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CSSB 74(FIN): "An Act relating to diagnosis, treatment, and prescription of drugs without a physical examination by a physician; relating to the delivery of services by a licensed professional counselor, marriage and family therapist, psychologist, psychological associate, and social worker by audio, video, or data communications; relating to the duties of the State Medical Board; relating to limitations of actions; establishing the Alaska Medical Assistance False Claim and Reporting Act; relating to medical assistance programs administered by the Department of Health and Social Services; relating to the controlled substance prescription database; relating to the duties of the Board of Pharmacy; relating to the duties of the Department of Commerce, Community, and Economic Development; relating to accounting for program receipts; relating to public record status of records related to the Alaska Medical Assistance False Claim and Reporting Act; establishing a telemedicine business registry; relating to competitive bidding for medical assistance products and services; relating to verification of eligibility for public assistance programs administered by the Department of Health and Social Services; relating to annual audits of state medical assistance providers; relating to reporting overpayments of medical assistance payments; establishing authority to assess civil penalties for violations of medical assistance program requirements; relating to seizure and forfeiture of property for medical assistance fraud; relating to the duties of the Department of Health and Social Services; establishing medical assistance demonstration projects; relating to Alaska Pioneers' Homes and Alaska Veterans' Homes; relating to the duties of the Department of Administration; relating to the Alaska Mental Health Trust Authority; relating to feasibility studies for the provision of specified state services; amending Rules 4, 5, 7, 12, 24, 26, 27, 41, 77, 79, 82, and 89, Alaska Rules of Civil Procedure, and Rule 37, Alaska Rules of Criminal Procedure; and providing for an effective date."

00                       CS FOR SENATE BILL NO. 74(FIN)                                                                    
01 "An Act relating to diagnosis, treatment, and prescription of drugs without a physical                                  
02 examination by a physician; relating to the delivery of services by a licensed professional                             
03 counselor, marriage and family therapist, psychologist, psychological associate, and                                    
04 social worker by audio, video, or data communications; relating to the duties of the State                              
05 Medical Board; relating to limitations of actions; establishing the Alaska Medical                                      
06 Assistance False Claim and Reporting Act; relating to medical assistance programs                                       
07 administered by the Department of Health and Social Services; relating to the controlled                                
08 substance prescription database; relating to the duties of the Board of Pharmacy;                                       
09 relating to the duties of the Department of Commerce, Community, and Economic                                           
10 Development; relating to accounting for program receipts; relating to public record                                     
11 status of records related to the Alaska Medical Assistance False Claim and Reporting                                    
12 Act; establishing a telemedicine business registry; relating to competitive bidding for                                 
01 medical assistance products and services; relating to verification of eligibility for public                            
02 assistance programs administered by the Department of Health and Social Services;                                       
03 relating to annual audits of state medical assistance providers; relating to reporting                                  
04 overpayments of medical assistance payments; establishing authority to assess civil                                     
05 penalties for violations of medical assistance program requirements; relating to seizure                                
06 and forfeiture of property for medical assistance fraud; relating to the duties of the                                  
07 Department of Health and Social Services; establishing medical assistance                                               
08 demonstration projects; relating to Alaska Pioneers' Homes and Alaska Veterans'                                         
09 Homes; relating to the duties of the Department of Administration; relating to the                                      
10 Alaska Mental Health Trust Authority; relating to feasibility studies for the provision of                              
11 specified state services; amending Rules 4, 5, 7, 12, 24, 26, 27, 41, 77, 79, 82, and 89,                               
12 Alaska Rules of Civil Procedure, and Rule 37, Alaska Rules of Criminal Procedure; and                                   
13 providing for an effective date."                                                                                       
14 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
15    * Section 1. AS 08.29.400 is amended by adding new subsections to read:                                            
16            (b)  The board may not impose disciplinary sanctions on a licensee for the                                   
17       evaluation, diagnosis, or treatment of a person through audio, video, or data                                     
18       communications when physically separated from the person if                                                       
19                 (1)  the licensee or another licensed health care provider is available to                              
20       provide follow-up care;                                                                                           
21                 (2)  the licensee requests that the person consent to sending a copy of                                 
22       all records of the encounter to a primary care provider if the licensee is not the                                
23       person's primary care provider and, if the person consents, the licensee sends the                                
24       records to the person's primary care provider; and                                                                
25                 (3)  the licensee meets the requirements established by the board in                                    
26       regulation.                                                                                                       
01            (c)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
02       supervision, and treatment of a person as authorized under (b) of this section by                                 
03       establishing standards of care, including standards for training, confidentiality,                                
04       supervision, practice, and related issues.                                                                        
05    * Sec. 2. AS 08.63.210 is amended by adding new subsections to read:                                               
06            (c)  The board may not impose disciplinary sanctions on a licensee for the                                   
07       evaluation, diagnosis, supervision, or treatment of a person through audio, video, or                             
08       data communications when physically separated from the person if                                                  
09                 (1)  the licensee or another licensed health care provider is available to                              
10       provide follow-up care;                                                                                           
11                 (2)  the licensee requests that the person consent to sending a copy of                                 
12       all records of the encounter to a primary care provider if the licensee is not the                                
13       person's primary care provider and, if the person consents, the licensee sends the                                
14       records to the person's primary care provider; and                                                                
15                 (3)  the licensee meets the requirements established by the board in                                    
16       regulation.                                                                                                       
17            (d)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
18       supervision, and treatment of a person as authorized under (c) of this section by                                 
19       establishing standards of care, including standards for training, confidentiality,                                
20       supervision, practice, and related issues.                                                                        
21    * Sec. 3. AS 08.64.101 is amended to read:                                                                         
22            Sec. 08.64.101. Duties. The board shall                                                                    
23                 (1)  examine and issue licenses to applicants;                                                          
24                 (2)  develop written guidelines to ensure that licensing requirements are                               
25       not unreasonably burdensome and the issuance of licenses is not unreasonably                                      
26       withheld or delayed;                                                                                              
27                 (3)  after a hearing, impose disciplinary sanctions on persons who                                      
28       violate this chapter or the regulations or orders of the board;                                                   
29                 (4)  adopt regulations ensuring that renewal of licenses is contingent on                           
30       [UPON] proof of continued competency on the part of the licensee; and                                             
31                 (5)  under regulations adopted by the board, contract with private                                      
01       professional organizations to establish an impaired medical professionals program to                              
02       identify, confront, evaluate, and treat persons licensed under this chapter who abuse                             
03       alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;                        
04                 (6)  adopt regulations that establish guidelines for a physician who                                
05       is rendering a diagnosis, providing treatment, or prescribing, dispensing, or                                 
06       administering a prescription drug to a person without conducting a physical                                   
07       examination under AS 08.64.364; the guidelines must include a nationally                                      
08       recognized model policy for standards of care of a patient who is at a different                              
09       location than the physician.                                                                                  
10    * Sec. 4. AS 08.64.364(a) is amended to read:                                                                      
11            (a)  The board may not impose disciplinary sanctions on a physician for                                      
12       rendering a diagnosis, providing treatment, or prescribing, dispensing, or                                    
13       administering a prescription drug that is not a controlled substance to a person                              
14       without conducting a physical examination if                                                                      
15                 (1)  [THE PRESCRIPTION DRUG IS                                                                          
16                      (A)  NOT A CONTROLLED SUBSTANCE; OR                                                                
17                      (B)  A CONTROLLED SUBSTANCE AND IS PRESCRIBED,                                                     
18            DISPENSED, OR ADMINISTERED BY A PHYSICIAN WHEN AN                                                            
19            APPROPRIATE LICENSED HEALTH CARE PROVIDER IS PRESENT                                                         
20            WITH THE PATIENT TO ASSIST THE PHYSICIAN WITH                                                                
21            EXAMINATION, DIAGNOSIS, AND TREATMENT;                                                                       
22                 (2)  THE PHYSICIAN IS LOCATED IN THIS STATE AND] the                                                    
23       physician or another licensed health care provider or physician in the physician's                                
24       group practice is available to provide follow-up care; and                                                        
25                 (2)  the physician requests that [(3)] the person consent                                       
26       [CONSENTS] to sending a copy of all records of the encounter to the person's primary                              
27       care provider if the prescribing physician is not the person's primary care provider,                             
28       and, if the patient consents, the physician sends the records to the person's primary                         
29       care provider.                                                                                                    
30    * Sec. 5. AS 08.64.364 is amended by adding new subsections to read:                                               
31            (c)  The board may not impose disciplinary sanctions on a physician for                                      
01       prescribing, dispensing, or administering a prescription drug that is a controlled                                
02       substance if the requirements under (a) of this section are met and the physician                                 
03       prescribes, dispenses, or administers the controlled substance when an appropriate                                
04       licensed health care provider is present with the patient to assist the physician with                            
05       examination, diagnosis, and treatment.                                                                            
06            (d)  Notwithstanding (b) and (c) of this section, a physician may not                                        
07                 (1)  prescribe an abortion-inducing drug; or                                                            
08                 (2)  prescribe, dispense, or administer a prescription drug in response to                              
09       an Internet questionnaire or electronic mail message to a person with whom the                                    
10       physician does not have a prior physician-patient relationship.                                                   
11    * Sec. 6. AS 08.86.204 is amended by adding new subsections to read:                                               
12            (c)  The board may not impose disciplinary sanctions on a licensee for the                                   
13       evaluation, diagnosis, or treatment of a person through audio, video, or data                                     
14       communications when physically separated from the person if                                                       
15                 (1)  the licensee or another licensed health care provider is available to                              
16       provide follow-up care;                                                                                           
17                 (2)  the licensee requests that the person consent to sending a copy of                                 
18       all records of the encounter to a primary care provider if the licensee is not the                                
19       person's primary care provider and, if the person consents, the licensee sends the                                
20       records to the person's primary care provider; and                                                                
21                 (3)  the licensee meets the requirements established by the board in                                    
22       regulation.                                                                                                       
23            (d)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
24       supervision, and treatment of a person as authorized under (c) of this section by                                 
25       establishing standards of care, including standards for training, confidentiality,                                
26       supervision, practice, and related issues.                                                                        
27    * Sec. 7. AS 08.95.050 is amended by adding new subsections to read:                                               
28            (b)  The board may not impose disciplinary sanctions on a licensee for the                                   
29       evaluation, diagnosis, or treatment of a person through audio, video, or data                                     
30       communications when physically separated from the person if                                                       
31                 (1)  the licensee or another licensed health care provider is available to                              
01       provide follow-up care;                                                                                           
02                 (2)  the licensee requests that the person consent to sending a copy of                                 
03       all records of the encounter to a primary care provider if the licensee is not the                                
04       person's primary care provider and, if the person consents, the licensee sends the                                
05       records to the person's primary care provider; and                                                                
06                 (3)  the licensee meets the requirements established by the board in                                    
07       regulation.                                                                                                       
08            (c)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
09       supervision, and treatment of a person as authorized under (b) of this section by                                 
10       establishing standards of care, including standards for training, confidentiality,                                
11       supervision, practice, and related issues.                                                                      
12    * Sec. 8. AS 09.10 is amended by adding a new section to read:                                                     
13            Sec. 09.10.075. Actions related to claims based on medical assistance                                      
14       payment fraud. Except as provided in AS 09.58.070, a person may not bring an                                    
15       action under AS 09.58.010 - 09.58.060, unless the action is commenced by the earlier                              
16       of (1) six years after the act or omission was committed, or (2) three years after the                            
17       date when facts material to the action were known, or reasonably should have been                                 
18       known, by the attorney general or the Department of Health and Social Services, but                               
19       in no event more than 10 years after the date the violation under AS 09.58.010                                    
20       occurred.                                                                                                         
21    * Sec. 9. AS 09.10.120(a) is amended to read:                                                                      
22            (a)  Except as provided in AS 09.10.075, an [AN] action brought in the name                              
23       of or for the benefit of the state, any political subdivision, or public corporation may                          
24       be commenced only within six years after [OF] the date of accrual of the cause of                             
25       action. However, if the action is for relief on the ground of fraud, the limitation                               
26       commences from the time of discovery by the aggrieved party of the facts constituting                             
27       the fraud.                                                                                                        
28    * Sec. 10. AS 09 is amended by adding a new chapter to read:                                                       
29        Chapter 58. Alaska Medical Assistance False Claim and Reporting Act.                                         
30            Sec. 09.58.010. False claims for medical assistance; civil penalty. (a) A                                  
31       medical assistance provider or medical assistance recipient may not                                               
01                 (1)  knowingly submit, authorize, or cause to be submitted to an officer                                
02       or employee of the state a false or fraudulent claim for payment or approval under the                            
03       medical assistance program;                                                                                       
04                 (2)  knowingly make, use, or cause to be made or used, directly or                                      
05       indirectly, a false record or statement to get a false or fraudulent claim for payment                            
06       paid or approved by the state under the medical assistance program;                                               
07                 (3)  conspire to defraud the state by getting a false or fraudulent claim                               
08       paid or approved under the medical assistance program;                                                            
09                 (4)  knowingly make, use, or cause to be made or used, a false record or                                
10       statement to conceal, avoid, increase, or decrease an obligation to pay or transmit                               
11       money or property to the medical assistance program;                                                              
12                 (5)  knowingly enter into an agreement, contract, or understanding with                                 
13       an officer or employee of the state for approval or payment of a claim under the                                  
14       medical assistance program knowing that the information in the agreement, contract,                               
15       or understanding is false or fraudulent.                                                                          
16            (b)  A beneficiary of an intentional or inadvertent submission of a false or                                 
17       fraudulent claim under the medical assistance program who later discovers the claim is                            
18       false or fraudulent shall disclose the false or fraudulent claim to the state not later than                      
19       60 days after discovering the false claim.                                                                        
20            (c)  In addition to any criminal penalties or seizure or forfeiture of property                              
21       under AS 47.05, a medical assistance provider or medical assistance recipient who                                 
22       violates (a) or (b) of this section shall be liable to the state in a civil action for                            
23                 (1)  a civil penalty of not less than $5,500 and not more than $11,000;                                 
24                 (2)  three times the amount of actual damages sustained by the state;                                   
25       and                                                                                                               
26                 (3)  reasonable attorney fees and costs calculated under applicable court                               
27       rules.                                                                                                            
28            (d)  Liability for actual damages under (c) of this section may be reduced to not                            
29       less than twice the amount of actual damages that the state sustains if the court finds                           
30       that a person liable for an act under (a) or (b) of this section                                                  
31                 (1)  furnished the attorney general or the Department of Health and                                     
01       Social Services with all information known to the person about the violation not later                            
02       than 30 days after the date the information was obtained;                                                         
03                 (2)  fully cooperated with the investigation of the violation under                                     
04       AS 09.58.020; and                                                                                                 
05                 (3)  at the time the person furnished the attorney general with the                                     
06       information about the violation, no criminal prosecution, civil action, investigation, or                         
07       administrative action had been started in this state with respect to the violation, and the                       
08       person did not have actual knowledge of the existence of an investigation of the                                  
09       violation.                                                                                                        
10            (e)  A corporation, partnership, or other individual is liable under this chapter                            
11       for acts of its agents if the agent acted with apparent authority, regardless of whether                          
12       the agent acted, in whole or in part, to benefit the principal and regardless of whether                          
13       the principal adopted or ratified the agent's claims, representations, statement, or other                        
14       action or conduct.                                                                                                
15            Sec. 09.58.015. Attorney general investigation; civil action. (a) The attorney                             
16       general or the Department of Health and Social Services may investigate an alleged                                
17       violation of AS 09.58.010. The attorney general may request assistance from the                                   
18       Department of Health and Social Services in an investigation under this section.                                  
19            (b)  The attorney general may bring a civil action in superior court under                                   
20       AS 09.58.010 - 09.58.060.                                                                                         
21            Sec. 09.58.020. Private plaintiff; civil action. (a) Notwithstanding                                       
22       AS 09.58.015, a person may bring an action under this section for a violation of                                  
23       AS 09.58.010 in the name of the person and the state.                                                             
24            (b)  To bring an action under this section, a person shall file a complaint, in                              
25       camera and under seal, and serve on the attorney general                                                          
26                 (1)  a copy of the complaint; and                                                                       
27                 (2)  written disclosure of substantially all material evidence and                                      
28       information the person possesses that pertains to the claim.                                                      
29            (c)  A complaint filed under this section must remain under seal for at least 60                             
30       days and may not be served on the defendant until the court so orders. The attorney                               
31       general may elect to intervene and proceed with the action within 60 days after the                               
01       attorney general receives both the complaint and the material evidence and the                                    
02       information required under (b) of this section. The attorney general may, for good                                
03       cause shown, move the court, under seal, for an extension of the time during which the                            
04       complaint remains under seal under this subsection.                                                               
05            (d)  Before the expiration of the 60-day period or an extension of time granted                              
06       under (c) of this section, the attorney general shall conduct an investigation and make                           
07       a written determination as to whether substantial evidence exists that a violation of                             
08       AS 09.58.010 has occurred. After the investigation and determination are complete,                                
09       the attorney general shall provide the person who brought the action and the                                      
10       Department of Health and Social Services with a copy of the determination unless the                              
11       action has been referred to the division of the Department of Law that has                                        
12       responsibility for criminal cases.                                                                                
13            (e)  Before the expiration of the 60-day period or an extension obtained under                               
14       (c) of this section, the attorney general shall                                                                   
15                 (1)  intervene in the action and proceed with the action on behalf of the                               
16       state;                                                                                                            
17                 (2)  notify the court that the attorney general declines to take over the                               
18       action, in which case the person bringing the action has the right to conduct the action;                         
19       or                                                                                                                
20                 (3)  if the attorney general determines that substantial evidence does not                              
21       exist that a violation of AS 09.58.010 has occurred, or that the action is barred under                           
22       AS 09.58.050, the attorney general shall move the court to dismiss the action.                                    
23            (f)  The named defendant in a complaint filed under this section is not required                             
24       to respond to a complaint filed under this section until after the complaint is unsealed                          
25       by the court and a copy of the summons and complaint are served on the defendant                                  
26       under the applicable Alaska Rules of Civil Procedure.                                                             
27            (g)  When a person brings an action under this section, only the attorney                                    
28       general may intervene or bring a related action based on similar facts to the underlying                          
29       action.                                                                                                           
30            Sec. 09.58.025. Subpoenas. In conducting an investigation under                                            
31       AS 09.58.015 or 09.58.020, the attorney general may issue subpoenas to compel the                                 
01       production of books, papers, correspondence, memoranda, and other records in                                      
02       connection with an investigation under or the administration of AS 09.58.010 -                                    
03       09.58.060. If a medical assistance provider or a medical assistance recipient fails or                            
04       refuses, without just cause, to obey a subpoena issued under this subsection, the                                 
05       superior court may, upon application by the attorney general, issue an order requiring                            
06       the medical assistance provider or medical assistance recipient to appear before the                              
07       attorney general to produce evidence.                                                                             
08            Sec. 09.58.030. Rights in false or fraudulent claims actions. (a) If the                                   
09       attorney general elects to intervene and proceed with an action under AS 09.58.020,                               
10       the attorney general has exclusive authority for prosecuting the action and is not bound                          
11       by an act of the person bringing the action. The person who brought the action has the                            
12       right to continue as a nominal party to the action, but does not have the right to                                
13       participate in the action except as a witness or as otherwise directed by the attorney                            
14       general. If the attorney general elects to intervene under AS 09.58.020, the attorney                             
15       general may file a new complaint or amend the complaint filed by the person who                                   
16       brought the action under AS 09.58.020(b).                                                                         
17            (b)  Notwithstanding the objections of the person who brought the action, the                                
18       attorney general may                                                                                              
19                 (1)  move to dismiss the action at any time under this chapter if the                                   
20       attorney general has notified the person who brought the action of the intent to seek                             
21       dismissal and the court has provided the person who brought the action with an                                    
22       opportunity to respond to the motion;                                                                             
23                 (2)  settle the action with the defendant at any time, if the court                                     
24       determines, after a hearing, that the proposed settlement is fair, adequate, and                                  
25       reasonable under all the circumstances; upon a showing of good cause, the hearing                                 
26       described in this paragraph shall be held in camera.                                                              
27            (c)  If the attorney general elects not to proceed under AS 09.58.020 with the                               
28       action, the person who brought the action has the right to proceed and conduct the                                
29       action. The attorney general may request at any time during the proceedings to be                                 
30       served with copies of all documents related to the action, including pleadings,                                   
31       motions, and discovery. The attorney general shall pay for the reasonable copying                                 
01       charges for documents provided under this subsection. If the person who brought the                               
02       action proceeds with the action, the court, without limiting the status and rights of the                         
03       person who brought the action, shall allow the attorney general to intervene at any                               
04       time.                                                                                                             
05            (d)  Whether or not the attorney general proceeds with the action under this                                 
06       chapter, on a showing by the attorney general that certain actions of discovery by the                            
07       person bringing the action would interfere with pending investigation or prosecution                              
08       of a criminal or civil proceeding arising out of the same matter, the court may stay the                          
09       discovery for not more than 90 days. The court may extend the 90-day period on a                                  
10       further showing, in camera, that the state has pursued the criminal or civil                                      
11       investigation or proceedings with reasonable diligence and that proposed discovery in                             
12       the civil action under AS 09.58.010 - 09.58.060 may interfere with the ongoing                                    
13       criminal or civil investigation or proceedings.                                                                   
14            Sec. 09.58.040. Award to false or fraudulent claim plaintiff. (a) If the                                   
15       attorney general proceeds with an action brought by a person for a violation of                                   
16       AS 09.58.010, the person who brought the action shall receive at least 15 percent but                             
17       not more than 25 percent of the proceeds of the action or settlement of the claim,                                
18       depending on the extent to which the person bringing the action contributed to the                                
19       prosecution of the action. The court order or settlement agreement shall state the                                
20       percentage and the amount to be received by the person who brought the action. A                                  
21       payment under this subsection to the person who brought the action may only be paid                               
22       from proceeds received from a judgment or settlement under this section.                                          
23            (b)  If the attorney general does not proceed with an action brought under                                   
24       AS 09.58.020, the person bringing the action to judgment or settlement by court order                             
25       shall receive an amount that the court decides is reasonable for collecting the civil                             
26       penalty and damages based on the person's effort to prosecute the action successfully.                            
27       The amount shall be at least 25 percent but not more than 30 percent of the proceeds                              
28       of the action or settlement of the claim. A payment under this subsection to the person                           
29       who brought the action may only be paid from proceeds received from a judgment or                                 
30       settlement received under this section.                                                                           
31            (c)  Whether or not the attorney general participates in the action, if the court                            
01       finds that the action was brought by a person who planned or initiated the violation                              
02       alleged in the action brought under AS 09.58.020, the court may, to the extent the                                
03       court considers appropriate, reduce the share of the proceeds of the action that the                              
04       person would otherwise receive under (a) or (b) of this section, taking into account the                          
05       role of that person in advancing the case to litigation and any relevant circumstances                            
06       pertaining to the violation. If the person bringing the action is convicted of criminal                           
07       conduct arising from the person's role in the violation of AS 09.58.010, the court shall                          
08       dismiss the person from the civil action and the person may not receive any share of                              
09       the proceeds of the action or settlement. A dismissal under this subsection does not                              
10       prejudice the right of the attorney general to continue the action.                                               
11            (d)  In this section, "proceeds of the action or settlement"                                                 
12                 (1)  includes damages, civil penalties, payment for cost of compliance,                                 
13       and other economic benefits realized by the state as a result of a civil action brought                           
14       under AS 09.58.010 - 09.58.060;                                                                                   
15                 (2)  does not include attorney fees and costs awarded to the state.                                     
16            Sec. 09.58.050. Certain actions barred. A person may not bring an action                                   
17       under AS 09.58.020 if the action is                                                                               
18                 (1)  based on evidence or information known to the state when the                                       
19       action was brought;                                                                                               
20                 (2)  based on allegations or transactions that are the subject of a civil or                            
21       criminal action or an administrative proceeding in which the state is already a party;                            
22                 (3)  based on the public disclosure of allegations or actions in a                                      
23       criminal or civil action or an administrative hearing, or from the news media, unless                             
24       the action is brought by the attorney general or the person bringing the action is an                             
25       original source of the information that was publicly disclosed; in this paragraph, a                              
26       person is an original source of the information that was publicly disclosed if the                                
27       person has independent knowledge, including knowledge based on personal                                           
28       investigation of the defendant's conduct, of the information on which the allegations                             
29       are based, and has voluntarily provided or verified the information on which the                                  
30       allegations are based or voluntarily provided the information to the attorney general                             
31       before filing an action under AS 09.58.020 that is based on the information; or                                   
01                 (4)  against the state or current or former state employees.                                            
02            Sec. 09.58.060. State not liable for attorney fees, costs, and other expenses.                             
03       The state, its agencies, current or former officers, and current or former employees, are                         
04       not liable for attorney fees, costs, and other expenses that a person incurs in bringing                          
05       an action under AS 09.58.020.                                                                                     
06            Sec. 09.58.070. Employee protection for retaliation. (a) An employee of a                                  
07       medical assistance provider who is discharged, demoted, suspended, threatened,                                    
08       harassed, or discriminated against in the terms and conditions of employment by the                               
09       employee's employer because of lawful acts done by the employee on behalf of the                                  
10       employee or others in furtherance of an action under AS 09.58.010 - 09.58.060,                                    
11       including investigation for, initiation of, testimony for or assistance in an action filed                        
12       or to be filed under AS 09.58.010 - 09.58.060, is entitled to the same relief authorized                          
13       under AS 39.90.120.                                                                                               
14            (b)  Notwithstanding (a) of this section, a state employee who is discharged,                                
15       demoted, suspended, threatened, harassed, or discriminated against in the terms and                               
16       conditions of employment because of lawful acts done by the employee on behalf of                                 
17       the employee or a person who brings an action under AS 09.58.020 or in furtherance                                
18       of an action under AS 09.58.010 - 09.58.060, including investigation, initiation of,                              
19       testimony for or assistance in an action filed or to be filed under AS 09.58.010 -                                
20       09.58.060, is entitled to relief under AS 39.90.100 - 39.90.150 (Alaska Whistleblower                             
21       Act).                                                                                                             
22            (c)  A person may not bring an action under this section unless the action is                                
23       commenced not later than three years after the date the employee was subject to                                   
24       retaliation under (a) or (b) of this section.                                                                     
25            Sec. 09.58.080. Regulations. The attorney general may adopt regulations                                    
26       under AS 44.62 as necessary to carry out the purposes of this chapter.                                            
27            Sec. 09.58.090. Special provisions. (a) This chapter does not apply to any                                 
28       controversy involving damages to the state of less than $5,500 in value.                                          
29            (b)  No punitive damages may be awarded in an action brought under                                           
30       AS 09.58.010 - 09.58.060.                                                                                         
31            Sec. 09.58.100. Definitions. In this chapter,                                                              
01                 (1)  "attorney general" includes a designee of the attorney general;                                    
02                 (2)  "claim" means a request for payment of health care services or                                     
03       equipment, whether made to a contractor, grantee, or other person, when the state                                 
04       provides, directly or indirectly, a portion of the money, property, or services requested                         
05       or demanded, or when the state will, directly or indirectly, reimburse the contractor,                            
06       grantee, or other recipient for a portion of the money, property, or services requested                           
07       or demanded;                                                                                                      
08                 (3)  "controversy" means the aggregate of one or more false claims                                      
09       submitted by the same medical assistance provider or medical assistance recipient                                 
10       under this chapter;                                                                                               
11                 (4)  "knowingly" means that a person, with or without specific intent to                                
12       defraud,                                                                                                          
13                      (A)  has actual knowledge of the information;                                                      
14                      (B)  acts in deliberate ignorance of the truth or falsity of the                                   
15            information; or                                                                                              
16                      (C)  acts in reckless disregard of the truth or falsity of the                                     
17            information;                                                                                                 
18                 (5)  "medical assistance program" means the federal-state program                                       
19       administered by the Department of Health and Social Services under AS 47.05 and                                   
20       AS 47.07 and regulations adopted under AS 47.05 and AS 47.07;                                                     
21                 (6)  "medical assistance provider" has the meaning given under                                          
22       AS 47.05.290;                                                                                                     
23                 (7)  "medical assistance recipient" has the meaning given under                                         
24       AS 47.05.290;                                                                                                     
25                 (8)  "obligation" means an established duty, whether or not fixed,                                      
26       arising from                                                                                                      
27                      (A)  an express or implied contractual grantor or grantee or                                       
28            licensor or licensee relationship;                                                                           
29                      (B)  a fee-based or similar relationship;                                                          
30                      (C)  a statute or regulation; or                                                                   
31                      (D)  the retention of any overpayment.                                                             
01            Sec. 09.58.110. Short title. This chapter may be cited as the Alaska Medical                               
02       Assistance False Claim and Reporting Act.                                                                         
03    * Sec. 11. AS 09.58.025, added by sec. 10 of this Act, is amended to read:                                         
04            Sec. 09.58.025. Subpoenas. In conducting an investigation under                                            
05       AS 09.58.015 [OR 09.58.020], the attorney general may issue subpoenas to compel                                   
06       the production of books, papers, correspondence, memoranda, and other records in                                  
07       connection with an investigation under or the administration of AS 09.58.010 -                                    
08       09.58.060. If a medical assistance provider or a medical assistance recipient fails or                            
09       refuses, without just cause, to obey a subpoena issued under this subsection, the                                 
10       superior court may, upon application by the attorney general, issue an order requiring                            
11       the medical assistance provider or medical assistance recipient to appear before the                              
12       attorney general to produce evidence.                                                                             
13    * Sec. 12. AS 09.58.070(b), added by sec. 10 of this Act, is amended to read:                                      
14            (b)  Notwithstanding (a) of this section, a state employee who is discharged,                                
15       demoted, suspended, threatened, harassed, or discriminated against in the terms and                               
16       conditions of employment because of lawful acts done by the employee on behalf of                                 
17       the employee [OR A PERSON WHO BRINGS AN ACTION UNDER AS 09.58.020]                                                
18       or in furtherance of an action under AS 09.58.010 - 09.58.060, including investigation,                           
19       initiation of, testimony for or assistance in an action filed or to be filed under                                
20       AS 09.58.010 - 09.58.060, is entitled to relief under AS 39.90.100 - 39.90.150 (Alaska                            
21       Whistleblower Act).                                                                                               
22    * Sec. 13. AS 17.30.200(a) is amended to read:                                                                     
23            (a)  The controlled substance prescription database is established in the Board                              
24       of Pharmacy. The purpose of the database is to contain data as described in this                                  
25       section regarding every prescription for a schedule [IA, IIA, IIIA, IVA, OR VA                                    
26       CONTROLLED SUBSTANCE UNDER STATE LAW OR A SCHEDULE I,] II, III,                                                   
27       or IV [, OR V] controlled substance under federal law dispensed in the state to a                             
28       person other than those administered to a patient at a health care facility. The                                  
29       Department of Commerce, Community, and Economic Development shall assist the                                      
30       board and provide necessary staff and equipment to implement this section.                                        
31                                                                                                                         
01    * Sec. 14. AS 17.30.200(b) is amended to read:                                                                     
02            (b)  The pharmacist-in-charge of each licensed or registered pharmacy,                                       
03       regarding each schedule [IA, IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE                                           
04       UNDER STATE LAW OR A SCHEDULE I,] II, III, or IV [, OR V] controlled                                          
05       substance under federal law dispensed by a pharmacist under the supervision of the                                
06       pharmacist-in-charge, and each practitioner who directly dispenses a schedule [IA,                                
07       IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE UNDER STATE LAW OR A                                                   
08       SCHEDULE I,] II, III, or IV [, OR V] controlled substance under federal law other                             
09       than those administered to a patient at a health care facility, shall submit to the board,                        
10       by a procedure and in a format established by the board, the following information for                            
11       inclusion in the database on at least a weekly basis:                                                         
12                 (1)  the name of the prescribing practitioner and the practitioner's                                    
13       federal Drug Enforcement Administration registration number or other appropriate                                  
14       identifier;                                                                                                       
15                 (2)  the date of the prescription;                                                                      
16                 (3)  the date the prescription was filled and the method of payment; this                               
17       paragraph does not authorize the board to include individual credit card or other                                 
18       account numbers in the database;                                                                                  
19                 (4)  the name, address, and date of birth of the person for whom the                                    
20       prescription was written;                                                                                         
21                 (5)  the name and national drug code of the controlled substance;                                       
22                 (6)  the quantity and strength of the controlled substance dispensed;                                   
23                 (7)  the name of the drug outlet dispensing the controlled substance;                                   
24       and                                                                                                               
25                 (8)  the name of the pharmacist or practitioner dispensing the controlled                               
26       substance and other appropriate identifying information.                                                          
27    * Sec. 15. AS 17.30.200(d) is amended to read:                                                                     
28            (d)  The database and the information contained within the database are                                      
29       confidential, are not public records, and are not subject to public disclosure. The board                         
30       shall undertake to ensure the security and confidentiality of the database and the                                
31       information contained within the database. The board may allow access to the                                      
01       database only to the following persons, and in accordance with the limitations                                    
02       provided and regulations of the board:                                                                            
03                 (1)  personnel of the board regarding inquiries concerning licensees or                                 
04       registrants of the board or personnel of another board or agency concerning a                                     
05       practitioner under a search warrant, subpoena, or order issued by an administrative law                           
06       judge or a court;                                                                                                 
07                 (2)  authorized board personnel or contractors as required for                                          
08       operational and review purposes;                                                                                  
09                 (3)  a licensed practitioner having authority to prescribe controlled                                   
10       substances or an agent or employee of the practitioner whom the practitioner has                              
11       authorized to access the database on the practitioner's behalf, to the extent the                             
12       information relates specifically to a current patient of the practitioner to whom the                             
13       practitioner is prescribing or considering prescribing a controlled substance;                                    
14                 (4)  a licensed or registered pharmacist having authority to dispense                                   
15       controlled substances or an agent or employee of the pharmacist whom the                                      
16       pharmacist has authorized to access the database on the pharmacist's behalf, to                               
17       the extent the information relates specifically to a current patient to whom the                                  
18       pharmacist is dispensing or considering dispensing a controlled substance;                                        
19                 (5)  federal, state, and local law enforcement authorities may receive                                  
20       printouts of information contained in the database under a search warrant, subpoena,                              
21       or order issued by a court establishing probable cause for the access and use of the                              
22       information; [AND]                                                                                                
23                 (6)  an individual who is the recipient of a controlled substance                                       
24       prescription entered into the database may receive information contained in the                                   
25       database concerning the individual on providing evidence satisfactory to the board that                           
26       the individual requesting the information is in fact the person about whom the data                               
27       entry was made and on payment of a fee set by the board under AS 37.10.050 that                                   
28       does not exceed $10;                                                                                          
29                 (7)  a licensed pharmacist employed by the Department of Health                                     
30       and Social Services who is responsible for administering prescription drug                                    
31       coverage for the medical assistance program under AS 47.07, to the extent that                                
01       the information relates specifically to prescription drug coverage under the                                  
02       program;                                                                                                      
03                 (8)  a licensed pharmacist, licensed practitioner, or authorized                                    
04       employee of the Department of Health and Social Services responsible for                                      
05       utilization review of prescription drugs for the medical assistance program under                             
06       AS 47.07, to the extent that the information relates specifically to utilization                              
07       review of prescription drugs provided to recipients of medical assistance;                                    
08                 (9)  the state medical examiner, to the extent that the information                                 
09       relates specifically to investigating the cause and manner of a person's death; and                           
10                 (10)  an authorized employee of the Department of Health and                                        
11       Social Services may receive information from the database that does not disclose                              
12       the identity of a patient, prescriber, dispenser, or dispenser location, for the                              
13       purpose of identifying and monitoring public health issues in the state; however,                             
14       the information provided under this paragraph may include the region of the                                   
15       state in which a patient, prescriber, and dispenser are located and the specialty of                          
16       the prescriber.                                                                                               
17    * Sec. 16. AS 17.30.200(e) is amended to read:                                                                     
18            (e)  The failure of a pharmacist-in-charge, pharmacist, or practitioner to                                   
19       register or submit information to the database as required under this section is                              
20       grounds for the board to take disciplinary action against the license or registration of                          
21       the pharmacy or pharmacist or for another licensing board to take disciplinary action                             
22       against a practitioner.                                                                                           
23    * Sec. 17. AS 17.30.200(h) is amended to read:                                                                     
24            (h)  An individual who has submitted information to the database in                                          
25       accordance with this section may not be held civilly liable for having submitted the                              
26       information. [NOTHING IN THIS SECTION REQUIRES OR OBLIGATES A                                                     
27       DISPENSER OR PRACTITIONER TO ACCESS OR CHECK THE DATABASE                                                         
28       BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING A                                                                
29       MEDICATION, OR PROVIDING MEDICAL CARE TO A PERSON.] Dispensers or                                                 
30       practitioners may not be held civilly liable for damages for accessing or failing to                              
31       access the information in the database.                                                                           
01    * Sec. 18. AS 17.30.200(k) is amended to read:                                                                     
02            (k)  In the regulations adopted under this section, the board shall provide                                  
03                 (1)  that prescription information in the database [SHALL] be purged                                    
04       from the database after two years have elapsed from the date the prescription was                                 
05       dispensed;                                                                                                        
06                 (2)  a method for an individual to challenge information in the database                                
07       about the individual that the person believes is incorrect or was incorrectly entered by                          
08       a dispenser;                                                                                                  
09                 (3)  a procedure and time frame for registration with the database;                                 
10                 (4)  that a pharmacist or practitioner review the information in the                                
11       database to check a patient's prescription records before dispensing, prescribing,                            
12       or administering a controlled substance to the patient; the regulations must                                  
13       provide that a pharmacist or practitioner is not required to review the                                       
14       information in the database before dispensing, prescribing, or administering a                                
15       controlled substance to a person who is receiving treatment                                                   
16                      (A)  in an inpatient setting;                                                                  
17                      (B)  at the scene of an emergency or in an ambulance; in this                                  
18            subparagraph, "ambulance" has the meaning given in AS 18.08.200;                                         
19                      (C)  in an emergency room; or                                                                  
20                      (D)  immediately before, during, or within the first 24 hours                                  
21            after surgery.                                                                                           
22    * Sec. 19. AS 17.30.200 is amended by adding new subsections to read:                                              
23            (o)  A pharmacist who dispenses or a practitioner who prescribes, administers,                               
24       or directly dispenses a schedule II, III, or IV controlled substance under federal law                            
25       shall register with the database by a procedure and in a format established by the                                
26       board.                                                                                                            
27            (p)  The board shall promptly notify the State Medical Board, the Board of                                   
28       Nursing, the Board of Dental Examiners, and the Board of Examiners in Optometry                                   
29       when a practitioner registers with the database under (o) of this section.                                        
30            (q)  The board is authorized to provide unsolicited notification to a pharmacist                             
31       or practitioner if a patient has received one or more prescriptions for controlled                                
01       substances in quantities or with a frequency inconsistent with generally recognized                               
02       standards of safe practice.                                                                                       
03            (r)  The board shall update the database on at least a weekly basis with the                                 
04       information submitted to the board under (b) of this section.                                                     
05    * Sec. 20. AS 37.05.146(c) is amended by adding a new paragraph to read:                                           
06                 (88)  monetary recoveries under AS 09.58 (Alaska Medical Assistance                                     
07       False Claim and Reporting Act).                                                                                   
08    * Sec. 21. AS 40.25.120(a) is amended by adding a new paragraph to read:                                           
09                 (15)  records relating to proceedings under AS 09.58 (Alaska Medical                                    
10       Assistance False Claim and Reporting Act).                                                                        
11    * Sec. 22. AS 44.33 is amended by adding a new section to read:                                                    
12                  Article 5A. Telemedicine Business Registry.                                                          
13            Sec. 44.33.381. Telemedicine business registry. (a) The department shall                                   
14       adopt regulations for establishing and maintaining a registry of businesses performing                            
15       telemedicine services in the state.                                                                               
16            (b)  The department shall maintain the registry of businesses performing                                     
17       telemedicine services in the state. The registry must include the name, address, and                              
18       contact information of businesses performing telemedicine services in the state.                                  
19            (c)  In this section,                                                                                        
20                 (1)  "department" means the Department of Commerce, Community,                                          
21       and Economic Development;                                                                                         
22                 (2)  "telemedicine services" means the delivery of health care services                                 
23       using the transfer of medical data through audio, visual, or data communications that                             
24       are performed over two or more locations by a provider who is physically separated                                
25       from the recipient of the health care services.                                                                   
26    * Sec. 23. AS 47.05.015 is amended by adding a new subsection to read:                                             
27            (e)  Notwithstanding (c) of this section, the department may enter into a                                    
28       contract through the competitive bidding process under AS 36.30 (State Procurement                                
29       Code) for medical assistance products and services offered under AS 47.07.030 if the                              
30       contract is for durable medical equipment or specific medical services that can be                                
31       delivered on a statewide basis.                                                                                   
01    * Sec. 24. AS 47.05 is amended by adding a new section to article 1 to read:                                       
02            Sec. 47.05.105. Enhanced computerized eligibility verification system. (a)                                 
03       The department shall establish an enhanced computerized income, asset, and identity                               
04       eligibility verification system for the purposes of verifying eligibility, eliminating                            
05       duplication of public assistance payments, and deterring waste and fraud in public                                
06       assistance programs administered by the department under AS 47.05.010. Nothing in                                 
07       this section prohibits the department from verifying eligibility for public assistance                            
08       through additional procedures or authorizes the department or a third-party vendor to                             
09       use data to verify eligibility for a federal program if the use of that data is prohibited                        
10       by federal law.                                                                                                   
11            (b)  The department shall enter into a competitively bid contract with a third-                              
12       party vendor for the purpose of developing a system under this section to prevent                                 
13       fraud, misrepresentation, and inadequate documentation when determining an                                        
14       applicant's eligibility for public assistance before the payment of benefits and for                              
15       periodically verifying eligibility between eligibility redeterminations and during                                
16       eligibility redeterminations and reviews under AS 47.05.110 - 47.05.120. The                                      
17       department may also contract with a third-party vendor to provide information to                                  
18       facilitate reviews of recipient eligibility and income verification.                                              
19            (c)  The annual savings to the state resulting from the use of the system under                              
20       this section must exceed the cost of implementing the system. A contract under this                               
21       section must require the third-party vendor to report annual savings to the state                                 
22       realized from implementing the system. Payment to the third-party vendor may be                                   
23       based on a fee for each applicant and may include incentives for achieving a rate of                              
24       success established by the department for identifying duplication, waste, and fraud in                            
25       public assistance programs.                                                                                       
26            (d)  To avoid a conflict of interest, the department may not award a contract to                             
27       provide services for the enrollment of public assistance providers or applicants under                            
28       this title to a vendor that is awarded a contract under this section.                                             
29    * Sec. 25. AS 47.05.200(a) is amended to read:                                                                     
30            (a)  The department shall annually contract for independent audits of a                                      
31       statewide sample of all medical assistance providers in order to identify overpayments                            
01       and violations of criminal statutes. The audits conducted under this section may not be                           
02       conducted by the department or employees of the department. The number of audits                                  
03       under this section may not be less than 50 each year [, AS A TOTAL FOR THE                                    
04       MEDICAL ASSISTANCE PROGRAMS UNDER AS 47.07 AND AS 47.08, SHALL                                                    
05       BE 0.75 PERCENT OF ALL ENROLLED PROVIDERS UNDER THE                                                               
06       PROGRAMS, ADJUSTED ANNUALLY ON JULY 1, AS DETERMINED BY THE                                                       
07       DEPARTMENT, EXCEPT THAT THE NUMBER OF AUDITS UNDER THIS                                                           
08       SECTION MAY NOT BE LESS THAN 75]. The audits under this section must                                              
09       include both on-site audits and desk audits and must be of a variety of provider types.                           
10       The department may not award a contract under this subsection to an organization that                             
11       does not retain persons with a significant level of expertise and recent professional                             
12       practice in the general areas of standard accounting principles and financial auditing                            
13       and in the specific areas of medical records review, investigative research, and Alaska                           
14       health care criminal law. The contractor, in consultation with the commissioner, shall                            
15       select the providers to be audited and decide the ratio of desk audits and on-site audits                         
16       to the total number selected. In identifying providers who are subject to an audit                            
17       under this chapter, the department shall attempt to minimize concurrent state or                              
18       federal audits.                                                                                               
19    * Sec. 26. AS 47.05.200(b) is amended to read:                                                                     
20            (b)  Within 90 days after receiving each audit report from an audit conducted                                
21       under this section, the department shall begin administrative procedures to recoup                                
22       overpayments identified in the audits and shall allocate the reasonable and necessary                             
23       financial and human resources to ensure prompt recovery of overpayments unless the                                
24       attorney general has advised the commissioner in writing that a criminal investigation                            
25       of an audited provider has been or is about to be undertaken, in which case, the                                  
26       commissioner shall hold the administrative procedure in abeyance until a final                                    
27       charging decision by the attorney general has been made. The commissioner shall                                   
28       provide copies of all audit reports to the attorney general so that the reports can be                            
29       screened for the purpose of bringing criminal charges. The department may assess                              
30       interest and penalties on any identified overpayment. Interest under this                                     
31       subsection shall be calculated using the statutory rates for postjudgment interest                            
01       accruing from the date of the issuance of the final agency decision to recoup                                 
02       overpayments identified in the audit. In this subsection, the date of issuance of                             
03       the final agency decision is the later of the date of                                                         
04                 (1)  the department's written notification of the decision and the                                  
05       provider's appeal rights; or                                                                                  
06                 (2)  if timely appealed by the provider, a final agency decision                                    
07       under AS 44.64.060.                                                                                           
08    * Sec. 27. AS 47.05 is amended by adding a new section to read:                                                    
09            Sec. 47.05.235. Duty to identify and repay self-identified overpayments. (a)                               
10       Unless a provider is being audited under AS 47.05.200(a), an enrolled medical                                     
11       assistance provider shall conduct a biennial review or audit of a statistically valid                             
12       sample of claims submitted to the department for reimbursement. If overpayments are                               
13       identified, the medical assistance provider shall report the overpayment to the                                   
14       department not later than 10 business days after identification of the overpayment. The                           
15       report must also identify how the medical assistance provider intends to repay the                                
16       department. After the department receives the report, the medical assistance provider                             
17       and the department shall enter into an agreement establishing a schedule for                                      
18       repayment of the identified overpayment. The agreement may authorize repayment in                                 
19       a lump sum, a payment plan, or by offsetting future billings as approved by the                                   
20       department.                                                                                                       
21            (b)  The department may not assess interest or penalties on an overpayment                                   
22       identified and repaid by a medical assistance provider under this section.                                        
23    * Sec. 28. AS 47.05 is amended by adding new sections to read:                                                     
24            Sec. 47.05.250. Civil penalties. (a) The department may assess a civil penalty                             
25       against a provider who violates this chapter, AS 47.07, or regulations adopted under                              
26       this chapter or AS 47.07.                                                                                         
27            (b)  The department shall adopt regulations establishing a range of civil                                    
28       penalties that the department may assess against a provider under this section. In                                
29       establishing the range of civil penalties, the department shall take into account                                 
30       appropriate factors, including the seriousness of the violation, the service provided by                          
31       the provider, and the severity of the penalty. The regulations may not provide for a                              
01       civil penalty of less than $100 or more than $25,000 for each violation.                                          
02            (c)  The provisions of this section are in addition to any other remedies                                    
03       available under this chapter, AS 47.07, or regulations adopted under this chapter or                              
04       AS 47.07.                                                                                                         
05            (d)  A provider against whom a civil penalty of less than $2,500 is assessed                                 
06       may appeal the decision assessing the penalty to the commissioner or the                                          
07       commissioner's designee. The commissioner shall, by regulation, establish time limits                             
08       and procedures for an appeal under this subsection. The decision of the commissioner                              
09       or the commissioner's designee may be appealed to the office of administrative                                    
10       hearings established under AS 44.64.                                                                              
11            (e)  A provider against whom a civil penalty of $2,500 or more is assessed may                               
12       appeal the decision assessing the penalty to the office of administrative hearings                                
13       established under AS 44.64.                                                                                       
14            Sec. 47.05.260. Seizure and forfeiture of real or personal property in                                   
15       medical assistance fraud cases. (a) Upon written application by the attorney general                            
16       establishing probable cause that a medical assistance provider has committed or is                                
17       committing medical assistance fraud under AS 47.05.210, the court may authorize the                               
18       seizure of real or personal property listed in (e) of this section to cover the cost of the                       
19       alleged fraud. The application may be made ex parte if the attorney general establishes                           
20       sufficient facts to show that notice to the owner of the property would lead to the                               
21       waste or dissipation of assets subject to seizure. If the attorney general does not                               
22       establish sufficient facts to show that notice to the owner would lead to the waste or                            
23       dissipation of assets subject to seizure, the application for seizure must be served on                           
24       the owners of the property.                                                                                       
25            (b)  Upon issuance of the court order authorizing seizure, the owners of the                                 
26       property may not take any action to dispose of the property through transfer of title or                          
27       sale of the property without written permission from the court. However, an innocent                              
28       purchaser may not be required to forfeit property purchased in good faith. The                                    
29       purchaser bears the burden of proof to establish that the property was purchased                                  
30       innocently and in good faith.                                                                                     
31            (c)  If a medical assistance provider is convicted of medical assistance fraud                               
01       under AS 47.05.210 after property is seized under this section, the court may order                               
02       that the property be forfeited to the state and disposed of as directed by the court. If                          
03       the property has been sold, the proceeds of the sale shall be transmitted to the proper                           
04       state officer or employee for deposit into the general fund. The attorney general shall                           
05       return to the owner of the property any property seized under this section that the court                         
06       does not order to be forfeited as soon as practicable after the court issues a final                              
07       judgment in the medical assistance fraud proceeding under AS 47.05.210 and the                                    
08       medical assistance provider pays any fine or restitution ordered by the court.                                    
09            (d)  An action for forfeiture under this section may be joined with a civil or                               
10       criminal action brought by the state to recover damages resulting from alleged medical                            
11       assistance fraud.                                                                                                 
12            (e)  Property that may be seized under this chapter includes bank accounts,                                  
13       automobiles, boats, airplanes, stocks, bonds, the medical assistance provider's business                          
14       inventory, and other real or personal property owned and used to conduct the medical                              
15       assistance provider's business.                                                                                   
16            Sec. 47.05.270. Medical assistance reform program. (a) The department                                      
17       shall adopt regulations to design and implement a program for reforming the state                                 
18       medical assistance program under AS 47.07. The reform program must include                                        
19                 (1)  referrals to community and social support services, including career                               
20       and education training services available through the Department of Labor and                                     
21       Workforce Development under AS 23.15, the University of Alaska, or other sources;                                 
22                 (2)  electronic distribution of an explanation of medical assistance                                    
23       benefits to recipients for health care services received under the program;                                       
24                 (3)  expanding the use of telehealth for primary care, behavioral health,                               
25       and urgent care;                                                                                                  
26                 (4)  enhancing fraud prevention, detection, and enforcement;                                            
27                 (5)  reducing the cost of behavioral health, senior, and disabilities                                   
28       services provided to recipients of medical assistance under the state's home and                                  
29       community-based services waiver under AS 47.07.045;                                                               
30                 (6)  pharmacy initiatives;                                                                              
31                 (7)  enhanced care management;                                                                          
01                 (8)  redesigning the payment process by implementing fee agreements                                     
02       that include one or more of the following:                                                                        
03                      (A)  premium payments for centers of excellence;                                                   
04                      (B)  penalties for hospital-acquired infections, readmissions,                                     
05            and outcome failures;                                                                                        
06                      (C)  bundled payments for specific episodes of care; or                                            
07                      (D)  global payments for contracted payers, primary care                                           
08            managers, and case managers for a recipient or for care related to a specific                                
09            diagnosis;                                                                                                   
10                 (9)  stakeholder involvement in setting annual targets for quality and                                  
11       cost-effectiveness;                                                                                               
12                 (10)  to the extent consistent with federal law, reducing travel costs by                               
13       requiring a recipient to obtain medical services in the recipient's home community, to                            
14       the extent appropriate services are available in the recipient's home community;                                  
15                 (11)  guidelines for health care providers to develop health care                                       
16       delivery models supported by evidence-based practices that encourage wellness and                                 
17       disease prevention.                                                                                               
18            (b)  The department shall, in coordination with the Alaska Mental Health Trust                               
19       Authority, efficiently manage a comprehensive and integrated behavioral health                                    
20       program that uses evidence-based, data-driven practices to achieve positive outcomes                              
21       for people with mental health or substance abuse disorders and children with severe                               
22       emotional disturbances. The goal of the program is to assist recipients of services                               
23       under the program to recover by achieving the highest level of autonomy with the least                            
24       dependence on state-funded services possible for each person. The program must                                    
25       include                                                                                                           
26                 (1)  a plan for providing a continuum of community-based services to                                    
27       address housing, employment, criminal justice, and other relevant issues;                                         
28                 (2)  services from a wide array of providers and disciplines, including                                 
29       licensed or certified mental health and primary care professionals; and                                           
30                 (3)  efforts to reduce operational barriers that fragment services,                                     
31       minimize administrative burdens, and reduce the effectiveness and efficiency of the                               
01       program.                                                                                                          
02            (c)  The department shall identify the areas of the state where improvements in                              
03       access to telehealth would be most effective in reducing the costs of medical                                     
04       assistance and improving access to health care services for medical assistance                                    
05       recipients. The department shall make efforts to improve access to telehealth for                                 
06       recipients in those locations. The department may enter into agreements with Indian                               
07       Health Service providers, if necessary, to improve access by medical assistance                                   
08       recipients to telehealth facilities and equipment.                                                                
09            (d)  On or before November 15 of each year, the department shall prepare a                                   
10       report and submit the report to the senate secretary and the chief clerk of the house of                          
11       representatives and notify the legislature that the report is available. The report must                          
12       include                                                                                                           
13                 (1)  realized cost savings related to reform efforts under this section;                                
14                 (2)  realized cost savings related to medical assistance reform efforts                                 
15       undertaken by the department other than the reform efforts described in this Act;                                 
16                 (3)  a statement of whether the department has met annual targets for                                   
17       quality and cost-effectiveness;                                                                                   
18                 (4)  recommendations for legislative or budgetary changes related to                                    
19       medical assistance reforms during the next fiscal year;                                                           
20                 (5)  changes in federal laws that the department expects will result in a                               
21       cost or savings to the state of more than $1,000,000;                                                             
22                 (6)  a description of any medical assistance grants, options, or waivers                                
23       the department applied for in the previous fiscal year;                                                           
24                 (7)  the results of demonstration projects the department has                                           
25       implemented;                                                                                                      
26                 (8)  legal and technological barriers to the expanded use of telehealth,                                
27       improvements in the use of telehealth in the state, and recommendations for changes                               
28       or investments that would allow cost-effective expansion of telehealth;                                           
29                 (9)  the percentage decrease in costs of travel for medical assistance                                  
30       recipients compared to the previous fiscal year;                                                                  
31                 (10)  the percentage decrease in the number of medical assistance                                       
01       recipients identified as frequent users of emergency departments compared to the                                  
02       previous fiscal year;                                                                                             
03                 (11)  the percentage increase or decrease in the number of hospital                                     
04       readmissions within 30 days after a hospital stay for medical assistance recipients                               
05       compared to the previous fiscal year;                                                                             
06                 (12)  the percentage increase or decrease in state general fund spending                                
07       for the average medical assistance recipient compared to the previous fiscal year;                                
08                 (13)  the percentage increase or decrease in uncompensated care costs                                   
09       incurred by medical assistance providers compared to the percentage change in private                             
10       health insurance premiums for individual and small group health insurance;                                        
11                 (14)  the cost, in state and federal funds, for providing optional services                             
12       under AS 47.07.030(b).                                                                                            
13            (e)  In this section, "telehealth" means the practice of health care delivery,                               
14       evaluation, diagnosis, consultation, or treatment, using the transfer of health care data                         
15       through audio, visual, or data communications, performed over two or more locations                               
16       between providers who are physically separated from the recipient or from each other                              
17       or between a provider and a recipient who are physically separated from each other.                               
18    * Sec. 29. AS 47.07.030(d) is amended to read:                                                                     
19            (d)  The department shall [MAY] establish as optional services a primary care                            
20       case management system or a managed care organization contract in which certain                                   
21       eligible individuals are required to enroll and seek approval from a case manager or                              
22       the managed care organization before receiving certain services. The purpose of a                             
23       primary care case management system or managed care organization contract is                                  
24       to increase the use of appropriate primary and preventive care by medical                                     
25       assistance recipients, while decreasing the unnecessary use of specialty care and                             
26       hospital emergency department services. The department shall                                                  
27                 (1)  establish enrollment criteria and determine eligibility for services                           
28       consistent with federal and state law; the department shall require recipients with                           
29       multiple hospitalizations to enroll in a primary care case management system or                               
30       with a managed care organization under this subsection, except that the                                       
31       department may exempt recipients with chronic, acute, or terminal medical                                     
01       conditions from the requirement under this paragraph;                                                         
02                 (2)  define the coordinated care services and provider types eligible                               
03       to participate as primary care providers;                                                                     
04                 (3)  create a performance and quality reporting system; and                                         
05                 (4)  integrate the coordinated care demonstration projects                                          
06       described under AS 47.07.039 and the demonstration projects described under                                   
07       AS 47.07.036(e) with the primary care case management system or managed care                                  
08       organization contract established under this subsection.                                                      
09    * Sec. 30. AS 47.07.036 is amended by adding new subsections to read:                                              
10            (d)  Notwithstanding (a) - (c) of this section, the department may                                           
11                 (1)  apply for a section 1915(i) option under 42 U.S.C. 1396n to                                        
12       improve services and care through home and community-based services to obtain a 50                                
13       percent federal match;                                                                                            
14                 (2)  apply for a section 1915(k) option under 42 U.S.C. 1396n to                                        
15       provide home and community-based services and support to increase the federal match                               
16       for these programs from 50 percent to 56 percent;                                                                 
17                 (3)  apply for a section 1945 option under 42 U.S.C. 1396w-4 to                                         
18       provide coordinated care through health homes for individuals with chronic conditions                             
19       and to increase the federal match for the services to 90 percent for the first eight                              
20       quarters the required state plan amendment is in effect;                                                          
21                 (4)  evaluate and seek permission from the United States Department of                                  
22       Health and Human Services Centers for Medicare and Medicaid Services to participate                               
23       in various demonstration projects, including payment reform, care management                                      
24       programs, workforce development and innovation, and innovative services delivery                                  
25       models; and                                                                                                       
26                 (5)  provide incentives for telehealth, including increasing the                                        
27       capability for and reimbursement of telehealth for recipients.                                                    
28            (e)  Notwithstanding (a) - (c) of this section, and in addition to the projects and                          
29       services described under (d) and (f) of this section, the department shall apply for a                            
30       section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration                                
31       projects focused on innovative payment models for one or more groups of medical                                   
01       assistance recipients in one or more specific geographic areas. The demonstration                                 
02       project or projects may include                                                                                   
03                 (1)  managed care organizations as described under 42 U.S.C. 1396u-2;                                   
04                 (2)  community care organizations;                                                                      
05                 (3)  patient-centered medical homes as described under 42 U.S.C. 256a-                                  
06       1; or                                                                                                             
07                 (4)  other innovative payment models that ensure access to health care                                  
08       without reducing the quality of care.                                                                             
09            (f)  Notwithstanding (a) - (c) of this section, and in addition to the projects and                          
10       services described under (d) and (e) of this section, the department shall apply for a                            
11       section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration                                
12       projects focused on improving the state's behavioral health system for medical                                    
13       assistance recipients. The department shall engage stakeholders and the community in                              
14       the development of a project or projects under this subsection. The demonstration                                 
15       project or projects must be consistent with the comprehensive and integrated                                      
16       behavioral health program described under AS 47.05.270(b).                                                        
17            (g)  In this section, "telehealth" has the meaning given in AS 47.05.270(e).                                 
18    * Sec. 31. AS 47.07 is amended by adding new sections to read:                                                     
19            Sec. 47.07.038. Collaborative, hospital-based project to reduce use of                                     
20       emergency department services. (a) On or before December 1, 2016, the department                                
21       shall collaborate with a statewide professional hospital association to establish a                               
22       hospital-based project to reduce the use of emergency department services by medical                              
23       assistance recipients. The statewide professional hospital association shall operate the                          
24       project. The project may include shared savings for participating hospitals. The project                          
25       must include                                                                                                      
26                 (1)  an interdisciplinary process for defining, identifying, and                                        
27       minimizing the number of frequent users of emergency department services;                                         
28                 (2)  to the extent consistent with federal law, a system for real-time                                  
29       electronic exchange of patient information, including recent emergency department                                 
30       visits, hospital care plans for frequent users of emergency departments, and data from                            
31       the controlled substance prescription database;                                                                   
01                 (3)  a procedure for educating patients about the use of emergency                                      
02       departments and appropriate alternative services and facilities for nonurgent care;                               
03                 (4)  a process for assisting users of emergency departments in making                                   
04       appointments with primary care or behavioral health providers within 96 hours after                               
05       an emergency department visit;                                                                                    
06                 (5)  a collaborative process between the department and the statewide                                   
07       professional hospital association to establish uniform statewide guidelines for                                   
08       prescribing narcotics in an emergency department; and                                                             
09                 (6)  designation of health care personnel to review successes and                                       
10       challenges regarding appropriate emergency department use.                                                        
11            (b)  The department shall adopt regulations necessary to implement this                                      
12       section, request technical assistance from the United States Department of Health and                             
13       Human Services, and apply to the United States Department of Health and Human                                     
14       Services for waivers or amendments to the state plan as necessary to implement the                                
15       projects under this section.                                                                                      
16            Sec. 47.07.039. Coordinated care demonstration projects. (a) The                                           
17       department shall contract with one or more third parties to implement one or more                                 
18       coordinated care demonstration projects for recipients of medical assistance identified                           
19       by the department. The purpose of a demonstration project under this section is to                                
20       assess the efficacy of a proposed health care delivery model with respect to cost for,                            
21       access to, and quality of care for medical assistance recipients. The department may                              
22       contract for separate demonstration projects to coordinate care for different groups of                           
23       medical assistance recipients to achieve more effective care for recipients at greater                            
24       cost savings for the medical assistance program. The department shall request                                     
25       proposals for at least one project under this section on or before December 31, 2016,                             
26       and may annually request proposals for additional projects under this section                                     
27       thereafter. The department may use an innovative procurement process as described                                 
28       under AS 36.30.308 to award a contract for a project under this section. A proposal for                           
29       a demonstration project under this section must be submitted to the committee                                     
30       established under (b) of this section and must include three or more of the following                             
31       elements:                                                                                                         
01                 (1)  comprehensive primary-care-based management for medical                                            
02       assistance services, including behavioral health services and coordination of long-term                           
03       services and support;                                                                                             
04                 (2)  care coordination, including the assignment of a primary care                                      
05       provider located in the local geographic area of the recipient, to the extent practical;                          
06                 (3)  health promotion;                                                                                  
07                 (4)  comprehensive transitional care and follow-up care after inpatient                                 
08       treatment;                                                                                                        
09                 (5)  referral to community and social support services, including career                                
10       and education training services available through the Department of Labor and                                     
11       Workforce Development under AS 23.15, the University of Alaska, or other sources;                                 
12                 (6)  sustainability and the ability to achieve similar results in other                                 
13       regions of the state;                                                                                             
14                 (7)  integration and coordination of benefits, services, and utilization                                
15       management;                                                                                                       
16                 (8)  local accountability for health and resource allocation.                                           
17            (b)  A project review committee is established in the department for the                                     
18       purpose of reviewing proposals for demonstration projects under this section. The                                 
19       project review committee consists of                                                                              
20                 (1)  the commissioner of the department, or the commissioner's                                          
21       designee;                                                                                                         
22                 (2)  the commissioner of administration, or the commissioner's                                          
23       designee;                                                                                                         
24                 (3)  the chief executive officer of the Alaska Mental Health Trust                                      
25       Authority, or the chief executive officer's designee;                                                             
26                 (4)  two representatives of stakeholder groups, appointed by the                                        
27       governor for staggered three-year terms;                                                                          
28                 (5)  a nonvoting member who is a member of the senate, appointed by                                     
29       the president of the senate; and                                                                                  
30                 (6)  a nonvoting member who is a member of the house of                                                 
31       representatives, appointed by the speaker of the house of representatives.                                        
01            (c)  The department may contract with a managed care organization, primary                                   
02       care case manager, accountable care organization, prepaid ambulatory health plan, or                              
03       provider-led entity to implement a demonstration project under this section. The fee                              
04       structure for a contract under this subsection may include global payments, bundled                               
05       payments, capitated payments, shared savings and risk, or other payment structures.                               
06       The department shall work with the division of insurance, Department of Commerce,                                 
07       Community, and Economic Development, to streamline the application process for a                                  
08       company to obtain a certificate of authority required under AS 21.09.010 as necessary                             
09       to participate in a demonstration project under this section.                                                     
10            (d)  A proposal for a demonstration project under this section must include, in                              
11       addition to the elements required under (a) of this section, information demonstrating                            
12       how the project will implement additional cost-saving measures including innovations                              
13       to reduce the cost of care for medical assistance recipients through the expanded use                             
14       of telehealth for primary care, urgent care, and behavioral health services. The                                  
15       department shall identify legal or cost barriers preventing the expanded use of                                   
16       telehealth and shall recommend remedies for identified barriers.                                                  
17            (e)  The department shall contract with a third-party actuary to review                                      
18       demonstration projects established under this section. The actuary shall review each                              
19       demonstration project after one year of implementation and make recommendations                                   
20       for the implementation of a similar project on a statewide basis. The actuary shall                               
21       evaluate each project based on cost savings for the medical assistance program, health                            
22       outcomes for participants in the project, and the ability to achieve similar results on a                         
23       statewide basis. On or before December 31 of each year starting in 2018, the actuary                              
24       shall submit a final report to the department regarding any demonstration project that                            
25       has been in operation for at least one year.                                                                      
26            (f)  The department shall prepare a plan regarding regional or statewide                                     
27       implementation of a coordinated care project based on the results of the demonstration                            
28       projects under this section. On or before November 15, 2019, the department shall                                 
29       submit the plan to the senate secretary and the chief clerk of the house of                                       
30       representatives and notify the legislature that the plan is available. On or before                               
31       November 15 of each year thereafter, the department shall submit a report regarding                               
01       any changes or recommendations regarding the plan developed under this subsection                                 
02       to the senate secretary and the chief clerk of the house of representatives and notify the                        
03       legislature that the report is available.                                                                         
04            (g)  In this section, "telehealth" has the meaning given in AS 47.05.270(e).                                 
05    * Sec. 32. AS 47.07 is amended by adding a new section to read:                                                    
06            Sec. 47.07.076. Report to legislature. (a) The department and the attorney                                 
07       general shall annually prepare a report relating to the medical assistance program                                
08       under AS 47.07. The report must include the following information:                                                
09                 (1)  the amount and source of funds used to prevent or prosecute fraud,                                 
10       abuse, payment errors, and errors in eligibility determinations for the previous fiscal                           
11       year;                                                                                                             
12                 (2)  actions taken to address fraud, abuse, payment errors, and errors in                               
13       eligibility determinations during the previous fiscal year;                                                       
14                 (3)  specific examples of fraud or abuse that were prevented or                                         
15       prosecuted;                                                                                                       
16                 (4)  identification of vulnerabilities in the medical assistance program,                               
17       including any vulnerabilities identified by independent auditors with whom the                                    
18       department contracts under AS 47.05.200;                                                                          
19                 (5)  initiatives the department has taken to prevent fraud or abuse;                                    
20                 (6)  recommendations to increase effectiveness in preventing and                                        
21       prosecuting fraud and abuse;                                                                                      
22                 (7)  the return to the state for every dollar expended by the department                                
23       and the attorney general to prevent and prosecute fraud and abuse;                                                
24                 (8)  the most recent payment error rate measurement report for the                                      
25       medical assistance program, including fee for service programs and pilot or                                       
26       demonstration projects; the report must also explain the reasons for the payment errors                           
27       and the total amount of state and federal funds paid in error during the reporting period                         
28       and not recovered by the department at the time of the report;                                                    
29                 (9)  results from the Medicaid Eligibility Quality Control program.                                     
30            (b)  On or before November 15 of each year, the department shall submit the                                  
31       report required under this section to the senate secretary and the chief clerk of the                             
01       house of representatives and notify the legislature that the report is available.                                 
02    * Sec. 33. AS 47.07.900(4) is amended to read:                                                                     
03                 (4)  "clinic services" means services provided by state-approved                                        
04       outpatient community mental health clinics [THAT RECEIVE GRANTS UNDER                                             
05       AS 47.30.520 - 47.30.620], state-operated community mental health clinics, outpatient                             
06       surgical care centers, and physician clinics;                                                                     
07    * Sec. 34. AS 47.07.900(17) is amended to read:                                                                    
08                 (17)  "rehabilitative services" means services for substance abusers and                                
09       emotionally disturbed or chronically mentally ill adults provided by                                              
10                      (A)  a drug or alcohol treatment center [THAT IS FUNDED                                            
11            WITH A GRANT UNDER AS 47.30.475]; or                                                                         
12                      (B)  an outpatient community mental health clinic [THAT HAS                                        
13            A CONTRACT TO PROVIDE COMMUNITY MENTAL HEALTH                                                                
14            SERVICES UNDER AS 47.30.520 - 47.30.620];                                                                    
15    * Sec. 35. AS 47.55.020(e) is amended to read:                                                                     
16            (e)  As a condition for receipt of payment assistance under (d) of this section,                             
17       the department, under regulations adopted by the department, shall [MAY] require a                            
18       person to                                                                                                         
19                 (1)  apply for other state or federally sponsored programs that may                                 
20       reduce the amount of the payment assistance; and                                                              
21                 (2)  submit to the department a copy of the person's application for                                
22       medical assistance coverage under AS 47.07 and the decision letter the person                                 
23       receives regarding the application.                                                                           
24    * Sec. 36. AS 09.58.020, 09.58.030, 09.58.040, 09.58.050, and 09.58.060 are repealed                               
25 July 1, 2019.                                                                                                           
26    * Sec. 37. The uncodified law of the State of Alaska is amended by adding a new section to                         
27 read:                                                                                                                   
28       INDIRECT COURT RULE AMENDMENTS. (a) AS 09.58.020, added by sec. 10 of                                             
29 this Act, and repealed by sec. 36 of this Act, has the effect of amending the following court                           
30 rules in the manner specified from the effective date of sec. 10 of this Act until July 1, 2019:                        
31            (1)  Rules 4, 5, 7, and 12, Alaska Rules of Civil Procedure, by requiring that a                             
01 complaint under AS 09.58 be filed in camera and under seal and may not be served on the                                 
02 defendant until unsealed and that a copy of the complaint be served on the attorney general;                            
03            (2)  Rules 41 and 77, Alaska Rules of Civil Procedure, by authorizing the                                    
04 attorney general to move for dismissal of a complaint filed by another person under                                     
05 AS 09.58.020, added by sec. 10 of this Act and repealed by sec. 36 of this Act, and requiring                           
06 court approval for dismissal of the action.                                                                             
07       (b)  AS 09.58.025, added by sec. 10 of this Act, and amended by sec. 11 of this Act,                              
08 has the effect of amending Rule 27, Alaska Rules of Civil Procedure, by authorizing the                                 
09 attorney general to issue subpoenas as part of an investigation                                                         
10            (1)  under AS 09.58.015, added by sec. 10 of this Act, from the effective date                               
11 of sec. 10 of this Act; and                                                                                             
12            (2)  under AS 09.58.020, added by sec. 10 of this Act, from the effective date                               
13 of sec. 10 of this Act until July 1, 2019.                                                                              
14       (c)  AS 09.58.030, added by sec. 10 of this Act, and repealed by sec. 36 of this Act,                             
15 has the effect of amending the following court rules in the manner specified from the effective                         
16 date of sec. 10 of this Act until July 1, 2019:                                                                         
17            (1)  Rule 24, Alaska Rules of Civil Procedure, by authorizing the attorney                                   
18 general to intervene in a civil action filed by another person under AS 09.58.020 added by                              
19 sec. 10 of this Act, and repealed by sec. 36 of this Act, and limiting the participation of a party                     
20 to the litigation;                                                                                                      
21            (2)  Rules 26 and 27, Alaska Rules of Civil Procedure, by authorizing the                                    
22 attorney general to request that the court issue a stay of discovery for a 90-day period, or                            
23 longer upon a showing by the attorney general.                                                                          
24       (d)  AS 09.58.040, added by sec. 10 of this Act, and repealed by sec. 36 of this Act,                             
25 has the effect of amending Rules 79 and 82, Alaska Rules of Civil Procedure, from the                                   
26 effective date of sec. 10 of this Act until July 1, 2019, by giving a person who brings an action                       
27 under AS 09.58.020, added by sec. 10 of this Act, and repealed by sec. 36 of this Act, the                              
28 right to reasonable attorney fees and costs in an action prosecuted by the attorney general.                            
29       (e)  AS 47.05.260, added by sec. 28 of this Act, has the effect of amending Rule 89,                              
30 Alaska Rules of Civil Procedure, and Rule 37, Alaska Rules of Criminal Procedure, by                                    
31 authorizing the attorney general to apply to the court for authorization to seize property in                           
01 conjunction with an action filed under AS 47.05.210.                                                                    
02    * Sec. 38. The uncodified law of the State of Alaska is amended by adding a new section to                         
03 read:                                                                                                                   
04       IMPLEMENT FEDERAL POLICY ON TRIBAL MEDICAID REIMBURSEMENT.                                                        
05 (a) The Department of Health and Social Services shall collaborate with Alaska tribal health                            
06 organizations and the United States Department of Health and Human Services to fully                                    
07 implement changes in federal policy that authorize 100 percent federal funding for services                             
08 provided to American Indian and Alaska Native individuals eligible for Medicaid.                                        
09       (b)  Within 30 days after the date the Centers for Medicare and Medicaid Services                                 
10 issues a final policy regarding the circumstances in which 100 percent federal funding is                               
11 available for medical assistance services received through the United States Indian Health                              
12 Service or tribal health facilities, the Department of Health and Social Services shall notify                          
13 and submit a report to the co-chairs of the house and senate finance committees of the Alaska                           
14 State Legislature that includes an estimate of the savings to the state resulting from the final                        
15 policy. Within six months after the date the Centers for Medicare and Medicaid Services                                 
16 issues the final policy, the Department of Health and Social Services shall fully implement the                         
17 policy in the state.                                                                                                    
18       (c)  In this section, "Alaska tribal health organization" means an organization                                   
19 recognized by the United States Indian Health Service to provide health-related services.                             
20    * Sec. 39. The uncodified law of the State of Alaska is amended by adding a new section to                         
21 read:                                                                                                                   
22       HEALTH INFORMATION INFRASTRUCTURE PLAN. (a) The Department of                                                     
23 Health and Social Services shall develop a health information infrastructure plan to strengthen                         
24 the health information infrastructure, including health data analytics capability. The purpose                          
25 of the health information infrastructure plan is to transform the health care system in the state                       
26 by providing                                                                                                            
27            (1)  data required by health care providers for care coordination and quality                                
28 improvement; and                                                                                                        
29            (2)  the information support required by the Department of Health and Social                                 
30 Services and health care providers to enable development and implementation of the other                                
31 provisions of this Act.                                                                                                 
01       (b)  To the greatest extent practicable, the health information infrastructure plan will                          
02 leverage existing resources, including the health information exchange, and will identify                               
03 opportunities for integrating and streamlining health data systems administered by the state.                           
04    * Sec. 40. The uncodified law of the State of Alaska is amended by adding a new section to                         
05 read:                                                                                                                   
06       FEASIBILITY STUDIES FOR THE PROVISION OF SPECIFIED STATE                                                          
07 SERVICES. (a) The Department of Health and Social Services shall procure a study                                        
08 analyzing the feasibility of privatizing services delivered at Alaska Pioneers' Homes and                               
09 select facilities of the division of juvenile justice. The Department of Health and Social                              
10 Services shall deliver a report summarizing the conclusions of the Department of Health and                             
11 Social Services to the senate secretary and the chief clerk of the house of representatives and                         
12 notify the legislature that the report is available within 10 days after the convening of the First                     
13 Regular Session of the Thirtieth Alaska State Legislature.                                                              
14       (b)  The Department of Health and Social Services, in conjunction with the Alaska                                 
15 Mental Health Trust Authority, shall procure a study analyzing the feasibility of privatizing                           
16 services delivered at the Alaska Psychiatric Institute. The Department of Health and Social                             
17 Services and the Alaska Mental Health Trust Authority shall deliver a joint report                                      
18 summarizing the conclusions of the Department of Health and Social Services and the Alaska                              
19 Mental Health Trust Authority to the senate secretary and the chief clerk of the house of                               
20 representatives and notify the legislature that the report is available within 10 days after the                        
21 convening of the First Regular Session of the Thirtieth Alaska State Legislature.                                       
22       (c)  The Department of Administration shall, in collaboration with the house and                                  
23 senate finance committees, procure a study to be completed on or before June 30, 2017, to                               
24 determine the feasibility of creating a health care authority to coordinate health care plans and                       
25 consolidate purchasing effectiveness for all state employees, retired state employees, retired                          
26 teachers, medical assistance recipients, University of Alaska employees, employees of state                             
27 corporations, and school district employees and to develop appropriate benefit sets, rules,                             
28 cost-sharing, and payment structures for all employees and individuals whose health care                                
29 benefits are funded directly or indirectly by the state, with the goal of achieving the greatest                        
30 possible savings to the state through a coordinated approach administered by a single entity.                           
31 In developing the study, the Department of Administration shall seek input from the                                     
01 Department of Health and Social Services, administrators familiar with managing government                              
02 employee health plans, and human resource professionals familiar with self-insured health                               
03 care plans. The study must                                                                                              
04            (1)  identify cost-saving strategies that a health care authority could implement;                           
05            (2)  analyze local government participation in the authority;                                                
06            (3)  analyze a phased approach to adding groups to the health care plans                                     
07 coordinated by the health care authority;                                                                               
08            (4)  consider previous studies procured by the Department of Administration                                  
09 and the legislature;                                                                                                    
10            (5)  assess the use of community-related health insurance risk pools and the use                             
11 of the private marketplace;                                                                                             
12            (6)  identify organizational models for a health care authority, including private                           
13 for-profit, private nonprofit, government, and state corporations; and                                                  
14            (7)  include a public review and comment opportunity for employers,                                          
15 employees, medical assistance recipients, retirees, and health care providers.                                          
16       (d)  In this section, "school district" has the meaning given in AS 14.30.350.                                    
17    * Sec. 41. The uncodified law of the State of Alaska is amended by adding a new section to                         
18 read:                                                                                                                   
19       MEDICAID STATE PLAN; WAIVERS; INSTRUCTIONS; NOTICE TO REVISOR                                                     
20 OF STATUTES. The Department of Health and Social Services shall amend and submit for                                    
21 federal approval a state plan for medical assistance coverage consistent with this Act. The                             
22 Department of Health and Social Services shall apply to the United States Department of                                 
23 Health and Human Services for any waivers necessary to implement this Act. The                                          
24 commissioner of health and social services shall certify to the revisor of statutes if the                              
25 provisions of AS 47.05.270(a)(5), (8), and (10), added by sec. 28 of this Act, and the                                  
26 provisions of AS 47.07.038, added by sec. 31 of this Act, are approved by the United States                             
27 Department of Health and Human Services.                                                                                
28    * Sec. 42. The uncodified law of the State of Alaska is amended by adding a new section to                         
29 read:                                                                                                                   
30       TRANSITION: REGULATIONS. (a) The Department of Health and Social Services                                         
31 may adopt regulations necessary to implement the changes made by this Act. The regulations                              
01 take effect under AS 44.62 (Administrative Procedure Act), but not before the effective date                            
02 of the relevant provision of this Act implemented by the regulation.                                                    
03       (b)  The Board of Pharmacy may adopt regulations necessary to implement the                                       
04 changes made by secs. 13 - 19 of this Act. The regulations take effect under AS 44.62                                   
05 (Administrative Procedure Act), but not before the effective date of the relevant provision of                          
06 secs. 13 - 19 of this Act implemented by the regulation.                                                                
07    * Sec. 43. The uncodified law of the State of Alaska is amended by adding a new section to                         
08 read:                                                                                                                   
09       CONDITIONAL EFFECT. (a) AS 47.05.270(a)(5), enacted by sec. 28 of this Act,                                       
10 takes effect only if the commissioner of health and social services certifies to the revisor of                         
11 statutes under sec. 41 of this Act, on or before October 1, 2017, that all of the provisions                            
12 added by AS 47.05.270(a)(5) have been approved by the United States Department of Health                                
13 and Human Services.                                                                                                     
14       (b)  AS 47.05.270(a)(8), enacted by sec. 28 of this Act, takes effect only if the                                 
15 commissioner of health and social services certifies to the revisor of statutes under sec. 41 of                        
16 this Act, on or before October 1, 2017, that all of the provisions added by AS 47.05.270(a)(8)                          
17 have been approved by the United States Department of Health and Human Services.                                        
18       (c)  AS 47.05.270(a)(10), enacted by sec. 28 of this Act, takes effect only if the                                
19 commissioner of health and social services certifies to the revisor of statutes under sec. 41 of                        
20 this Act, on or before October 1, 2017, that all of the provisions added by                                             
21 AS 47.05.270(a)(10) have been approved by the United States Department of Health and                                    
22 Human Services.                                                                                                         
23       (d)  AS 47.07.038, enacted by sec. 31 of this Act, takes effect only if the commissioner                          
24 of health and social services certifies to the revisor of statutes under sec. 41 of this Act, on or                     
25 before October 1, 2017, that all of the provisions added by AS 47.07.038 have been approved                             
26 by the United States Department of Health and Human Services.                                                           
27       (e)  AS 09.58.020, added by sec. 10 of this Act, AS 09.58.025, added by sec. 10 of this                           
28 Act and amended by sec. 11 of this Act, AS 09.58.030, added by sec. 10 of this Act and                                  
29 repealed by sec. 36 of this Act, AS 09.58.040, added by sec. 10 of this Act, and AS 47.05.260,                          
30 added by sec. 28 of this Act, take effect only if sec. 37 of this Act receives the two-thirds                           
31 majority vote of each house required by art. IV, sec. 15, Constitution of the State of Alaska.                          
01    * Sec. 44. If AS 47.05.270(a)(5), enacted by sec. 28 of this Act, takes effect, it takes effect                    
02 on the day after the date the commissioner of health and social services makes a certification                          
03 to the revisor of statutes under secs. 41 and 43(a) of this Act.                                                        
04    * Sec. 45. If AS 47.05.270(a)(8), enacted by sec. 28 of this Act, takes effect, it takes effect                    
05 on the day after the date the commissioner of health and social services makes a certification                          
06 to the revisor of statutes under secs. 41 and 43(b) of this Act.                                                        
07    * Sec. 46. If AS 47.05.270(a)(10), enacted by sec. 28 of this Act, takes effect, it takes effect                   
08 on the day after the date the commissioner of health and social services makes a certification                          
09 to the revisor of statutes under secs. 41 and 43(c) of this Act.                                                        
10    * Sec. 47. If AS 47.07.038, enacted by sec. 31 of this Act, takes effect, it takes effect on the                   
11 day after the date the commissioner of health and social services makes a certification to the                          
12 revisor of statutes under secs. 41 and 43(d) of this Act.                                                             
13    * Sec. 48. Sections 40, 41, 42(a), and 43 of this Act take effect immediately under                                
14 AS 01.10.070(c).                                                                                                        
15    * Sec. 49. Sections 13 - 19 of this Act take effect January 1, 2017.                                               
16    * Sec. 50. Section 42(b) of this Act takes effect July 1, 2016.                                                    
17    * Sec. 51. Sections 11 and 12 of this Act take effect July 1, 2019.