HCS 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                HOUSE CS FOR 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 included                                   
13       vaccines to providers approved by the department who agree to provide the included                                
14       vaccines to state residents under terms consistent with the program and state and                                 
01       federal law.                                                                                                      
02            (b)  The commissioner shall                                                                                  
03                 (1)  establish a procedure to phase in the program over a three-year                                    
04       period that provides for participation by an assessable entity;                                                   
05                 (2)  maintain a list of recommended vaccines for inclusion in the                                       
06       program;                                                                                                          
07                 (3)  for each included vaccine, establish the initial vaccine assessment                                
08       for the first year of the program and thereafter make annual assessments based on the                             
09       determinations made by the council established under AS 18.09.210;                                                
10                 (4)  notify assessable entities and other program participants of the                                   
11       annual vaccine assessment for each vaccine included in the program;                                               
12                 (5)  devise a method for crediting to assessable entities and other                                     
13       program participants overpayments of vaccine assessments made for reasons related to                              
14       administrative error, program termination, or lower than anticipated actual usage of                              
15       the program by covered individuals;                                                                               
16                 (6)  coordinate collective purchases of included vaccines;                                              
17                 (7)  establish a procedure for statewide distributions of vaccines                                      
18       purchased under the program; and                                                                                  
19                 (8)  review vaccine assessment appeals for error.                                                       
20            Sec. 18.09.210. State Vaccine Assessment Council; members; duties. (a)                                     
21       The State Vaccine Assessment Council is established in the department for the                                     
22       purpose of determining the amount of vaccine assessments made by the commissioner                                 
23       to be paid by assessable entities and other program participants in the state under                               
24       procedures established by the council.                                                                            
25            (b)  The council consists of eight members appointed by the commissioner as                                  
26       follows:                                                                                                          
27                 (1)  the department's chief medical officer for public health or the chief                              
28       medical officer's designee, who shall serve as chair;                                                             
29                 (2)  two health care providers licensed in the state, one of whom must                                  
30       be a pediatrician;                                                                                                
31                 (3)  three members representing health care insurers licensed in the                                    
01       state under AS 21.54, one of whom must be a plan administrator; each insurer must                                 
02       represent a different organization in the state;                                                                  
03                 (4)  a representative of a tribal or public health insurance plan;                                      
04                 (5)  the director of the division of insurance or the director's designee.                              
05            (c)  A member appointed to the council under (b)(2) - (4) of this section serves                             
06       without compensation and reimbursement of expenses for a term of three years or until                             
07       a successor is appointed. A member may not serve more than two consecutive terms.                                 
08            (d)  The council shall meet at the call of the chair and conduct business by                                 
09       majority vote.                                                                                                    
10            (e)  The department shall provide staff and other assistance to the council.                                 
11            (f)  The council shall                                                                                       
12                 (1)  establish and implement a plan of operation to                                                     
13                      (A)  determine the amount of the annual vaccine assessment,                                        
14            subject to review by the commissioner, for each included vaccine for each                                    
15            covered individual following the initial vaccine assessment amounts                                          
16            determined by the commissioner;                                                                              
17                      (B)  use a method for determining the vaccine assessment                                           
18            amount that attributes to each assessable entity and other program participant                               
19            the proportionate costs of included vaccines for covered individuals;                                        
20                      (C)  establish procedures for the collection and deposit of the                                    
21            vaccine assessment;                                                                                          
22                      (D)  establish procedures for collecting and updating data from                                    
23            assessable entities and other program participants as necessary for the                                      
24            operation of the program and the determination of the annual vaccine                                         
25            assessment; the data collected must include the number of covered individuals                                
26            by each assessable entity and other program participant and the annual vaccine                               
27            program usage by each covered individual;                                                                    
28                      (E)  devise a system for reducing surplus payments made by an                                      
29            assessable entity and other program participant by crediting past overpayments                               
30            to current year vaccine assessments;                                                                         
31                 (2)  submit to the commissioner and to the legislature, not later than                                  
01       July 1 of each year, an annual financial report, including assessment determinations                              
02       and overall costs of the program, in a form acceptable to the commissioner and the                                
03       legislature;                                                                                                      
04                 (3)  monitor compliance with the program requirements and vaccine                                       
05       assessments and submit a periodic noncompliance report to the commissioner and the                                
06       director of insurance that lists assessable entities and other program participants that                          
07       failed to                                                                                                         
08                      (A)  remit vaccine assessments as determined by the council                                        
09            and approved by the commissioner; or                                                                         
10                      (B)  comply with a reporting or auditing requirement under the                                     
11            program after notice from the council.                                                                       
12            Sec. 18.09.220. Vaccine assessment and reporting requirements. (a) An                                      
13       assessable entity and other program participant shall, after being phased into the                                
14       program under procedures approved by the commissioner,                                                            
15                 (1)  pay to the department the annual combined vaccine assessments as                                   
16       determined under the program for the included vaccines covered by the assessable                                  
17       entity or other program participant for each covered individual on a schedule adopted                             
18       by the council;                                                                                                   
19                 (2)  provide information requested by the council to determine the                                      
20       number of covered individuals, actual vaccine usage under the program, and other data                             
21       necessary to calculate and monitor compliance with the vaccine assessment; and                                    
22                 (3)  provide audited financial statements upon request of the council.                                  
23            (b)  A vaccine assessment must include a reasonable contribution toward                                      
24       support of the program and appropriate reserve funds, as determined by the council. A                             
25       vaccine assessment may not include a provider fee for the administration of the                                   
26       vaccine.                                                                                                          
27            (c)  A vaccine assessment shall be construed as a medical expense of the                                     
28       assessable entity or other program participant.                                                                   
29            (d)  An assessable entity or other program participant may appeal a                                          
30       determination of a vaccine assessment made by the council to the commissioner                                     
31       within 10 days after receiving notification of the assessment. The commissioner shall                             
01       review the appeal and all materials relevant to the assessment that is the subject of the                         
02       appeal and shall modify the assessment if the commissioner finds substantial evidence                             
03       of an error.                                                                                                      
04            (e)  An assessable entity may opt out of the program during the three-year                                   
05       phase-in period under procedures approved by the commissioner.                                                    
06            Sec. 18.09.225. Other program participants. (a) A health care provider or                                  
07       group of providers may opt into the program if approved by the commissioner under                                 
08       regulations adopted by the department.                                                                            
09            (b)  An assessable entity may not deny a claim for coverage by a health care                                 
10       provider of vaccines not distributed under the program.                                                           
11            (c)  A health care provider may not bill a payor for or resell a vaccine                                     
12       distributed under the program.                                                                                    
13            Sec. 18.09.230. Vaccine assessment account; creation. (a) The vaccine                                      
14       assessment account is created as an account in the general fund. The legislature may                              
15       appropriate to the account program receipts attributable to vaccine assessments under                             
16       AS 18.09.220, money from other sources, and interest earned on money in the                                       
17       account. Appropriations to the account do not lapse.                                                              
18            (b)  The legislature may make appropriations from the vaccine assessment                                     
19       account for the purchase of included vaccines for the benefit of state residents in an                            
20       amount requested by the department and for other purposes of the program.                                         
21            Sec. 18.09.240. Penalties. An assessable entity or other program participant                               
22       that fails to pay a required annual vaccine assessment after notification of the                                  
23       assessment or fails to comply with a request for information necessary for                                        
24       determination of the assessment may be assessed an additional noncompliance fee as                                
25       determined by the commissioner under regulations adopted by the department.                                       
26    * Sec. 2. AS 18.09.990 is amended by adding new paragraphs to read:                                                
27                 (3)  "assessable entity" means                                                                          
28                      (A)  a health care insurer as defined in AS 21.54.500;                                             
29                      (B)  an entity that provides the state health care plan described                                  
30            in AS 39.30.090 and 39.30.091;                                                                               
31                      (C)  a public or private entity that offers a publicly funded plan                                 
01            in the state, to the extent participation in the program is authorized by law;                               
02                      (D)  a third-party administrator as defined in AS 21.97.900;                                       
03                 (4)  "commissioner" means the commissioner of health and social                                         
04       services;                                                                                                         
05                 (5)  "council" means the State Vaccine Assessment Council;                                              
06                 (6)  "covered individual" means an adult or child who resides in the                                    
07       state and who is provided insurance coverage for an included vaccine by an assessable                             
08       entity or who is a patient of another program participant;                                                        
09                 (7)  "included vaccine" means a vaccine recommended by the Advisory                                     
10       Committee on Immunization Practices of the Centers for Disease Control and                                        
11       Prevention, United States Department of Health and Human Services, and included on                                
12       a list maintained by the commissioner for inclusion in the program;                                               
13                 (8)  "other program participant" and "another program participant"                                      
14       mean a health care provider or group of providers who have opted into the program                                 
15       under AS 18.09.225 to both purchase vaccines for and administer vaccinations to                                   
16       residents of the state;                                                                                           
17                 (9)  "program" means the statewide immunization program;                                                
18                 (10)  "provider" means a person licensed or certified by the state to                                   
19       administer vaccines or provide health care services or a partnership, corporation, or                             
20       other entity made up of persons licensed or certified to administer vaccines or provide                           
21       health care services;                                                                                             
22                 (11)  "vaccine" means a preparation of killed microorganisms, living                                    
23       attenuated organisms, living fully virulent organisms, or other substances that are                               
24       administered to humans for the purpose of producing or artificially increasing specific                           
25       immunity to life-threatening and disabling diseases.                                                              
26    * Sec. 3. AS 21.09.242 is amended by adding a new subsection to read:                                              
27            (b)  An assessable entity, as defined in AS 18.09.990, shall provide                                         
28       information and assessments to the Department of Health and Social Services and the                               
29       State Vaccine Assessment Council established under AS 18.09.210 as necessary for                                  
30       the statewide immunization program established under AS 18.09.200.                                                
31    * Sec. 4. AS 37.05.146(c) is amended by adding a new paragraph to read:                                            
01                 (87)  the vaccine assessment account under AS 18.09.230.                                                
02    * Sec. 5. AS 18.09.200, 18.09.210, 18.09.220, 18.09.225, 18.09.230, 18.09.240,                                     
03 18.09.990(3), 18.09.990(4), 18.09.990(5), 18.09.990(6), 18.09.990(7), 18.09.990(8),                                     
04 18.09.990(9), 18.09.990(10), 18.09.990(11); AS 21.09.242(b); and AS 37.05.146(c)(87) are                                
05 repealed January 1, 2021.                                                                                             
06    * Sec. 6. Chapter 24, SLA 2012, is repealed.                                                                       
07    * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to                          
08 read:                                                                                                                   
09       TRANSITION; DEPOSIT OF FUNDS REMAINING FROM CHILD AND ADULT                                                       
10 IMMUNIZATION PROGRAM. All unobligated funds remaining in the program established                                        
11 under sec. 2, ch. 24, SLA 2012, shall be deposited into the account created in AS 18.09.230,                            
12 added by sec. 1 of this Act.                                                                                          
13    * Sec. 8. This Act takes effect January 1, 2015.