SB 169: "An Act establishing in the Department of Health and Social Services a statewide immunization program and the State Vaccine Assessment Commission; creating a vaccine assessment account; requiring a fee assessment from health care insurers and other program participants for statewide immunization purchases; repealing the temporary child and adult immunization program; and providing for an effective date."
00 SENATE BILL NO. 169 01 "An Act establishing in the Department of Health and Social Services a statewide 02 immunization program and the State Vaccine Assessment Commission; creating a 03 vaccine assessment account; requiring a fee assessment from health care insurers and 04 other program participants for statewide immunization purchases; repealing the 05 temporary child and adult immunization program; and providing for an effective date." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. AS 18.09 is amended by adding new sections to read: 08 Article 1A. Statewide Immunization Program. 09 Sec. 18.09.200. Statewide immunization program established; 10 commissioner's duties. (a) In addition to health promotion and vaccine registration 11 activities of the department, a statewide immunization program is established in the 12 department for the purpose of monitoring, purchasing, and distributing recommended 13 vaccines to providers approved by the department who agree to provide the
01 recommended vaccines to state residents under terms consistent with the program and 02 state and federal law. 03 (b) The commissioner shall 04 (1) maintain a list of recommended vaccines for inclusion in the 05 program; 06 (2) for each recommended vaccine, establish the initial vaccine 07 assessment for the first year of the program and thereafter make annual assessments 08 based on the determinations made by the commission established under AS 18.09.210; 09 (3) notify health care insurers and other program participants of the 10 annual fee assessment for each vaccine included in the program; 11 (4) devise a method for crediting to health care insurers and other 12 program participants overpayments of vaccine assessments made for reasons related to 13 administrative error, program termination, or lower than anticipated actual usage of 14 the program by covered individuals; 15 (5) coordinate collective purchases of recommended vaccines; 16 (6) establish a procedure for statewide distributions of vaccines 17 purchased under the program; and 18 (7) review fee assessment appeals for error. 19 Sec. 18.09.210. State Vaccine Assessment Commission; members; duties. 20 (a) The State Vaccine Assessment Commission is established in the department for the 21 purpose of determining the amount of vaccine assessments made by the commissioner 22 to be paid by health care insurers and other program participants in the state under 23 procedures established by the commission. 24 (b) The commission consists of eight members appointed by the commissioner 25 as follows: 26 (1) the department's chief medical officer for public health, who shall 27 serve as chair; 28 (2) two health care providers licensed in the state; 29 (3) three members representing insurers licensed in the state, one of 30 whom must be a plan administrator; each insurer must represent a different 31 organization in the state;
01 (4) a representative of a tribal or public health insurance plan; 02 (5) the director of the division of insurance or the director's designee. 03 (c) A member appointed to the commission under (b)(2) - (4) of this section 04 serves without compensation and reimbursement of expenses for a term of three years 05 or until a successor is appointed. A member may not serve more than two consecutive 06 terms. 07 (d) The commission shall meet at the call of the chair and conduct business by 08 majority vote. 09 (e) The department shall provide staff and other assistance to the commission. 10 (f) The commission shall 11 (1) establish and implement a plan of operation to 12 (A) determine the amount of the annual vaccine assessment, 13 subject to review by the commissioner, for each recommended vaccine for 14 each covered individual following the initial vaccine assessment amounts 15 determined by the commissioner; 16 (B) use a method for determining the vaccine assessment 17 amount that attributes to each health care insurer and other program participant 18 the proportionate costs of recommended vaccines for covered individuals; 19 (C) establish procedures for the collection and deposit of the 20 vaccine assessment; 21 (D) establish procedures for collecting and updating data from 22 health care insurers and other program participants as necessary for the 23 operation of the program and the determination of the annual vaccine 24 assessment; the data collected must include the number of covered individuals 25 by each health care insurer and other program participant and the annual 26 vaccine program usage by each covered individual; 27 (E) devise a system for reducing surplus payments made by a 28 health care insurer and other program participant by crediting past 29 overpayments to current year vaccine assessments; 30 (2) submit to the commissioner, not later than July 1 of each year, an 31 annual financial report, including assessment determinations, in a form acceptable to
01 the commissioner; 02 (3) monitor compliance with the program requirements and vaccine 03 assessments and submit a periodic noncompliance report to the commissioner and the 04 director of insurance that lists health care insurers and other program participants that 05 failed to 06 (A) remit vaccine assessments as determined by the 07 commission and approved by the commissioner; or 08 (B) comply with a reporting or auditing requirement under the 09 program after notice from the commission. 10 Sec. 18.09.220. Vaccine assessment and reporting requirements. (a) A 11 health care insurer and other program participant shall 12 (1) pay to the department the annual combined vaccine assessments as 13 determined under the program for the recommended vaccines covered by the health 14 care insurer or other program participant for each covered individual on a schedule 15 adopted by the commission; 16 (2) provide information requested by the commission to determine the 17 number of covered individuals, actual vaccine usage under the program, and other data 18 necessary to calculate and monitor compliance with the vaccine assessment; and 19 (3) provide audited financial statements upon request of the 20 commission. 21 (b) A vaccine assessment must include a reasonable contribution toward 22 support of the program and appropriate reserve funds, as determined by the 23 commission. A vaccine assessment may not include a provider fee for the 24 administration of the vaccine. 25 (c) A vaccine assessment shall be construed as a medical expense of the health 26 care insurer or other program participant. 27 (d) A health care insurer or other program participant may appeal a 28 determination of a vaccine fee assessment made by the commission to the 29 commissioner within 10 days after receiving notification of the assessment. The 30 commissioner shall review the appeal and all materials relevant to the assessment that 31 is the subject of the appeal and shall modify the assessment if the commissioner finds
01 substantial evidence of an error. 02 Sec. 18.09.225. Other program participants. A health care provider or group 03 of providers may opt into the program if approved by the commissioner under 04 regulations adopted by the department. 05 Sec. 18.09.230. Vaccine assessment account; creation. (a) The vaccine 06 assessment account is created as an account in the general fund for the purpose of 07 receiving vaccine assessments and purchasing recommended vaccines under the 08 program. The account consists of money appropriated, including income from the 09 account and money deposited into the account from program receipts. Appropriations 10 to the account do not lapse. 11 (b) The legislature may make appropriations from the vaccine assessment 12 account for the purchase of recommended vaccines for the benefit of state residents in 13 an amount requested by the department and for other purposes of the program. 14 Sec. 18.09.240. Penalties. A health care insurer or other program participant 15 that fails to pay a required annual vaccine assessment after notification of the 16 assessment or fails to comply with a request for information necessary for 17 determination of the assessment may be assessed an additional noncompliance fee as 18 determined by the commissioner under regulations adopted by the department. 19 * Sec. 2. AS 18.09.990 is amended by adding new paragraphs to read: 20 (3) "commission" means the State Vaccine Assessment Commission; 21 (4) "commissioner" means the commissioner of health and social 22 services; 23 (5) "covered individual" means an adult or child who resides in the 24 state and who is provided insurance coverage for a recommended vaccine by a health 25 care insurer or who is a patient of another program participant; 26 (6) "health care insurer" means 27 (A) a health care insurer as defined in AS 21.54.500; and 28 (B) to the extent participation in the program is permitted by 29 law, a person that provides 30 (i) a health benefit plan as defined in AS 21.54.500; 31 (ii) a self-funded church plan or government plan; or
01 (iii) creditable coverage as defined in AS 21.54.500; 02 (7) "other program participant" and "another program participant" 03 mean a health care provider or group of providers who have opted into the program 04 under AS 18.09.225 to both purchase and administer vaccinations to residents of the 05 state; 06 (8) "program" means the statewide immunization program; 07 (9) "provider" means a person licensed or certified by the state to 08 administer vaccines or provide health care services or a partnership, corporation, or 09 other entity made up of persons licensed or certified to administer vaccines or provide 10 health care services; 11 (10) "recommended vaccine" means a vaccine recommended by the 12 Advisory Committee on Immunization Practices of the Centers for Disease Control 13 and Prevention, United States Department of Health and Human Services, and 14 included on a list maintained by the commissioner for inclusion in the program; 15 (11) "vaccine" means a preparation of killed microorganisms, living 16 attenuated organisms, living fully virulent organisms, or other substances that are 17 administered to humans for the purpose of producing or artificially increasing specific 18 immunity to life-threatening and disabling diseases. 19 * Sec. 3. AS 21.09.242 is amended by adding a new subsection to read: 20 (b) A health care insurer, as defined in AS 18.09.990, shall provide 21 information and assessments to the Department of Health and Social Services and the 22 State Vaccine Assessment Commission established under AS 18.09.210 as necessary 23 for the statewide immunization program established under AS 18.09.200. 24 * Sec. 4. AS 37.05.146(c) is amended by adding a new paragraph to read: 25 (87) the vaccine assessment account under AS 18.09.230. 26 * Sec. 5. Chapter 24, SLA 2012, is repealed. 27 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 28 read: 29 TRANSITION; DEPOSIT OF FUNDS REMAINING FROM CHILD AND ADULT 30 IMMUNIZATION PROGRAM. All unobligated funds remaining in the program established 31 under sec. 2, ch. 24, SLA 2012, shall be deposited into the account created in AS 18.09.230,