HCS SB 109(RLS)(efd fld): "An Act repealing the statute that sets priorities for the Department of Health and Social Services to apply to administration of the medical assistance program when there are insufficient funds allocated in the state budget for that program; and authorizing the department to make cost containment decisions that may include decisions about eligibility of persons and availability of services under the medical assistance program."
00 HOUSE CS FOR SENATE BILL NO. 109(RLS)(efd fld) 01 "An Act repealing the statute that sets priorities for the Department of Health and 02 Social Services to apply to administration of the medical assistance program when there 03 are insufficient funds allocated in the state budget for that program; and authorizing the 04 department to make cost containment decisions that may include decisions about 05 eligibility of persons and availability of services under the medical assistance program." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 08 to read: 09 LEGISLATIVE INTENT. (a) It is the intent of the legislature that the Department of 10 Health and Social Services should have the authority to make cost containment decisions 11 related to the Medicaid program under AS 47.07 during any fiscal year when the department 12 finds that the cost of medical assistance for all persons eligible under the program will exceed 13 the amount allocated in the state budget for that fiscal year. Further, it is the intent of the
01 legislature that the department continue to provide coverage for all Medicaid approved 02 medications. If the department develops a preferred drug list to improve the Medicaid 03 program's efficiency, it is the legislature's intent that the department should work with 04 providers to develop the preferred drug list and that the department should establish an 05 authorization system that is minimally intrusive to the providers while protecting access to 06 medically necessary medications. The legislature encourages the department to develop case 07 management systems or tools that allow for the comparison of cost savings associated with a 08 preferred drug list or alternative cost containment methodologies. 09 (b) The legislature intends, with the enactment of sec. 3 of this Act, that the cost 10 containment decisions made by the Department of Health and Social Services should be those 11 that best reflect the needs and interests of the eligible recipients and the coverage options 12 available under AS 47.07 and that the department should take all reasonable measures to 13 effect cost containment in ways that least affect the recipients who are eligible for services 14 and the types of services that are available. 15 * Sec. 2. AS 47.07.030(c) is amended to read: 16 (c) Notwithstanding (b) of this section, the department may offer a service for 17 which the department has received a waiver from the federal government if the 18 department was authorized, directed, or requested to apply for the waiver by law or by 19 a concurrent or joint resolution of the legislature. [THE DEPARTMENT SHALL 20 ANNUALLY MAKE AVAILABLE TO THE LEGISLATURE ITS 21 RECOMMENDATIONS ABOUT WHERE A SERVICE OFFERED UNDER THIS 22 SUBSECTION SHOULD BE PLACED ON THE PRIORITY LIST IN AS 47.07.035. 23 THE DEPARTMENT SHALL NOTIFY THE LEGISLATURE THAT THE 24 RECOMMENDATIONS ARE AVAILABLE.] 25 * Sec. 3. AS 47.07 is amended by adding a new section to read: 26 Sec. 47.07.036. Cost containment measures authorized. (a) If the 27 department finds that the costs of medical assistance for all persons eligible under this 28 chapter will exceed the amount allocated in the state budget for a fiscal year, the 29 department may implement cost containment measures to reduce anticipated program 30 costs for that fiscal year as authorized under this section. 31 (b) The department, in implementing this section, shall take all reasonable
01 steps to implement cost containment measures that do not eliminate program 02 eligibility or the scope of services required or authorized under AS 47.07.020 and 03 47.07.030 before implementing cost containment measures under (c) of this section 04 that directly affect program eligibility or coverage of services. The cost containment 05 measures taken under this subsection may include new utilization review procedures, 06 changes in provider payment rates, pre-certification requirements for coverage of 07 services, and agreements with federal officials under which the federal government 08 will assume responsibility for coverage of some individuals or some services for some 09 individuals through such federal programs as the Indian Health Service or Medicare. 10 (c) If cost containment measures authorized under (b) of this section are 11 insufficient to reduce the anticipated program costs for a fiscal year to the amount 12 allocated in the state budget for the program for that fiscal year, the department may, 13 to the extent authorized under federal law and the state's constitution, deny any or all 14 optional services listed in AS 47.07.030(b) - (d) to a person eligible for services under 15 AS 47.07.020 or deny program eligibility to a person who is eligible for the medical 16 assistance program under the optional coverage provisions of AS 47.07.020(b) - (i). 17 However, the department may not eliminate program participation of a person who is 18 eligible for coverage under AS 47.07.020(a), nor may the department deny coverage 19 of a service described in AS 47.07.030(a) for a person who is eligible for the medical 20 assistance program under AS 47.07.020. 21 * Sec. 4. AS 47.07.035 is repealed. 22 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 23 read: 24 APPLICABILITY. AS 47.07.036, enacted by sec. 3 of this Act, applies only to 25 eligibility determinations made and medical services performed on or after July 1, 2003.