Transcript Highlights:

• President, there's concern about CMS and all that, and I just frankly don't understand that.
• people that understand this that are CMS people that understand this world,<01:03:13.680> right?
• department um with the federal um CMS. department um with the federal um CMS.
• Um what happened was CMS, Centers folks.
• Vote no. when CMS says, "Yeah, we're not going to when CMS says, "Yeah, we're not going to approve<01

Keywords: 1187, senate, all

Transcript Highlights:

• CMS SET CERTIFICATION IS ESSENTIAL BECAUSE IT ENSURES THE STATE'S MEDICAID SYSTEM FOR THE MODULE MEETS
• IN 2016 CMS FINALIZED THEIR RULE AND PUBLISHED REQUIREMENTS RELATED TO THIS EFFORT.
• MODULES MUST MEET MODERNIZATION CERTIFICATION REQUIREMENTS, A FEDERAL CMS IS VERY INVOLVED IN THE PLANNING
• THEN WE DO HAVE TO GO THROUGH THE OPERATIONAL READINESS REVIEW PROCESS WHICH IS A FEDERAL REVIEW BY CMS
• THIS IS SOMETHING CMS HAS HISTORICALLY NOT BEEN IN FAVOR OF WHAT A LOT HAS BEEN LEARNED AS OTHER STATES

Transcript Highlights:

• All of the information that CMS needs, or what is the sort of driver behind that?
• So these are the CMS core measures.
• And so there are not CMS core measures to compare adult utilization across the state.
• Now, if we were to have a vote with CMS, we would say, If we were to have a vote with CMS, we would say
• This is the CMS 416 report that is annually collected. This is looking at trends over time.

Keywords: 962, all

Summary: The Care Management Meeting opened with a DSS update on the PCMH program. Staff reported the program remained steady at 124 practices, 553 sites, and 2,548 providers, with some month-to-month fluctuation driven by practice consolidation, retirements, and a few practices leaving the program because NCQA requirements were burdensome. Members asked about declining provider and site counts, member attribution trends, and whether PCMH practices overlap with behavioral health homes; DSS said attribution changes are largely due to members becoming ineligible, moving, or getting other insurance, and that PCMH and behavioral health homes are separate programs that coordinate informally. The committee also discussed why some smaller practices leave the program and whether the requirements could be made easier to support retention. The committee then resumed a detailed presentation on the Husky Dental program. The presenter described the dental benefit’s history, the importance of preventive oral health, workforce and consolidation pressures in dentistry, and the lack of interoperability between dental and medical records. Network data showed year-over-year declines in enrolled dental practitioners and service locations, with access gaps concentrated in rural and eastern parts of the state. Appointment availability surveys showed average waits of 38 days for adults and 23 days for children, but much longer waits at FQHCs than private fee-for-service practices. The presenter said Connecticut remains above the national median on CMS pediatric dental quality measures, though sealant rates remain a concern, and noted that preventive care is associated with lower per-member costs. Members raised concerns about provider participation, large practices dropping Medicaid, mobile dental care, and whether the public directory accurately reflects which dentists are actually accepting new patients. The presenter said the plan uses secret-shopper calls, tracks appointment availability, and has begun using place-of-service coding to better identify school-based dental care. She also noted a new MOU with 20 Head Start programs to share data and provide oral health literacy and navigation support. The final major topic was implementation planning for HR1. DSS said CMS guidance was expected in early June and proposed using upcoming meetings to cover medical frailty, communication strategy, and data integration/ex parte verification. Committee members urged the department to create a dashboard to track disenrollments and other impacts of HR1, to build a process for complaints and problem resolution, and to think through cost-sharing, caregiver verification, exemptions, and notices. Members also asked about using existing eligibility structures such as the working-disabled program as a model. The committee agreed to move the next meeting to June 10 by Zoom, with the agenda to be circulated in advance and any PCMH Plus quality data shared if available.

Transcript Highlights:

• Do we have anybody that's talked to the CMS to find out what those standards are and when they will be
• /c><00:09:48.880> to<00:09:49.079> find<00:09:49.320> out that's talked to the CMS
• these days uh I think we anyone at CMS these days uh I think we have<00:10:06.079> somebody<00
• met with Anthem and other what CMS met with Anthem and other stakeholders<00:12:07.240> on<00
• Okay, just my team that covers this for all Anthem states has been in touch with CMS, was commenting

Keywords: 928, house, all

Summary: The subcommittee first took up House Bill 507, which concerns the timeline for credentialing mental health care providers. Members discussed and approved an amendment that removed section 2 and changed the bill’s effective date to January 1. A motion for ought to pass as amended was made, seconded, and approved by a 6-0 vote, with Representative Miles assigned to write the committee report. The bulk of the meeting focused on House Bill 705, a price-transparency measure requiring insurance-related data reporting and uniform formatting. Committee members and a representative from Anthem discussed how the bill would interact with federal requirements, including a recent presidential executive order and anticipated CMS guidance on uniformity standards. Anthem testified that the federal timeline was uncertain, that final rules could take months, and that the machine-readable files involved are complex and costly to produce. Some members argued the state should mirror federal standards but wait for final federal guidance; others said the bill should create a firm state requirement and not leave everything to rulemaking. The main unresolved issue was timing. Members debated whether the bill should be effective upon passage, apply to plan years beginning January 1, 2026, or be delayed until after federal guidance is finalized, with several references to a possible six-month implementation window after final federal rules. No final vote was taken on HB 705 in the portion provided; instead, the committee planned to revisit the bill the next morning after language was rewritten and circulated, with a straw vote anticipated before the executive session.

Transcript Highlights:

• I've got a lot of experience with CMS, so you're just going to have to listen.
• Remorseless, senseless CMS bureaucracy.
• But the insensate CMS bureaucracy takes a court order to be awakened to the harm they cause.
• CMS should let Rhode Island try humane end-of-life care through CMMI.
• Actually, you do, and that's CMS.

Transcript Highlights:

• AND WE ARE WORKING ON THE STATE PLAN AND WE WILL BE WORKING WITH APPROVAL ON THE STATE PLAN AMENDMENT CMS
• WE PROVIDE A STATE ASSURANCE PAGES IN THEIR APPLICATION PAGES HAVE BEEN SUBMITTED TO CMS.
• WE WILL CONTINUE TO WORK WITH CMS AS WE WORK THROUGH THAT PROCESS.
• ANOTHER DOCUMENT SO WE CAN WORK ON A METHODOLOGY WITH LEGISLATED PARTNERS THAT WOULD BE PALATABLE TO CMS
• ON DISH SPECIFICALLY, IS THERE ANY INDICATION SO FAR THAT WE HAVE, WHETHER OR NOT CMS AT THE FEDERAL

Transcript Highlights:

• On the federal level, the CMS interoperability and prior authorization final rule has provisions for
• On the federal level, the CMS interoperability and prior authorization final rule has provisions for
• And on the federal level, you may all be aware that very recently CMS proposed a voluntary pledge to
• And on the federal level, you may all be aware that very recently CMS proposed a voluntary pledge to
• So since then, CMS reimburses physicians and CRNAs the exact same amount, 100% of the fee.

Keywords: 995, all

Summary: The committee held a hearing on several health care access and insurance-related bills, with most testimony focused on H.1136 to improve the prior authorization process. The Massachusetts Medical Society, Massachusetts Health and Hospital Association, Health Care for All, the Leukemia & Lymphoma Society, physicians, and hospital representatives all supported the bill, arguing that prior authorization delays care, increases administrative burden, contributes to clinician burnout, and can worsen patient outcomes. Witnesses described examples involving delayed cancer treatment, diabetes care, COPD medication, shingles pain treatment, and hospital discharge delays. They said the bill would preserve prior authorization but add guardrails such as longer validity periods, continuity-of-care protections, faster responses for urgent care, clearer lists of services requiring authorization, and more transparency and standardization. The committee also heard testimony on H.1142/S.783 regarding equitable reimbursement for certified registered nurse anesthetists (CRNAs), with Senator Lovely and CRNA advocates supporting parity with physician anesthesiologists. They said CRNAs provide the same services at the same standard of care, but private insurers sometimes reimburse them at lower rates than physicians, which they argued is inconsistent with federal and state policy and harms access. Senator Keenan testified in support of a bill addressing claim denials and appeals, saying insurers should provide clearer explanations, time to resubmit claims, and timely appeal responses. Dr. Lorraine Schratz supported H.1126 to align state patient disclosure requirements with federal No Surprises Act rules, and Dr. Michael Trimbley supported H.1120 to recognize direct primary care as not being insurance and to encourage primary care participation. The committee also heard testimony on H.1140/S.801 to remove barriers to patient care by updating insurance statutes to reflect nurse practitioners’ full practice authority, and on H.1168/S.A.18 to eliminate the PCP referral requirement for specialty gynecological care. Witnesses on those bills described delays and denials affecting autism diagnosis, nutrition coverage, and endometriosis care, and said the proposals would reduce unnecessary barriers and improve timely access. After testimony and a few member questions, the chair closed the hearing; no votes were taken during the session.

Transcript Highlights:

• We’ve also had regulatory action from the Centers for Medicare and Medicaid Services, CMS.
• We anticipate a waiver that we have from CMS would be rescinded.
• And we are anxiously awaiting the proposed language from CMS.
• So some of that detail from CMS is in particular what we're waiting for.
• So we are working with all the states and CMS.

Summary: The committee first welcomed new DSHS Secretary Angela Ramirez, who introduced herself and described her background in public service, federal and state legislative work, and health and human services leadership. Members emphasized the importance of building strong relationships with her and noted her focus on protecting services, using strategic approaches in a tight budget environment, and improving partnerships with the Legislature. Ramirez said she wanted to keep communication open and that her priorities would be shaped by what she learns from lawmakers and agency partners. The next work session focused on the West Coast Health Alliance and the broader Governor’s Public Health Alliance. Department of Health and governor’s office staff said the West Coast alliance, involving Washington, Oregon, California, and Hawaii, was formed to coordinate science-based public health guidance, especially around vaccines, return-to-work guidance, and responses to federal changes. They said the alliance is intended to reduce confusion, counter misinformation, and preserve access to evidence-based recommendations, with early actions including vaccine guidance for COVID-19, flu, and RSV, a statement rejecting any vaccine-autism link, and preparation for possible ACIP changes. Members asked about workload and coordination with other regional alliances, and staff said there is informal coordination but no formal regular meetings. The committee then heard from the Washington State Health Benefit Exchange about open enrollment and the effects of federal policy changes. Exchange leaders said the expiration of enhanced premium tax credits, HR1 provisions, and immigration-related eligibility changes are affecting affordability and enrollment, with some customers facing large premium increases and some counties becoming harder to serve. They reported early open-enrollment traffic increases, nearly 10,000 new sign-ups, and nearly 12,000 active coverage drops so far, while noting that many more people may disenroll later if subsidies are not extended. They also described mitigation efforts such as silver loading, Cascade Care Savings, outreach through navigators and community partners, and planning for future HR1 requirements like ending auto-renewal and adding verification steps. In the final work session, staff from the Health Care Authority and Insurance Commissioner’s office reviewed Washington’s health reform history and the state’s current affordability and access efforts. They highlighted past ACA-related coverage gains, continued work on prescription drug affordability, PBM oversight, primary care and behavioral health access, and a pending legislative proposal to preserve access to preventive services. They also discussed federal changes affecting Medicaid and the exchange, including work requirements, six-month redeterminations, and the need to coordinate across agencies to implement new rules. Members raised concerns about network adequacy, provider access, and the complexity of the health care system, while staff said they are trying to mitigate harm, simplify administration, and keep coverage and access as stable as possible.

Transcript Highlights:

• So, does this bill help us in any way with compliance with CMS?
• coop with uh compliance with CMS? coop with uh compliance with CMS?
• Um and CMS couldn't agree with you more.
• was involved on been doing before CMS was involved on this<00:14:47.440> matter.
• from CMS from the feds uh<00:15:59.199> for<00:15:59.519> Minnesota?

Keywords: 1187, senate, all

Transcript Highlights:

• Then CMS will provide questions of the state, maybe they'll set up a meeting and say, what about this
• uh to give us feedback tell allows CMS uh to give us feedback tell us<01:24:16.639> to<01:24:
• where they typically have 90 for CMS where they typically have 90 days<01:24:36.040> of<01:24
• questions comments concerns um and CMS questions comments concerns um and CMS has<01:24:55.199><
• <01:31:54.320> will and so there are times that CMS will and so there are times that CMS will

Keywords: 1187, senate, all

Transcript Highlights:

• CMS noted in 2022 that 76% of improper payments were due to eligibility. That's $61 billion a year.
• The program needs digital health, AI, and machine learning expertise built into CMS, into each of the
• We're trying to convince our colleagues, particularly those with relationships to CMS, that if we...
• Require CMS to do that and have a clear timeline. Okay, so you'd have the Medicaid eligibility...
• Would he grab the state data and CMS do the match? Would you do a match to private data?

Keywords: artificial intelligence, waste reduction, fraud prevention, government efficiency, improper payments, data reliability, oversight

Summary: The meeting was chaired by Chairman Schweikert and involved a comprehensive discussion on how to utilize artificial intelligence (AI) for reducing waste, fraud, and improper payments within federal programs. Key witnesses, including Mr. Andrew Canarsa from the Council of the Inspectors General, provided insights on the potential of AI in enhancing government efficiency. The committee emphasized the importance of reliable data and thorough examination of AI application to avoid unintended consequences while addressing the estimated $162 billion in improper payments reported by the federal government. Concerns were raised regarding the recent firing of inspectors general and the impacts that could have on oversight and accountability processes.

Transcript Highlights:

• I'm a fourth generation CM Christian Methodist Episcopal Church.
• I'm a fourth generation CM Christian Methodist Episcopal Church.
• I'm a fourth generation CM Christian Methodist Episcopal Church.
• I'm a fourth generation CM Christian Methodist Episcopal Church.
• I'm a fourth generation CM to see me.

Bills: SB8, SB22, SB137, HB295, HB2, HB343, HB220, HB303, HB81, SB8, SB22, SB137, HB295, HB2, HB343, HB220, HB303, HB81

Keywords: emergency management, public funds, educational materials, state legislation, disaster response, uniformity, state laws, legislative commission, appointments, government structure, resilience, natural disasters, risk management, Alabama Resilience Council, Chief Resilience Officer, state planning, environmental protection, community preparedness, Alabama Office of Civic Engagement, Alabama Office of Minority Affairs

Transcript Highlights:

• We actually have to submit a budget to CMS in August.
• I will tell you we're working out with CMS.
• And has there, in the process, you said you discussed with CMS a few other things, has CMS talked about
• We are working through that as we’re doing the August submission to CMS.
• So we are working through that as we're doing the August, you know, the submission to CMS.

Summary: The committee met with a quorum, approved the March 18 minutes, and then received a series of updates on health-related projects and Department of Health and Human Services budget matters. Representatives from CHI St. Alexius in Bismarck and Williston, and Altru in Grand Forks, reported progress on behavioral health expansion projects, including demolition and construction milestones, updated timelines, funding status, staffing plans, and barriers such as an unbudgeted air handler replacement in Williston. Members asked about original completion dates, use of telehealth, recruitment of psychiatrists and other staff, and whether the new beds might reduce the need for patients to travel to Jamestown State Hospital. The projects were described as on track overall, with completion expected in 2027 for the larger builds and earlier openings for some phases in Williston. The committee then heard from HHS leadership on technical line-item transfers and the Salaries and Wages Block Grant. Donna Ockland explained that recent transfers were administrative corrections to place spending in the proper budget lines and did not involve new spending, and she reviewed FTE counts and vacancies across the department. Questions focused on behavioral health staffing changes and the use of consultants in the Rural Health Transformation Program. Pat Rainer outlined the rural health program’s first-year grants and priorities, including workforce retention, rural rotations and housing, community wellness initiatives, behavioral health promotion, safety net services, hospital equipment, suicide prevention training, technology, and EMS support. He said North Dakota’s plan was drawing positive national attention, but the department still needed to obligate roughly $199 million by September and was working with CMS on timing and compliance. The committee also received an update on certified community behavioral health clinics from Elena Zeller. She said North Dakota had been accepted as a demonstration state, with certification efforts underway in Williston, North Central, Fargo, and Dickinson. Members asked about care coordination, service growth, staffing, and whether certification would expand to all clinics; the department said it was still collecting baseline data and evaluating impacts before making future recommendations. Finally, Rebecca Askins reviewed SNAP payment error rates, explaining that the 2025 rate was finalized at 9.89 percent and that the department is working on training, system changes, and quality assurance steps to get below 6 percent. Members pressed on the causes of monthly variability, the performance of the SPACES system, and accountability for ongoing errors, and the department said it expects improvement over the next 6 to 12 months.

Transcript Highlights:

• And so if we don't have those documents or if CMS determines that we provided a service that was not
• So how is it that it's deemed by AHCCCS or CMS that it is not clinically necessary?
• So how is it that it's deemed by access or CMS that it is not clinically necessary?
• So we just kind of need to, like, flip that—seek approval from CMS kind of later in the bill.
• Because of this cap, we will need to pursue a CMS waiver.

Bills: SB1086, SB1193, SB1318, SB1345, SB1346, SB1451, SB1496, SB1611, SB1630, SB1631, SB1632, SB1672

Keywords: reimbursement, healthcare, laboratory services, noncontracting providers, Arizona health care cost containment, personal identifying information, PII, privacy, confidential records, public records exemption, commercial disclosure, data privacy, licensure, certification, health professions, health care licensing, Arizona Department of Health Services, ADHS, emergency medical care technician, EMCT

Summary: The committee first approved the February 4 minutes and then heard Senate Bill 1086, which would require AHCCCS contractors to reimburse non-contracting providers for certain laboratory services when a member was referred by a contracting provider, and would bar prior authorization for diagnostic services and retaliation tied to such referrals. AHCCCS testified neutral but warned the prior-authorization ban could increase utilization and create fiscal and federal compliance concerns. The committee adopted the Warner amendment limiting non-contracting reimbursement to no more than contracting-provider rates, then passed SB 1086 as amended on a 4-2 vote. The committee next took up Senate Bill 1611, an emergency measure to require AHCCCS to contract with an administrative services organization for program integrity and case management functions for the American Indian Health Plan, while keeping AHCCCS ultimately responsible. The chair’s amendment expanded the ASO’s duties to include provider support, quality improvement, and data analytics, removed AHCCCS claims payment authority, added more tribal observers, and exempted IHS and tribal facilities. Testimony strongly supported reforming the system after fraud and overcorrection harmed Native members and providers, but AHCCCS raised concerns about the fast timeline, possible duplication of fraud-fighting functions, and the need for 45 days of tribal consultation. The committee adopted the amendment and passed SB 1611 as amended on a 5-2 vote. Senate Bill 1630 would create a Medicaid-funded home and community-based services program for adults with serious mental illness, capped initially at 250 members under the Angius amendment, with semiannual reporting and a process for future expansion only if costs are reduced or neutral. Supporters said the bill would help the sickest SMI patients avoid repeated hospitalizations, jail, and homelessness, and could save the state general fund by shifting costs to federal Medicaid funding; AHCCCS was neutral and said it was finalizing the fiscal estimate. The committee adopted the amendment and passed SB 1630 unanimously. The committee also passed SB 1193, protecting emergency medical care technician personal information from disclosure; SB 1318, repealing an outdated state dense-breast notification requirement to align with FDA language; and SB 1345, restricting anonymous complaints against health care institutions, though AHCCCS warned that federal law may still require investigation of complaints from any source and that the bill could reduce reporting and invite litigation.

Transcript Highlights:

• We're still finalizing budget numbers with CMS.
• Uh we anticipate u numbers with CMS.
• CMS intended for there to be accountability in the program.
• this was really built and and CMS this was really built and and CMS intended<00:15:00.079> for
• Uh part of a budget narrative to CMS.

Keywords: Meeting Start 00:00:00 Attendance Roll Call 00:00:01 Department for Public Health Budget Request 00:01:46 Department for Community Based Services Budget Request 00:31:58 Certified Community Behavioral Health Clinics (CCBHC) 00:57:13, 958, all

Summary: The committee first approved the minutes, then heard a lengthy presentation from the Department for Public Health on Kentucky’s rural health transformation plan and related budget questions. Commissioner John Langfeld said the state received a $212.9 million federal award, one of the larger awards nationally, and outlined five focus areas: maternal and infant health, integrated EMS/trauma response, behavioral health and substance use disorder, oral health, and chronic disease prevention with an emphasis on obesity and diabetes. He stressed that the effort is intended to be integrated, data-driven, and sustainable, and that the federal funds cannot be used for new construction, clinician salaries, research and development, EHR replacement, or to pay for currently billable services. He also said the program carries accountability requirements and that funds can be clawed back if milestones are not met. Members pressed for clarification on duplication with other budget requests, sustainability after the five-year funding period, and how success would be measured. Langfeld said he was not aware of any duplicate funding with the department’s additional budget requests and said the rural health funds were separate from those requests. He also said the program will be tracked through specific metrics and timelines, using both execution measures and outcome measures such as readmissions, with more rapid-cycle feedback to allow course correction. Representative Fleming raised concerns about possible overlap with navigator funding and asked for more detail on the budget breakdown; Langfeld said a detailed line-item budget had been prepared but was still awaiting final CMS approval before release, and that he would explore sharing more information once restrictions were lifted. The committee then heard from the Kentucky State Public Health Laboratory about a request for a new central lab expansion. The presenter described the current 35-year-old facility as outdated and constrained by aging infrastructure, obsolete equipment, deferred maintenance, and inadequate space, and said the lab performs critical work with no in-state alternative for many services, including newborn screening, select-agent and biosafety level 3 testing, animal necropsy for rabies, genetic sequencing, environmental and food safety testing, and response to emerging infectious diseases. The project is already in design phase C, expected to finish in mid-April, with construction funding sought at roughly $276 million on top of about $35 million already approved for design. Members asked about long-term operating costs, backup arrangements, and whether the current facility would remain in use; the presenter said the current lab would continue to be used by the department while other divisions move into vacated space, and that the lab has mutual-aid agreements with the Southeast Consortium and universities for contingency support. Finally, the Department for Community Based Services began its budget presentation on SNAP and relative caregiver issues. Commissioner Lisa Dennis and budget director Misty Sammons identified the governor’s recommended budget items tied to new federal requirements under HR1, including changes affecting payment error rates. The discussion was just beginning when the transcript ended.

Transcript Highlights:

• So that's what this report details, and this was a required report that DMS submits to CMS.
• As far as covered benefits go, CMS says that Medicaid agencies cover mandatory benefits.
• As far as covered benefits go, CMS says that Medicaid agencies cover mandatory benefits.
• As far as covered benefits go, CMS says that Medicaid agencies cover mandatory benefits.
• CMS says that Medicaid agencies cover mandatory benefits.

Keywords: Call to Order and Roll Call – 00:00:00 Introduction of Board Members – 00:02:04 Overview of the Purpose and Goals of the Medicaid Oversight and Advisory Board – 00:12:46 Medicaid Legislative Update - 00:20:26 Discussion of Next Steps and Future Meeting Dates – 01:04:06 Adjournment – 01:06:37, 958, all

Summary: The first meeting of the Medicaid Oversight Advisory Board opened with Chair Ken Fleming and Co-Chair Rocky Adams welcoming members, explaining the board’s purpose, and introducing the diverse membership of legislators, providers, advocates, and state officials. Fleming said the board would meet monthly, allow public comment at the end of meetings, and operate transparently with materials posted online and distributed in advance. Both chairs emphasized that the board’s work would focus on improving Medicaid outcomes, efficiency, and oversight, while preparing for possible federal changes and avoiding premature assumptions about what Congress may do. Members then gave brief introductions describing their backgrounds in medicine, nursing, hospital administration, behavioral health, insurance, budgeting, pharmacy, and Medicaid administration. Several noted direct experience with Medicaid populations or managed care, including the Department for Medicaid Services commissioner, health plan representatives, hospital and clinic leaders, and legislators with health care backgrounds. The board also heard from Stephanie Bates of the LRC Office of Health Data Analytics, who said her office supports the General Assembly with health-related data, policy, and research and would serve as a resource to the board. Bates then began a presentation on Medicaid basics, explaining that House Bill 695 created the board and that the presentation would cover eligibility, enrollment, covered benefits, waivers, managed care, the budget, and the federal reconciliation bill. She described Medicaid eligibility as complex, noted that Kentucky had more than 1.4 million enrollees, and explained enrollment churn and the unwinding of pandemic-era continuous coverage. She also outlined mandatory and optional Medicaid benefits, the requirement that services be medically necessary and provided by enrolled providers, and the main waiver types used in Kentucky, including 1115, 1915(b), and 1915(c) waivers. No votes or formal actions were taken at this meeting beyond organizational setup and receiving the initial informational presentation.

Transcript Highlights:

• Typically uh CMS holds themselves frame.
• We put it in, and we've already had our meetings with CMS.
• already had our meetings with CMS. already had our meetings with CMS.
• They can 2026, which is typical for CMS.
• <01:13:24.400> waiver moving ahead with the CMS waiver moving ahead with the CMS waiver process

Bills: HB2488, HB2456

Keywords: disability, communication access, deaf, hard-of-hearing, deaf-blind, healthcare, sign language interpreters, auxiliary aids, weight loss, GLP-1 drugs, obesity, Medicaid, healthcare costs, 910, house, all

Summary: The committee heard testimony on HP 1972, which would create a nonrefundable family caregiver tax credit, and on a related tax measure to increase the existing dependent care tax credit. Supporters of HP 1972, including AARP, the Executive Office on Aging, the Hawaii Public Health Institute, Hawaii Children’s Action Network, and others, said unpaid caregivers are essential to keeping kūpuna and other loved ones at home and described significant out-of-pocket costs. The Department of Taxation and the Tax Foundation raised technical concerns, including the need to avoid overlap with existing credits and to prevent double-dipping. The department said taxpayers can claim credits to the extent allowed, but recommended explicit language barring the same costs from being claimed under more than one credit. No vote was taken in the excerpt, and the chair moved the bill along after questions. The committee then heard HP 1975, which would repeal the sunset on the state rent supplement program for kūpuna. AARP, Catholic Charities Hawaii, the Executive Office on Aging, and others supported making the program permanent, saying it helps low-income older adults avoid eviction and homelessness and allows them to remain in affordable housing. Catholic Charities described clients who were paying unsustainable shares of income for rent before receiving the supplement. Members also shared a constituent example of an elderly retiree who needed the subsidy to stay housed. Written support was noted from additional organizations and individuals. Next, the committee took up HB 1706, which would expand Medicaid prospective payment reimbursement to include mental health services furnished in federally qualified health centers and rural health clinics by mental health professionals under supervision. The Office of Hawaiian Affairs supported the bill, and DHS said it appreciated the intent to address workforce shortages and expand training, but cautioned that unlicensed professionals cannot currently bill Medicaid and that a state plan amendment would be needed, with limited precedent for approval. Members asked about the likelihood and timing of federal approval and whether the bill could help rural areas; DHS said approval is uncertain and the process can take time, though it saw possible alignment with the state’s rural health transformation efforts. The committee also discussed HB 546, a three-year health coverage continuity pilot program for people losing Medicaid coverage. DHS, the Attorney General’s office, DCCA, Catholic Charities, the University of Hawaii, and others testified, with DHS warning that federal changes could increase uninsured rates and that the state may need to act quickly. Catholic Charities and others emphasized the risk to Medicaid recipients, including homeless and near-elderly residents, while DHS explained the state’s existing premium assistance program for certain immigrants and compared it to the proposed pilot. The excerpt ends during discussion of that comparison, with no vote shown.

Transcript Highlights:

• In December, CMS, that's our federal regulator, the Centers for Medicare and Medicaid Services, awarded
• And that means it is a funding vehicle that has very specific parameters and very specific CMS involvement
• to manage independently like we would in a normal grant, states must collaborate directly with the CMS
• So just to be clear, again, that we haven't actually received any funding from CMS.
• discretion that the... ...involve us as a state of New Mexico versus the broad discretion that the CMS

Bills: SB193, SB132, SB35, SB145

Keywords: SB193, acequia, community ditch, irrigation works construction fund, water infrastructure, ditch infrastructure, irrigation, New Mexico water law, agricultural water, farmers, Rio Grande, acequia association, forest land protection revolving fund, state fund transfer, irrigation projects, SB132, DOIT, Department of Information Technology, software replacement, equipment replacement

Transcript Highlights:

• I'm familiar with the premise of CMS.
• We know how the CMS interprets the mandatory exemptions.
• Some of these things are going to be determined by CMS.
• Let's just do what CMS tells us to do, and we do not have to amend our Constitution and lock, you know
• Because if we have a PERM audit, which is a payment error rate Medicaid audit from CMS... ...CMS used

Keywords: 959, house, all

Transcript Highlights:

• This slide also shows that CMS is asking us to revalidate all high-risk provider agencies.
• And that should have been a flag months before CMS told you to do this, right?
• our committee, by CMS, by somebody else? our committee, by CMS, by somebody else?
• I did write a letter asking for a full audit by CMS last July and now they are working on it.
• I did write a letter asking for a full audit by CMS last July and now they are working on it.

Bills: HF3542

Keywords: data privacy, investigative data, welfare system, public funds, transparency, 1183, house