Video & Transcript Research : 'fraud reporting'
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US
US Federal 2025-2026 Regular Session
Hearings to examine insurance markets and the role of mitigation policies. May 1st, 2025 at 09:00 am
Banking, Housing, and Urban Affairs Committee
Transcript Highlights:
- I've heard reports of the Bureau of Land Management and U.S.
- Fraud is an enormous challenge in the insurance industry.
- The Coalition Against Insurance Fraud estimates that fraud against insurers is increasing costs by more
- You're talking about illegal immigrants, MS-13, and some of those related fraud incidents?
- I've seen certainly the reports that indicate they're involved, but not an expert in that area.
Keywords:
homeowners insurance, natural disasters, insurance costs, climate change, disaster preparedness, federal policies, bipartisan solutions
Summary:
The meeting reviewed critical issues surrounding the rising costs and accessibility of homeowners insurance across the United States, particularly in light of increasing natural disasters linked to climate change. Members engaged in extensive discussions regarding the implications for families and the economy, citing significant increases in premiums and decreasing availability of policies in high-risk areas. Supervisor Peysko highlighted the direct impact of federal policies on local communities, emphasizing the growing burden on homeowners as they face skyrocketing insurance costs amidst a backdrop of environmental challenges and regulatory constraints. The committee expressed a unified call to action for bipartisan solutions, focusing on improving building codes and enhancing disaster preparedness measures.
WY
Wyoming 2026 Regular Session
Joint Corporations, Elections & Political Subdivisions, May 22, 2026 - AM
Corporations, Elections & Political Subdivisions
Transcript Highlights:
- a fraud pro, excuse me, fraud problem. a fraud pro, excuse me, fraud problem.
- reporting and transparency. reporting and transparency.
- The big problem with voter fraud, in fact any fraud, is repudiation.
- fact any fraud, is repudiation. fact any fraud, is repudiation.
- So, we're we put fraud after fraud.
MN
Transcript Highlights:
- The lack of election integrity is a variant of fraud.
- And [clears throat] that is an incredible avenue for fraud.
- The lack of election integrity is a variant of fraud.
- And [clears throat] that is an incredible avenue for fraud.
- Thank you. avenue for fraud. As such, I'm offering avenue for fraud.
LA
Louisiana 2026 Regular Session
Labor and Industrial Relations May 13th, 2026
Transcript Highlights:
- We've taken out the fraud section of my bill.
- The fraud part was not taken out.
- have committed workers’ compensation fraud.
- And I think that there's a reporting system.
- And I think that there's a reporting system.
Summary:
The committee first took up Senate Bill 408 by Senator Myers, a major workers’ compensation overhaul centered on creating an all-claims medical database, requiring electronic reporting and billing, and modernizing fee schedule and claims data collection. Myers said the bill was designed to improve transparency, reduce disputes, address outliers and abuse, and help injured workers return to work faster. The committee adopted technical amendments, then considered a large amendment set combining portions of House bills 780 and 1101, which added preliminary determination procedures, fraud language, temporary total disability and supplemental earnings benefit changes, and a fallback deadline for the department to establish a fee schedule if no agreement is reached by 2029. Several members and witnesses objected that the amendments were dropped late and would turn SB 408 into an omnibus bill; supporters argued the package was the best chance for comprehensive reform. After debate, the committee adopted the amendments and reported SB 408 favorably as amended.
Testimony on SB 408 was sharply divided. Supporters, including some providers and injured-worker advocates, said the bill’s core value was transparency through the database and that the system needed modernization and a better fee schedule. Opponents argued the added amendments would burden pro se claimants, expand litigation, and weaken injured workers’ rights, especially through fraud and preliminary hearing provisions. Committee members also questioned whether the combined package was germane and whether it should be allowed to move as a single reform measure. Louisiana Workforce Commission staff explained the timeline for data collection, electronic billing, dispute rules, and eventual fee schedule rulemaking, and said the department could execute the law as amended.
The committee then turned to House Bill 585 by Representative Chasson, concerning workplace violence and safety plans for small-box discount retailers. The bill was revised through a substitute that required covered retailers to develop and submit a written workforce safety plan, or submit an existing plan if one already existed. Representative Glorioso raised concerns that requiring a written safety plan could create new civil liability under Louisiana’s assumption-of-duty doctrine and increase litigation and insurance costs. Chasson responded that the intent was simply to encourage safety planning and that businesses already had such plans. The committee discussed possible narrowing language, but the transcript ends before a final disposition on HB 585 is shown.
VA
Virginia 2026 1st Special Session
Commission on Unemployment Compensation Jul 9th, 2026
Transcript Highlights:
- We are pleased to be able to report on where we're projecting, on our projections today.
- Want to be clear today, VC collects on and works with law enforcement to prosecute all fraud.
- When folks are victims of identity theft, when, uh, All fraud.
- And we have, we've put in place systems and metrics to help us prevent that kind of fraud.
- And our fraud rate is lower than the national out. To detect it.
Summary:
The Commission on Unemployment Compensation met, established a quorum, and elected Delegate Destiny LeVere Bolling as chair and Senator Mike Jones as vice chair. The commission also adopted its electronic meeting policy and heard introductions from new members, staff, and officials from the Secretary of Labor’s office and the Virginia Employment Commission (VEC). Secretary Jessica Lumen outlined the administration’s workforce and labor priorities, including supporting workers, employers, and program transparency, while members raised concerns about business climate, job losses, labor participation, and the implementation of paid family and medical leave.
Staff provided legislative updates on recent unemployment-related bills. These included increases to the weekly unemployment benefit amount enacted in 2025 and 2026, a bill on labor dispute disqualification that changed how lockouts are treated for benefit eligibility, and a budget item providing $75,000 for actuarial support to the commission. The commission also discussed the 2025 work group on annual adjustments to weekly benefit amounts; staff reported that the work group did not complete its charge, and members agreed to revisit whether to reconstitute it at a future meeting. Delegate Martinez expressed support for continuing the work, and the chair said the issue would be taken up at the next meeting.
Deputy Commissioner Joanna Darkus gave a detailed presentation on Virginia’s unemployment insurance system, including current claims data, eligibility rules, employer tax structure, benefit levels, trust fund solvency, fraud prevention, and customer service operations. She reported that Virginia’s unemployment rate remains low, weekly claims are modest, the current weekly benefit range is $160 to $478, and the trust fund balance factor is projected at 50.9 percent, near the threshold for additional employer charges. Members asked about the taxable wage base, trust fund solvency, the effect of benefit increases, fraud controls, and the planned paid family and medical leave program. VEC said it is implementing that program through regulations, staffing, IT procurement, public listening sessions, and consultation with other states. A public commenter from the Virginia Poverty Law Center urged the commission to strengthen state investment in unemployment insurance and warned that federal support is uncertain. The commission then adjourned without taking further action.
MN
Minnesota 2025-2026 Regular Session
Governor Tim Walz Media Availability 12/4/25
Minnesota House Floor Meeting
Transcript Highlights:
- Should there be a better effort made to quantify the amount of money lost to fraud?
- And I think the important thing is... how much fraud has impacted how much fraud has impacted >>
- Do you have any concerns about the reports about how agents are conducting business?
- Do you have any concerns about the reports about how agents are conducting business?
- One of the biggest frauds, billions of dollars committed on this.
Summary:
The meeting centered on Minnesota’s budget outlook, with the governor and budget officials saying the state remains in a stronger fiscal position than expected despite national economic uncertainty. He emphasized that Minnesota has a surplus, historic rainy-day funds, and continued economic growth, and said the administration plans to continue budgeting over the horizon, using inflation assumptions and long-term planning to avoid abrupt cuts. He also defended last year’s budget compromises and said another budget proposal would be released early next year.
A major theme was the governor’s criticism of President Trump and federal actions, which he said were creating economic chaos and harming Minnesotans. He condemned Trump’s comments about Somali Minnesotans and the state, called them racist and dangerous, and argued that elected officials should denounce such rhetoric. He also raised concerns about federal immigration enforcement operations in Minnesota, saying masked agents were causing fear and confusion and that state and local law enforcement lacked communication from federal authorities.
The governor and commissioners also discussed fraud in state programs, saying the state has paused certain programs for 90 days and brought in independent forensic auditors to determine the scope of losses. He said the administration is using new stop-payment authority and referrals to the Bureau of Criminal Apprehension to prevent and prosecute fraud, while avoiding broad cuts to programs that help children, families, and vulnerable Minnesotans. In response to questions, he said the fraud total is not yet known, the audit should conclude around the end of January, and the state will use the findings to add safeguards and address program growth and health care cost pressures in the upcoming session.
US
US Federal 2025-2026 Regular Session
US House Floor Proceedings (Monday, December 1, 2025)
US Federal House Floor Meeting
Transcript Highlights:
- <00:07:26.639>
that Bureau of Labor Statistics reports that Bureau of Labor Statistics reports - and pass the bill HR 4495, the SBA Fraud and pass the bill HR 4495, the SBA Fraud Enforcement<02
- the resources to root out the fraud. the resources to root out the fraud.
- fraud simply because the clock ran out. fraud simply because the clock ran out.
- become victims of identity fraud. become victims of identity fraud.
MN
Minnesota 2025-2026 Regular Session
House Floor Session 4/27/26 - Part 2
Minnesota House Floor Meeting
Transcript Highlights:
- The clerk will report the bill. The clerk will report the bill.
- report the bill. report the bill.
- enforcement, stop fraud, and vote green. enforcement, stop fraud, and vote green.
- And from the BCA's own<01:15:05.200>
reporting own reporting own reporting last<01:15:07.680>< - report the bill. report the bill.
Summary:
The House first took up House File 1794, which would remove the post-graduate collaborative practice requirement for advanced practice registered nurses. The author and several supporters argued the bill would reduce barriers to practice, improve access to primary care and mental health services, especially in rural areas, and align Minnesota with other states. Supporters cited backing from APRN organizations and said the Board of Nursing had no concerns, while opponents, led by Representative Liebling, argued the current one-year collaborative period is a patient-safety safeguard that gives new APRNs needed experience working with physicians before practicing independently. After debate and questions about how the current requirement works in practice, the House passed the bill 119-12.
The House then considered House File 4595, which changes licensure reciprocity rules for marriage and family therapists. Representative Schumacher said the bill would expand access to mental health care at no cost by making it easier for qualified out-of-state therapists to obtain Minnesota licenses, eliminating a five-year waiting period and other barriers while maintaining standards through background checks and a jurisprudence exam. Supporters, including Representatives Bierman and Gilman, emphasized workforce shortages and the value of more therapy access for families and relationships. The Board of Marriage and Family Therapy was noted as neutral, and the bill passed unanimously, 133-0.
Finally, the House began debate on House File 4493, which would authorize pharmacists to initiate, prescribe, administer, and dispense certain drugs for opioid use disorder, including buprenorphine/Suboxone. Representative Baker said the bill would save lives by allowing people to access treatment immediately through local pharmacies, especially in greater Minnesota, and help them through withdrawal when they are most likely to seek help. The transcript cuts off during the opening of discussion on this bill, before any vote or final action is shown.
MN
MN
Minnesota 2025-2026 Regular Session
House Human Services Finance and Policy Committee 3/4/26
Human Services Finance and Policy
Transcript Highlights:
- So, it's just regarding the report.
- Uh, this regarding the report.
- um, expanding reports. One of the things um, expanding reports.
- It could be an effective fraud prevention system. I don't see any fraud out there.
- the fraud that we've exposed? the fraud that we've exposed?
Keywords:
pediatric care, hospital discharge, home care, healthcare accessibility, nursing services, family support, mental health, crisis services, Dakota County, mobile crisis response, public safety, treatment services, rehabilitation, behavioral health fund, client eligibility, home and community-based services, case management, waiver services, county services, disability advocacy
MN
Minnesota 2025 1st Special Session
Conference Committee on HF2432 5/7/25
Transcript Highlights:
- years ago in the 2023 bill to uh report years ago in the 2023 bill to uh report on<00:08:36.000>
- And it fraud section within the BCA.
- They expand supervision funding report.
- committee and change a reporting committee and change a reporting deadline<00:48:15.200>
for< - The only differences are the reporting date and the frequency of the reports.
MA
Massachusetts 2025-2026 Regular Session
Joint Committee on Emergency Preparedness and Management Jun 21st, 2026 at 01:00 pm
Joint Committee on Emergency Preparedness and Management
Transcript Highlights:
- This is unconscionable that this was going on, and nobody reported it.
- Blunt Force, trauma, spent an old, any fraud on death records.
- So I'm publicly accusing them a fraud. Will they sue me for defamation?
- So with the fraud that I'm accusing, what good are all your statistics?
- It's simply reports that the public made. people bring you those those that information it's simply reports
Summary:
The Joint Committee on Emergency Preparedness and Management held a hearing on several emergency management bills, with most of the testimony focused on Senate Bill 539, which would prohibit COVID-19 mRNA vaccination or gene-altering procedures as a condition of entry, employment, school attendance, or access to public venues. Senator Durant and many public witnesses supported the bill, arguing that COVID-era mandates were coercive, ineffective, and harmful, and that the state should not require proof of vaccination in future emergencies. One witness, Joanne Tuller, testified in opposition, saying the government should retain authority to impose public health measures in emergencies and warning against permanently limiting that power based on the COVID experience.
The committee also heard testimony on Senate Bill 540, concerning the prevention of radioactive material discharge, with a Sierra Club representative and local residents opposing Holtec’s disposal of wastewater from the Pilgrim Nuclear Power Plant and citing health, environmental, and economic concerns in Plymouth and nearby communities. Senator Driscoll testified in support of Senate Bills 537 and 538, describing them as measures to strengthen the Commonwealth’s strategic preparedness stockpile and to create a framework for emergency response during surges in hospitalizations, including temporary waivers of prior authorization when hospitals are over capacity.
In addition, Dr. Jennifer Carlson testified in support of H.885, a resolve creating a special commission on the field of emergency management, arguing that the profession should be more fully professionalized and staffed by dedicated experts rather than part-time “second hat” officials. Several other bills on the docket, including H.883 and H.84, had no sign-ups. The chair closed each bill’s testimony section as the list was exhausted, and the hearing was adjourned without any votes taken during the session.
NH
New Hampshire 2025 Regular Session
Senate Election Law and Municipal Affairs (03/11/2025)
Election Law and Municipal Affairs
Transcript Highlights:
- So the first line of the HAVA report indicated that New Hampshire town clerks mailed 23 ballots to a
- I want to be very clear: this does not represent voter fraud or anything of that type.
- We don't know. of the uh Hava report indicated that New of the uh Hava report indicated that New Hampshire
- or anything of represent uh voter fraud or anything of th<00:09:35.279>
that <00:09:35.519> - But I also want to ask this committee to look at the very few cases of voter fraud prosecuted in New
US
US Federal 2025-2026 Regular Session
US House Floor Proceedings (Thursday, June 4, 2026)
US Federal House Floor Meeting
Transcript Highlights:
- Each amendment printed in House Report 119-676 may be offered only in the order printed in the report
- Each amendment printed in House Report 119-676 may be offered only in the order printed in the report
- Each amendment printed in House Report 119-676 may be offered only in the order printed in the report
- reported from the committee on rules. reported from the committee on rules.
- >> The clerk will report the motion. >> The clerk will report the motion.
MN
Minnesota 2025 1st Special Session
House Workforce, Labor, and Economic Development Finance and Policy Committee 2/11/25
Workforce, Labor, and Economic Development Finance and Policy
Transcript Highlights:
- All in all, we are proud that we have a strong track record at DEED of preventing fraud and then also
- All in all, we are proud that we have a strong track record at DEED of preventing fraud and then also
- All in all, we are proud that we have a strong track record at DEED of preventing fraud and then also
- All in all, we are proud that we have a strong track record at DEED of preventing fraud and then also
- Commissioner, you mentioned again the fraud work and the prevention of that.
Summary:
The committee held an introductory organizational meeting for the newly named Workforce and Economic Development Committee, with Chair Dave Baker noting a quorum and that no votes or formal actions were scheduled. Members and staff introduced themselves and described their districts, backgrounds, and priorities. Several members emphasized worker protections, labor experience, small business concerns, rural economic issues, and the importance of balancing employer and employee interests. Others highlighted education-to-workforce pathways, affordability, support for seniors, and opportunities for immigrant and refugee communities.
Chair Baker said he wants the committee to find a balance between protecting labor and ensuring a strong employment base, fair rules, and fair taxes, while also acknowledging concerns about recent policy trends and the need to get proposals right before they leave the committee. Members from both parties echoed themes of collaboration and economic opportunity, though some Republicans criticized past rules and regulations as burdensome on small businesses. The committee also welcomed nonpartisan staff and DFL/GOP staff, including the committee administrator, legislative assistant, House Research, and fiscal analysis staff.
The committee then received an overview from DEED Commissioner Matt Varilek and deputy commissioners. Varilek described DEED’s mission as empowering growth of the Minnesota economy for everyone, increasing prosperity and extending it broadly, and coordinating with other agencies such as Labor and Industry to avoid duplication and use taxpayer dollars efficiently. He said DEED focuses on business attraction, retention, and expansion, workforce development, and helping Minnesotans—including people with disabilities—prepare for jobs and independent living. A deputy commissioner began outlining the economic development division’s structure and operations, but the transcript cuts off before the full presentation was completed.
KY
Kentucky 2025 Regular Session
Interim Joint Committee on Banking and Insurance (10-14-25)
Transcript Highlights:
- . fraud. fraud.
- referrals of fraud in the state. referrals of fraud in the state.
- /c> frankly I think fraud is fraud and as frankly I think fraud is fraud and as long<00:06:41.759>
- <00:07:25.919>
Hard <00:07:26.240>fraud <00:07:26.639>is fraud and soft fraud - Hard fraud is fraud and soft fraud.
Keywords:
Meeting Start 00:00:00
Call to Order and Roll Call 00:00:15
Department of Insurance Update 00:01:39
Department of Financial Institutions Update 00:37:07
Insurance Industry Update 00:54:50
Credit Union Industry Update 01:10:53, 958, all
Summary:
The committee met with a quorum, approved the September 16 minutes, and then received an update from Insurance Commissioner Sharon Clark and staff on the Department of Insurance. Clark reviewed department activity, including growth in premium volume and licensing, consumer complaints and recoveries, and a rise in fraud referrals. She said the department has 66 open fraud cases and described common schemes such as staged auto accidents, inflated repair or cleanup charges, and roofing scams. She also said the department’s investigators often prepare strong cases but face reluctance from local prosecutors, especially in Fayette and Jefferson counties, to pursue them.
Clark reported favorable workers’ compensation news, saying rates will decrease 9.7% next year for the 20th straight year. She contrasted that with a difficult property insurance market driven by storms, reinsurance costs, inflation, labor shortages, and litigation, but said Kentucky’s market remains relatively stable, citing the Kentucky Fair Plan’s small number of policies. She then warned of significant 2026 health insurance premium increases on the exchange: 16.1% for Molina, 23% for Anthem, and 37% for WCare, after CareSource withdrew. She said the rates were reviewed by actuaries and found fair, but that the biggest pressure point is the scheduled expiration of enhanced premium tax credits, which she said could leave about 90% of exchange enrollees facing a compounded increase.
Members questioned Clark about fraud prosecution, the number of people in commercial versus public coverage, and the impact of expiring subsidies. Clark said the prosecution issue is mainly with Commonwealth attorneys and that rural counties are more cooperative than urban ones. She also said the health market is individually rated and that older enrollees would be hit harder, while the loss of tax credits could push some people out of the marketplace. One member asked about the attorney general’s recent opinion on SB 188, the PBM bill; staff said attorneys were still reviewing it. Clark closed by noting that Kentucky’s fraud and towing/storage legislation has become a model for other states.
AL
Alabama 2026 1st Special Session
Alabama House Financial Services Committee Jan 28th, 2026
Financial Services
Transcript Highlights:
- Chairman, I move that we give a favorable report. >> Right. Got a motion for a favorable report.
- Chairman, I move that we give a favorable report. >> Right. Got a motion of favorable report.
- Chairman, I move that we make give a for report. >> Right. Got a motion of favor report.
- It, uh, Genius covers backing, fraud, and anti-fraud. Know your customer, know your member.
- :12:23.760>
and Genius covers backing, fraud, and Genius covers backing, fraud, and anti-fraud
Keywords:
income tax credit, tax incentive, recruitment, remote work, remote worker, recruited worker, rural counties, small counties, county population tiers, opportunity zone, teacher recruitment, nurse recruitment, law enforcement recruitment, workforce development, economic development, relocation incentive, Alabama Department of Revenue, nonrefundable tax credit, tax carryforward, state income tax
HI
Hawaii 2025 Regular Session
CPN DEFER, CPN, CPN-HHS, CPN-HHS DEFER Public Hearings 02-12-2025
Commerce and Consumer Protection
Transcript Highlights:
- We’ll also insert language that requires the HPIA to submit a report to the insurance commissioner that
- I'm a victim of gift card fraud.
- This starts to evolve on all the other things of fraud itself.
- I'm a victim of gift card fraud.
- This starts to evolve on all the other things of fraud itself.
Summary:
The Senate Committee on Commerce and Consumer Protection held decision-making on SB 146, SB 147, and SB 1166. SB 146 and SB 147, both relating to condominiums, were recommended to pass with amendments. The committee adopted amendments based on testimony from Anne Anderson, including mediator/arbitrator qualifications, clarifications about disputes involving managing agents, small claims timing, lien rights, and refund determinations by an early neutral evaluator. For both bills, the effective date was deferred to July 1, 2050 for further discussion. Each measure was adopted with no objections.
SB 1166, relating to insurance, was also passed with amendments. The committee removed language that would have required insurers to bring claims and condition rates on doing so, replacing it with encouraging language. The amended bill adds a private cause of action against responsible parties, authorizes insurer actions under certain conditions, defines terms tied to climate-related events and fossil fuel products, and requires HPIA to report to the insurance commissioner on whether it exercised direct action rights. The effective date was likewise deferred to July 1, 2050, and the measure was adopted without objection.
The committee then heard SB 985, relating to consumer protection and gift card fraud, and SB 1525, relating to electronic smoking devices and e-liquids. SB 985 drew support from a consumer fraud victim and others who said gift card scams disproportionately harm kupuna, while the Retail Merchants of Hawaii opposed the bill’s packaging/display requirements and suggested stronger penalties instead. The committee voted to pass SB 985 with amendments, deferring its effective date to July 1, 2050, and noted it would move on to Judiciary next. SB 1525 drew significant opposition from the Attorney General’s office, Department of Taxation, Department of Health, and public health groups, who argued it conflicted with federal tobacco law, was hard for Tax to administer, and would not effectively remove unauthorized vape products. After testimony, the committee recommended deferral of SB 1525 without objection.
MN
Minnesota 2025-2026 Regular Session
Motion to refer inspector general bill to judiciary committee 2/25/26
Transcript Highlights:
- fraud. Please vote yes. fraud. Please vote yes.
- fraud fraud fraud is<00:19:55.840>
amazing. - >
fraud. - on fraud. on fraud.
- Fraud requires action. enough. Fraud requires action.
Summary:
The House considered a motion by Representative Nash to recall Senate File 856 from the Committee on State Government, Finance, and Policy and re-refer it to Judiciary, Finance, and Civil Law. Nash argued the bill, which concerns creating or empowering an inspector general to address fraud, had already received two hearings and should move quickly because time was limited. Supporters of the motion said the bill needed further work on constitutional and data-practices issues in Judiciary, and that holding it in State Government would delay or effectively kill it.
Opponents of the motion, led by Representative Cleorne, argued the bill should remain in State Government because that committee was the proper place to address constitutional concerns and other substantive changes. Cleorne said the committee had already considered a delete-everything amendment and nine amendments, with only two adopted, and maintained the bill as amended raised separation-of-powers concerns. Other members said the bill had bipartisan support in the Senate, passed 60-7, and that further negotiations should happen in a working group rather than through floor maneuvering.
The debate focused heavily on whether the bill’s structure for selecting an inspector general was constitutional and whether the motion was an attempt to speed the bill along or to block it. Representative Norris said nonpartisan staff, the legislative auditor, and Senate and House authors had all indicated the bill needed fixes to be constitutional. After a roll call vote, the motion failed 67-66, so Senate File 856 remained in the Committee on State Government, Finance, and Policy.
KY
Kentucky 2025 Regular Session
House Standing Committee BR Sub. on Health & Family Services (2-12-25)
Transcript Highlights:
- <00:21:37.720>
to have that behavoral Health Report to have that behavoral Health Report to - We have quarterly and annual reports.
- We have quarterly and annual reports.
- We have quarterly and annual reports.
- to just talk a little bit about fraud to just talk a little bit about fraud View<00:37:52.280>
Summary:
The Budget Review Subcommittee on Health and Family Services held its first meeting and received an overview from the Department for Medicaid Services on Medicaid’s behavioral health and substance use disorder services. Commissioner Lisa Lee and CFO Steve Beal said Kentucky Medicaid serves about 1.4 million members, including over half of Kentucky children, with 485,000 expansion members, more than 69,000 enrolled providers, and total fiscal year 2024 expenditures of $18.5 billion. They said Kentucky covers a broad range of behavioral health services, and behavioral health provider enrollment has grown from a little over 4,500 in 2019 to nearly 8,000 in 2024. They also described how Medicaid spending and utilization are tracked through claims and encounter data, with most members served through managed care organizations.
Members focused on sharp increases in certain behavioral health billing codes, especially peer-to-peer services, and asked about reimbursement, utilization review, and whether the growth reflected increased need or expanded coverage. DMS said the rise was partly tied to combining facility and nonfacility behavioral health fee schedules in 2023, choosing the higher reimbursement rate to avoid cuts, and that the department has seen an uptick in peer-to-peer services. In response to concerns about overutilization, DMS said it mailed a letter to behavioral health providers, is considering limits and prior authorizations for some services, and plans to create a standardized monthly behavioral health report to monitor trends consistently and identify when controls may be needed.
Lawmakers also asked whether the provider network is sufficient and whether access is adequate, especially for children. DMS said provider enrollment has expanded because behavioral health services were added to Medicaid in 2014 and because demand increased after COVID, but acknowledged studies showing children have less access than adults and said that would be an area of focus. The department said managed care organizations are required to ensure access to needed services and that current trends indicate access is available, though one member disagreed and said workforce shortages remain a major concern. Another member asked about non-emergency medical transportation spending, and DMS explained that it is handled through a capitated arrangement administered by the Transportation Cabinet rather than directly by the managed care organizations.