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CSSB 169(HSS): "An Act establishing in the Department of Health and Social Services a statewide immunization program and the State Vaccine Assessment Council; creating a vaccine assessment account; requiring a vaccine assessment from assessable entities and other program participants for statewide immunization purchases; repealing the temporary child and adult immunization program; and providing for an effective date."

00                       CS FOR SENATE BILL NO. 169(HSS)                                                                   
01 "An Act establishing in the Department of Health and Social Services a statewide                                        
02 immunization program and the State Vaccine Assessment Council; creating a vaccine                                       
03 assessment account; requiring a vaccine assessment from assessable entities and other                                   
04 program participants for statewide immunization purchases; repealing the temporary                                      
05 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 council established under AS 18.09.210;                                   
09                 (3)  notify assessable entities and other program participants of the                                   
10       annual vaccine assessment for each vaccine included in the program;                                               
11                 (4)  devise a method for crediting to assessable entities 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 vaccine assessment appeals for error.                                                       
19            Sec. 18.09.210. State Vaccine Assessment Council; members; duties. (a)                                     
20       The State Vaccine Assessment Council 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 assessable entities and other program participants in the state under                               
23       procedures established by the council.                                                                            
24            (b)  The council consists of eight members appointed by the commissioner as                                  
25       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 health care insurers licensed in the                                    
30       state under AS 21.54, one of whom must be a plan administrator; each insurer must                                 
31       represent a different 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 council under (b)(2) - (4) of this section serves                             
04       without compensation and reimbursement of expenses for a term of three years or until                             
05       a successor is appointed. A member may not serve more than two consecutive terms.                                 
06            (d)  The council shall meet at the call of the chair and conduct business by                                 
07       majority vote.                                                                                                    
08            (e)  The department shall provide staff and other assistance to the council.                                 
09            (f)  The council shall                                                                                       
10                 (1)  establish and implement a plan of operation to                                                     
11                      (A)  determine the amount of the annual vaccine assessment,                                        
12            subject to review by the commissioner, for each recommended vaccine for                                      
13            each covered individual following the initial vaccine assessment amounts                                     
14            determined by the commissioner;                                                                              
15                      (B)  use a method for determining the vaccine assessment                                           
16            amount that attributes to each assessable entity and other program participant                               
17            the proportionate costs of recommended vaccines for covered individuals;                                     
18                      (C)  establish procedures for the collection and deposit of the                                    
19            vaccine assessment;                                                                                          
20                      (D)  establish procedures for collecting and updating data from                                    
21            assessable entities and other program participants as necessary for the                                      
22            operation of the program and the determination of the annual vaccine                                         
23            assessment; the data collected must include the number of covered individuals                                
24            by each assessable entity and other program participant and the annual vaccine                               
25            program usage by each covered individual;                                                                    
26                      (E)  devise a system for reducing surplus payments made by an                                      
27            assessable entity and other program participant by crediting past overpayments                               
28            to current year vaccine assessments;                                                                         
29                 (2)  submit to the commissioner, not later than July 1 of each year, an                                 
30       annual financial report, including assessment determinations, in a form acceptable to                             
31       the commissioner;                                                                                                 
01                 (3)  monitor compliance with the program requirements and vaccine                                       
02       assessments and submit a periodic noncompliance report to the commissioner and the                                
03       director of insurance that lists assessable entities and other program participants that                          
04       failed to                                                                                                         
05                      (A)  remit vaccine assessments as determined by the council                                        
06            and approved by the commissioner; or                                                                         
07                      (B)  comply with a reporting or auditing requirement under the                                     
08            program after notice from the council.                                                                       
09            Sec. 18.09.220. Vaccine assessment and reporting requirements. (a) An                                      
10       assessable entity and other program participant shall                                                             
11                 (1)  pay to the department the annual combined vaccine assessments as                                   
12       determined under the program for the recommended vaccines covered by the                                          
13       assessable entity or other program participant for each covered individual on a                                   
14       schedule adopted by the council;                                                                                  
15                 (2)  provide information requested by the council to determine the                                      
16       number of covered individuals, actual vaccine usage under the program, and other data                             
17       necessary to calculate and monitor compliance with the vaccine assessment; and                                    
18                 (3)  provide audited financial statements upon request of the council.                                  
19            (b)  A vaccine assessment must include a reasonable contribution toward                                      
20       support of the program and appropriate reserve funds, as determined by the council. A                             
21       vaccine assessment may not include a provider fee for the administration of the                                   
22       vaccine.                                                                                                          
23            (c)  A vaccine assessment shall be construed as a medical expense of the                                     
24       assessable entity or other program participant.                                                                   
25            (d)  An assessable entity or other program participant may appeal a                                          
26       determination of a vaccine assessment made by the council to the commissioner                                     
27       within 10 days after receiving notification of the assessment. The commissioner shall                             
28       review the appeal and all materials relevant to the assessment that is the subject of the                         
29       appeal and shall modify the assessment if the commissioner finds substantial evidence                             
30       of an error.                                                                                                      
31            Sec. 18.09.225. Other program participants. A health care provider or group                                
01       of providers may opt into the program if approved by the commissioner under                                       
02       regulations adopted by the department.                                                                            
03            Sec. 18.09.230. Vaccine assessment account; creation. (a) The vaccine                                      
04       assessment account is created as an account in the general fund for the purpose of                                
05       receiving vaccine assessments and purchasing recommended vaccines under the                                       
06       program. The account consists of money appropriated, including income from the                                    
07       account and money deposited into the account from program receipts. Appropriations                                
08       to the account do not lapse.                                                                                      
09            (b)  The legislature may make appropriations from the vaccine assessment                                     
10       account for the purchase of recommended vaccines for the benefit of state residents in                            
11       an amount requested by the department and for other purposes of the program.                                      
12            Sec. 18.09.240. Penalties. An assessable entity or other program participant                               
13       that fails to pay a required annual vaccine assessment after notification of the                                  
14       assessment or fails to comply with a request for information necessary for                                        
15       determination of the assessment may be assessed an additional noncompliance fee as                                
16       determined by the commissioner under regulations adopted by the department.                                       
17    * Sec. 2. AS 18.09.990 is amended by adding new paragraphs to read:                                                
18                 (3)  "assessable entity" means                                                                          
19                      (A)  a health care insurer as defined in AS 21.54.500;                                             
20                      (B)  an entity that provides the state health care plan described                                  
21            in AS 39.30.090 and 39.30.091;                                                                               
22                      (C)  a public or private entity that offers a publicly funded plan                                 
23            in the state, to the extent participation in the program is authorized by law; and                           
24                      (D)  a third-party administrator as defined in AS 21.97.900;                                       
25                 (4)  "commissioner" means the commissioner of health and social                                         
26       services;                                                                                                         
27                 (5)  "council" means the State Vaccine Assessment Council;                                              
28                 (6)  "covered individual" means an adult or child who resides in the                                    
29       state and who is provided insurance coverage for a recommended vaccine by an                                      
30       assessable entity or who is a patient of another program participant;                                             
31                 (7)  "other program participant" and "another program participant"                                      
01       mean a health care provider or group of providers who have opted into the program                                 
02       under AS 18.09.225 to both purchase vaccines for and administer vaccinations to                                   
03       residents of the state;                                                                                           
04                 (8)  "program" means the statewide immunization program;                                                
05                 (9)  "provider" means a person licensed or certified by the state to                                    
06       administer vaccines or provide health care services or a partnership, corporation, or                             
07       other entity made up of persons licensed or certified to administer vaccines or provide                           
08       health care services;                                                                                             
09                 (10)  "recommended vaccine" means a vaccine recommended by the                                          
10       Advisory Committee on Immunization Practices of the Centers for Disease Control                                   
11       and Prevention, United States Department of Health and Human Services, and                                        
12       included on a list maintained by the commissioner for inclusion in the program;                                   
13                 (11)  "vaccine" means a preparation of killed microorganisms, living                                    
14       attenuated organisms, living fully virulent organisms, or other substances that are                               
15       administered to humans for the purpose of producing or artificially increasing specific                           
16       immunity to life-threatening and disabling diseases.                                                              
17    * Sec. 3. AS 21.09.242 is amended by adding a new subsection to read:                                              
18            (b)  An assessable entity, as defined in AS 18.09.990, shall provide                                         
19       information and assessments to the Department of Health and Social Services and the                               
20       State Vaccine Assessment Council established under AS 18.09.210 as necessary for                                  
21       the statewide immunization program established under AS 18.09.200.                                                
22    * Sec. 4. AS 37.05.146(c) is amended by adding a new paragraph to read:                                            
23                 (87)  the vaccine assessment account under AS 18.09.230.                                                
24    * Sec. 5. Chapter 24, SLA 2012, is repealed.                                                                       
25    * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to                          
26 read:                                                                                                                   
27       TRANSITION; DEPOSIT OF FUNDS REMAINING FROM CHILD AND ADULT                                                       
28 IMMUNIZATION PROGRAM. All unobligated funds remaining in the program established                                        
29 under sec. 2, ch. 24, SLA 2012, shall be deposited into the account created in AS 18.09.230,                            
30 added by sec. 1 of this Act.                                                                                          
31    * Sec. 7. This Act takes effect July 1, 2014.