<01:
• would not only be able to take advantage of the 50/50, but this would also impact where we have higher FMAPs
• would not only be able to take advantage of the 50/50, but this would also impact where we have higher FMAPs

Keywords: 1191, senate, all

Transcript Highlights:

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

Keywords: 1204, all

Summary: The Legislative Joint Auditing Committee met on June 5 and first adopted the March 2026 minutes, then approved reports from the executive committee and the standing committees on counties and municipalities, educational institutions, and state agencies. The counties and municipalities report noted progress on delinquent private water and sewer audits, compliance improvements by Denning and Gum Springs, and a 60-day compliance window for Omer and Fargo; several reports were deferred, while others were referred to prosecutors, the Attorney General, or the Government Bonding Board. The educational institutions committee filed 103 audit reports, including findings for several school districts, and one Booneville School District finding was referred to law enforcement. The state agencies committee filed 13 reports and deferred one Department of Health report to August. The committee then reviewed the State of Arkansas annual comprehensive financial report and single audit for fiscal year 2025. Legislative Audit reported clean opinions on the state’s financial statements, but identified two material weaknesses: insufficient internal controls at the Office of State Technology over threat monitoring and unauthorized access, and problems at the Division of Workforce Services with changes to year-end accounting estimates and documentation for unemployment-related receivables and payables. The single audit covered $12.4 billion in federal awards across 469 programs, with 16 major programs reviewed; auditors reported 33 findings, including 31 federal findings, $12.9 million in outstanding questioned costs, and qualified opinions for the Summer EBT program, the Coronavirus Capital Projects Fund, and the Child Care Development Fund cluster. Findings included improper advance draws and reporting issues in Summer EBT, documentation problems in broadband projects, and reporting/reconciliation issues in child care funding. Members questioned agency officials from DHS, the Office of State Technology, the Department of Finance and Administration, the Department of Education, and Workforce Services about the findings and corrective actions. DHS said the Summer EBT issue involved drawing funds in advance and that procedures had been changed for the 2026 cycle; it also explained several repeat findings as timing or provider-enrollment issues. OST officials said they were expanding logging, endpoint detection, and enterprise monitoring, and described cybersecurity as a moving target requiring more investment and training. DFA and Workers’ Compensation officials discussed the workers’ comp fund’s actuarial position and said it should be monitored but did not require immediate action. Education officials said the child care reconciliation problems stemmed from a former employee’s failure to reconcile reports, that staffing and checks had been strengthened, and that the federal funding cut affecting child care was a separate issue. The committee voted to hold the two major state financial reports over until the August meeting, with members asked to submit specific questions in advance, and then received a special report on the Hot Spring County Solid Waste Authority review.

Transcript Highlights:

• So, if the FMAP or the SHOP is reduced, can the 16% cover the cost? No. What are you gonna do?

Keywords: 914, all

Transcript Highlights:

• It limits the federal matching payment for emergency Medicaid to the match. for the state's regular FMAP

Keywords: 988, house, all

Transcript Highlights:

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

Summary: The committee met to adopt prior minutes and reports from its executive and standing committees, including counties and municipalities, educational institutions, and state agencies. Those reports covered routine audit activity, delinquent private water and sewer audits, municipal accounting compliance issues, education audit findings, and several state agency audit items. The committee also reviewed and adopted the State of Arkansas annual comprehensive financial report for fiscal year 2025 and the related single audit report, both presented by Legislative Audit staff. The state financial report showed unmodified opinions on the state’s financial statements and described total assets of about $41.9 billion and liabilities of about $11.1 billion, along with retirement system assets of $39.9 billion and a net pension liability of $9 billion. Two material weaknesses were identified: insufficient internal controls at the Office of State Technology to monitor threats and unauthorized access, and a Division of Workforce Services methodology change for unemployment-related estimates that was not properly documented or approved. The single audit covered $12.4 billion in federal awards across 469 programs, with 16 major programs reviewed; it resulted in 33 findings, 14 with questioned costs totaling $16.6 million, and qualified opinions for the Summer EBT program, the Coronavirus Capital Projects Fund, and the Child Care Development Fund cluster. Members questioned agency officials in detail about the Summer EBT questioned costs, DHS unresolved findings, broadband grant documentation, cyber security controls, workers’ compensation liabilities, and child care funding and reporting. DHS explained that the Summer EBT issue involved drawing federal funds in advance rather than as benefits were redeemed, and said the process has been corrected. Broadband officials said the questioned $6.6 million reflected documentation-detail disagreements across many invoices rather than missing payments. OST officials described new logging, endpoint detection, and phishing-training efforts, and DFA and Education officials addressed specific audit findings and corrective actions. The committee ultimately moved to hold the two large statewide reports over until the August meeting for further review, with discussion continuing on whether to release some agency staff in the meantime.

Transcript Highlights:

• It just amends to stay the healthcare authority can only access the FAP Preservation Fund if FMAP rates

Bills: HB4030, HB4031, HB4032, HB4033, HB4034, HB4035, HB4036, HB4037, HB4038, HB4039, HB4040, HB4041, HB4042, HB4043, HB4044, HB4045, HB4046, HB4047, HB4048, HB4049, HB4050, HB4051, HB4052, HB4053, HB4054, HB4056, HB4057, HB4065, HB4067, HB4071, HB4072, SB1144, SB1145, SB1146, SB1147, SB1148, SB1149, SB1156, SB1157, SB1158, SB1159, SB1161, SB1162, SB1163, SB1164, SB1165, SB1166, SB1167, SB1174, SB1175, SB1176

Keywords: education funding, budget appropriations, public schools, teachers' retirement, early childhood education, aeronautics, infrastructure, funding, sustainability, Oklahoma, mining, operator fees, coal production, noncoal mining, department of mines, revenue, state budget, budgetary reform, financial legislation, fiscal accountability

Transcript Highlights:

• It would go through the normal FMAP process and would be additional dollars available specifically for

Keywords: 996, all

Transcript Highlights:

• the one thing that didn't show up that we were a little bit worried about are the last bullet, any FMAP

Transcript Highlights:

• So in FY 25, our FMAP decreased by 0.91% and that ended up costing us almost $70 million that year.

Transcript Highlights:

• to implement Medical Aid in Dying where we only use state funds rather than federal funds through FMAP
• c><01:57:34.599> funds<01:57:35.159> U<01:57:35.280> through<01:57:35.599> fmap
• rather than federal funds U through fmap rather than federal funds U through fmap U<01:57:36.719

Keywords: 910, house, all

Summary: The joint hearing opened with House Bill 1462 on crisis services. Testimony from the Department of Law Enforcement, the Community Alliance on Prisons, and the Department of Health supported expanding behavioral health crisis services as an alternative to arrest or incarceration. Witnesses said additional crisis sites would help divert people in mental health crisis to appropriate care, and the Department of Health described its current crisis center in Ewa, including the need for renovations such as a padded room and the time required to get the facility operational. In response to questions, the department estimated the Ewa center’s budgeted cost at about $4.3 million, not including rent or startup repairs, and said a second site’s cost would depend on whether it was freestanding or attached to an existing facility. The committee then heard House Bill 700 on cognitive assessments. The Executive Office on Aging supported the bill’s intent but asked that it be amended to make assessments optional rather than mandated, to pilot the program first, and to allow flexibility in handling HIPAA-protected data. SHPDA also supported the measure but said it should not be mandatory and suggested that payers reimburse for assessments when requested by patients, families, or physicians. The Alzheimer’s Association and caregivers strongly supported standardizing cognitive assessments to improve early detection and access to newer treatments, while noting the existing opt-out provision. The Hawaii State Council on Developmental Disabilities supported the bill but asked that the age 65 threshold be removed because cognitive decline can begin much earlier for people with Down syndrome, autism, traumatic brain injury, stroke, and related conditions. In response to a question, the Office on Aging said a pilot project could likely be done for about $150,000, with data security being the main added cost. The final bill discussed was House Bill 237 on peer support programs. Testimony from Family Hui Hawaii, Early Childhood Action Strategy, peer support workers, and families described peer-to-peer programs as a cost-effective way to reduce isolation, strengthen families, and provide long-term community support. Speakers said these programs help parents and caregivers navigate crises, child welfare involvement, addiction recovery, and other challenges, and can have lasting benefits for children’s development and family stability. Several witnesses tied the bill to broader state goals, including infant and early childhood mental health, trauma-informed care, and child welfare reform. Written testimony from about a dozen organizations and individuals was also noted in support.

Transcript Highlights:

• It limits the federal matching payment for emergency Medicaid to the match for the state's regular FMAP

Summary: The Assembly Budget Subcommittee on Accountability and Oversight held its fifth hearing of the year to examine the newly enacted federal H.R. 1 and its effects on California. Members and the chair described the law as a major threat to state health, food, education, and climate programs, and emphasized that California would not be able to fully backfill the federal cuts. Several members also highlighted the bill’s tax provisions, including temporary deductions for tips, overtime, seniors, and auto loan interest, while warning that the largest benefits flow to higher-income taxpayers and that major cuts to Medi-Cal, CalFresh, and clean-energy incentives are delayed or phased in over time. The Legislative Analyst’s Office and the Department of Finance presented detailed overviews of the bill’s likely impacts and implementation timelines. They identified the main affected areas as health care coverage and financing, food assistance, higher education, personal income taxes, and clean-energy/electric-vehicle credits. They explained that H.R. 1 limits provider taxes used to finance Medi-Cal, adds work and redetermination requirements, restricts CalFresh eligibility and increases state costs, changes student loan and Pell Grant rules, extends and modifies federal tax provisions, and phases out many clean-energy credits. Finance also noted major rescissions of Inflation Reduction Act funds, new border and immigration enforcement spending, and the possibility of PAYGO sequestration if Congress does not act to offset the deficit increase. During member questions, the committee focused on likely enrollment losses, administrative burdens, and fiscal exposure for the state and counties. Witnesses said many details still depend on federal guidance, but they estimated significant impacts on Medi-Cal, CalFresh, and graduate/professional student borrowing, and noted that California’s high CalFresh error rate could increase state costs. UC testified that the elimination of Graduate PLUS loans would affect thousands of professional students, especially in health, law, and other high-cost programs. Members asked for follow-up data on county, health, and tax impacts, and staff agreed to provide additional tables and estimates as implementation guidance becomes clearer. Public commenters from counties, early childhood advocates, health coalitions, disability rights groups, immigrant-rights organizations, and other stakeholders urged the Legislature to mitigate the law’s effects. They warned of higher county costs, reduced access to health care and food assistance, increased administrative burdens, and harm to children, immigrants, people with disabilities, and low-income families. Several urged new state revenue solutions and stronger protections for Medi-Cal, CalFresh, child care, and home- and community-based services. No votes were taken; the hearing was informational and ended with a commitment to continue monitoring federal guidance and to work on state responses in the budget process.

Transcript Highlights:

• in an area where you and I spoke about with the federal investment in Medicaid, which is known as FMAP

Transcript Highlights:

• It's a partnership, usually 60/40, depending on the FMAP.
• those cases, we were seeing that a lot of states were using it as a Mechanism to lower their overall FMAP

Summary: The Senate Committee on Health and Human Services convened to discuss interim charges regarding fraud, waste, and abuse in Texas human services, particularly focusing on Medicaid and childcare programs. The meeting highlighted the importance of preventing misuse of taxpayer funds, with testimony from various stakeholders emphasizing the need for increased oversight and accountability in these programs. Key points included the alarming rise in healthcare fraud in other states, the necessity for Texas to enhance its fraud prevention measures, and the potential financial repercussions of failing to meet federal compliance standards. Several committee members expressed concerns about the impact of fraud on vulnerable populations, particularly those relying on Medicaid services. Testimonies from experts underscored the effectiveness of Texas's Office of Inspector General (OIG) in combating fraud, yet pointed out existing vulnerabilities, such as inconsistent enforcement and the need for better data sharing among agencies. The discussion also touched on the challenges faced by hospice care providers, with a significant increase in the number of hospices in Texas raising concerns about quality and oversight. The committee heard from various witnesses, including representatives from health plans and advocacy organizations, who provided insights into the complexities of managing Medicaid and the importance of maintaining program integrity. The meeting concluded with a commitment to further explore legislative solutions to enhance oversight and ensure that resources are directed to those in genuine need.