The conference committee discussed proposed language in HB1012 (section 31) that would state legislative intent for the Department of Health and Human Services to review Medicaid utilization and, if needed, implement adjustments to keep the program cost effective.

Sarah Acre, executive director of the Division of Medical Assistance, told the committee the department seeks authority to manage Medicaid efficiently in the face of federal uncertainty and utilization changes. “I think in terms of what we're hearing from, DC these days, there's still a lot of uncertainty... I think we're getting a little tight, in terms of our preparations. And so wanna make sure that we are doing our best to control costs,” Acre said, adding that changes requiring administrative rules, state-plan amendments or other formal actions would continue to follow existing public-comment and tribal-consultation processes.

Committee members raised concerns about the breadth of language that would allow the department to "implement any adjustments the department determines appropriate," saying it could be interpreted as granting broad authority to change amounts, duration or covered services without prior legislative review. Senator Plurio said striking that phrase would be appropriate because otherwise "we're abdicating some of our responsibility" and constituents would ask why cuts occurred without legislative action.

Several conferees suggested a middle path: keep department authority to manage utilization but require interim oversight, for example by reporting proposed adjustments to a legislative budget or budget section before implementation. The committee did not adopt final language at this meeting; members agreed to reconvene at 1:00 p.m. after consulting counsel and checking current Century Code delegation language.

Donna (staff) and other committee members said the language in question is legislative intent rather than a change to Century Code; the committee asked staff to confirm whether the current statutory delegation exists and to bring legal counsel for the 1:00 p.m. meeting. "If we remove the language that would also be satisfactory. We just default to normal operating practices," one staff member said. The committee agreed to hold the issue for further legal review and a later decision.