Transcript Highlights:

• His background makes him uniquely qualified to manage the intricacies of CMS. At his hearing, Dr.
• Oz discussed his vision to ensure CMS provides Americans with access to superb care, especially our most
• Oz will work tirelessly to deliver much needed change at CMS.
• Oz to be the administrator of CMS.
• And CMS sits on its hands and couldn't care less about doing anything about that differential even as

Keywords: Social Security, Medicaid, Frank Bisignano, Elon Musk, benefit processing, office closures, public testimony, administration policies, health care, vulnerable populations

Summary: The committee meeting focused heavily on the nomination of Frank Bisignano as the Commissioner of the Social Security Administration, with intense discussions around the current state of Social Security and its management under the current administration. Members voiced significant concerns regarding potential changes to Social Security and Medicaid, specifically addressing issues such as office closures, delays in benefit processing, and the perceived policies from Elon Musk's association with the administration. Public testimonies highlighted fears that these changes would severely impact the accessibility of benefits for seniors and vulnerable individuals, resulting in a chaotic environment at the SSA. Members expressed a unified opposition to the notion of dismantling these critical programs, emphasizing the long-term implications on their constituents' well-being.

Transcript Highlights:

• I know that Medicaid operates strict federal guidelines by CMS, including how federal funds are spent
• My first question is: has CMS formally reviewed this legislation?
• CMS that this is okay.
• If the question is, have we run it through CMS, Madam Chair, we have not.
• Okay, I understand that, and I share that concern, but this doesn't have anything to do with CMS.

Transcript Highlights:

• Because of this cap, we will need to pursue a CMS waiver to get approval.
• There are, like, I think there were four main steps to getting CMS certified.
• Once you get your license, then you can apply for the federal CMS? Yes.
• , because you can't send the third-party survey results to CMS on your own, can you?
• Well, the past three to submitting it to the feds for CMS approval?

Bills: SB1052, SB1115, SB1118, SB1120, SB1121, SB1124, SB1171, SB1172, SB1174, SB1175, SB1214, SB1233, SB1235, SB1316, SB1345, SB1372, SB1399, SB1458, SB1494, SB1496, SB1564, SB1602, SB1621, SB1628, SB1630, SB1631, SB1668, SB1672, SB1814, SB1821

Keywords: assisted living, health care, hyperbaric oxygen therapy, physician orders, informed consent, AHCCCS, remote work, state agency, employment, public health, housing, zoning, middle housing, urban development, duplexes, triplexes, fourplexes, townhomes, historic preservation, radiation protection

Summary: The committee first heard Senate Bill 1121, which would prohibit hospitals from requiring lead aprons for cardiac catheterization staff when a radiation protection system is in place, while still allowing hospitals to require aprons outside the designated safety zone or when exposure levels warrant additional protection. An amendment added flexibility for radiation safety officers to require lead or other PPE if exposures approach occupational limits and removed expedited rulemaking language. Supporters, including the sponsor and interventional cardiologists, argued the devices reduce radiation and orthopedic injuries and improve recruitment and retention; hospital groups shifted to neutral after the amendment. The committee adopted the amendment and passed SB 1121 on a 9-2 vote. The committee then considered Senate Bill 1120, which would require hospitals performing cardiac catheterization procedures to equip at least 50% of those rooms with radiation protection systems by 2027. Supporters said the systems protect clinicians from radiation and long-term injury, while opponents, including hospital and radiology groups, argued the bill was overly prescriptive, could create a captive market, and might not fit all rooms or procedures. After adopting a children’s hospital exemption amendment, the committee passed SB 1120 on a 6-6 vote, with the chair breaking the tie in favor of the bill. Senate Bill 1118, an appropriation measure tied to the radiation protection system proposal, was also advanced after brief discussion, passing 6-5. The committee then took up Senate Bill 1214, which would create guardrails for non-FDA-approved stem cell and regenerative therapies, including provider standards, informed consent, advertising limits, reporting requirements, and a private right of action for violations. Supporters described it as a patient-protection and access bill, while testimony emphasized concerns about unregulated “bad actors” and patients traveling out of state for treatment. The committee adopted an amendment removing a reference to the National Law and passed SB 1214 on a 9-3 vote. The transcript then began discussion of SB 1630, which would create a Medicaid-funded home and community-based service benefit for adults with serious mental illness, with AHCCCS taking a neutral position and estimating a significant fiscal impact.

Transcript Highlights:

• Prior to this, it was documented in special terms and conditions and negotiated between CMS and states
• Chair Holle, members of the committee, yeah, I believe that we do have that in writing from CMS, from
• If we don't have it in writing from CMS, we could try to obtain it.
• Yeah, I believe that we do have that in writing from CMS, from previous questions that we have asked
• If we don't have it in writing from CMS, we could try to obtain it.

Keywords: 908, all

Transcript Highlights:

• So, Chairman Devere and Senator Cleary, for those that CMS has approved for us?
• There's a lot that goes into working back and forth with a budget with CMS.
• It's been approved by CMS. Lots to get this to fruition.
• And CMS has been gracious.
• We've had two people ask that, and we haven't asked CMS what their stand is on that.

Keywords: 908, all

Summary: The committee first approved the December 10 minutes and then received a DEQ base budget summary and agency overview. DEQ staff explained that the agency is largely federally and special funded, with major ongoing costs in salaries, operating expenses, grants, and continuing appropriations. Director Dave Glatt and accounting director Beth Jacobson highlighted core programs, the move to a new chemistry laboratory, the new state fuel inspection program, wastewater-related funding from HB 1577, and implementation of SB 2267 for on-site wastewater rules. They also noted the agency’s spending patterns, possible federal EPA cuts, and the likelihood of some fee adjustments or program changes if federal support declines. Members asked about DEQ’s travel, field offices, future staffing, and how the agency would respond to reduced federal regulation. DEQ said most staff are based in Bismarck, with field offices in Fargo, Sawyer, and Gwinner, and that travel is driven by inspections and spill response. Glatt said the agency would continue to rely on science and law, and that any future federal retrenchment could mean more state responsibility but likely not a wholesale increase in FTEs. The committee also discussed a feedlot enforcement case in the Minot area, with DEQ explaining its role in ensuring compliance, permitting, and animal-waste management standards. The Department of Health and Human Services then presented on FTE block grant reporting, TANF balances, child care transfers, and the Rural Health Transformation Program. Donna Ockland explained that no line-item transfers had occurred yet for the new rural health work, but about 33 positions were planned and some current staff time could be reimbursed through approved cost allocation. HHS also reviewed TANF’s frozen eligibility and block grant structure, the transfer of up to 30% of TANF funds to child care, and recent program changes that increased benefits and raised the income limit. Staff said the department is using TANF more strategically to support child care and other allowable uses, while still carrying over unused funds as many states do. Finally, Pat and HHS staff gave an update on the Rural Health Transformation Program, saying the first funding opportunity was being posted and that the state is on track to obligate the federal funds within the required timeline. They described priorities such as workforce retention, preceptor development, technical assistance for critical access hospitals, community wellness projects, and ambulance upgrades. Members asked about rural versus urban eligibility, immigrant recruitment, evaluation of year-two funding, and how the program would address varied local workforce needs. The meeting then shifted to an Office of Management and Budget update on the new State Hospital project, where Lindsay Ashley reported continued construction progress, updated cost information, and selected alternates, with photos and details showing work underway in multiple building sections.

Transcript Highlights:

• For consistent use of the state CMS net system, shortages of physical therapy and occupational therapy
• CMS intends to update regulations through the rulemaking process to revise the statistical test.
• Our federal partners at CMS require an independent evaluation of community supports.
• Further, CMS requires... Specifically on the cost-effectiveness of community supports.
• It's a three-way agreement between us, DHCS, and CMS. We want that partnership to be there.

Keywords: 988, house, all

Transcript Highlights:

• So in which case then health care facilities will not be under the gun from CMS because it's Schedule
• So in which case then health care facilities will not be under the gun from CMS because it's Schedule
• So in which case then health care facilities will not be under the gun from CMS because it's Schedule
• So in which case then health care facilities will not be under the gun from CMS because it's Schedule
• from CMS from CMS because because because it's<00:54:21.119> schedule<00:54:21.520> three

Keywords: 912, senate, all

Summary: The committee heard testimony on SB 3025, relating to medical debt, with multiple organizations and individuals, including the Office of Wellness and Resilience, Healthcare Association of Hawaii, Queens Health Systems, the American Cancer Society Cancer Action Network, Aloha Care, Hawaii Health and Harm Reduction, Hawaii Data Collaborative, and Hawaii Appleseed, all speaking in support. No opposition was heard, and the member present had no questions. The committee then took up SB 3199, which would establish a mental health emerging therapies task force. Testimony was overwhelmingly in support, with speakers including veterans, clinicians, researchers, and advocacy groups describing personal experiences with PTSD, depression, traumatic brain injury, and treatment-resistant conditions, and arguing that Hawaii should prepare for regulated access to emerging therapies such as MDMA, psilocybin, ketamine, and ibogaine. The Department of Health and some medical organizations provided comments, and one opposition witness was called but not present. The chair noted broad support, especially from veterans, and no vote was taken during the excerpt. The final measure discussed was SB 3324, relating to Medicaid. The Department of Human Services, Department of Health, Hawaii State Council on Developmental Disabilities, Hawaii Disability Rights Center, Aloha Care, and numerous care-provider and aging/disability organizations testified in support, while one witness was in opposition and several others offered comments. The discussion then moved to SB 2563, relating to homelessness, where the Department of the Attorney General offered comments on specific sections and recommended adopting suggested amendments if the bill proceeds. Additional testimony on SB 2563 began with support from several individuals, including Shelby Pikachu, who emphasized the severity of homelessness and related social problems in the community.

Transcript Highlights:

• Our application to CMS reflected thoughtful planning and collaboration.
• greenlighting four pieces of legislation that significantly helped improve our application score with CMS
• We filed our application to CMS in early November and received our award, We filed our application to
• CMS in early November and received our award right before the new year.

Keywords: 908, all

Summary: The House convened in joint session for the special session of the 69th Legislative Assembly, with introductions of visiting officials and a moment of silence for former Governor Alan Olson. The chamber then escorted Lieutenant Governor Michelle Strind and Governor Kelly Armstrong, along with First Lady Kirstie Armstrong, to the rostrum. The governor’s remarks were ordered printed in the journal. Governor Armstrong addressed the special session’s single purpose: considering North Dakota’s $199 million first-year federal award under the rural health transformation program. He thanked legislators, HHS, tribal partners, providers, and community leaders for their work on the state’s CMS application, and said four bills helped improve the application score: requiring the presidential fitness test in PE courses, adding nutrition education to physicians’ continuing education, joining the physician assistant licensure compact, and expanding pharmacists’ scope of practice. He said he looked forward to signing those bills and the accompanying appropriation measure. The governor described the rural health plan as focused on four pillars: promoting wellness and healthy lifestyles, stabilizing the rural health workforce, expanding access through telehealth and mobile services, and using technology and data to improve care. He emphasized that the plan would avoid new buildings and unsustainable programs, and instead use federal funds for lasting, scalable reforms. He said the state could receive at least $500 million over five years, possibly more, and urged quick authorization and appropriation so the funding could be deployed responsibly. After the governor and lieutenant governor were escorted out, the joint session was dissolved. The House then returned to regular business, announced committee meetings, excused absent members, and adjourned until 8:30 a.m. on Thursday, January 22, 2026.

Transcript Highlights:

• CMS, in its final rule, acknowledged that part of the 80% is intended to pressure states to reevaluate
• So, Megan, can you tell me, doesn't this require CMS approval for these rate increases? increases?
• The state has to usually make the request to CMS, get that information.
• Well, this is federal CMS language.
• The revenue is controlled by CMS in the state of New Mexico.

Transcript Highlights:

• But he also announced that CMS is going to cover certain costs related to CBD, and they're currently
• CMS is supposed to be issuing guidance on the insurance.
• also announced that CMS is going to<00:33:08.480> cover<00:33:09.840> uh<00:33:10.000>
• [clears throat] Now, the CMS guidelines might...
• > guidelines [clears throat] Now, the CMS guidelines [clears throat] Now, the CMS guidelines might

Keywords: 912, senate, all

Summary: The committee first heard SB 888, which would bar operators of smart household security devices from sharing user data with law enforcement unless the user consents or police obtain a warrant. DCCA’s Office of Consumer Protection offered comments and Judiciary submitted written support. Several individuals also submitted written support. The committee recommended passage with amendments clarifying that the Office of Consumer Protection may enforce violations and adopting Judiciary’s recommended changes, while also deferring the effective date to July 1, 2050. The motion passed unanimously among members present, with one senator excused. The committee then took up SB 2777 on insurance disclosures. The bill would require authorized insurers to disclose claim-handling data to consumers, including claims open at the start of a period, closed with payment, closed without payment, and open at the end of the period. The committee described amendments to clarify the bill, remove a requirement for the DCCA insurance division to handle publication, and defer the effective date to July 1, 2050. The measure was passed with amendments and the recommendation was adopted, with one member voting no and another excused. In a joint Commerce and Consumer Protection/Judiciary hearing on SP2738 relating to tax haven abuse, the Department of Taxation offered comments and the Tax Foundation testified in opposition, arguing the state should rely on IRS audits and existing worldwide reporting rules rather than create a separate state approach. Other written testimony was noted in both support and opposition. The committees recommended passage with amendments adopting Taxation’s technical changes and deferring the effective date to July 1, 2050; the recommendation was adopted, with one senator noting reservations. The joint hearing then moved to health-related bills, including SB 2690 on primary care spending, SB 3103 on energy assistance, SB 3137 on Department of Health authority over food, drugs, and cosmetics, SB 3164 on child welfare service organizations, and SB 3206 on cannabinoids. SB 2690 drew strong support from physicians and advocates who said it would address primary care shortages, especially on neighbor islands, while HMSA and others warned a fixed spending percentage could raise costs and suggested a working group. SB 3164 drew support from child welfare providers and opposition from the Attorney General over indemnification language, and SB 3206 drew mixed testimony: state agencies raised federal-law and vagueness concerns, while hemp and cannabis advocates and some farmers supported the measure and urged broader legalization or amendments.

Transcript Highlights:

• <00:24:23.760> regulations practices with current CMS regulations practices with current CMS
• We have to inspect the facility and we have to make a recommendation to CMS.
• Uh, we are delegated authority from CMS to conduct these inspections and to regulate these entities.
• Um and so our recommendation to CMS.
• <00:31:10.159> to are delegated authority from CMS to are delegated authority from CMS to

Keywords: 912, senate, all

Summary: The committee opened its Health and Human Services calendar, noted quorum, and first took up HB 194. The chair explained amendments to add an exemption for a person invited by a patient to attend a birth outside an accredited birth facility when no compensation is involved, remove a date reference in section 9, and accept Department of Health amendments. Members raised no objections, and the committee voted to pass HB 194 with amendments. The committee then heard HB 139 on insurance, with the Attorney General flagging possible unlawful delegation issues and suggesting clarifying language, while the Insurance Division stood on written testimony. A number of health organizations and advocates, including HMSA, Hawaii Association of Health Plans, oncology and fertility groups, testified in support. HB 613 on homeless youth drew broad support from state agencies, counties, youth advocates, and community groups; testimony emphasized the need for permanent safe spaces and more attention to unaccompanied minors, with one witness asking for clarity on funding and shelter capacity. HB 71 on a tax credit for family caregivers drew support from AARP, Alzheimer’s and children’s advocates, and several individuals, while the Tax Foundation raised concerns about blank provisions and the cost-effectiveness of administering a small credit. The Department of Taxation said a prior version with a $5,000 nonrefundable credit would have cost the general fund about $397.4 million. HB 716 on health care technology support received strong support from SHPDA, OHIN, and many provider groups, who described it as a one-time investment of roughly $20–25 million to connect rural and neighbor island providers to electronic health records; members questioned how the grant program would be allocated. HB 799 on physician hospital privileges also drew mixed testimony: supporters said it would align Hawaii with updated CMS rules and improve access, especially on Maui, while Maui Health and some members worried it could reduce on-call coverage and hospital safety, leading to discussion of a possible report and sunset date.

Transcript Highlights:

• Madam Chair, can you tell me what the current CMS standards are for staffing?
• So there are CMS nursing standards set by the federal government.
• Okay, CMS does have standards when it comes to nursing.
• I do have the CMS standards that you had asked about earlier.
• And the standards for CMS are: Med-Surg is one to three or four, ICUs is one to two, and that is CMS

Transcript Highlights:

• the transition from the older CDO program to the new PDS program that was mandated by federal law and CMS
• We've gone with CMS approval and we are ready to implement. There's 100 slots.
• <00:15:32.800> and<00:15:32.880> the<00:15:32.960> translation law and CMS and
• the translation law and CMS and the translation transition<00:15:34.080> from<00:15:34.280>
• <00:16:02.120> and<00:16:02.920> we<00:16:03.080> are We've gone with CMS approval

Keywords: • 0:00 - Roll Call • 0:19 - Approval of June 2026 meeting minutes • 0:36 - Fish & Wildlife (301 KAR 1:201 and 301 KAR 2:178) • 1:35 - Board of Veterinary Examiners (201 KAR 16:767) • 4:10 - State Board of Elections (31 KAR 4:240 Emergency) • 4:50 - Office of the Attorney General, Regulatory Relief (40 KAR 12:300, 12:610, 12:400, 12:420 and 12:600) • 7:03 - Department of Revenue (103 KAR 43:341 Emergency) • 8:05 - Kentucky Public Pensions Authority (105 KAR 1:001 and 1:440) • 9:19 - Finance and Administration Cabinet, Office of the Controller (200 KAR 38:080) • 10:10 - Board of Physical Therapy (201 KAR 22:010 and 22:070) • 11:06 - Kentucky Department of Education (702 KAR 3:220 and 6:110) • 12:43 - Cabinet for Health and Family Services, Department for Public Health (902 KAR 1:400) • 13:47 - Cabinet for Health and Family Services, Department for Medicaid Services (907 KAR 2:720 and 2:725) • 28:11 - Next meeting and adjournment, 958, all

Summary: The subcommittee met with a quorum present, approved the minutes without objection, and then reviewed a series of administrative regulations from multiple agencies. Most of the regulations received staff-suggested amendments and were approved without objection, including fish and wildlife rules on fishing limits and deer hunting on local government property, veterinary board changes to responsible party and veterinary manager requirements, election procedures for safe-at-home voters, attorney general regulatory relief rules, emergency gasoline tax pricing, public pensions updates, controller fraud-prevention policies, physical therapy licensure and English proficiency standards, school nutrition and fee-waiver rules, public health conference procedures, and Medicaid waiver regulations. Several agencies briefly identified themselves and answered procedural questions, but most items drew no substantive opposition. The Board of Veterinary Examiners regulation included an agency amendment that removed a proposed limit on the number of facilities a veterinary manager could oversee. The Department of Education regulations updated fee waiver and meal program procedures, while the Department of Public Health regulation clarified notification and conference-request procedures. The Department of Revenue and Kentucky Public Pensions Authority items were largely technical or conforming changes, including a special-needs trust definition added for consistency with Senate Bill 85. The most extensive discussion involved the Department for Medicaid Services’ 1915C child waiver regulations. Kentucky Protection and Advocacy testified in opposition to the waiver’s lack of participant-directed services, arguing that consumer-driven services such as respite and community living support are required and especially important in rural areas and for higher-acuity children. Cabinet representatives responded that the waiver is intended to provide wraparound services to keep children in homes and communities, that it has CMS approval, and that the program is limited to 100 slots with about 21 participants already enrolled. Members did not move a deficiency motion, and the chair indicated the regulations would continue through the process. The meeting adjourned after setting the next meeting for Tuesday, August 11 at 1:00 p.m.

Transcript Highlights:

• This is a model that we are participating in through CMS that allows us to enter into value-based payment
• We did not receive any comments on this, and these are going through approval with CMS now.
• This is simply an administrative change required by CMS.
• However, CMS is removing an expiration date of their federal rule and extending that out permanently,
• However, CMS is removing an expiration date of their federal rule and extending that out permanently,

Keywords: 1204, all

Transcript Highlights:

• <01:40:35.159> told with that is the dad's rate CMS told with that is the dad's rate CMS told
• and approved by CMS to transition those functions.
• a rate process developed in collaboration with CMS and approved by CMS to transition those functions
• <01:50:33.679> standard that's basically the CMS standard that's basically the CMS standard
• So again, it could be a difference of opinion, but we... to CMS which they did approve um which to CMS

Keywords: 1191, senate, all

Transcript Highlights:

• And if the bill were to pass, it CMS.
• That was an in-person meeting that we had with CMS and they declined that.
• asked CMS if we could have a waiver. asked CMS if we could have a waiver.
• <00:50:56.720> So, had with CMS and they declined that.
• So, had with CMS and they declined that.

Keywords: Meeting Start 00:00:00 Call to Order and Roll Call 00:00:23 Kentucky Bankers Association 00:02:32 How to Read and Understand KRS 6.948 Health Mandate and Federal Cost Defrayal Impact Statements 00:25:40 Proposed Amendments to Kentucky's Essential Health Benefit-Benchmark Plan 00:50:18 Proposed Health Insurance Legislation for the 2026 Session 01:04:22 Reimbursement for Covered Benefits Delivered Through the Psychiatric Collaborative Care Model 01:01:46 Coverage of Eating or Feeding Disorders 01:18:47 Coverage of Hearing Loss 01:25:31, 958, all

Summary: The Interim Joint Committee on Banking and Insurance met for its first interim meeting, established a quorum, approved routine opening items, and welcomed a new committee assistant and a legislative intern. The committee first heard a Kentucky Bankers Association presentation from Tim Shank and John Cooper focused on the state’s housing shortage, which they described as affecting all 120 counties and especially low- and moderate-income and workforce housing. They urged support for a proposed $20 million banker-backed revolving fund, paired with tax credits, to finance new housing construction; they said the program would be flexible, could support alternatives such as manufactured housing, and would use below-market loans with tax credits vesting over five years only after units are completed. They also asked for extension of the historical tax credit carryforward from five to seven years and for continued support of new market tax credits, arguing that supply-chain delays make the longer period necessary for historic rehabilitation projects. The bankers also raised concerns about credit unions, arguing that because credit unions do not pay the same taxes as banks, they should not be allowed to acquire healthy state-chartered banks or hold state and local deposits. They cited the recent purchase of First State Bank of Middlesborough as an example, saying the transaction would reduce state, county, and city tax revenue and weaken local tax bases. In response to committee questions, the presenters said local regulations, zoning, parking, sidewalk, and utility easement issues can significantly delay housing projects, and they emphasized that state policy and infrastructure support are needed to help address affordability and development barriers. The committee then shifted to a Department of Insurance presentation by Commissioner Sharon Clark on how to read KRS 6.948 health mandate and federal cost defrayal impact statements. Clark explained that the mandate statements were created in 1998 so legislators would have actuarial estimates of how proposed health insurance mandates would affect administrative costs, premiums, and total costs, and she noted that later legislation added federal cost-defrayal analysis. She also reviewed the background of the Affordable Care Act’s essential health benefits framework and said the department’s statements are intended to help lawmakers make informed decisions on proposed health coverage mandates. No votes or formal actions were taken during the portion of the meeting provided.

Transcript Highlights:

• to CMS.
• CMS sent us a notice of award, which requires us to reallocate our budget and resubmit to CMS by the
• CMS sent us a notice of a award which requires us to reallocate our budget and resubmit to CMS by the
• It's federally funded and comes from CMS.
• It's federally funded comes from CMS.

Bills: HB2190, HB2202, HB2233, HB2251, HB2252, HB2396, HB2437, HB2689, HB2796

Keywords: physician assistants, licensure compact, medical services, multistate practice, patient care access, healthcare workforce, military families, adverse actions, dementia care, telementoring, healthcare education, rural communities, grant funding, HB 2233, rural health transformation, rural health transformation program, AHCCCS, Arizona Health Care Cost Containment System, Joint Legislative Budget Committee, JLBC

Summary: The committee began with a presentation from the Alzheimer’s Association Desert Southwest Chapter and Dr. Anna Burke of Barrow Neurological Institute on the scope of Alzheimer’s disease, the shortage of specialists, low rates of timely diagnosis, and the need for caregiver support and early intervention. Speakers emphasized that Arizona is a leader in Alzheimer’s research and that lifestyle changes, new therapies, and research funding offer hope, but only if patients are diagnosed earlier and providers are better trained. The committee then heard House Bill 2202, which would appropriate $300,000 over three years for a dementia care telemonitoring/telementoring grant program through the Department of Health Services to help providers statewide learn best practices in dementia care. Supporters, including the Alzheimer’s Association, Dr. Danny Cabral, and a patient advocate, said the bill would address major gaps in provider training and improve early diagnosis and treatment. There was no opposition, and the committee voted 11-0 to give HB 2202 a do pass recommendation. The committee next took up House Bill 2251, the “Jordan and MacTerry Act,” which would expand licensed midwives’ authority to administer certain medications, require liability insurance disclosure and reporting, and create an Arizona Midwifery Advisory Committee. Supporters said the bill would improve safety, oversight, and access to emergency medications in home births, while opponents from ACOG and the Arizona Osteopathic Medical Association raised concerns about the adequacy of oversight, the medication list, and whether eight hours of pharmacology training is sufficient. After testimony from midwives, physicians, and stakeholders, the bill was held for further stakeholder work and anticipated floor amendments. House Bill 2252, which would allow certified nurse midwives, certified professional midwives, or licensed midwives to accompany a patient in a ground ambulance during transport if approved by medical direction, also drew support and opposition. Supporters argued it would preserve continuity of care in emergencies, while firefighters and EMS representatives objected to ambiguity and scene control concerns. That bill was likewise held for further stakeholder meetings. The committee then recessed and reconvened for later presentations on federal budget and health-related topics.

Transcript Highlights:

• CMS utilized to come up with those cuts. CMS utilized to come up with those cuts.
• We don’t know yet what’s going to happen with CMS and our proposed rule.
• We don’t know yet what’s going to happen with CMS and our proposed rule.
• We don’t know yet what’s going to happen with CMS and our proposed rule.
• We don’t know yet what’s going to happen with CMS and our proposed rule.

Keywords: 928, house, all

Summary: The committee to study long-term managed care met to approve the prior meeting minutes, with a clarification that “OB3” referred to the “one big beautiful bill.” The minutes were then approved. Chair Jim Kofalt outlined the day’s agenda, which included testimony from the Granite State Home Health and Hospice Association, the New Hampshire Association of Counties, and later DHHS. He also noted that future meetings were expected soon and that the meetings were being livestreamed on YouTube. Granite State Home Health and Hospice Association, represented by Kellyanne Totten and Amy Moore, urged inclusive planning and a cautious, phased approach if managed care is considered. They emphasized that home care providers are not uniform, with different licensing and service models, and said any pilot should include varied provider types, rural and southern regions, and agencies of different sizes. They warned that workforce shortages, inflation, and a possible 9% CMS cut to Medicare home health payments could force agencies to reduce service areas or service types. They also said the 2023 Medicaid CFI rate increase has begun to lose its effect. In response to questions, they said the rural health transformation fund may help with planning and telehealth but likely cannot be used directly for rates or recruitment/retention. They also described the New England Home Care Nurse Residency Program, a Department of Labor grant, as a way to bring new registered nurses into home care with added training and school partnerships. The New Hampshire Association of Counties, through county nursing home administrators Craig Labore and David Ross, revisited the earlier Step Two managed care discussions from 2016-2018. They said prior consultants found the long-term services and supports system was underfunded and needed investment to stabilize providers and expand community-based care. They argued the same concerns remain today and said a managed model would jeopardize the Medicaid quality incentive payment program and, for county nursing homes, the proportionate share payment program. Their testimony was generally opposed to moving forward with managed long-term services and supports without significant additional funding and safeguards.

Transcript Highlights:

• /c><00:05:19.680> stated<00:05:20.120> that<00:05:20.240> the requirements, um CMS
• I think that would allow us to fully implement and be in compliance with CMS by the due date of January
• >> So, again, CMS requires that our rates be actuarially sound. So, our rates are submitted to CMS.
• So that was just my only comment. rates are uh submitted to CMS.
• They are rates are uh submitted to CMS.

Keywords: 958, all

Summary: The Medicaid Oversight and Advisory Board met on January 12, 2026, to approve the December 10, 2025 minutes and continue finalizing its findings and recommendations. Members reviewed findings on administrative inefficiencies, Medicaid and workforce participation under HR 1, Medicaid budget growth, rural health transformation fund development, and provider tax/state-directed payment changes. The board approved a motion to change “pilot” to “partnership” in the workforce-related recommendation, and also adopted a technical amendment clarifying overlapping HCBS services by removing reference to adult daycare waiver services and revising the language to focus on reducing duplication, simplifying provider contracting, and standardizing processes across programs. A separate technical correction was noted to change “DMS” to “DPH” in the rural health transformation finding, to be handled in the final edits. Several findings drew discussion but no final substantive vote during the meeting. On the rural health transformation fund, Dr. Berg said Kentucky had done well in federal funding and noted limits on what could be shared publicly, while Commissioner Lee said a public website had been created and recommended the department reference be changed to the Department for Public Health. Finding five prompted extended discussion about provider taxes, state-directed payment reductions under HR 1, and whether the board should address the relationship between actuarial studies, MCO payments, and actual provider reimbursement more directly. Senator Meredith and others argued for a broader, more transparent baseline review of rates across provider groups, while Commissioner Lee said CMS will require certain fee schedule comparisons to Medicare beginning July 1, 2026, and that quarterly expenditure reports already go to LRC. The board did not finish resolving finding five during the meeting and agreed to return to it after staff prepared more explicit language. Members also discussed the possibility of an all-payers claims database as a better way to understand what is being paid across payers and services. No final vote on the full findings package was taken in the portion of the meeting provided, but the board did adopt the noted amendments and continued working through the remaining language.

Transcript Highlights:

• So, we wanted to make directly from CMS.
• >> So, CMS ... big sigh there.
• Um, it's also being called the Working Families and Tax Cuts Act by CMS.
• Um, so there's lots of Act by CMS.
• have not been notified yet from CMS have not been notified yet from CMS about<02:16:34.399> what

Keywords: 912, senate, all

Summary: The joint informational briefing by the Health and Human Services and Commerce and Consumer Protection committees focused on projected impacts to Hawaii consumers from federal changes affecting Med-QUEST and the ACA marketplace, including the loss of ACA premium tax credits, OBVA/HR1-related Medicaid changes, immigrant eligibility restrictions, and new Medicaid work/community engagement requirements. Committee members noted the meeting was being streamed live and emphasized the need to explain potential coverage losses affecting a significant share of the state population. Med-QUEST administrators reported current enrollment at 390,766, about 27% of Hawaii’s population, and broke that down into major groups including roughly 128,000 ACA expansion adults and about 52,000 parent/caretaker relatives. They said the expansion adult population would be most affected by the new federal requirements, which will shorten renewal periods from 12 months to 6 months and impose community engagement rules beginning in late 2026 and 2027. They described the work requirement as 80 hours per month of work, community service, work program participation, or half-time education, with an income-based pathway tied to $580 per month at the federal minimum wage; they also noted a long list of exemptions, but said many details are still awaiting federal guidance and rulemaking. The administrators said federal changes to immigrant eligibility would eliminate Medicaid coverage for certain noncitizen categories, with an estimated 1,200 to 2,400 people affected, though about 200 may remain covered through a state-funded program for otherwise eligible individuals. They also said marketplace subsidies would no longer be available for some immigrants under 100% of the federal poverty level starting January 1, 2026, with further restrictions expected in 2027. For Hawaii overall, they estimated the new Medicaid work and renewal rules could push an additional 19,000 to 38,000 people into uninsured status, with another estimated 6,000 at risk from the six-month renewal process alone. Members asked about how exemptions would be determined, especially for medically frail and seriously mentally ill individuals, and administrators said they were still awaiting detailed federal rules and were working on data-matching and verification processes to reduce coverage losses.