Transcript Highlights:

• And then on the long-term care side, we actually have a team of nurse reviewers.
• Again, we have that 360 review underway.
• That gives us very little runway to get out $14 million in reviewing provider applications.
• Every three years, states are reviewed.
• The reduction here we're planning to reduce our external quality review contract expenditures.

Summary: The House Health and Welfare Committee approved the February 5, 2026 minutes and then heard a lengthy budget presentation from Department of Health and Welfare Director Juliet Sharon and Medicaid Director Sasha O’Connell. The department outlined numerous supplemental and line-item requests across Medicaid, child and family services, welfare/self-reliance, and support functions, including funding for state hospital billing authority, Medicaid caseload and cost growth, rural health transformation staffing and program funds, child care capacity and program integrity work, kinship navigation, home visiting, and IT and procurement modernization. The committee also discussed the department’s reorganization and the need for additional procurement support for large Medicaid contracts. Much of the discussion focused on Medicaid spending growth, especially in disability services and behavioral health. Sharon said higher utilization and more intensive services, including residential habilitation, youth residential treatment, and substance use services, were driving costs. Members asked about safeguards against provider overuse or steerage; the director said the department uses annual assessments, internal reviews, data mining, and referrals to program integrity, and that some provider behavior had already prompted a proposed rate reduction for residential habilitation. She also explained that the department is seeking to maintain contractor support for disability assessments rather than absorb the work in-house. The committee also reviewed the department’s response to budget reductions and federal changes. Sharon explained the 4% provider rate reduction, the resulting savings, and the need for an additional $22 million in general funds to balance Medicaid, with options for further cuts still before the legislature. Other topics included the state’s Medicaid estate recovery and program integrity contractors, the impact of new SNAP administrative cost-sharing rules, Medicaid work requirements and more frequent eligibility reviews under state and federal law, and a request for three dedicated procurement staff in the Department of Administration to speed Medicaid contracting. No further votes were taken beyond approval of the minutes, and the committee adjourned to attend the floor session.

Transcript Highlights:

• , we go back and we re-review the top 10%.
• State and international students coming in under that holistic review?
• So that holistic review is actually.
• So you're saying in your holistic review, you have percentages within that holistic review that are limiting
• But everybody gets a holistic review. Okay. And so if it were lower.

Bills: HB42 , HB 125 , HB 1233 , HB2853 , HB3148 , HB3326 , HB3701 , HB4066 , HB4361 , HB4762 , HB4909 , HB4912 , HB42 , HB125

Committee: House Higher Education

Keywords: higher education, funding, financial allocation, state budget, Texas A&M University, University of Houston, education funding, medical education, osteopathic medicine, healthcare workforce, Tarleton State University, industry-recognized credentials, workforce development, career opportunities, feasibility study, student fees, university funding, student union, education, UT El Paso

Transcript Highlights:

• They've been reviewed. They've been re-reviewed by the federal government.
• </c> reviewed.
• They've been review reviewed.
• </c> re-reviewed by the federal government. re-reviewed by the federal government.
• If there they review review everything.

Committee: House Agriculture

Keywords: Meeting Start: 00:00 Attendance Roll Call: 00:15 HB 195 Discussion: 05:22 HB 195 Roll Call Vote: 16:33 SB 199 Discussion: 18:34 SB 199 Roll Call Vote: 41:25 SB 5 Discussion: 43:50 SB 5 Roll Call Vote: 46:35 HB 687 Discussion: 48:10 HB 687 Roll Call Vote: 50:15, 958, all

Transcript Highlights:

• </c> clarifies that we're reviewing clarifies that we're reviewing ordinances<00:26:59.399><c> not</c
• </c> subcommittee is our cycle of reviewing subcommittee is our cycle of reviewing the<00:45:37.720><
• We're reviewing the 2024; we reviewed 2021 last year here.
• </c> we're reviewing the 2024 we reviewed we're reviewing the 2024 we reviewed 2021<00:46:56.280><c>
• I think that we’ve heard that the building code review board is still working on that and reviewing it

Keywords: 928, house, all

Summary: The subcommittee first took up HB 428, with Philip Sherman of the Building Code Review Board presenting a detailed amendment intended to reorganize building-code statutes and limit local changes. He said the proposal would move code-related provisions into RSA 155-A, preserve municipalities’ ability to adopt and administer local enforcement mechanisms and additional non-state codes such as housing or property maintenance codes, but prohibit technical amendments to the State Building Code. He also explained that local administrative functions like permits, fees, certificates of occupancy, plan review, and staffing would remain local, while any local ordinance would still need BCRB confirmation. Members discussed the distinction between administrative and technical amendments, the need to keep fire-code provisions separate, and a date error in the draft’s submission deadline; Sherman suggested the effective-date language should be corrected to reference July 1, 2024. The committee did not vote on the amendment and instead agreed to circulate the draft and revisit it in a later subcommittee meeting before bringing it to the full committee. The discussion then shifted to fire-code issues, with State Fire Marshal Sean Tumi explaining that fire-code-related provisions should be cleaned up in the fire-code statutes and that the state should restrict technical local amendments while possibly allowing limited administrative local standards for transparency and operational consistency. He gave examples such as driveway access, sprinkler connections, key boxes, and other fire-system details that could benefit from local standardization if clearly disclosed. He noted that a separate Senate bill, SB 94, may be a more appropriate vehicle for some of the fire-code language. The chair again emphasized the need for further review and scheduled another subcommittee meeting before the matter would go to the full committee. The committee then began HB 244, and Sherman introduced it as a cleanup of the older municipal-building-code provisions scattered through the RSA 67X series. He said the bill would consolidate and update those references, continuing the effort to align municipal enforcement and appeals provisions with the statewide building-code structure. The transcript cuts off before any further action or vote on HB 244.

Transcript Highlights:

• The review panel piece is where we would be looking at now. The applications have been reviewed.
• </c> under Legacy then we would only review under Legacy then we would only review the<01:10:46.600><
• </c> portion would not proceed to the review portion would not proceed to the review panel Once you've
• panel would be denied so the review panel would be reviewing<01:13:37.360><c> the</c><01:13:37.560><
• by the review panel at this level.

Committee: Senate Environment, Climate, and Legacy

Keywords: 1187, senate, all

Transcript Highlights:

• The Claims Review Litigation Reports Oversight Subcommittee met on Tuesday, April 14th.
• The Claims Review Litigation Reports Oversight Subcommittee met on Tuesday, April 14th, reviewed two
• The peer review subcommittee met yesterday, April 15th.
• K2 discretionary grants for DHS are held for the next peer review meeting.
• I move adoption of the report, including review of contract number eight in L-4.

Committee: All JOINT BUDGET COMMITTEE

Summary: The committee first took up several subcommittee reports. The Claims Review Litigation Reports Oversight Subcommittee report was adopted after noting two Department of Corrections settlement reviews and one affirmed denial/dismissal by the Claims Commission. The JBC Personnel Subcommittee report was also adopted, covering governor’s letters and amendments, with items related to the Auditor of State and Lieutenant Governor sent back for further review and one Lieutenant Governor amendment not passing. Next, the peer review subcommittee report was adopted after discussion of various temporary appropriations, ARPA and infrastructure-related appropriations, reserve fund transfers, and a resource reallocation. Two DHS-related items were held, including a discretionary grants item and a contract with DHS and EMS/LINQ; one hold was later released after additional information was provided. A member asked about returned ARPA funds, and staff explained the money was being returned to the federal government because it was not fully expended within the federal time frame. The committee then discussed several bills and amendments with special language, including Senate Bills 63, 67, and 73 and House Bills 1089, 1090, and 1093, along with amendments to the Department of Health, the Office of the Treasurer, and the State Board of Election Commission. Leadership warned that holds on bills should be resolved by the following Thursday or be released, and members were encouraged to work with agencies and notify leadership if agencies were not responsive. The meeting then adjourned.

Transcript Highlights:

• The Claims Review Litigation Reports Oversight Subcommittee met on Tuesday, April 14th.
• The Claims Review Litigation Reports Oversight Subcommittee met on Tuesday, April 14th, reviewed two
• Yeah, the peer review subcommittee met yesterday, April 15th.
• K2 discretionary grants for DHS are held for the next peer review meeting.
• I move adoption of the report, including review of contract number eight in L-4.

Committee: All JOINT BUDGET COMMITTEE

Summary: The committee heard several subcommittee reports and adopted them. The Claims Review Litigation Reports Oversight Subcommittee reported on two Department of Corrections litigation settlements and one denied and dismissed claim, and its report was adopted. The JBC Personnel Subcommittee reported on Governor’s letters and amendments; all items were released back to the Joint Budget Committee as adopted except item 3, the Lieutenant Governor’s Office amendment, and items 3 and 4 were sent back for further review. The peer review subcommittee reported approval of several temporary appropriations, ARPA and IIJA appropriations, reserve fund transfers, and a resource reallocation. Two items were held: DHS K-2 discretionary grants and an L-4 DHS/EMS contract; after additional information was provided, the hold on the contract was released and the report was adopted. A member asked about returned ARPA funds, and staff explained the money was being returned to the federal government because it was not fully expended within the federal time frame. The committee also referred several measures to special language, including Senate Bills 63, 67, and 73 and House Bills 1089, 1090, and 1093. Special-language amendments were noted for the Department of Health, the Office of the Treasurer, and the State Board of Election Commission. The chair urged members to resolve any remaining holds by the following Thursday or they would be released, and the meeting adjourned.

Transcript Highlights:

• They've reviewed the contract.
• So it doesn't require periodic review. It's been negotiated. Pay the bill.
• I don't put much reviews, but Cindy B. hit the nail on the head.
• These negative reviews are the truth.
• I reviewed it.

Committee: Senate Senate Ad Hoc Committee on Elder Abuse

Summary: The Senate Ad Hoc Committee on Elder Abuse opened by explaining it was gathering testimony on elder abuse, especially alleged misconduct involving court-appointed systems such as guardians ad litem and fiduciaries, to identify gaps in law and oversight and develop legislative fixes. The chair limited each witness’s time, asked for names and contact information for follow-up, and repeatedly noted that some allegations might warrant referral to law enforcement, the attorney general, or county attorneys if basic criminal elements were present. Several witnesses described alleged abuse in guardianship, conservatorship, and fiduciary cases. Dr. Holly Lauder said her mother, who had Alzheimer’s disease, was subjected to allegedly deficient psychological capacity evaluations that ignored treating doctors and family input, leading to a fiduciary arrangement that later resulted in neglect. Kevin Axson described his mother’s probate case, saying a guardian ad litem and conservator were appointed after a family financial dispute, that the guardian ad litem and fiduciary had little contact with his mother, and that the estate was burdened with substantial fees and a $200,000 bond requirement. Frieda Alvarado testified about a 94-year-old client, Samuel Armento, saying he was isolated, medicated without his request, and treated without dignity after a fiduciary and care team took control. Bill Chalmers, Johnny Hamilton, and Kathy Hamilton also testified about Sam Armento’s case, alleging isolation, excessive fees, conflicts of interest, and poor oversight by fiduciaries and caregivers. Other witnesses raised broader concerns about Arizona probate practices. David Redkey said he has been under a long-running conservatorship despite earning degrees and maintaining capacity, and alleged that court-appointed professionals and fiduciaries overcharged his estate and blocked efforts to terminate the arrangement. Susan Wolfe described the Peyton case, alleging that a wife’s conservatorship and related court actions led to the loss of assets, exclusion of witnesses, and large fees for a relatively small monthly care bill. Dr. Lewis Heller, an OB-GYN and disciplinary committee member, said the medical evaluations he reviewed showed the people involved were competent and that the conduct he observed was unethical and possibly criminal. Renee Self testified that she lost her role as trustee and spent large sums defending her father’s estate, alleging that the probate process stripped her father of assets and limited her access to him despite APS findings that her actions were in his best interests. No formal committee votes or legislative actions were taken in the excerpt, but members repeatedly expressed concern, asked for documents and transcripts, and indicated they would follow up with witnesses and consider stakeholder meetings to craft legislation addressing oversight, transparency, and accountability in guardianship and fiduciary systems.

Transcript Highlights:

• review comments revise applicant to review comments revise designs<00:14:37.720><c> and</c><00:14:37.959
• </c> required for the Department's review required for the Department's review since<00:15:10.519><c>
• and deadlines might levels of review and deadlines might apply<00:17:11.319><c> review</c><00:17:11.679
• </c> negotiations required for each review negotiations required for each review Department<00:17:51.840
• </c><00:19:08.520><c> by</c> timeline for expectations for review by timeline for expectations for review

Committee: Senate Transportation

Keywords: 1191, senate, all

Transcript Highlights:

• And so there's a technological level of review and then there's a human level of review from there.
• And so there's a technological level of review and then there's a human level of review from there.
• reviewing the accuracy and completeness of the authority's draft business plan.
• When that review is complete, my office will finish a review requested by Senator Cortese of the costs
• We also plan to complete our review of the authority's construction quality program, review how compliance

Committee: House Transportation

Keywords: 988, house, all

Transcript Highlights:

• I've published over 30 peer-reviewed journal articles on topics like this, and the bulk of my research
• In peer-reviewed work with Dr.
• Bentley Coffee and Pietro Pareto, published in the journal called the Review of Economic Dynamics, I
• regulations that come out, the chair and that committee can do the review.
• Yeah, it's like a select committee that could review.

Summary: The Special Committee on Regulatory Reform met to hear from Patrick McLaughlin of the Hoover Institution and Pacific Legal Foundation about regulatory accumulation and reform. Chair Mark Wright explained the meeting was a study hearing only, with no votes planned or quorum for action. McLaughlin described his research measuring regulation by counting binding words such as “shall” and “must,” and said Louisiana ranks among the most regulated states, with about 183,000 restrictions and growth in regulatory stock outpacing the national average. He argued that excessive regulation slows GDP growth, raises consumer prices, and disproportionately burdens small businesses and low-income households. McLaughlin pointed to reform examples in British Columbia, Idaho, and Virginia, where centralized oversight, periodic review, one-in-one-out or similar rules, and simplified benefit-cost analysis were used to reduce regulations without harming safety. He said Virginia’s regulatory modernization effort, including use of AI and a regulatory management office, helped cut requirements and lower homebuilding costs. Committee members asked about how the data were measured, how regulation affects housing, licensing, and population growth, and whether Louisiana could use similar tools. McLaughlin emphasized that AI should assist human reviewers, not replace them, by identifying outdated, duplicative, or overly burdensome rules. Members also discussed Louisiana’s own reform efforts, including LaDOGE, permit streamlining, and prior bills to create public hearings and legislative review of regulations. Wright and others asked about federal mandates, “gold plating” of state rules, and how to identify unnecessary state-level additions. McLaughlin said some state rules are required by federal law, but many others are not, and AI can help distinguish required language from added burdens. No votes were taken, and the committee adjourned after members expressed interest in following up on McLaughlin’s report and examples from other states.

Transcript Highlights:

• Yeah, so just as a brief reminder, House Bill 2200 is the bill that requires JLARC to conduct a review
• are the least restrictive conditions necessary to maintain the safety of the child in the home, reviewed
• To review every 30 days, is there... To review every 30 days, is there a timeline on when it ends?
• This bill, in its current form, now directs JLARC to conduct a four-year review, from 2023 to 2026, of
• least restrictive conditions were met, and that they wanted to make sure that the judge was also reviewing

Summary: The House Early Learning & Human Services Committee met in executive session on three bills. House Bill 2200, concerning JLARC review of safety and stability outcomes for DSHS developmental disabilities clients and a DSHS public reporting requirement, was amended with a technical correction (House Amendment 799) and then reported out with a do pass recommendation. Supporters said the substitute shifts from a dashboard to an annual downloadable report, delays the timeline, and asks JLARC to recommend a methodology for future data collection; one member raised concerns about possible stigma and impacts on providers, but the bill passed 9-2. House Bill 2468, which updates DSHS statutory references to reflect agency restructuring and makes related technical changes, was advanced without amendment after the substitute reinstated the Dementia Action Collaborative expiration date and the requirement for two permanent employees to review the no-paid-services caseload. Members described it as a non-substantive cleanup bill to streamline and harmonize agency law. It was reported out unanimously, 11-0. House Bill 2660, authorizing courts to order conditions to keep a child under age five safe in the home after a shelter care hearing, had several proposed amendments withdrawn before action. The remaining amendment, Wickham 848, was adopted; it adds that the conditions must be the least restrictive necessary, reviewed every 30 days, and consistent with state and federal Indian Child Welfare Act requirements. The substitute bill then passed 9-2, with supporters saying it responds to recent critical incidents and opponents noting concerns but acknowledging shared commitment to child safety. The committee then adjourned and noted there would be no meeting the following day.

Transcript Highlights:

• </c> our special review unit on that. our special review unit on that.
• So with regard to 63, there was the review in 2019 that was a special review and not a financial audit
• in uh 2019 was a call it the review in uh 2019 was a special<00:27:16.559><c> review</c><00:27:16.960
• If we look at our existing inspector generals... actually reviewing new legislation if we actually reviewing
• Thank you. you to review. Um make a selection to you to review.

Keywords: 919, house, all

Summary: The Legislative Audit Commission Evaluation Subcommittee met on October 6, 2025, to choose additional program evaluation topics for the Office of the Legislative Auditor. Deputy Legislative Auditor Jody Mson Rodriguez explained that the commission had previously selected seven topics from an initial list of 11, with background papers already prepared on five of those items, and that the subcommittee was now being asked to select five more topics for background papers before narrowing the full set to four recommendations later in the fall or early spring. Members discussed several possible topics, especially emergency medical services, non-emergency medical transportation, MinnesotaCare eligibility, child care assistance, medical assistance fraud prevention, and U.S. Bank Stadium. David Kersner of OLA said emergency medical services and non-emergency medical transportation are distinct programs, and noted the EMS topic was evaluated in 2022 while non-emergency medical transportation had not been reviewed since 2011. Auditor Judy Randall said MinnesotaCare eligibility, child care assistance, and medical assistance fraud prevention are better suited to OLA’s financial audit division or special review unit rather than program evaluation, and that financial audits and special reviews do not require Legislative Audit Commission nomination. On process, Mson Rodriguez said the subcommittee had already met its minimum required selections under the commission’s policy and was free to choose additional topics. The discussion also covered whether to broaden the stadium topic beyond U.S. Bank Stadium; staff said the U.S. Bank financing structure alone would be a major undertaking, but they could help craft a future topic focused on maintenance across multiple facilities. No final vote or motion was taken in the portion of the meeting provided, and the chair indicated the committee would continue nominations and discussion.

Transcript Highlights:

• One, the timeline for September 10 for final review.
• From a broader operational review, we've also done some work.
• That is a review of my first handful of months in town.
• Plan review processes.
• So think of plan review as the preface.

Summary: The committee began with roll call, introductions of a new fiscal analyst and a new member, and approval of the March 19 minutes. The first major presentation was from the Office of Management and Budget on the state’s general fund and special fund status through May. OMB reported general fund revenues were running below the legislative forecast by about $76 million, driven largely by weaker individual income tax and sales tax collections, though the projected ending balance remained positive and above the budgeted level. The budget stabilization fund was above its cap and would transfer excess earnings to the general fund, and the legacy fund balance continued to grow. Members also asked about federal funding uncertainty and mineral leasing revenue variability. The committee then reviewed compliance reports and trust fund analyses, followed by discussion of a bill draft for the fixed-route city transportation network study. The draft would create a $15 million general fund grant program with a formula-based distribution to eligible fixed-route transit cities, intended to support operating and capital needs and help match federal transit funds. Transit officials from Minot and Fargo testified in support, explaining local fare and match structures and the difficulty of replacing aging buses and securing federal matching dollars. Several members questioned whether the program should be limited to the current four cities or broadened to future eligible urban areas, and whether local funding sources should be explored further. The committee did not finalize the bill draft at that point and planned to continue discussion at a later meeting. The committee also approved a bill draft repealing obsolete language related to approval of a bi-state authority with South Dakota, after staff explained that no agreements had ever been implemented and the provision appeared outdated. A roll call vote was taken and the motion carried. Later, the Department of Commerce and the Northern Plains UAS Test Site presented updates on uncrewed aircraft systems initiatives, including the Vantis radar data enclave, the drone replacement program, and efforts to build a revenue model for Vantis. Test site officials said FAA approval had been secured for the radar data program, replacement of noncompliant drones was underway, and future revenue could come from state and external users once pricing and intellectual property arrangements are finalized. Members asked about Chinese-made drones, supply chain issues, automation, and how the system would manage beyond-visual-line-of-sight operations. The Department of Corrections and Rehabilitation then presented on the design of a new minimum-security prison and a reentry housing study. Officials said the proposed facility would relocate the minimum-security prison to the penitentiary campus, reduce costs from an earlier estimate, and provide more beds and programming space, with construction potentially beginning in 2027 and opening around 2031. They also described staffing needs, the planned move of women to the New England facility, and possible expansion of men’s housing there. The parole and probation chief described a reentry housing task force studying housing needs for people leaving incarceration, with a goal of developing data-driven recommendations for subsidies and support services; a representative from Protection and Advocacy closed by expressing general support for fixed-route and paratransit funding.

Transcript Highlights:

• It has been reviewed, and this report stands as reviewed. It has been passed, has been reviewed.
• And this report stands as reviewed. Next is item E. Folks are now on item D.
• This is a review of a supplementary report for the Arkansas Fire Protection and Licensing Board.
• Without objection, this report stands as reviewed.
• Seeing none, without objection, this report stands as reviewed. Thank you.

Committee: All ALC-OCCUPATIONAL LICENSING REVIEW SUBCOMMITTEE

Summary: The committee met and first recognized a visiting student cohort from Arkansas State University’s Medical Laboratory and Radiation Sciences program. It then suspended the rules and approved a supplemental report, which was reviewed without objection. Members reviewed the Arkansas Fire Protection and Licensing Board’s occupational report. Department of Labor and Licensing counsel Lacey Kirchner answered questions and confirmed there were no fee increases. The report was then accepted as reviewed. The committee next heard from the Arkansas Department of Health’s Radiation Control Section. Officials Craig Smith, Charles Thompson, and Shane David explained the radiologic technologist licensing program, including full and limited-scope licensure, unchanged fees since 1999, and a current deficit covered through cost allocation from other programs. They also noted compliance with automatic licensure provisions for service members and said apprenticeship provisions already exist in the rules if such programs become available. The report was accepted as reviewed. Finally, the Arkansas State Board of Physical Therapy presented its report. Staff described the board’s structure, licensing and complaint functions, compact participation, and growth in licensees. Members asked about the board’s $200,000 scholarship program, which provides awards to 10 recipients per year, and about low fees and a $1.1 million balance. Officials said recent fee reductions and the scholarship program are intended to return funds to licensees. The report was also accepted as reviewed, and the committee moved to other business.

Transcript Highlights:

• It has been reviewed, and this report stands as reviewed. It has been passed, has been reviewed.
• This is a review of a supplementary report for the Arkansas Fire Protection and License Board.
• Senator, if you want to review it without me, it's okay. Ma'am, if you will, identify yourself?
• Without objection, this report Without objection, this report stands as reviewed.
• Seeing none, without objection, this report stands as reviewed. Thank you.

Committee: All ALC-OCCUPATIONAL LICENSING REVIEW SUBCOMMITTEE

Keywords: 1204, all

Transcript Highlights:

• Chairman, I move that the record reflect that earlier this morning the Government Contracts Review Committee
• Uh, the motion is to have the record reflect that the Government Contracts Review Committee met this
• </c><00:05:23.600><c> And</c><00:05:23.840><c> you</c> just provided for your review.
• And you just provided for your review.
• We are currently reviewing and rating the applicants based on the résumés that we've looked at.

Keywords: This video was pulled from back ups and loaded into YouTube after the fact., 958, all

Summary: The meeting began with a procedural motion to have the record reflect that the Government Contracts Review Committee had met earlier that morning, that the chairman had attended in person, and that the committee approved a retroactive contract for enforcement counsel in the case under consideration. The motion was seconded, clarified to include any future ratification or approval if needed, and then approved unanimously. The commission then took up a motion to deny a motion to dismiss in matters 24 LEC3 and 24 LEC6; after clarifying that it was denying the motion made on August 18 and not considering a new filing, the motion passed unanimously. Staff then reported that the commission office was busy with required forms and that the budget remained in good standing and within parameters. The commission approved the financial report by motion. It was also noted that informal advisory opinions issued since the last meeting were included in the materials for review, with any questions to be handled in closed session if needed. The chairman updated members on the search for a new executive director, saying Denita would serve as acting executive director in the interim. He reported that several strong applications had been received, that a committee was reviewing and ranking candidates, and that the formal application period had closed on August 15. Members were told they could forward recommendations to the personnel committee, but that the full commission would make the final hiring decision. In new business, a member offered a remembrance of Representative Jeff Greer, and the commission observed a moment of silence in his honor before adjourning.

Transcript Highlights:

• Review. What is that right post review on that to say?
• But then if 2 or 3 months later the sample is pulled in that case is reviewed, they're reviewing it based
• Each month, a sample is pulled for review.
• We're constantly subject to a desk review.
• Each review brings a new reviewer every year with a different interpretation of what's cost-effective

Committee: Senate Health & Human Services

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.

Transcript Highlights:

• </c> updated annually, we would review those. updated annually, we would review those.
• We did review contractual relationships with these MCOs. And so we actually reviewed 11 contracts.
• So, uh, there's a lot to review here. So, uh, there's a lot to review here.
• </c><01:23:51.600><c> the</c> also stopped annually reviewing the also stopped annually reviewing the
• </c><01:25:18.800><c> Uh</c> that we're reviewing right now. Uh that we're reviewing right now.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board meeting began with a roll call and approval of the October 7 meeting minutes. The chair then reordered the agenda to hear the item on Medicaid reimbursement rates and network adequacy first because of scheduling issues. Dr. Steve Robertson of the Kentucky Dental Association was sworn in and testified at length about Kentucky’s dental Medicaid program, arguing that reimbursement rates are unsustainably low, have been largely flat for decades, and are often below the cost of providing care. He said Kentucky ranks near the bottom nationally in oral health, dental Medicaid rates are often 60% or less of commercial rates, and the program’s share of the Medicaid budget has effectively remained around 2% despite growth in enrollment and services. Dr. Robertson said the low rates are contributing to provider losses, rural access gaps, longer wait times, dental deserts, and greater use of emergency rooms for preventable dental problems. He cited examples of office costs exceeding reimbursement for basic procedures, noted that many dentists are small private businesses, and said the state is struggling to recruit and retain dentists because of low payment levels and high student debt. He also pointed to disparities with neighboring states and said recent increases in some oral surgery and cleaning codes were not enough to address the broader problem. His recommendations included completing the rebasing study, increasing dental reimbursement in the upcoming budget, tying future reviews to inflation and cost data, aligning benchmarks, and prioritizing preventive and restorative care to improve workforce stability and access. Board members asked about the size of the needed increase, the effect of private insurance on dental practice finances, and what a new dentist might expect to earn. Dr. Robertson said the association is working on an appropriations request and that private insurance pressures are part of the problem as well, since many plans are HMOs or PPOs with limited provider control over rates. He also said the association can no longer conduct reimbursement surveys because of FTC restrictions, but would try to obtain current ADA data. In response to questions about the future of the program, he warned that without significant changes it could become unsustainable and cited Ohio and Missouri as examples where higher reimbursement improved provider participation and access. The board then heard from Mr. Bowman of Baldwin Consulting, who discussed outpatient behavioral health providers, including ABA therapy and mental health/substance use disorder services. He said these providers face similar issues of rising costs, flat reimbursement, and access problems. He reviewed Kentucky’s network adequacy standards, including travel-time standards, 30-day appointment limits, and newer federal requirements that will require services within 10 business days by 2029. He said wait times for outpatient behavioral health, especially children’s services and ABA, have grown substantially, sometimes to more than a year, and emphasized that the Medicaid department must enforce these standards.

Transcript Highlights:

• THIS EXEMPTION IS SUBJECT TO FUTURE LEGISLATIVE REVIEW THIS EXEMPTION IS SUBJECT TO FUTURE LEGISLATIVE
• REVIEW AND CAN BE REPEALED IF DEEMED UNNECESSARY.
• IF I UNDERSTAND THERE IS THE POLICY COMMITTEE THEN WE HAVE REVIEWERS THEN THE COMMENT.
• CAN WE TALK MORE ABOUT THE REVIEWERS?
• COUNCIL AND THE GRANT APPLICATION PROCESS AND OF THE APPOINTED REVIEWERS SHALL REVIEW APPLICATIONS AND

Keywords: 999, senate, all