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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,                            
01 added by sec. 1 of this Act.                                                                                          
02    * Sec. 7. This Act takes effect July 1, 2014.