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Health Professions Committee begins markup of Budget Adjustment Act, closes multiple line items for now
Summary
The Health Professions Committee met Jan. 27 to work through the governor's Budget Adjustment Act (BAA), tentatively agreeing to many technical adjustments while leaving several large items open for follow-up, including ADS charges and a Medicaid caseload reconciliation.
The Health Professions Committee met Monday, Jan. 27, 2025, to begin markup of the governor's Budget Adjustment Act and to review midyear adjustments across human services portfolios.
Committee members and staff moved through the BAA spreadsheet, tentatively closing many technical and housekeeping items while holding back several larger expenditure and revenue questions for additional information. Committee members repeatedly stressed that "nothing is decided until everything is decided," reflecting the committee's practice of leaving items open pending further data.
Members flagged several topics for follow-up: technical corrections to Agency of Digital Services (ADS) billing across agencies, a large Medicaid caseload and utilization reconciliation (a gross adjustment discussed as about $78.8 million with a roughly $33 million general-fund share noted in committee materials), outstanding questions about $333,000 in carryforward grant offset details, and a $13 million childcare caseload/carryforward question. Staff said additional memos and letters (including a letter from House Judiciary on judiciary-related tech funding) will be circulated and that several agency witnesses (including Health Care staff) will appear at upcoming hearings.
On procedure, the committee agreed to close many small, clearly documented adjustments for now, including software contract amendments (GainWell), pharmacy-benefit manager project funding, and certain Medicaid IT modifications, while leaving several ADS-related charges and one inflated ADS estimate open for reconciliation. Committee members who spoke said ADS billing practices appear to use an "after-the-fact" billable-hours model and that some agencies did not submit BAA requests for costs they had already absorbed.
Committee staff said they will bring updated numbers and narrative handouts to the committee's next session, which will include testimony from the Department of Health Care staff and other agency representatives. Members scheduled a follow-up session after the governor's budget address to consider any impacts from the RAN24 close and to finish unresolved BAA items.
Decisions and next steps: multiple line items were provisionally closed (listed below), while key items remain open for additional documentation and reconciliation. The committee emphasized that closed items can be reopened if new information emerges.
Votes at a glance (committee action, not formal recorded roll-call): - Closed for now: digital services technical correction on page 105; Judiciary core technology fund item (with House Judiciary letter); GainWell Medicaid Management Information System contract amendment; several ADS-related service-level agreements flagged as approved in principle; Medicaid IT modifications related to reentry Medicaid enrollment; several small caseload and staffing adds for Health Access Eligibility (temp staff); Blueprint Spoke classification and internal cost-center housekeeping moves; cannabis prevention transfer (30% of cannabis revenues) to Department of Health prevention programs; a $100,000 Planned Parenthood medication stocking item was checked for now though one member asked to hold if desired; many child development and restorative-justice reallocations described as housekeeping. - Left open for follow-up: ADS aggregate charges reconciliation (notably a discrepancy in an ADS figure that staff reconciled down from ~405,000 to ~168,000 in committee materials); a $333,000 state fiscal year 2024 carryforward question; large Medicaid caseload/utilization reconciliation (gross ~$78.8M; GF ~$33M) and related global-commitment breakout across accounts; childcare carryforward/caseload adjustments (approx. $13M discussed); certain TANF revenue realignments and time-study revenue impacts; several grant and federal-fund realignments where narrative was not yet provided.
What matters: committee members said the largest fiscal items are the Medicaid caseload/utilization adjustment and ADS billing practices. Several members urged continued oversight of ADS billing mechanics, and staff promised additional documentation and letters from affected agencies. Committee staff scheduled further testimony and follow-up memos.
The committee will reconvene with additional agency testimony and updated spreadsheets before finalizing BAA recommendations to the Appropriations Committee.
