CSHB 148(HSS): "An Act relating to medical assistance reform measures; relating to eligibility for medical assistance coverage; relating to medical assistance cost containment measures by the Department of Health and Social Services; and providing for an effective date."
00 CS FOR HOUSE BILL NO. 148(HSS) 01 "An Act relating to medical assistance reform measures; relating to eligibility for 02 medical assistance coverage; relating to medical assistance cost containment measures 03 by the Department of Health and Social Services; and providing for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 06 to read: 07 MEDICAL ASSISTANCE REFORM: LEGISLATIVE FINDINGS AND INTENT. 08 The legislature finds that the current Medicaid program is not sustainable. Although annual 09 growth has fallen from 6.45 percent to 4.8 percent, further reductions are needed. In order to 10 maintain a viable Medicaid program, it is the intent of the legislature that 11 (1) the governor, through the Department of Health and Social Services, take 12 all necessary action to capture federal revenue and offset state general funds and evaluate the 13 most cost-effective method for revising expansion coverage, including more efficient benefit 14 plans, cost sharing, utilization control, and other innovative health care financing strategies;
01 (2) the Department of Health and Social Services be instructed to 02 (A) evaluate and implement meaningful Medicaid reform measures, 03 including working with tribal and community partners to develop innovative practices 04 leading to a sustainable Medicaid program available for future generations; 05 (B) evaluate all options available to it, including 06 (i) obtaining waivers to the Medicaid program to address 07 choice, statewide compatibility, or other core Medicaid requirements; and 08 (ii) regulatory action to improve provider and recipient 09 compliance with program rules; 10 (3) the Department of Health and Social Services, after consulting with 11 stakeholders, submit to the legislature not later than January 25, 2016, a proposal to authorize 12 a provider tax up to the maximum extent allowed by federal law to offset some of the cost of 13 the Medicaid program; and the Department of Health and Social Services shall contract with 14 an independent third party to advise the department during the development of the tax 15 proposal under this paragraph; 16 (4) the Department of Health and Social Services establish prevention of 17 disease as a primary model of health care in the state, as requested by the legislature in 18 Legislative Resolve 16 of the Twenty-Seventh Alaska State Legislature. 19 * Sec. 2. AS 43.23.075 is amended by adding a new subsection to read: 20 (d) The provisions of this section do not apply to persons who are eligible for 21 Medicaid under 42 U.S.C. 1396a(a)(10)(A)(i)(VIII) (Title XIX, Social Security Act). 22 * Sec. 3. AS 47.05.010 is amended to read: 23 Sec. 47.05.010. Duties of department. The Department of Health and Social 24 Services shall 25 (1) administer adult public assistance, the Alaska temporary assistance 26 program, and all other assistance programs, and receive and spend money made 27 available to it; 28 (2) adopt regulations necessary for the conduct of its business and for 29 carrying out federal and state laws granting adult public assistance, temporary cash 30 assistance, diversion payments, or self-sufficiency services for needy families under 31 the Alaska temporary assistance program, and other assistance;
01 (3) establish minimum standards for personnel employed by the 02 department and adopt necessary regulations to maintain those standards; 03 (4) require those bonds and undertakings from persons employed by it 04 that, in its judgment, are necessary, and pay the premiums on them; 05 (5) cooperate with the federal government in matters of mutual 06 concern pertaining to adult public assistance, the Alaska temporary assistance 07 program, and other forms of public assistance; 08 (6) make the reports, in the form and containing the information, that 09 the federal government from time to time requires; 10 (7) cooperate with the federal government, its agencies, or 11 instrumentalities in establishing, extending, and strengthening services for the 12 protection and care of homeless, dependent, and neglected children in danger of 13 becoming delinquent, and receive and expend funds available to the department by the 14 federal government, the state, or its political subdivisions for that purpose; 15 (8) cooperate with the federal government in adopting state plans to 16 make the state eligible for federal matching in appropriate categories of assistance, and 17 in all matters of mutual concern, including adoption of the methods of administration 18 that are found by the federal government to be necessary for the efficient operation of 19 welfare programs; 20 (9) adopt regulations, not inconsistent with law, defining need, 21 prescribing the conditions of eligibility for assistance, and establishing standards for 22 determining the amount of assistance that an eligible person is entitled to receive; the 23 amount of the assistance is sufficient when, added to all other income and resources 24 available to an individual, it provides the individual with a reasonable subsistence 25 compatible with health and well-being; an individual who meets the requirements for 26 eligibility for assistance shall be granted the assistance promptly upon application for 27 it; 28 (10) grant to a person claiming or receiving assistance and who is 29 aggrieved because of the department's action or failure to act, reasonable notice and an 30 opportunity for a fair hearing by the office of administrative hearings (AS 44.64.010), 31 and the department shall adopt regulations relative to this;
01 (11) enter into reciprocal agreements with other states relative to 02 public assistance, welfare services, and institutional care that are considered advisable; 03 (12) establish the requirements of residence for public assistance, 04 welfare services, and institutional care that are considered advisable, subject to the 05 limitations of other laws of the state, or law or regulation imposed as conditions for 06 federal financial participation; 07 (13) establish the divisions and local offices that are considered 08 necessary or expedient to carry out a duty or authority assigned to it and appoint and 09 employ the assistants and personnel that are necessary to carry on the work of the 10 divisions and offices, and fix the compensation of the assistants or employees, except 11 that a person engaged in business as a retail vendor of general merchandise, or a 12 member of the immediate family of a person who is so engaged, may not serve as an 13 acting, temporary, or permanent local agent of the department, unless the 14 commissioner of health and social services certifies in writing to the governor, with 15 relation to a particular community, that no other qualified person is available in the 16 community to serve as local welfare agent; for the purposes of this paragraph, a 17 "member of the immediate family" includes a spouse, child, parent, brother, sister, 18 parent-in-law, brother-in-law, or sister-in-law; 19 (14) provide education and health-related services and referrals 20 designed to reduce the number of out-of-wedlock pregnancies and the number of 21 induced pregnancy terminations in the state; 22 (15) investigate reports of abuse, neglect, or misappropriation of 23 property by certified nurse aides in facilities licensed by the department under 24 AS 47.32; 25 (16) establish state policy relating to and administer federal programs 26 subject to state control as provided under 42 U.S.C. 3001 - 3058ee (Older Americans 27 Act of 1965), as amended, and related federal regulations; 28 (17) administer the older Alaskans service grants under AS 47.65.010 - 29 47.65.050 and the adult day care and family respite care grants under AS 47.65.100; 30 (18) establish guidelines for medical assistance providers to 31 develop health care delivery models that encourage adequate nutrition and
01 disease prevention. 02 * Sec. 4. AS 47.05.200(a) is amended to read: 03 (a) The department shall annually contract for independent audits of a 04 statewide sample of all medical assistance providers in order to identify overpayments 05 and violations of criminal statutes. The audits conducted under this section may not be 06 conducted by the department or employees of the department. The number of audits 07 under this section may not be less than 50 each year [, AS A TOTAL FOR THE 08 MEDICAL ASSISTANCE PROGRAMS UNDER AS 47.07 AND AS 47.08, SHALL 09 BE 0.75 PERCENT OF ALL ENROLLED PROVIDERS UNDER THE 10 PROGRAMS, ADJUSTED ANNUALLY ON JULY 1, AS DETERMINED BY THE 11 DEPARTMENT, EXCEPT THAT THE NUMBER OF AUDITS UNDER THIS 12 SECTION MAY NOT BE LESS THAN 75]. The audits under this section must 13 include both on-site audits and desk audits and must be of a variety of provider types. 14 The department may not award a contract under this subsection to an organization that 15 does not retain persons with a significant level of expertise and recent professional 16 practice in the general areas of standard accounting principles and financial auditing 17 and in the specific areas of medical records review, investigative research, and Alaska 18 health care criminal law. The contractor, in consultation with the commissioner, shall 19 select the providers to be audited and decide the ratio of desk audits and on-site audits 20 to the total number selected. In identifying providers who are subject to an audit 21 under this chapter, the department shall attempt to minimize concurrent state or 22 federal audits. 23 * Sec. 5. AS 47.05.200(b) is amended to read: 24 (b) Within 90 days after receiving each audit report from an audit conducted 25 under this section, the department shall begin administrative procedures to recoup 26 overpayments identified in the audits and shall allocate the reasonable and necessary 27 financial and human resources to ensure prompt recovery of overpayments unless the 28 attorney general has advised the commissioner in writing that a criminal investigation 29 of an audited provider has been or is about to be undertaken, in which case, the 30 commissioner shall hold the administrative procedure in abeyance until a final 31 charging decision by the attorney general has been made. The commissioner shall
01 provide copies of all audit reports to the attorney general so that the reports can be 02 screened for the purpose of bringing criminal charges. The department may assess 03 interest and penalties on any identified overpayment. Interest under this 04 subsection shall be calculated using the statutory rates for postjudgment interest 05 accruing from the date of the issuance of the final audit. 06 * Sec. 6. AS 47.05 is amended by adding a new section to read: 07 Sec. 47.05.250. Fines. (a) The department may adopt regulations to impose a 08 civil fine against a provider who violates AS 47.05, AS 47.07, or regulations adopted 09 under those chapters. 10 (b) A fine imposed under this section may not be less than $100 or more than 11 $25,000 for each occurrence. 12 (c) The provisions of this section are in addition to any other remedies 13 available under AS 47.05, AS 47.07, or regulations adopted under those chapters. 14 * Sec. 7. AS 47.07.020(b) is amended to read: 15 (b) In addition to the persons specified in (a) of this section, the following 16 optional groups of persons for whom the state may claim federal financial 17 participation are eligible for medical assistance: 18 (1) persons eligible for but not receiving assistance under any plan of 19 the state approved under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act, 20 Supplemental Security Income) or a federal program designated as the successor to the 21 aid to families with dependent children program; 22 (2) persons in a general hospital, skilled nursing facility, or 23 intermediate care facility, who, if they left the facility, would be eligible for assistance 24 under one of the federal programs specified in (1) of this subsection; 25 (3) persons under 21 years of age who are under supervision of the 26 department, for whom maintenance is being paid in whole or in part from public 27 funds, and who are in foster homes or private child-care institutions; 28 (4) aged, blind, or disabled persons, who, because they do not meet 29 income and resources requirements, do not receive supplemental security income 30 under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act), and who do not 31 receive a mandatory state supplement, but who are eligible, or would be eligible if
01 they were not in a skilled nursing facility or intermediate care facility to receive an 02 optional state supplementary payment; 03 (5) persons under 21 years of age who are in an institution designated 04 as an intermediate care facility for persons with intellectual and developmental 05 disabilities and who are financially eligible as determined by the standards of the 06 federal program designated as the successor to the aid to families with dependent 07 children program; 08 (6) persons in a medical or intermediate care facility whose income 09 while in the facility does not exceed 300 percent of the supplemental security income 10 benefit rate under 42 U.S.C. 1381 - 1383c (Title XVI, Social Security Act) but who 11 would not be eligible for an optional state supplementary payment if they left the 12 hospital or other facility; 13 (7) persons under 21 years of age who are receiving active treatment in 14 a psychiatric hospital and who are financially eligible as determined by the standards 15 of the federal program designated as the successor to the aid to families with 16 dependent children program; 17 (8) persons under 21 years of age and not covered under (a) of this 18 section, who would be eligible for benefits under the federal program designated as 19 the successor to the aid to families with dependent children program, except that they 20 do not meet the deprivation criteria under 42 U.S.C. 1396u-1(b)(1)(A)(ii) [HAVE 21 THE CARE AND SUPPORT OF BOTH THEIR NATURAL AND ADOPTIVE 22 PARENTS]; 23 (9) pregnant women not covered under (a) of this section and who 24 meet the income and resource requirements of the federal program designated as the 25 successor to the aid to families with dependent children program; 26 (10) persons under 21 years of age not covered under (a) of this section 27 who the department has determined cannot be placed for adoption without medical 28 assistance because of a special need for medical or rehabilitative care and who the 29 department has determined are hard-to-place children eligible for subsidy under 30 AS 25.23.190 - 25.23.210; 31 (11) persons who can be considered under 42 U.S.C. 1396a(e)(3) (Title
01 XIX, Social Security Act, Medical Assistance) to be individuals with respect to whom 02 a supplemental security income is being paid under 42 U.S.C. 1381 - 1383c (Title 03 XVI, Social Security Act) because they meet all of the following criteria: 04 (A) they are 18 years of age or younger and qualify as disabled 05 individuals under 42 U.S.C. 1382c(a) (Title XVI, Social Security Act); 06 (B) the department has determined that 07 (i) they require a level of care provided in a hospital, 08 nursing facility, or intermediate care facility for persons with 09 intellectual and developmental disabilities; 10 (ii) it is appropriate to provide their care outside of an 11 institution; and 12 (iii) the estimated amount that would be spent for 13 medical assistance for their individual care outside an institution is not 14 greater than the estimated amount that would otherwise be expended 15 individually for medical assistance within an appropriate institution; 16 (C) if they were in a medical institution, they would be eligible 17 for medical assistance under other provisions of this chapter; and 18 (D) home and community-based services under a waiver 19 approved by the federal government are either not available to them under this 20 chapter or would be inappropriate for them; 21 (12) disabled persons, as described in 42 U.S.C. 22 1396a(a)(10)(A)(ii)(XIII), who are in families whose income, as determined under 23 applicable federal regulations or guidelines, is less than 250 percent of the official 24 poverty line applicable to a family of that size according to the United States 25 Department of Health and Human Services, and who, but for earnings in excess of the 26 limit established under 42 U.S.C. 1396d(q)(2)(B), would be considered to be 27 individuals with respect to whom a supplemental security income is being paid under 28 42 U.S.C. 1381 - 1383c; a person eligible for assistance under this paragraph who is 29 not eligible under another provision of this section shall pay a premium or other cost- 30 sharing charges according to a sliding fee scale that is based on income as established 31 by the department in regulations;
01 (13) persons under 19 years of age who are not covered under (a) of 02 this section and whose household income does not exceed 203 [175] percent of the 03 federal poverty line as defined by the United States Department of Health and Human 04 Services and revised under 42 U.S.C. 9902(2); 05 (14) pregnant women who are not covered under (a) of this section and 06 whose household income does not exceed 200 [175] percent of the federal poverty line 07 as defined by the United States Department of Health and Human Services and revised 08 under 42 U.S.C. 9902(2); 09 (15) persons who have been diagnosed with breast or cervical cancer 10 and who are eligible for coverage under 42 U.S.C. 1396a(a)(10)(A)(ii)(XVIII); 11 (16) persons who are under 65 years of age, who are not pregnant, 12 whose household income does not exceed 138 percent of the federal poverty line, 13 including the five percent income disregard, as defined by the United States 14 Department of Health and Human Services and revised under 42 U.S.C. 9902(2), 15 and who are eligible under 42 U.S.C. 1396a(a)(10)(A)(i)(VIII), if the federal 16 medical assistance percentage paid to the state for the coverage is not less than 90 17 percent. 18 * Sec. 8. AS 47.07.020(g) is amended to read: 19 (g) For a person whose Medicaid eligibility is not calculated using the 20 modified adjusted gross income standard set out in 42 U.S.C. 1396a(e)(14), the 21 [A] person's eligibility for medical assistance under this chapter may not be denied or 22 delayed on the basis of a transfer of assets for less than fair market value if the person 23 establishes to the satisfaction of the department that the denial or delay would work an 24 undue hardship on the person as determined on the basis of criteria in applicable 25 federal regulations. The department may only consider information provided by a 26 person claiming undue hardship that the department verifies through a source 27 other than the person's own statement. 28 * Sec. 9. AS 47.07.020(m) is amended to read: 29 (m) For a person whose Medicaid eligibility is not calculated using the 30 modified adjusted gross income standard set out in 42 U.S.C. 1396a(e)(14), and, 31 except [EXCEPT] as provided in (g) of this section, the department shall impose a
01 penalty period of ineligibility for the transfer of an asset for less than fair market value 02 by an applicant or an applicant's spouse consistent with 42 U.S.C. 1396p(c)(1). 03 * Sec. 10. AS 47.07.030(d) is amended to read: 04 (d) The department shall [MAY] establish [AS OPTIONAL SERVICES] a 05 primary care case management system or a managed care organization contract in 06 which certain eligible individuals, including super-utilizers as identified by the 07 department, are required to enroll and seek approval from a case manager or the 08 managed care organization before receiving certain services. The department shall 09 establish enrollment criteria and determine eligibility for services consistent with 10 federal and state law. 11 * Sec. 11. AS 47.07.030 is amended by adding a new subsection to read: 12 (g) In an annual report to the legislature, the department shall include 13 information separately describing state costs for optional and mandatory services 14 provided under this section. 15 * Sec. 12. AS 47.07.036(b) is amended to read: 16 (b) The department, in implementing this section, shall take all reasonable 17 steps to implement cost containment measures that do not eliminate program 18 eligibility or the scope of services required or authorized under AS 47.07.020 and 19 47.07.030 before implementing cost containment measures under (c) of this section 20 that directly affect program eligibility or coverage of services. The cost containment 21 measures taken under this subsection may include new utilization review procedures, 22 changes in provider payment rates, and precertification requirements for coverage [OF 23 SERVICES, AND AGREEMENTS WITH FEDERAL OFFICIALS UNDER WHICH 24 THE FEDERAL GOVERNMENT WILL ASSUME RESPONSIBILITY FOR 25 COVERAGE OF SOME INDIVIDUALS OR SOME SERVICES FOR SOME 26 INDIVIDUALS THROUGH SUCH FEDERAL PROGRAMS AS THE INDIAN 27 HEALTH SERVICE OR MEDICARE]. 28 * Sec. 13. AS 47.07.036 is amended by adding new subsections to read: 29 (d) Notwithstanding (a) - (c) of this section, the department shall 30 (1) apply for a section 1115 waiver under 42 U.S.C. 1315(a) to use 31 innovative service delivery system models to improve care, increase efficiency, reduce
01 costs, and expand services provided to Indian Health Service beneficiaries through the 02 Indian Health Service and tribal health facilities; 03 (2) apply for a section 1915(i) option under 42 U.S.C. 1396n to 04 improve services and care through home and community-based services to obtain a 50 05 percent federal match; 06 (3) apply for a section 1915(k) option under 42 U.S.C. 1396n to 07 provide home and community-based services and support to increase the federal match 08 for these programs from 50 percent to 56 percent; 09 (4) evaluate and seek permission from the United States Department of 10 Health and Human Services Centers for Medicare and Medicaid Services to participate 11 in various demonstration projects, including payment reform, care management 12 programs, workforce development and innovation, and innovative services delivery 13 models; and 14 (5) enhance telemedicine capability and reimbursement to incentivize 15 its use for Medicaid recipients. 16 (e) Notwithstanding (a) - (c) of this section and in addition to the projects and 17 services described under (d) of this section, the department shall apply for a section 18 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration projects 19 focused on innovative payment models for one or more groups of medical assistance 20 recipients in one or more specific geographic areas. The demonstration project or 21 projects may include 22 (1) managed care organizations as described under 42 U.S.C. 1396u-2; 23 (2) community care organizations; 24 (3) patient-centered medical homes as described under 42 U.S.C. 256a- 25 1; or 26 (4) other innovative payment models that ensure access to health care 27 without reducing the quality of care. 28 (f) The department shall design and implement at least one demonstration 29 project under (e) of this section that is a coordinated care demonstration project using 30 a global payment fee structure. The demonstration project must include a managed 31 care system that operates within a fixed budget to reduce medical cost inflation,
01 improves the quality of health care for recipients, and results in a healthier population. 02 The department shall design the managed care system to reduce the growth in medical 03 assistance expenditures with a goal of reducing the per capita growth rate for medical 04 assistance expenditures by at least two percentage points. The managed care system 05 must implement alternative payment methodologies and create a network of patient- 06 centered primary care homes, and will be measured based on quality and performance 07 outcomes. The department shall prepare a report regarding the progress of this 08 demonstration project and shall, on or before February 1, 2019, deliver the report to 09 the senate secretary and the chief clerk of the house of representatives and notify the 10 legislature that the report is available. 11 (g) In this section, "telemedicine" means the practice of health care delivery, 12 evaluation, diagnosis, consultation, or treatment, using the transfer of medical data 13 through audio, visual, or data communications that are performed over two or more 14 locations between providers who are physically separated from the recipient or from 15 each other. 16 * Sec. 14. AS 47.07.900(4) is amended to read: 17 (4) "clinic services" means services provided by state-approved 18 outpatient community mental health clinics [THAT RECEIVE GRANTS UNDER 19 AS 47.30.520 - 47.30.620], state-operated community mental health clinics, outpatient 20 surgical care centers, and physician clinics; 21 * Sec. 15. AS 47.07.900(17) is amended to read: 22 (17) "rehabilitative services" means services for substance abusers and 23 emotionally disturbed or chronically mentally ill adults provided by 24 (A) a drug or alcohol treatment center [THAT IS FUNDED 25 WITH A GRANT UNDER AS 47.30.475]; or 26 (B) an outpatient community mental health clinic [THAT HAS 27 A CONTRACT TO PROVIDE COMMUNITY MENTAL HEALTH 28 SERVICES UNDER AS 47.30.520 - 47.30.620]; 29 * Sec. 16. The uncodified law of the State of Alaska is amended by adding a new section to 30 read: 31 DEMONSTRATION PROJECT: REDUCING PRE-TERM BIRTHS. Before
01 January 1, 2018, the Department of Health and Social Services shall investigate the design of 02 a demonstration project for the purpose of reducing pre-term birth rates in the state from the 03 current rate of 10.3 percent. The demonstration project shall provide for the voluntary 04 enrollment of approximately 500 recipients who are eligible for medical assistance under 05 AS 47.07.020(b)(14). The Department of Health and Social Services shall offer pregnancy 06 counselling, nutritional counselling, and, as necessary, vitamin D supplementation to maintain 07 levels of 40 ng/ml vitamin D during pregnancy for participants in the demonstration project. 08 The demonstration project may be modeled after the Protect Our Children NOW! project 09 implemented as a cooperative project of the South Carolina Department of Health and Human 10 Services and private health organizations. The goal of the demonstration project is to achieve 11 a reduction in pre-term births in the state, consistent with the results of the following 12 published studies: Wagner, C. L., et al., "A Randomized Trial of Vitamin D Supplementation 13 in Two Community Health Center Networks in South Carolina," American Journal of 14 Obstetrics and Gynecology 208 (February 2013); Bodnar, L. M., et al., "Maternal 25- 15 Hydroxyvitamin D and Preterm Birth in Twin Gestations," Obstetrics and Gynecology 122 16 (July 2013). 17 * Sec. 17. The uncodified law of the State of Alaska is amended by adding a new section to 18 read: 19 MEDICAID MANAGED CARE FOR SUPER-UTILIZERS. On or before January 1, 20 2017, the Department of Health and Social Services shall 21 (1) establish a primary care case management system or a managed care 22 organization contract under AS 47.07.030(d), as amended by sec. 10 of this Act, for super- 23 utilizers, as identified by the department; and 24 (2) deliver a report on the system or contract to the senate secretary and the 25 chief clerk of the house of representatives and notify the legislature that the report is 26 available. 27 * Sec. 18. The uncodified law of the State of Alaska is amended by adding a new section to 28 read: 29 MEDICAID REDESIGN; REPORTS TO LEGISLATURE. (a) The Department of 30 Health and Social Services shall present to the legislature on or before the 10th day of the 31 Second Regular Session of the Twenty-Ninth Alaska State Legislature the results of the
01 Medicaid Redesign and Expansion Technical Assistance study, advertised under request for 02 proposal number 2015-0600-2986, issued February 25, 2015. The department shall deliver a 03 report describing the results of the study and a program for reforming the medical assistance 04 program to the senate secretary and chief clerk of the house of representatives and notify the 05 legislature that the report is available. 06 (b) The Department of Health and Social Services shall prepare a report summarizing 07 cost-sharing measures implemented before October 1, 2015, by the Department of Health and 08 Social Services under AS 47.07.042 and describing the effect of those measures on the state 09 budget. On or before March 1, 2016, the Department of Health and Social Services shall 10 deliver a copy of the report to the senate secretary and chief clerk of the house of 11 representatives and notify the legislature that the report is available. 12 (c) On or before February 1, 2019, the Department of Health and Social Services shall 13 complete a report informing the legislature of the results of the applications for waivers and 14 options under AS 47.07.036(d)(1) - (3), enacted by sec. 13 of this Act, and shall deliver the 15 report to the senate secretary and chief clerk of the house of representatives and notify the 16 legislature that the report is available. The report must include 17 (1) information explaining whether the department's applications for a section 18 1115 waiver under 42 U.S.C. 1315(a), a section 1915(i) option under 42 U.S.C. 1396n, and a 19 section 1915(k) option under 42 U.S.C. 1396n were approved by the United States 20 Department of Health and Human Services; 21 (2) a description of cost savings to the state resulting from the programs 22 implemented under the waivers, including 23 (A) the extent to which the programs implemented under the section 24 1115 waiver under 42 U.S.C. 1315(a) achieved the savings estimated by the 25 department; 26 (B) the extent to which the programs implemented under the section 27 1915(i) and (k) options under 42 U.S.C. 1396n achieved the savings estimated by the 28 department. 29 * Sec. 19. The uncodified law of the State of Alaska is amended by adding a new section to 30 read: 31 MEDICAID STATE PLAN INSTRUCTIONS. The Department of Health and Social
01 Services shall immediately amend and submit for approval to the appropriate federal agency 02 the state plan for provisions of medical assistance consistent with this Act. 03 * Sec. 20. The uncodified law of the State of Alaska is amended by adding a new section to 04 read: 05 EMERGENCY REGULATIONS AUTHORIZED. In order to ensure that sec. 1 of this 06 Act, and AS 47.07.036, as amended by sec. 13 of this Act, are timely implemented to achieve 07 a sustainable Medicaid program with cost-saving measures, including waivers, necessary for 08 more persons to qualify for Medicaid services and thus ensure the public peace, health, safety, 09 or general welfare, the Department of Health And Social Services may adopt emergency 10 regulations under AS 44.62 (Administrative Procedure Act) to implement secs. 1 and 13 of 11 this Act. 12 * Sec. 21. Section 20 of this Act is repealed June 30, 2017. 13 * Sec. 22. The uncodified law of the State of Alaska is amended by adding a new section to 14 read: 15 REVISOR'S INSTRUCTION. The revisor of statutes is requested to change the catch 16 line of AS 47.07.036 from "Cost containment measures authorized" to "Medical assistance 17 cost-containment and reform measures authorized." 18 * Sec. 23. Sections 19 and 20 of this Act take effect immediately under AS 01.10.070(c). 19 * Sec. 24. Except as provided in sec. 23 of this Act, this Act takes effect August 1, 2015.