txt

HCS 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 audiologist, speech-language pathologist, professional counselor, marriage and family therapist, psychologist, psychological associate, social worker, physical therapist, occupational therapist, and registered speech-language pathologist assistant 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 Board of Dental Examiners; relating to the duties of the Board of Nursing; relating to the duties of the Board of Examiners in Optometry; relating to the duties of the Department of Commerce, Community, and Economic Development; relating to the duties of the Department of Corrections; 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 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 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; relating to a report by the Board of Pharmacy, Board of Examiners in Optometry, Board of Dental Examiners, Board of Nursing, and State Medical Board; amending Rules 4, 5, 7, 12, 24, 26, 27, 41, 77, 79, and 82, Alaska Rules of Civil Procedure; and providing for an effective date."

00                 HOUSE CS FOR 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 audiologist,                             
03 speech-language pathologist, professional counselor, marriage and family therapist,                                     
04 psychologist, psychological associate, social worker, physical therapist, occupational                                  
05 therapist, and registered speech-language pathologist assistant by audio, video, or data                                
06 communications; relating to the duties of the State Medical Board; relating to                                          
07 limitations of actions; establishing the Alaska Medical Assistance False Claim and                                      
08 Reporting Act; relating to medical assistance programs administered by the Department                                   
09 of Health and Social Services; relating to the controlled substance prescription                                        
10 database; relating to the duties of the Board of Pharmacy;  relating to the duties of the                               
11 Board of Dental Examiners; relating to the duties of the Board of Nursing; relating to                                  
12 the duties of the Board of Examiners in Optometry; relating to the duties of the                                        
01 Department of Commerce, Community, and Economic Development; relating to the                                            
02 duties of the Department of Corrections; relating to accounting for program receipts;                                   
03 relating to public record status of records related to the Alaska Medical Assistance False                              
04 Claim and Reporting Act; establishing a telemedicine business registry; relating to                                     
05 verification of eligibility for public assistance programs administered by the Department                               
06 of Health and Social Services; relating to annual audits of state medical assistance                                    
07 providers; relating to reporting overpayments of medical assistance payments;                                           
08 establishing authority to assess civil penalties for violations of medical assistance                                   
09 program requirements; relating to the duties of the Department of Health and Social                                     
10 Services; establishing medical assistance demonstration projects; relating to Alaska                                    
11 Pioneers' Homes and Alaska Veterans' Homes; relating to the duties of the Department                                    
12 of Administration; relating to the Alaska Mental Health Trust Authority; relating to                                    
13 feasibility studies for the provision of specified state services; relating to a report by the                          
14 Board of Pharmacy, Board of Examiners in Optometry, Board of Dental Examiners,                                          
15 Board of Nursing, and State Medical Board; amending Rules 4, 5, 7, 12, 24, 26, 27, 41,                                  
16 77, 79, and 82, Alaska Rules of Civil Procedure; and providing for an effective date."                                  
17 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
18    * Section 1. AS 08.11.080 is amended by adding new subsections to read:                                            
19            (b)  The department may not impose disciplinary sanctions on an audiologist                                  
20       for the evaluation, diagnosis, or treatment of a person through audio, video, or data                             
21       communications when physically separated from the person if the audiologist                                       
22                 (1)  or another licensed health care provider is available to provide                                   
23       follow-up care;                                                                                                   
24                 (2)  requests that the person consent to sending a copy of all records of                               
25       the encounter to a primary care provider if the audiologist is not the person's primary                           
01       care provider and, if the person consents, the audiologist sends the records to the                               
02       person's primary care provider; and                                                                               
03                 (3)  meets the requirements established by the department in regulation.                                
04            (c)  The department shall adopt regulations restricting the evaluation,                                      
05       diagnosis, supervision, and treatment of a person as authorized under (b) of this                                 
06       section by establishing standards of care, including standards for training,                                      
07       confidentiality, supervision, practice, and related issues.                                                       
08    * Sec. 2. AS 08.11.083 is amended by adding new subsections to read:                                               
09            (b)  The department may not impose disciplinary sanctions on a speech-                                       
10       language pathologist assistant for the evaluation, diagnosis, or treatment of a person                            
11       through audio, video, or data communications when physically separated from the                                   
12       person if the speech-language pathologist assistant                                                               
13                 (1)  or another licensed health care provider is available to provide                                   
14       follow-up care;                                                                                                   
15                 (2)  requests that the person consent to sending a copy of all records of                               
16       the encounter to a primary care provider if the speech-language pathologist assistant is                          
17       not the person's primary care provider and, if the person consents, the speech-language                           
18       pathologist assistant sends the records to the person's primary care provider; and                                
19                 (3)  meets the requirements established by the board in regulation.                                     
20            (c)  The department shall adopt regulations restricting the evaluation,                                      
21       diagnosis, supervision, and treatment of a person as authorized under (b) of this                                 
22       section by establishing standards of care, including standards for training,                                      
23       confidentiality, supervision, practice, and related issues.                                                       
24    * Sec. 3. AS 08.11.085 is amended by adding new subsections to read:                                               
25            (b)  The department may not impose disciplinary sanctions on a speech-                                       
26       language pathologist for the evaluation, diagnosis, or treatment of a person through                              
27       audio, video, or data communications when physically separated from the person if the                             
28       speech-language pathologist                                                                                       
29                 (1)  or another licensed health care provider is available to provide                                   
30       follow-up care;                                                                                                   
31                 (2)  requests that the person consent to sending a copy of all records of                               
01       the encounter to a primary care provider if the speech-language pathologist is not the                            
02       person's primary care provider and, if the person consents, the speech-language                                   
03       pathologist sends the records to the person's primary care provider; and                                          
04                 (3)  meets the requirements established by the board in regulation.                                     
05            (c)  The department shall adopt regulations restricting the evaluation,                                      
06       diagnosis, supervision, and treatment of a person as authorized under (b) of this                                 
07       section by establishing standards of care, including standards for training,                                      
08       confidentiality, supervision, practice, and related issues.                                                       
09    * Sec. 4. AS 08.29.400 is amended by adding new subsections to read:                                               
10            (b)  The board may not impose disciplinary sanctions on a licensee for the                                   
11       evaluation, diagnosis, or treatment of a person through audio, video, or data                                     
12       communications when physically separated from the person if                                                       
13                 (1)  the licensee or another licensed health care provider is available to                              
14       provide follow-up care;                                                                                           
15                 (2)  the licensee requests that the person consent to sending a copy of                                 
16       all records of the encounter to a primary care provider if the licensee is not the                                
17       person's primary care provider and, if the person consents, the licensee sends the                                
18       records to the person's primary care provider; and                                                                
19                 (3)  the licensee meets the requirements established by the board in                                    
20       regulation.                                                                                                       
21            (c)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
22       supervision, and treatment of a person as authorized under (b) of this section by                                 
23       establishing standards of care, including standards for training, confidentiality,                                
24       supervision, practice, and related issues.                                                                        
25    * Sec. 5. AS 08.36.070(a) is amended to read:                                                                      
26            (a)  The board shall                                                                                         
27                 (1)  provide for the examination of applicants and the credentialing,                                   
28       registration, and licensure of those applicants it finds qualified;                                               
29                 (2)  maintain a registry of licensed dentists, licensed dental hygienists,                              
30       and registered dental assistants who are in good standing;                                                        
31                 (3)  affiliate with the American Association of Dental Boards and pay                                   
01       annual dues to the association;                                                                                   
02                 (4)  hold hearings and order the disciplinary sanction of a person who                                  
03       violates this chapter, AS 08.32, or a regulation of the board;                                                    
04                 (5)  supply forms for applications, licenses, permits, certificates,                                    
05       registration documents, and other papers and records;                                                             
06                 (6)  enforce the provisions of this chapter and AS 08.32 and adopt or                                   
07       amend the regulations necessary to make the provisions of this chapter and AS 08.32                               
08       effective;                                                                                                        
09                 (7)  adopt regulations ensuring that renewal of a license, registration, or                             
10       certificate under this chapter or a license, certificate, or endorsement under AS 08.32                           
11       is contingent upon proof of continued professional competence;                                                    
12                 (8)  at least annually, cause to be published on the Internet and in a                                  
13       newspaper of general circulation in each major city in the state a summary of                                     
14       disciplinary actions the board has taken during the preceding calendar year;                                      
15                 (9)  issue permits or certificates to licensed dentists, licensed dental                                
16       hygienists, and dental assistants who meet standards determined by the board for                                  
17       specific procedures that require specific education and training;                                             
18                 (10)  require that a licensed dentist who has a federal Drug                                        
19       Enforcement Administration registration number register with the controlled                                   
20       substance prescription database under AS 17.30.200(o).                                                        
21    * Sec. 6. AS 08.63.210 is amended by adding new subsections to read:                                               
22            (c)  The board may not impose disciplinary sanctions on a licensee for the                                   
23       evaluation, diagnosis, supervision, or treatment of a person through audio, video, or                             
24       data communications when physically separated from the person if                                                  
25                 (1)  the licensee or another licensed health care provider is available to                              
26       provide follow-up care;                                                                                           
27                 (2)  the licensee requests that the person consent to sending a copy of                                 
28       all records of the encounter to a primary care provider if the licensee is not the                                
29       person's primary care provider and, if the person consents, the licensee sends the                                
30       records to the person's primary care provider; and                                                                
31                 (3)  the licensee meets the requirements established by the board in                                    
01       regulation.                                                                                                       
02            (d)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
03       supervision, and treatment of a person as authorized under (c) of this section by                                 
04       establishing standards of care, including standards for training, confidentiality,                                
05       supervision, practice, and related issues.                                                                        
06    * Sec. 7. AS 08.64.101 is amended to read:                                                                         
07            Sec. 08.64.101. Duties. The board shall                                                                    
08                 (1)  examine and issue licenses to applicants;                                                          
09                 (2)  develop written guidelines to ensure that licensing requirements are                               
10       not unreasonably burdensome and the issuance of licenses is not unreasonably                                      
11       withheld or delayed;                                                                                              
12                 (3)  after a hearing, impose disciplinary sanctions on persons who                                      
13       violate this chapter or the regulations or orders of the board;                                                   
14                 (4)  adopt regulations ensuring that renewal of licenses is contingent on                           
15       [UPON] proof of continued competency on the part of the licensee; and                                             
16                 (5)  under regulations adopted by the board, contract with private                                      
17       professional organizations to establish an impaired medical professionals program to                              
18       identify, confront, evaluate, and treat persons licensed under this chapter who abuse                             
19       alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;                        
20                 (6)  adopt regulations that establish guidelines for a physician who                                
21       is rendering a diagnosis, providing treatment, or prescribing, dispensing, or                                 
22       administering a prescription drug to a person without conducting a physical                                   
23       examination under AS 08.64.364; the guidelines must include a nationally                                      
24       recognized model policy for standards of care of a patient who is at a different                              
25       location than the physician;                                                                                  
26                 (7)  require that a licensee who has a federal Drug Enforcement                                     
27       Administration registration number register with the controlled substance                                     
28       prescription database under AS 17.30.200(o).                                                                  
29    * Sec. 8. AS 08.64.364(a) is amended to read:                                                                      
30            (a)  The board may not impose disciplinary sanctions on a physician for                                      
31       rendering a diagnosis, providing treatment, or prescribing, dispensing, or                                    
01       administering a prescription drug that is not a controlled substance to a person                              
02       without conducting a physical examination if                                                                      
03                 (1)  [THE PRESCRIPTION DRUG IS                                                                          
04                      (A)  NOT A CONTROLLED SUBSTANCE; OR                                                                
05                      (B)  A CONTROLLED SUBSTANCE AND IS PRESCRIBED,                                                     
06            DISPENSED, OR ADMINISTERED BY A PHYSICIAN WHEN AN                                                            
07            APPROPRIATE LICENSED HEALTH CARE PROVIDER IS PRESENT                                                         
08            WITH THE PATIENT TO ASSIST THE PHYSICIAN WITH                                                                
09            EXAMINATION, DIAGNOSIS, AND TREATMENT;                                                                       
10                 (2)  THE PHYSICIAN IS LOCATED IN THIS STATE AND] the                                                    
11       physician or another licensed health care provider or physician in the physician's                                
12       group practice is available to provide follow-up care; and                                                        
13                 (2)  the physician requests that [(3)] the person consent                                       
14       [CONSENTS] to sending a copy of all records of the encounter to the person's primary                              
15       care provider if the prescribing physician is not the person's primary care provider,                             
16       and, if the patient consents, the physician sends the records to the person's primary                         
17       care provider.                                                                                                    
18    * Sec. 9. AS 08.64.364 is amended by adding new subsections to read:                                               
19            (c)  The board may not impose disciplinary sanctions on a physician for                                      
20       prescribing, dispensing, or administering a prescription drug that is a controlled                                
21       substance or botulinum toxin if the requirements under (a) of this section are met and                            
22       the physician prescribes, dispenses, or administers the controlled substance or                                   
23       botulinum toxin when an appropriate licensed health care provider is present with the                             
24       patient to assist the physician with examination, diagnosis, and treatment.                                       
25            (d)  Notwithstanding (a) and (c) of this section, a physician may not                                        
26                 (1)  prescribe, dispense, or administer an abortion-inducing drug under                                 
27       (a) of this section unless the physician complies with AS 18.16.010; or                                           
28                 (2)  prescribe, dispense, or administer a prescription drug in response to                              
29       an Internet questionnaire or electronic mail message to a person with whom the                                    
30       physician does not have a prior physician-patient relationship.                                                   
31    * Sec. 10. AS 08.68.100(a) is amended to read:                                                                     
01            (a)  The board shall                                                                                         
02                 (1)  adopt regulations necessary to implement this chapter, including                                   
03       regulations                                                                                                       
04                      (A)  pertaining to practice as an advanced nurse practitioner and                                  
05            a certified registered nurse anesthetist;                                                                    
06                      (B)  necessary to implement AS 08.68.331 - 08.68.336 relating                                      
07            to certified nurse aides in order to protect the health, safety, and welfare of                              
08            clients served by nurse aides;                                                                               
09                      (C)  pertaining to retired nurse status; and                                                       
10                      (D)  establishing criteria for approval of practical nurse                                         
11            education programs that are not accredited by a national nursing accrediting                                 
12            body;                                                                                                        
13                 (2)  approve curricula and adopt standards for basic education programs                                 
14       that prepare persons for licensing under AS 08.68.190;                                                            
15                 (3)  provide for surveys of the basic nursing education programs in the                                 
16       state at the times it considers necessary;                                                                        
17                 (4)  approve education programs that meet the requirements of this                                      
18       chapter and of the board, and deny, revoke, or suspend approval of education                                      
19       programs for failure to meet the requirements;                                                                    
20                 (5)  examine, license, and renew the licenses of qualified applicants;                                  
21                 (6)  prescribe requirements for competence before a former nurse may                                    
22       resume the practice of nursing under this chapter;                                                                
23                 (7)  define by regulation the qualifications and duties of the executive                                
24       administrator and delegate authority to the executive administrator that is necessary to                          
25       conduct board business;                                                                                           
26                 (8)  develop reasonable and uniform standards for nursing practice;                                     
27                 (9)  publish advisory opinions regarding whether nursing practice                                       
28       procedures or policies comply with acceptable standards of nursing practice as defined                            
29       under this chapter;                                                                                               
30                 (10)  require applicants under this chapter to submit fingerprints and the                              
31       fees required by the Department of Public Safety under AS 12.62.160 for criminal                                  
01       justice information and a national criminal history record check; the department shall                            
02       submit the fingerprints and fees to the Department of Public Safety for a report of                               
03       criminal justice information under AS 12.62 and a national criminal history record                                
04       check under AS 12.62.400;                                                                                     
05                 (11)  require that a licensed advanced nurse practitioner who has a                                 
06       federal Drug Enforcement Administration registration number register with the                                 
07       controlled substance prescription database under AS 17.30.200(o).                                             
08    * Sec. 11. AS 08.72.060(c) is amended to read:                                                                     
09            (c)  The board shall                                                                                         
10                 (1)  elect a chair and secretary from among its members;                                                
11                 (2)  order a licensee to submit to a reasonable physical examination if                                 
12       the licensee's physical capacity to practice safely is at issue;                                              
13                 (3)  require that a licensee who has a federal Drug Enforcement                                     
14       Administration registration number register with the controlled substance                                     
15       prescription database under AS 17.30.200(o).                                                                  
16    * Sec. 12. AS 08.80.030(b) is amended to read:                                                                     
17            (b)  In order to fulfill its responsibilities, the board has the powers necessary                            
18       for implementation and enforcement of this chapter, including the power to                                        
19                 (1)  elect a president and secretary from its membership and adopt rules                                
20       for the conduct of its business;                                                                                  
21                 (2)  license by examination or by license transfer the applicants who are                               
22       qualified to engage in the practice of pharmacy;                                                                  
23                 (3)  assist the department in inspections and investigations for                                        
24       violations of this chapter, or of any other state or federal statute relating to the practice                     
25       of pharmacy;                                                                                                      
26                 (4)  adopt regulations to carry out the purposes of this chapter;                                       
27                 (5)  establish and enforce compliance with professional standards and                                   
28       rules of conduct for pharmacists engaged in the practice of pharmacy;                                             
29                 (6)  determine standards for recognition and approval of degree                                         
30       programs of schools and colleges of pharmacy whose graduates shall be eligible for                                
31       licensure in this state, including the specification and enforcement of requirements for                          
01       practical training, including internships;                                                                        
02                 (7)  establish for pharmacists and pharmacies minimum specifications                                    
03       for the physical facilities, technical equipment, personnel, and procedures for the                               
04       storage, compounding, and dispensing of drugs or related devices, and for the                                     
05       monitoring of drug therapy;                                                                                       
06                 (8)  enforce the provisions of this chapter relating to the conduct or                                  
07       competence of pharmacists practicing in the state, and the suspension, revocation, or                             
08       restriction of licenses to engage in the practice of pharmacy;                                                    
09                 (9)  license and regulate the training, qualifications, and employment of                               
10       pharmacy interns and pharmacy technicians;                                                                        
11                 (10)  issue licenses to persons engaged in the manufacture and                                          
12       distribution of drugs and related devices;                                                                        
13                 (11)  establish and maintain a controlled substance prescription                                        
14       database as provided in AS 17.30.200;                                                                             
15                 (12)  establish standards for the independent administration by a                                       
16       pharmacist of vaccines and related emergency medications under AS 08.80.168,                                      
17       including the completion of an immunization training program approved by the board;                           
18                 (13)  require that a licensed pharmacist who has a federal Drug                                     
19       Enforcement Administration registration number register with the controlled                                   
20       substance prescription database under AS 17.30.200(o).                                                      
21    * Sec. 13. AS 08.84.120 is amended by adding new subsections to read:                                              
22            (c)  The board may not impose disciplinary sanctions on a licensee for the                                   
23       evaluation, diagnosis, or treatment of a person through audio, video, or data                                     
24       communications when physically separated from the person if the licensee                                          
25                 (1)  or another licensed health care provider is available to provide                                   
26       follow-up care;                                                                                                   
27                 (2)  requests that the person consent to sending a copy of all records of                               
28       the encounter to a primary care provider if the licensee is not the person's primary care                         
29       provider and, if the person consents, the licensee sends the records to the person's                              
30       primary care provider; and                                                                                        
31                 (3)  meets the requirements established by the board in regulation.                                     
01            (d)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
02       supervision, and treatment of a person as authorized under (c) of this section by                                 
03       establishing standards of care, including standards for training, confidentiality,                                
04       supervision, practice, and related issues.                                                                        
05    * Sec. 14. AS 08.86.204 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, or treatment of a person through audio, video, or data                                     
08       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. 15. AS 08.95.050 is amended by adding new subsections to read:                                              
22            (b)  The board may not impose disciplinary sanctions on a licensee for the                                   
23       evaluation, diagnosis, or treatment of a person through audio, video, or data                                     
24       communications when physically separated from the person if                                                       
25                 (1)  the licensee or another licensed health care provider is available to                              
26       provide follow-up care;                                                                                           
27                 (2)  the licensee requests that the person consent to sending a copy of                                 
28       all records of the encounter to a primary care provider if the licensee is not the                                
29       person's primary care provider and, if the person consents, the licensee sends the                                
30       records to the person's primary care provider; and                                                                
31                 (3)  the licensee meets the requirements established by the board in                                    
01       regulation.                                                                                                       
02            (c)  The board shall adopt regulations restricting the evaluation, diagnosis,                                
03       supervision, and treatment of a person as authorized under (b) of this section by                                 
04       establishing standards of care, including standards for training, confidentiality,                                
05       supervision, practice, and related issues.                                                                      
06    * Sec. 16. AS 09.10 is amended by adding a new section to read:                                                    
07            Sec. 09.10.075. Actions related to claims based on medical assistance                                      
08       payment fraud. Except as provided in AS 09.58.070, a person may not bring an                                    
09       action under AS 09.58.010 - 09.58.060, unless the action is commenced by (1) six                                  
10       years after the act or omission was committed, or (2) three years after the date when                             
11       facts material to the action were known, or reasonably should have been known, by                                 
12       the attorney general or the Department of Health and Social Services, whichever is                                
13       later, but in no event more than 10 years after the date the violation under                                      
14       AS 09.58.010 occurred.                                                                                            
15    * Sec. 17. AS 09.10.120(a) is amended to read:                                                                     
16            (a)  Except as provided in AS 09.10.075, an [AN] action brought in the name                              
17       of or for the benefit of the state, any political subdivision, or public corporation may                          
18       be commenced only within six years after [OF] the date of accrual of the cause of                             
19       action. However, if the action is for relief on the ground of fraud, the limitation                               
20       commences from the time of discovery by the aggrieved party of the facts constituting                             
21       the fraud.                                                                                                        
22    * Sec. 18. AS 09 is amended by adding a new chapter to read:                                                       
23        Chapter 58. Alaska Medical Assistance False Claim and Reporting Act.                                         
24            Sec. 09.58.010. False claims for medical assistance; civil penalty. (a) A                                  
25       medical assistance provider or medical assistance recipient may not                                               
26                 (1)  knowingly submit, authorize, or cause to be submitted to an officer                                
27       or employee of the state a false or fraudulent claim for payment or approval under the                            
28       medical assistance program;                                                                                       
29                 (2)  knowingly make, use, or cause to be made or used, directly or                                      
30       indirectly, a false record or statement to get a false or fraudulent claim for payment                            
31       paid or approved by the state under the medical assistance program;                                               
01                 (3)  conspire to defraud the state by getting a false or fraudulent claim                               
02       paid or approved under the medical assistance program;                                                            
03                 (4)  knowingly make, use, or cause to be made or used, a false record or                                
04       statement to conceal, avoid, increase, or decrease an obligation to pay or transmit                               
05       money or property to the medical assistance program;                                                              
06                 (5)  knowingly enter into an agreement, contract, or understanding with                                 
07       an officer or employee of the state for approval or payment of a claim under the                                  
08       medical assistance program knowing that the information in the agreement, contract,                               
09       or understanding is false or fraudulent.                                                                          
10            (b)  A beneficiary of an intentional or inadvertent submission of a false or                                 
11       fraudulent claim under the medical assistance program who later discovers the claim is                            
12       false or fraudulent shall disclose the false or fraudulent claim to the state not later than                      
13       60 days after discovering the false claim.                                                                        
14            (c)  In addition to any criminal penalties under AS 47.05, a medical assistance                              
15       provider or medical assistance recipient who violates (a) or (b) of this section shall be                         
16       liable to the state in a civil action for                                                                         
17                 (1)  a civil penalty of not less than $5,500 and not more than $11,000;                                 
18                 (2)  three times the amount of actual damages sustained by the state;                                   
19                 (3)  full reasonable attorney fees and costs in a case involving a                                      
20       fraudulent claim, agreement, contract, or understanding; and                                                      
21                 (4)  reasonable attorney fees and costs calculated under applicable court                               
22       rules in a case that does not involve a fraudulent claim, agreement, contract, or                                 
23       understanding.                                                                                                    
24            (d)  Liability for actual damages under (c) of this section may be reduced to not                            
25       less than twice the amount of actual damages that the state sustains if the court finds                           
26       that a person liable for an act under (a) or (b) of this section                                                  
27                 (1)  furnished the attorney general or the Department of Health and                                     
28       Social Services with all information known to the person about the violation not later                            
29       than 30 days after the date the information was obtained;                                                         
30                 (2)  fully cooperated with the investigation of the violation under                                     
31       AS 09.58.020;                                                                                                     
01                 (3)  at the time the person furnished the attorney general with the                                     
02       information about the violation, no criminal prosecution, civil action, investigation, or                         
03       administrative action had been started in this state with respect to the violation, and the                       
04       person did not have actual knowledge of the existence of an investigation of the                                  
05       violation.                                                                                                        
06            (e)  A corporation, partnership, or other individual is liable under this section                            
07       for acts of its agents if the agent acted with apparent authority, regardless of whether                          
08       the agent acted, in whole or in part, to benefit the principal and regardless of whether                          
09       the principal adopted or ratified the agent's claims, representations, statement, or other                        
10       action or conduct.                                                                                                
11            Sec. 09.58.015. Attorney general investigation; civil action. (a) The attorney                             
12       general or the Department of Health and Social Services may investigate an alleged                                
13       violation of AS 09.58.010. The attorney general may request assistance from the                                   
14       Department of Health and Social Services in an investigation under this section.                                  
15            (b)  The attorney general may bring a civil action in superior court under                                   
16       AS 09.58.010 - 09.58.060.                                                                                         
17            Sec. 09.58.020. Private plaintiff; civil action. (a) Notwithstanding                                       
18       AS 09.58.015, a person may bring an action under this section for a violation of                                  
19       AS 09.58.010 in the name of the person and the state.                                                             
20            (b)  To bring an action under this section, a person shall file a complaint, in                              
21       camera and under seal, and serve on the attorney general                                                          
22                 (1)  a copy of the complaint; and                                                                       
23                 (2)  written disclosure of substantially all material evidence and                                      
24       information the person possesses that pertains to the claim.                                                      
25            (c)  A complaint filed under this section must remain under seal for at least 60                             
26       days and may not be served on the defendant until the court so orders. The attorney                               
27       general may elect to intervene and proceed with the action within 60 days after the                               
28       attorney general receives both the complaint and the material evidence and the                                    
29       information required under (b) of this section. The attorney general may, for good                                
30       cause shown, move the court, under seal, for an extension of the time during which the                            
31       complaint remains under seal under this subsection.                                                               
01            (d)  Before the expiration of the 60-day period or an extension of time granted                              
02       under (c) of this section, the attorney general shall conduct an investigation and make                           
03       a written determination as to whether substantial evidence exists that a violation of                             
04       AS 09.58.010 has occurred. After the investigation and determination are complete,                                
05       the attorney general shall provide the person who brought the action and the                                      
06       Department of Health and Social Services with a copy of the determination unless the                              
07       action has been referred to the division of the Department of Law that has                                        
08       responsibility for criminal cases.                                                                                
09            (e)  Before the expiration of the 60-day period or an extension obtained under                               
10       (c) of this section, the attorney general shall                                                                   
11                 (1)  intervene in the action and proceed with the action on behalf of the                               
12       state;                                                                                                            
13                 (2)  notify the court that the attorney general declines to take over the                               
14       action, in which case the person bringing the action has the right to conduct the action;                         
15       or                                                                                                                
16                 (3)  if the attorney general determines that substantial evidence does not                              
17       exist that a violation of AS 09.58.010 has occurred, or that the action is barred under                           
18       AS 09.58.050, the attorney general shall move the court to dismiss the action.                                    
19            (f)  The named defendant in a complaint filed under this section is not required                             
20       to respond to a complaint filed under this section until after the complaint is unsealed                          
21       by the court and a copy of the summons and complaint are served on the defendant                                  
22       under the applicable Alaska Rules of Civil Procedure.                                                             
23            (g)  When a person brings an action under this section, only the attorney                                    
24       general may intervene or bring a related action based on similar facts to the underlying                          
25       action.                                                                                                           
26            Sec. 09.58.025. Subpoenas. In conducting an investigation under                                            
27       AS 09.58.015 or 09.58.020, the attorney general may issue subpoenas to compel the                                 
28       production of books, papers, correspondence, memoranda, and other records in                                      
29       connection with an investigation under or the administration of AS 09.58.010 -                                    
30       09.58.060. If a medical assistance provider or a medical assistance recipient fails or                            
31       refuses, without just cause, to obey a subpoena issued under this subsection, the                                 
01       superior court may, upon application by the attorney general, issue an order requiring                            
02       the medical assistance provider or medical assistance recipient to appear before the                              
03       attorney general to produce evidence.                                                                             
04            Sec. 09.58.030. Rights in false or fraudulent claims actions. (a) If the                                   
05       attorney general elects to intervene and proceed with an action under AS 09.58.020,                               
06       the attorney general has exclusive authority for prosecuting the action and is not bound                          
07       by an act of the person bringing the action. The person who brought the action has the                            
08       right to continue as a nominal party to the action, but does not have the right to                                
09       participate in the action except as a witness or as otherwise directed by the attorney                            
10       general. If the attorney general elects to intervene under AS 09.58.020, the attorney                             
11       general may file a new complaint or amend the complaint filed by the person who                                   
12       brought the action under AS 09.58.020(b).                                                                         
13            (b)  Notwithstanding the objections of the person who brought the action, the                                
14       attorney general may                                                                                              
15                 (1)  move to dismiss the action at any time under this chapter if the                                   
16       attorney general has notified the person who brought the action of the intent to seek                             
17       dismissal and the court has provided the person who brought the action with an                                    
18       opportunity to respond to the motion;                                                                             
19                 (2)  settle the action with the defendant at any time, if the court                                     
20       determines, after a hearing, that the proposed settlement is fair, adequate, and                                  
21       reasonable under all the circumstances; upon a showing of good cause, the hearing                                 
22       described in this paragraph shall be held in camera.                                                              
23            (c)  If the attorney general elects not to proceed under AS 09.58.020 with the                               
24       action, the person who brought the action has the right to proceed and conduct the                                
25       action. The attorney general may request at any time during the proceedings to be                                 
26       served with copies of all documents related to the action, including pleadings,                                   
27       motions, and discovery. The attorney general shall pay for the reasonable copying                                 
28       charges for documents provided under this subsection. If the person who brought the                               
29       action proceeds with the action, the court, without limiting the status and rights of the                         
30       person who brought the action, shall allow the attorney general to intervene at any                               
31       time.                                                                                                             
01            (d)  Whether or not the attorney general proceeds with the action under this                                 
02       chapter, on a showing by the attorney general that certain actions of discovery by the                            
03       person bringing the action would interfere with pending investigation or prosecution                              
04       of a criminal or civil proceeding arising out of the same matter, the court may stay the                          
05       discovery for not more than 90 days. The court may extend the 90-day period on a                                  
06       further showing, in camera, that the state has pursued the criminal or civil                                      
07       investigation or proceedings with reasonable diligence and that proposed discovery in                             
08       the civil action under AS 09.58.010 - 09.58.060 may interfere with the ongoing                                    
09       criminal or civil investigation or proceedings.                                                                   
10            Sec. 09.58.040. Award to false or fraudulent claim plaintiff. (a) If the                                   
11       attorney general proceeds with an action brought by a person for a violation of                                   
12       AS 09.58.010, the person who brought the action shall receive at least 15 percent but                             
13       not more than 25 percent of the proceeds of the action or settlement of the claim,                                
14       depending on the extent to which the person bringing the action contributed to the                                
15       prosecution of the action. The court order or settlement agreement shall state the                                
16       percentage and the amount to be received by the person who brought the action. A                                  
17       payment under this subsection to the person who brought the action may only be paid                               
18       from proceeds received from a judgment or settlement under this section.                                          
19            (b)  If the attorney general does not proceed with an action brought under                                   
20       AS 09.58.020, the person bringing the action to judgment or settlement by court order                             
21       shall receive an amount that the court decides is reasonable for collecting the civil                             
22       penalty and damages based on the person's effort to prosecute the action successfully.                            
23       The amount shall be at least 25 percent but not more than 30 percent of the proceeds                              
24       of the action or settlement of the claim. A payment under this subsection to the person                           
25       who brought the action may only be paid from proceeds received from a judgment or                                 
26       settlement received under this section. In addition, if the person bringing the action                            
27       prevails, the person is entitled to                                                                               
28                 (1)  full reasonable attorney fees and court costs in a case involving a                                
29       fraudulent claim, agreement, contract, or understanding; or                                                       
30                 (2)  reasonable attorney fees and court costs calculated under applicable                               
31       court rules in a case that does not involve a fraudulent claim, agreement, contract, or                           
01       understanding.                                                                                                    
02            (c)  Whether or not the attorney general participates in the action, if the court                            
03       finds that the action was brought by a person who planned or initiated the violation                              
04       alleged in the action brought under AS 09.58.020, the court may, to the extent the                                
05       court considers appropriate, reduce the share of the proceeds of the action that the                              
06       person would otherwise receive under (a) or (b) of this section, taking into account the                          
07       role of that person in advancing the case to litigation and any relevant circumstances                            
08       pertaining to the violation. If the person bringing the action is convicted of criminal                           
09       conduct arising from the person's role in the violation of AS 09.58.010, the court shall                          
10       dismiss the person from the civil action and the person may not receive any share of                              
11       the proceeds of the action or settlement. A dismissal under this subsection does not                              
12       prejudice the right of the attorney general to continue the action.                                               
13            (d)  In this section, "proceeds of the action or settlement"                                                 
14                 (1)  includes damages, civil penalties, payment for cost of compliance,                                 
15       and other economic benefits realized by the state as a result of a civil action brought                           
16       under AS 09.58.010 - 09.58.060;                                                                                   
17                 (2)  does not include attorney fees and costs awarded to the state.                                     
18            Sec. 09.58.050. Certain actions barred. A person may not bring an action                                   
19       under AS 09.58.020 if the action is                                                                               
20                 (1)  based on evidence or information known to the state when the                                       
21       action was brought;                                                                                               
22                 (2)  based on allegations or transactions that are the subject of a civil or                            
23       criminal action or an administrative proceeding in which the state is already a party;                            
24                 (3)  based on the public disclosure of allegations or actions in a                                      
25       criminal or civil action or an administrative hearing, or from the news media, unless                             
26       the action is brought by the attorney general or the person bringing the action is an                             
27       original source of the information that was publicly disclosed; in this paragraph, a                              
28       person is an original source of the information that was publicly disclosed if the                                
29       person has independent knowledge, including knowledge based on personal                                           
30       investigation of the defendant's conduct, of the information on which the allegations                             
31       are based, and has voluntarily provided or verified the information on which the                                  
01       allegations are based or voluntarily provided the information to the attorney general                             
02       before filing an action under AS 09.58.020 that is based on the information; or                                   
03                 (4)  against the state or current or former state employees.                                            
04            Sec. 09.58.060. State not liable for attorney fees, costs, and other expenses.                             
05       The state, its agencies, current or former officers, and current or former employees, are                         
06       not liable for attorney fees, costs, and other expenses that a person incurs in bringing                          
07       an action under AS 09.58.020.                                                                                     
08            Sec. 09.58.070. Employee protection for retaliation. (a) An employee of a                                  
09       medical assistance provider who is discharged, demoted, suspended, threatened,                                    
10       harassed, or discriminated against in the terms and conditions of employment by the                               
11       employee's employer because of lawful acts done by the employee on behalf of the                                  
12       employee or others in furtherance of an action under AS 09.58.010 - 09.58.100,                                    
13       including investigation for, initiation of, testimony for or assistance in an action filed                        
14       or to be filed under AS 09.58.010 - 09.58.100, is entitled to the same relief authorized                          
15       under AS 39.90.120.                                                                                               
16            (b)  Notwithstanding (a) of this section, a state employee who is discharged,                                
17       demoted, suspended, threatened, harassed, or discriminated against in the terms and                               
18       conditions of employment because of lawful acts done by the employee on behalf of                                 
19       the employee or a person who brings an action under AS 09.58.020 or in furtherance                                
20       of an action under AS 09.58.010 - 09.58.100, including investigation, initiation of,                              
21       testimony for or assistance in an action filed or to be filed under AS 09.58.010 -                                
22       09.58.100, is entitled to relief under AS 39.90.100 - 39.90.150 (Alaska Whistleblower                             
23       Act).                                                                                                             
24            (c)  A person may not bring an action under this section unless the action is                                
25       commenced not later than three years after the date the employee was subject to                                   
26       retaliation under (a) or (b) of this section.                                                                     
27            Sec. 09.58.080. Regulations. The attorney general may adopt regulations                                    
28       under AS 44.62 as necessary to carry out the purposes of this chapter.                                            
29            Sec. 09.58.090. Special provisions. (a) This chapter does not apply to any                                 
30       controversy involving damages to the state of less than $5,500 in value.                                          
31            (b)  No punitive damages may be awarded in an action brought under                                           
01       AS 09.58.010 - 09.58.060.                                                                                         
02            Sec. 09.58.100. Definitions. In this chapter,                                                              
03                 (1)  "attorney general" includes a designee of the attorney general;                                    
04                 (2)  "claim" means a request for payment of health care services or                                     
05       equipment, whether made to a contractor, grantee, or other person, when the state                                 
06       provides, directly or indirectly, a portion of the money, property, or services requested                         
07       or demanded, or when the state will, directly or indirectly, reimburse the contractor,                            
08       grantee, or other recipient for a portion of the money, property, or services requested                           
09       or demanded;                                                                                                      
10                 (3)  "controversy" means the aggregate of one or more false claims                                      
11       submitted by the same medical assistance provider or medical assistance recipient                                 
12       under this chapter;                                                                                               
13                 (4)  "knowingly" means that a person, with or without specific intent to                                
14       defraud,                                                                                                          
15                      (A)  has actual knowledge of the information;                                                      
16                      (B)  acts in deliberate ignorance of the truth or falsity of the                                   
17            information; or                                                                                              
18                      (C)  acts in reckless disregard of the truth or falsity of the                                     
19            information;                                                                                                 
20                 (5)  "medical assistance program" means the federal-state program                                       
21       administered by the Department of Health and Social Services under AS 47.05 and                                   
22       AS 47.07 and regulations adopted under AS 47.05 and AS 47.07;                                                     
23                 (6)  "medical assistance provider" has the meaning given under                                          
24       AS 47.05.290;                                                                                                     
25                 (7)  "medical assistance recipient" has the meaning given under                                         
26       AS 47.05.290;                                                                                                     
27                 (8)  "obligation" means an established duty, whether or not fixed,                                      
28       arising from                                                                                                      
29                      (A)  an express or implied contractual grantor or grantee or                                       
30            licensor or licensee relationship;                                                                           
31                      (B)  a fee-based or similar relationship;                                                          
01                      (C)  a statute or regulation; or                                                                   
02                      (D)  the retention of any overpayment.                                                             
03            Sec. 09.58.110. Short title. This chapter may be cited as the Alaska Medical                               
04       Assistance False Claim and Reporting Act.                                                                         
05    * Sec. 19. AS 09.58.025, added by sec. 18 of this Act, is amended to read:                                         
06            Sec. 09.58.025. Subpoenas. In conducting an investigation under                                            
07       AS 09.58.015 [OR 09.58.020], the attorney general may issue subpoenas to compel                                   
08       the production of books, papers, correspondence, memoranda, and other records in                                  
09       connection with an investigation under or the administration of AS 09.58.010 -                                    
10       09.58.060. If a medical assistance provider or a medical assistance recipient fails or                            
11       refuses, without just cause, to obey a subpoena issued under this subsection, the                                 
12       superior court may, upon application by the attorney general, issue an order requiring                            
13       the medical assistance provider or medical assistance recipient to appear before the                              
14       attorney general to produce evidence.                                                                             
15    * Sec. 20. AS 09.58.070(b), added by sec. 18 of this Act, is amended to read:                                      
16            (b)  Notwithstanding (a) of this section, a state employee who is discharged,                                
17       demoted, suspended, threatened, harassed, or discriminated against in the terms and                               
18       conditions of employment because of lawful acts done by the employee on behalf of                                 
19       the employee [OR A PERSON WHO BRINGS AN ACTION UNDER AS 09.58.020]                                                
20       or in furtherance of an action under AS 09.58.010 - 09.58.060, including investigation,                           
21       initiation of, testimony for or assistance in an action filed or to be filed under                                
22       AS 09.58.010 - 09.58.060, is entitled to relief under AS 39.90.100 - 39.90.150 (Alaska                            
23       Whistleblower Act).                                                                                               
24    * Sec. 21. AS 17.30.200(a) is amended to read:                                                                     
25            (a)  The controlled substance prescription database is established in the Board                              
26       of Pharmacy. The purpose of the database is to contain data as described in this                                  
27       section regarding every prescription for a schedule [IA, IIA, IIIA, IVA, OR VA                                    
28       CONTROLLED SUBSTANCE UNDER STATE LAW OR A SCHEDULE I,] II, III,                                                   
29       or IV [, OR V] controlled substance under federal law dispensed in the state to a                             
30       person other than those administered to a patient at a health care facility. [THE                                 
31       DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC                                                                   
01       DEVELOPMENT SHALL ASSIST THE BOARD AND PROVIDE NECESSARY                                                          
02       STAFF AND EQUIPMENT TO IMPLEMENT THIS SECTION.]                                                                   
03    * Sec. 22. AS 17.30.200(a), as amended by sec. 21 of this Act, is amended to read:                                 
04            (a)  The controlled substance prescription database is established in the Board                              
05       of Pharmacy. The purpose of the database is to contain data as described in this                                  
06       section regarding every prescription for a schedule II, III, or IV controlled substance                           
07       under federal law dispensed in the state to a person other than those administered to a                           
08       patient at a health care facility. The Department of Commerce, Community, and                                 
09       Economic Development shall assist the board and provide necessary staff and                                   
10       equipment to implement this section.                                                                          
11    * Sec. 23. AS 17.30.200(b) is amended to read:                                                                     
12            (b)  The pharmacist-in-charge of each licensed or registered pharmacy,                                       
13       regarding each schedule [IA, IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE                                           
14       UNDER STATE LAW OR A SCHEDULE I,] II, III, or IV [, OR V] controlled                                          
15       substance under federal law dispensed by a pharmacist under the supervision of the                                
16       pharmacist-in-charge, and each practitioner who directly dispenses a schedule [IA,                                
17       IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE UNDER STATE LAW OR A                                                   
18       SCHEDULE I,] II, III, or IV [, OR V] controlled substance under federal law other                             
19       than those administered to a patient at a health care facility, shall submit to the board,                        
20       by a procedure and in a format established by the board, the following information for                            
21       inclusion in the database on at least a weekly basis:                                                         
22                 (1)  the name of the prescribing practitioner and the practitioner's                                    
23       federal Drug Enforcement Administration registration number or other appropriate                                  
24       identifier;                                                                                                       
25                 (2)  the date of the prescription;                                                                      
26                 (3)  the date the prescription was filled and the method of payment; this                               
27       paragraph does not authorize the board to include individual credit card or other                                 
28       account numbers in the database;                                                                                  
29                 (4)  the name, address, and date of birth of the person for whom the                                    
30       prescription was written;                                                                                         
31                 (5)  the name and national drug code of the controlled substance;                                       
01                 (6)  the quantity and strength of the controlled substance dispensed;                                   
02                 (7)  the name of the drug outlet dispensing the controlled substance;                                   
03       [AND]                                                                                                             
04                 (8)  the name of the pharmacist or practitioner dispensing the controlled                               
05       substance and other appropriate identifying information; and                                                  
06                 (9)  if a prescription is dispensed to a person other than the patient                              
07       for whom the prescription was written, the name and date of birth of the person                               
08       to whom the prescription was dispensed.                                                                       
09    * Sec. 24. AS 17.30.200(b), as amended by sec. 23 of this Act, is amended to read:                                 
10            (b)  The pharmacist-in-charge of each licensed or registered pharmacy,                                       
11       regarding each schedule II, III, or IV controlled substance under federal law dispensed                           
12       by a pharmacist under the supervision of the pharmacist-in-charge, and each                                       
13       practitioner who directly dispenses a schedule II, III, or IV controlled substance under                          
14       federal law other than those administered to a patient at a health care facility, shall                           
15       submit to the board, by a procedure and in a format established by the board, the                                 
16       following information for inclusion in the database [ON AT LEAST A WEEKLY                                         
17       BASIS]:                                                                                                           
18                 (1)  the name of the prescribing practitioner and the practitioner's                                    
19       federal Drug Enforcement Administration registration number or other appropriate                                  
20       identifier;                                                                                                       
21                 (2)  the date of the prescription;                                                                      
22                 (3)  the date the prescription was filled and the method of payment; this                               
23       paragraph does not authorize the board to include individual credit card or other                                 
24       account numbers in the database;                                                                                  
25                 (4)  the name, address, and date of birth of the person for whom the                                    
26       prescription was written;                                                                                         
27                 (5)  the name and national drug code of the controlled substance;                                       
28                 (6)  the quantity and strength of the controlled substance dispensed;                                   
29                 (7)  the name of the drug outlet dispensing the controlled substance;                                   
30       and                                                                                                           
31                 (8)  the name of the pharmacist or practitioner dispensing the controlled                               
01       substance and other appropriate identifying information [; AND                                                    
02                 (9)  IF A PRESCRIPTION IS DISPENSED TO A PERSON OTHER                                                   
03       THAN THE PATIENT FOR WHOM THE PRESCRIPTION WAS WRITTEN, THE                                                       
04       NAME AND DATE OF BIRTH OF THE PERSON TO WHOM THE                                                                  
05       PRESCRIPTION WAS DISPENSED].                                                                                      
06    * Sec. 25. AS 17.30.200(d) is amended to read:                                                                     
07            (d)  The database and the information contained within the database are                                      
08       confidential, are not public records, and are not subject to public disclosure. The board                         
09       shall undertake to ensure the security and confidentiality of the database and the                                
10       information contained within the database. The board may allow access to the                                      
11       database only to the following persons, and in accordance with the limitations                                    
12       provided and regulations of the board:                                                                            
13                 (1)  personnel of the board regarding inquiries concerning licensees or                                 
14       registrants of the board or personnel of another board or agency concerning a                                     
15       practitioner under a search warrant, subpoena, or order issued by an administrative law                           
16       judge or a court;                                                                                                 
17                 (2)  authorized board personnel or contractors as required for                                          
18       operational and review purposes;                                                                                  
19                 (3)  a licensed practitioner having authority to prescribe controlled                                   
20       substances or an agent or employee of the practitioner whom the practitioner has                              
21       authorized to access the database on the practitioner's behalf, to the extent the                             
22       information relates specifically to a current patient of the practitioner to whom the                             
23       practitioner is prescribing or considering prescribing a controlled substance; the agent                      
24       or employee must be licensed or registered under AS 08;                                                       
25                 (4)  a licensed or registered pharmacist having authority to dispense                                   
26       controlled substances or an agent or employee of the pharmacist whom the                                      
27       pharmacist has authorized to access the database on the pharmacist's behalf, to                               
28       the extent the information relates specifically to a current patient to whom the                                  
29       pharmacist is dispensing or considering dispensing a controlled substance; the agent                          
30       or employee must be licensed or registered under AS 08;                                                       
31                 (5)  federal, state, and local law enforcement authorities may receive                                  
01       printouts of information contained in the database under a search warrant [,                                      
02       SUBPOENA,] or order issued by a court establishing probable cause for the access                                  
03       and use of the information; [AND]                                                                                 
04                 (6)  an individual who is the recipient of a controlled substance                                       
05       prescription entered into the database may receive information contained in the                                   
06       database concerning the individual on providing evidence satisfactory to the board that                           
07       the individual requesting the information is in fact the person about whom the data                               
08       entry was made and on payment of a fee set by the board under AS 37.10.050 that                                   
09       does not exceed $10;                                                                                          
10                 (7)  a licensed pharmacist employed by the Department of Health                                     
11       and Social Services who is responsible for administering prescription drug                                    
12       coverage for the medical assistance program under AS 47.07, to the extent that                                
13       the information relates specifically to prescription drug coverage under the                                  
14       program;                                                                                                      
15                 (8)  a licensed pharmacist, licensed practitioner, or authorized                                    
16       employee of the Department of Health and Social Services responsible for                                      
17       utilization review of prescription drugs for the medical assistance program under                             
18       AS 47.07, to the extent that the information relates specifically to utilization                              
19       review of prescription drugs provided to recipients of medical assistance;                                    
20                 (9)  the state medical examiner, to the extent that the information                                 
21       relates specifically to investigating the cause and manner of a person's death;                               
22                 (10)  an authorized employee of the Department of Health and                                        
23       Social Services may receive information from the database that does not disclose                              
24       the identity of a patient, prescriber, dispenser, or dispenser location, for the                              
25       purpose of identifying and monitoring public health issues in the state; however,                             
26       the information provided under this paragraph may include the region of the                                   
27       state in which a patient, prescriber, and dispenser are located and the specialty of                          
28       the prescriber; and                                                                                           
29                 (11)  a practitioner, pharmacist, or clinical staff employed by an                                  
30       Alaska tribal health organization, including commissioned corps officers of the                               
31       United States Public Health Service employed under a memorandum of                                            
01       agreement; in this paragraph, "Alaska tribal health organization" has the                                     
02       meaning given to "tribal health program" in 25 U.S.C. 1603.                                                   
03    * Sec. 26. AS 17.30.200(d), as amended by sec. 25 of this Act, is amended to read:                                 
04            (d)  The database and the information contained within the database are                                      
05       confidential, are not public records, and are not subject to public disclosure. The board                         
06       shall undertake to ensure the security and confidentiality of the database and the                                
07       information contained within the database. The board may allow access to the                                      
08       database only to the following persons, and in accordance with the limitations                                    
09       provided and regulations of the board:                                                                            
10                 (1)  personnel of the board regarding inquiries concerning licensees or                                 
11       registrants of the board or personnel of another board or agency concerning a                                     
12       practitioner under a search warrant, subpoena, or order issued by an administrative law                           
13       judge or a court;                                                                                                 
14                 (2)  authorized board personnel or contractors as required for                                          
15       operational and review purposes;                                                                                  
16                 (3)  a licensed practitioner having authority to prescribe controlled                                   
17       substances [OR AN AGENT OR EMPLOYEE OF THE PRACTITIONER WHOM                                                      
18       THE PRACTITIONER HAS AUTHORIZED TO ACCESS THE DATABASE ON                                                         
19       THE PRACTITIONER'S BEHALF], to the extent the information relates specifically                                    
20       to a current patient of the practitioner to whom the practitioner is prescribing or                               
21       considering prescribing a controlled substance; [THE AGENT OR EMPLOYEE                                            
22       MUST BE LICENSED OR REGISTERED UNDER AS 08;]                                                                      
23                 (4)  a licensed or registered pharmacist having authority to dispense                                   
24       controlled substances [OR AN AGENT OR EMPLOYEE OF THE PHARMACIST                                                  
25       WHOM THE PHARMACIST HAS AUTHORIZED TO ACCESS THE DATABASE                                                         
26       ON THE PHARMACIST'S BEHALF], to the extent the information relates                                                
27       specifically to a current patient to whom the pharmacist is dispensing or considering                             
28       dispensing a controlled substance; [THE AGENT OR EMPLOYEE MUST BE                                                 
29       LICENSED OR REGISTERED UNDER AS 08;]                                                                              
30                 (5)  federal, state, and local law enforcement authorities may receive                                  
31       printouts of information contained in the database under a search warrant, subpoena,                          
01       or order issued by a court establishing probable cause for the access and use of the                              
02       information; and                                                                                              
03                 (6)  an individual who is the recipient of a controlled substance                                       
04       prescription entered into the database may receive information contained in the                                   
05       database concerning the individual on providing evidence satisfactory to the board that                           
06       the individual requesting the information is in fact the person about whom the data                               
07       entry was made and on payment of a fee set by the board under AS 37.10.050 that                                   
08       does not exceed $10 [;                                                                                            
09                 (7)  A LICENSED PHARMACIST EMPLOYED BY THE                                                              
10       DEPARTMENT OF HEALTH AND SOCIAL SERVICES WHO IS RESPONSIBLE                                                       
11       FOR ADMINISTERING PRESCRIPTION DRUG COVERAGE FOR THE                                                              
12       MEDICAL ASSISTANCE PROGRAM UNDER AS 47.07, TO THE EXTENT                                                          
13       THAT THE INFORMATION RELATES SPECIFICALLY TO PRESCRIPTION                                                         
14       DRUG COVERAGE UNDER THE PROGRAM;                                                                                  
15                 (8)  A LICENSED PHARMACIST, LICENSED PRACTITIONER,                                                      
16       OR AUTHORIZED EMPLOYEE OF THE DEPARTMENT OF HEALTH AND                                                            
17       SOCIAL SERVICES RESPONSIBLE FOR UTILIZATION REVIEW OF                                                             
18       PRESCRIPTION DRUGS FOR THE MEDICAL ASSISTANCE PROGRAM                                                             
19       UNDER AS 47.07, TO THE EXTENT THAT THE INFORMATION RELATES                                                        
20       SPECIFICALLY TO UTILIZATION REVIEW OF PRESCRIPTION DRUGS                                                          
21       PROVIDED TO RECIPIENTS OF MEDICAL ASSISTANCE;                                                                     
22                 (9)  THE STATE MEDICAL EXAMINER, TO THE EXTENT THAT                                                     
23       THE INFORMATION RELATES SPECIFICALLY TO INVESTIGATING THE                                                         
24       CAUSE AND MANNER OF A PERSON'S DEATH;                                                                             
25                 (10)  AN AUTHORIZED EMPLOYEE OF THE DEPARTMENT OF                                                       
26       HEALTH AND SOCIAL SERVICES MAY RECEIVE INFORMATION FROM                                                           
27       THE DATABASE THAT DOES NOT DISCLOSE THE IDENTITY OF A                                                             
28       PATIENT, PRESCRIBER, DISPENSER, OR DISPENSER LOCATION, FOR THE                                                    
29       PURPOSE OF IDENTIFYING AND MONITORING PUBLIC HEALTH ISSUES IN                                                     
30       THE STATE; HOWEVER, THE INFORMATION PROVIDED UNDER THIS                                                           
31       PARAGRAPH MAY INCLUDE THE REGION OF THE STATE IN WHICH A                                                          
01       PATIENT, PRESCRIBER, AND DISPENSER ARE LOCATED AND THE                                                            
02       SPECIALTY OF THE PRESCRIBER; AND                                                                                  
03                 (11)  A PRACTITIONER, PHARMACIST, OR CLINICAL STAFF                                                     
04       EMPLOYED BY AN ALASKA TRIBAL HEALTH ORGANIZATION,                                                                 
05       INCLUDING COMMISSIONED CORPS OFFICERS OF THE UNITED STATES                                                        
06       PUBLIC HEALTH SERVICE EMPLOYED UNDER A MEMORANDUM OF                                                              
07       AGREEMENT; IN THIS PARAGRAPH, "ALASKA TRIBAL HEALTH                                                               
08       ORGANIZATION" HAS THE MEANING GIVEN TO "TRIBAL HEALTH                                                             
09       PROGRAM" IN 25 U.S.C. 1603].                                                                                      
10    * Sec. 27. AS 17.30.200(e) is amended to read:                                                                     
11            (e)  The failure of a pharmacist-in-charge, pharmacist, or practitioner to                                   
12       register or submit information to the database as required under this section is                              
13       grounds for the board to take disciplinary action against the license or registration of                          
14       the pharmacy or pharmacist or for another licensing board to take disciplinary action                             
15       against a practitioner.                                                                                           
16    * Sec. 28. AS 17.30.200(e), as amended by sec. 27 of this Act, is amended to read:                                 
17            (e)  The failure of a pharmacist-in-charge, pharmacist, or practitioner to                                   
18       [REGISTER OR] submit information to the database as required under this section is                                
19       grounds for the board to take disciplinary action against the license or registration of                          
20       the pharmacy or pharmacist or for another licensing board to take disciplinary action                             
21       against a practitioner.                                                                                           
22    * Sec. 29. AS 17.30.200(h) is amended to read:                                                                     
23            (h)  An individual who has submitted information to the database in                                          
24       accordance with this section may not be held civilly liable for having submitted the                              
25       information. [NOTHING IN THIS SECTION REQUIRES OR OBLIGATES A                                                     
26       DISPENSER OR PRACTITIONER TO ACCESS OR CHECK THE DATABASE                                                         
27       BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING A                                                                
28       MEDICATION, OR PROVIDING MEDICAL CARE TO A PERSON.] Dispensers or                                                 
29       practitioners may not be held civilly liable for damages for accessing or failing to                              
30       access the information in the database.                                                                           
31    * Sec. 30. AS 17.30.200(h), as amended by sec. 29 of this Act, is amended to read:                                 
01            (h)  An individual who has submitted information to the database in                                          
02       accordance with this section may not be held civilly liable for having submitted the                              
03       information. Nothing in this section requires or obligates a dispenser or                                     
04       practitioner to access or check the database before dispensing, prescribing, or                               
05       administering a medication, or providing medical care to a person. Dispensers or                              
06       practitioners may not be held civilly liable for damages for accessing or failing to                              
07       access the information in the database.                                                                           
08    * Sec. 31. AS 17.30.200(k) is amended to read:                                                                     
09            (k)  In the regulations adopted under this section, the board shall provide                                  
10                 (1)  that prescription information in the database [SHALL] be purged                                    
11       from the database after two years have elapsed from the date the prescription was                                 
12       dispensed;                                                                                                        
13                 (2)  a method for an individual to challenge information in the database                                
14       about the individual that the person believes is incorrect or was incorrectly entered by                          
15       a dispenser;                                                                                                  
16                 (3)  a procedure and time frame for registration with the database;                                 
17                 (4)  that a practitioner review the information in the database to                                  
18       check a patient's prescription records before dispensing, prescribing, or                                     
19       administering a schedule II or III controlled substance under federal law to the                              
20       patient; the regulations must provide that a practitioner is not required to review                           
21       the information in the database before dispensing, prescribing, or administering                              
22                      (A)  a controlled substance to a person who is receiving                                       
23            treatment                                                                                                
24                           (i)  in an inpatient setting;                                                             
25                           (ii)  at the scene of an emergency or in an ambulance;                                    
26                 in this sub-subparagraph, "ambulance" has the meaning given in                                      
27                 AS 18.08.200;                                                                                       
28                           (iii)  in an emergency room;                                                              
29                           (iv)  immediately before, during, or within the first                                     
30                 48 hours after surgery or  a medical procedure;                                                     
31                           (v)  in a hospice or nursing home that has an in-                                         
01                 house pharmacy; or                                                                                  
02                      (B)  a nonrefillable prescription of a controlled substance in                                 
03            a quantity intended to last for not more than three days.                                                
04    * Sec. 32. AS 17.30.200(k), as amended by sec. 31 of this Act, is amended to read:                                 
05            (k)  In the regulations adopted under this section, the board shall provide                                  
06                 (1)  that prescription information in the database be purged from the                                   
07       database after two years have elapsed from the date the prescription was dispensed;                               
08                 (2)  a method for an individual to challenge information in the database                                
09       about the individual that the person believes is incorrect or was incorrectly entered by                          
10       a dispenser [;                                                                                                    
11                 (3)  A PROCEDURE AND TIME FRAME FOR REGISTRATION                                                        
12       WITH THE DATABASE;                                                                                                
13                 (4)  THAT A PRACTITIONER REVIEW THE INFORMATION IN                                                      
14       THE DATABASE TO CHECK A PATIENT'S PRESCRIPTION RECORDS                                                            
15       BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING A SCHEDULE II                                                    
16       OR III CONTROLLED SUBSTANCE UNDER FEDERAL LAW TO THE                                                              
17       PATIENT; THE REGULATIONS MUST PROVIDE THAT A PRACTITIONER IS                                                      
18       NOT REQUIRED TO REVIEW THE INFORMATION IN THE DATABASE                                                            
19       BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING                                                                  
20                      (A)  A CONTROLLED SUBSTANCE TO A PERSON WHO                                                        
21            IS RECEIVING TREATMENT                                                                                       
22                           (i)  IN AN INPATIENT SETTING;                                                                 
23                           (ii)  AT THE SCENE OF AN EMERGENCY OR IN                                                      
24                 AN AMBULANCE; IN THIS SUB-SUBPARAGRAPH,                                                                 
25                 "AMBULANCE" HAS THE MEANING GIVEN IN AS 18.08.200;                                                      
26                           (iii)  IN AN EMERGENCY ROOM;                                                                  
27                           (iv)  IMMEDIATELY BEFORE, DURING, OR                                                          
28                 WITHIN THE FIRST 48 HOURS AFTER SURGERY OR  A                                                           
29                 MEDICAL PROCEDURE;                                                                                      
30                           (v)  IN A HOSPICE OR NURSING HOME THAT                                                        
31                 HAS AN IN-HOUSE PHARMACY; OR                                                                            
01                      (B)  A NONREFILLABLE PRESCRIPTION OF A                                                             
02            CONTROLLED SUBSTANCE IN A QUANTITY INTENDED TO LAST                                                          
03            FOR NOT MORE THAN THREE DAYS].                                                                               
04    * Sec. 33. AS 17.30.200(m) is amended to read:                                                                     
05            (m)  To assist in fulfilling the program responsibilities, performance measures                              
06       shall be reported to the legislature annually. Performance measures                                               
07                 (1)  may include outcomes detailed in the federal prescription drug                                 
08       monitoring program grant regarding efforts to                                                                     
09                      (A) [(1)]  reduce the rate of inappropriate use of prescription                                
10            drugs by reporting education efforts conducted by the Board of Pharmacy;                                     
11                      (B) [(2)]  reduce the quantity of pharmaceutical controlled                                    
12            substances obtained by individuals attempting to engage in fraud and deceit;                                 
13                      (C) [(3)]  increase coordination among prescription drug                                       
14            monitoring program partners;                                                                                 
15                      (D)  [AND (4)] involve stakeholders in the planning process;                               
16                 (2)  shall include information related to the                                                       
17                      (A)  security of the database; and                                                             
18                      (B)  reductions, if any, in the inappropriate use or                                           
19            prescription of controlled substances resulting from the use of the                                      
20            database.                                                                                                
21    * Sec. 34. AS 17.30.200 is amended by adding new subsections to read:                                              
22            (o)  A pharmacist who dispenses or a practitioner who prescribes, administers,                               
23       or directly dispenses a schedule II, III, or IV controlled substance under federal law                            
24       shall register with the database by a procedure and in a format established by the                                
25       board.                                                                                                            
26            (p)  The board shall promptly notify the State Medical Board, the Board of                                   
27       Nursing, the Board of Dental Examiners, and the Board of Examiners in Optometry                                   
28       when a practitioner registers with the database under (o) of this section.                                        
29            (q)  The board is authorized to provide unsolicited notification to a pharmacist                             
30       or practitioner if a patient has received one or more prescriptions for controlled                                
31       substances in quantities or with a frequency inconsistent with generally recognized                               
01       standards of safe practice.                                                                                       
02            (r)  The board shall update the database on at least a weekly basis with the                                 
03       information submitted to the board under (b) of this section.                                                     
04            (s)  The Department of Commerce, Community, and Economic Development                                         
05       shall                                                                                                             
06                 (1)  assist the board and provide necessary staff and equipment to                                      
07       implement this section; and                                                                                       
08                 (2)  establish fees for registration with the database by a pharmacist or                               
09       practitioner required to register under (o) of this section so that the total amount of                           
10       fees collected by the department equals the total operational costs of the database                               
11       minus all federal funds acquired for the operational costs of the database; in setting the                        
12       fee levels, the department shall                                                                                  
13                      (A)  set the fees for registration with the database so that the                                   
14            fees are the same for all practitioners and pharmacists required to register; and                            
15                      (B)  consult with the board to establish the fees under this                                       
16            subsection.                                                                                                  
17    * Sec. 35. AS 33.30.028 is amended by adding new subsections to read:                                              
18            (c)  The commissioner shall apply for medical assistance under AS 47.07 and                                  
19       for general relief assistance under AS 47.25.120 - 47.25.300 on behalf of a prisoner                              
20       incarcerated in a correctional facility to establish medical assistance coverage or                               
21       general relief assistance for the prisoner during a period of hospitalization outside of                          
22       the correctional facility.                                                                                        
23            (d)  The commissioner may obtain information necessary to determine whether                                  
24       a prisoner incarcerated in a correctional facility is eligible for medical assistance under                       
25       AS 47.07 or public assistance under AS 47.25. Information obtained under this                                     
26       subsection may only be used for the purpose of applying for medical assistance or                                 
27       public assistance under (c) of this section and may not be disclosed for any other                                
28       purpose without the permission of the prisoner. An employee of the commissioner                                   
29       who discloses a prisoner's social security number in an application for medical                                   
30       assistance or public assistance under this section is considered to be acting in the                              
31       performance of the employee's duties or responsibilities under AS 45.48.400(b).                                   
01    * Sec. 36. AS 37.05.146(c) is amended by adding a new paragraph to read:                                           
02                 (88)  monetary recoveries under AS 09.58 (Alaska Medical Assistance                                     
03       False Claim and Reporting Act).                                                                                   
04    * Sec. 37. AS 40.25.120(a) is amended by adding a new paragraph to read:                                           
05                 (15)  records relating to proceedings under AS 09.58 (Alaska Medical                                    
06       Assistance False Claim and Reporting Act).                                                                        
07    * Sec. 38. AS 44.33 is amended by adding a new section to read:                                                    
08                  Article 5A. Telemedicine Business Registry.                                                          
09            Sec. 44.33.381. Telemedicine business registry. (a) The department shall                                   
10       adopt regulations for establishing and maintaining a registry of businesses performing                            
11       telemedicine services in the state.                                                                               
12            (b)  The department shall maintain the registry of businesses performing                                     
13       telemedicine services in the state. The registry must include the name, address, and                              
14       contact information of businesses performing telemedicine services in the state.                                  
15            (c)  In this section,                                                                                        
16                 (1)  "department" means the Department of Commerce, Community,                                          
17       and Economic Development;                                                                                         
18                 (2)  "telemedicine services" means the delivery of health care services                                 
19       using the transfer of medical data through audio, visual, or data communications that                             
20       are performed over two or more locations by a provider who is physically separated                                
21       from the recipient of the health care services.                                                                   
22    * Sec. 39. AS 47.05 is amended by adding a new section to article 1 to read:                                       
23            Sec. 47.05.105. Enhanced computerized eligibility verification system. (a)                                 
24       The department shall establish an enhanced computerized income, asset, and identity                               
25       eligibility verification system for the purposes of verifying eligibility, eliminating                            
26       duplication of public assistance payments, and deterring waste and fraud in public                                
27       assistance programs administered by the department under AS 47.05.010. Nothing in                                 
28       this section prohibits the department from verifying eligibility for public assistance                            
29       through additional procedures or authorizes the department or a third-party vendor to                             
30       use data to verify eligibility for a federal program if the use of that data is prohibited                        
31       by federal law.                                                                                                   
01            (b)  The department shall enter into a competitively bid contract with a third-                              
02       party vendor for the purpose of developing a system under this section to prevent                                 
03       fraud, misrepresentation, and inadequate documentation when determining an                                        
04       applicant's eligibility for public assistance before the payment of benefits and for                              
05       periodically verifying eligibility between eligibility redeterminations and during                                
06       eligibility redeterminations and reviews under AS 47.05.110 - 47.05.120. The                                      
07       department may also contract with a third-party vendor to provide information to                                  
08       facilitate reviews of recipient eligibility and income verification.                                              
09            (c)  The annual savings to the state resulting from the use of the system under                              
10       this section must exceed the cost of implementing the system. A contract under this                               
11       section must require the third-party vendor to report annual savings to the state                                 
12       realized from implementing the system. Payment to the third-party vendor may be                                   
13       based on a fee for each applicant and may include incentives for achieving a rate of                              
14       success established by the department for identifying duplication, waste, and fraud in                            
15       public assistance programs.                                                                                       
16            (d)  To avoid a conflict of interest, the department may not award a contract to                             
17       provide services for the enrollment of public assistance providers or applicants under                            
18       this title to a vendor that is awarded a contract under this section.                                             
19    * Sec. 40. AS 47.05.200(a) is amended to read:                                                                     
20            (a)  The department shall annually contract for independent audits of a                                      
21       statewide sample of all medical assistance providers in order to identify overpayments                            
22       and violations of criminal statutes. The audits conducted under this section may not be                           
23       conducted by the department or employees of the department. The number of audits                                  
24       under this section may not be less than 50 each year [, AS A TOTAL FOR THE                                    
25       MEDICAL ASSISTANCE PROGRAMS UNDER AS 47.07 AND AS 47.08, SHALL                                                    
26       BE 0.75 PERCENT OF ALL ENROLLED PROVIDERS UNDER THE                                                               
27       PROGRAMS, ADJUSTED ANNUALLY ON JULY 1, AS DETERMINED BY THE                                                       
28       DEPARTMENT, EXCEPT THAT THE NUMBER OF AUDITS UNDER THIS                                                           
29       SECTION MAY NOT BE LESS THAN 75]. The audits under this section must                                              
30       include both on-site audits and desk audits and must be of a variety of provider types.                           
31       The department may not award a contract under this subsection to an organization that                             
01       does not retain persons with a significant level of expertise and recent professional                             
02       practice in the general areas of standard accounting principles and financial auditing                            
03       and in the specific areas of medical records review, investigative research, and Alaska                           
04       health care criminal law. The contractor, in consultation with the commissioner, shall                            
05       select the providers to be audited and decide the ratio of desk audits and on-site audits                         
06       to the total number selected. In identifying providers who are subject to an audit                            
07       under this chapter, the department shall attempt to minimize concurrent state or                              
08       federal audits.                                                                                               
09    * Sec. 41. AS 47.05.200(b) is amended to read:                                                                     
10            (b)  Within 90 days after receiving each audit report from an audit conducted                                
11       under this section, the department shall begin administrative procedures to recoup                                
12       overpayments identified in the audits and shall allocate the reasonable and necessary                             
13       financial and human resources to ensure prompt recovery of overpayments unless the                                
14       attorney general has advised the commissioner in writing that a criminal investigation                            
15       of an audited provider has been or is about to be undertaken, in which case, the                                  
16       commissioner shall hold the administrative procedure in abeyance until a final                                    
17       charging decision by the attorney general has been made. The commissioner shall                                   
18       provide copies of all audit reports to the attorney general so that the reports can be                            
19       screened for the purpose of bringing criminal charges. The department may assess                              
20       interest and penalties on any identified overpayment. Interest under this                                     
21       subsection shall be calculated using the statutory rates for postjudgment interest                            
22       accruing from the date of the issuance of the final agency decision to recoup                                 
23       overpayments identified in the audit. In this subsection, the date of issuance of                             
24       the final agency decision is the later of the date of                                                         
25                 (1)  the department's written notification of the decision and the                                  
26       provider's appeal rights; or                                                                                  
27                 (2)  if timely appealed by the provider, a final agency decision                                    
28       under AS 44.64.060.                                                                                           
29    * Sec. 42. AS 47.05 is amended by adding a new section to read:                                                    
30            Sec. 47.05.235. Duty to identify and repay self-identified overpayments. (a)                               
31       Unless a provider is being audited under AS 47.05.200(a), an enrolled medical                                     
01       assistance provider shall conduct a biennial review or audit of a statistically valid                             
02       sample of claims submitted to the department for reimbursement. If overpayments are                               
03       identified, the medical assistance provider shall report the overpayment to the                                   
04       department not later than 10 business days after identification of the overpayment. The                           
05       report must also identify how the medical assistance provider intends to repay the                                
06       department. After the department receives the report, the medical assistance provider                             
07       and the department shall enter into an agreement establishing a schedule for                                      
08       repayment of the identified overpayment. The agreement may authorize repayment in                                 
09       a lump sum, a payment plan, or by offsetting future billings as approved by the                                   
10       department.                                                                                                       
11            (b)  The department may not assess interest or penalties on an overpayment                                   
12       identified and repaid by a medical assistance provider under this section.                                        
13    * Sec. 43. AS 47.05 is amended by adding new sections to read:                                                     
14            Sec. 47.05.250. Civil penalties. (a) The department may assess a civil penalty                             
15       against a provider who violates this chapter, AS 47.07, or regulations adopted under                              
16       this chapter or AS 47.07.                                                                                         
17            (b)  The department shall adopt regulations establishing a range of civil                                    
18       penalties that the department may assess against a provider under this section. In                                
19       establishing the range of civil penalties, the department shall take into account                                 
20       appropriate factors, including the seriousness of the violation, the service provided by                          
21       the provider, and the severity of the penalty. The regulations may not provide for a                              
22       civil penalty of less than $100 or more than $25,000 for each violation.                                          
23            (c)  The provisions of this section are in addition to any other remedies                                    
24       available under this chapter, AS 47.07, or regulations adopted under this chapter or                              
25       AS 47.07.                                                                                                         
26            (d)  A provider against whom a civil penalty of less than $2,500 is assessed                                 
27       may appeal the decision assessing the penalty to the commissioner or the                                          
28       commissioner's designee. The commissioner shall, by regulation, establish time limits                             
29       and procedures for an appeal under this subsection. The decision of the commissioner                              
30       or the commissioner's designee may be appealed to the office of administrative                                    
31       hearings established under AS 44.64.                                                                              
01            (e)  A provider against whom a civil penalty of $2,500 or more is assessed may                               
02       appeal the decision assessing the penalty to the office of administrative hearings                                
03       established under AS 44.64.                                                                                       
04            Sec. 47.05.270. Medical assistance reform program. (a) The department                                      
05       shall adopt regulations to design and implement a program for reforming the state                                 
06       medical assistance program under AS 47.07. The reform program must include                                        
07                 (1)  referrals to community and social support services, including career                               
08       and education training services available through the Department of Labor and                                     
09       Workforce Development under AS 23.15, the University of Alaska, or other sources;                                 
10                 (2)  electronic distribution of an explanation of medical assistance                                    
11       benefits to recipients for health care services received under the program;                                       
12                 (3)  expanding the use of telehealth for primary care, behavioral health,                               
13       and urgent care;                                                                                                  
14                 (4)  enhancing fraud prevention, detection, and enforcement;                                            
15                 (5)  reducing the cost of behavioral health, senior, and disabilities                                   
16       services provided to recipients of medical assistance under the state's home and                                  
17       community-based services waiver under AS 47.07.045;                                                               
18                 (6)  pharmacy initiatives;                                                                              
19                 (7)  enhanced care management;                                                                          
20                 (8)  redesigning the payment process by implementing fee agreements                                     
21       that include one or more of the following:                                                                        
22                      (A)  premium payments for centers of excellence;                                                   
23                      (B)  penalties for hospital-acquired infections, readmissions,                                     
24            and outcome failures;                                                                                        
25                      (C)  bundled payments for specific episodes of care; or                                            
26                      (D)  global payments for contracted payers, primary care                                           
27            managers, and case managers for a recipient or for care related to a specific                                
28            diagnosis;                                                                                                   
29                 (9)  stakeholder involvement in setting annual targets for quality and                                  
30       cost-effectiveness;                                                                                               
31                 (10)  to the extent consistent with federal law, reducing travel costs by                               
01       requiring a recipient to obtain medical services in the recipient's home community, to                            
02       the extent appropriate services are available in the recipient's home community;                                  
03                 (11)  guidelines for health care providers to develop health care                                       
04       delivery models supported by evidence-based practices that encourage wellness and                                 
05       disease prevention.                                                                                               
06            (b)  The department shall, in coordination with the Alaska Mental Health Trust                               
07       Authority, efficiently manage a comprehensive and integrated behavioral health                                    
08       program that uses evidence-based, data-driven practices to achieve positive outcomes                              
09       for people with mental health or substance abuse disorders and children with severe                               
10       emotional disturbances. The goal of the program is to assist recipients of services                               
11       under the program to recover by achieving the highest level of autonomy with the least                            
12       dependence on state-funded services possible for each person. The program must                                    
13       include                                                                                                           
14                 (1)  a plan for providing a continuum of community-based services to                                    
15       address housing, employment, criminal justice, and other relevant issues;                                         
16                 (2)  services from a wide array of providers and disciplines, including                                 
17       licensed or certified mental health and primary care professionals; and                                           
18                 (3)  efforts to reduce operational barriers that fragment services,                                     
19       minimize administrative burdens, and reduce the effectiveness and efficiency of the                               
20       program.                                                                                                          
21            (c)  The department shall identify the areas of the state where improvements in                              
22       access to telehealth would be most effective in reducing the costs of medical                                     
23       assistance and improving access to health care services for medical assistance                                    
24       recipients. The department shall make efforts to improve access to telehealth for                                 
25       recipients in those locations. The department may enter into agreements with Indian                               
26       Health Service providers, if necessary, to improve access by medical assistance                                   
27       recipients to telehealth facilities and equipment.                                                                
28            (d)  On or before November 15 of each year, the department shall prepare a                                   
29       report and submit the report to the senate secretary and the chief clerk of the house of                          
30       representatives and notify the legislature that the report is available. The report must                          
31       include                                                                                                           
01                 (1)  realized cost savings related to reform efforts under this section;                                
02                 (2)  realized cost savings related to medical assistance reform efforts                                 
03       undertaken by the department other than the reform efforts described in this Act;                                 
04                 (3)  a statement of whether the department has met annual targets for                                   
05       quality and cost-effectiveness;                                                                                   
06                 (4)  recommendations for legislative or budgetary changes related to                                    
07       medical assistance reforms during the next fiscal year;                                                           
08                 (5)  changes in federal laws that the department expects will result in a                               
09       cost or savings to the state of more than $1,000,000;                                                             
10                 (6)  a description of any medical assistance grants, options, or waivers                                
11       the department applied for in the previous fiscal year;                                                           
12                 (7)  the results of demonstration projects the department has                                           
13       implemented;                                                                                                      
14                 (8)  legal and technological barriers to the expanded use of telehealth,                                
15       improvements in the use of telehealth in the state, and recommendations for changes                               
16       or investments that would allow cost-effective expansion of telehealth;                                           
17                 (9)  the percentage decrease in costs of travel for medical assistance                                  
18       recipients compared to the previous fiscal year;                                                                  
19                 (10)  the percentage decrease in the number of medical assistance                                       
20       recipients identified as frequent users of emergency departments compared to the                                  
21       previous fiscal year;                                                                                             
22                 (11)  the percentage increase or decrease in the number of hospital                                     
23       readmissions within 30 days after a hospital stay for medical assistance recipients                               
24       compared to the previous fiscal year;                                                                             
25                 (12)  the percentage increase or decrease in state general fund spending                                
26       for the average medical assistance recipient compared to the previous fiscal year;                                
27                 (13)  the percentage increase or decrease in uncompensated care costs                                   
28       incurred by medical assistance providers compared to the percentage change in private                             
29       health insurance premiums for individual and small group health insurance;                                        
30                 (14)  the cost, in state and federal funds, for providing optional services                             
31       under AS 47.07.030(b);                                                                                            
01                 (15)  the amount of state funds saved as a result of implementing                                       
02       changes in federal policy authorizing 100 percent federal funding for services                                    
03       provided to American Indian and Alaska Native individuals eligible for Medicaid, and                              
04       the estimated savings in state funds that could have been achieved if the department                              
05       had fully implemented the changes in policy.                                                                      
06            (e)  In this section, "telehealth" means the practice of health care delivery,                               
07       evaluation, diagnosis, consultation, or treatment, using the transfer of health care data                         
08       through audio, visual, or data communications, performed over two or more locations                               
09       between providers who are physically separated from the recipient or from each other                              
10       or between a provider and a recipient who are physically separated from each other.                               
11    * Sec. 44. AS 47.07.030(d) is amended to read:                                                                     
12            (d)  The department shall [MAY] establish as optional services a primary care                            
13       case management system or a managed care organization contract in which certain                                   
14       eligible individuals are required to enroll and seek approval from a case manager or                              
15       the managed care organization before receiving certain services. The purpose of a                             
16       primary care case management system or managed care organization contract is                                  
17       to increase the use of appropriate primary and preventive care by medical                                     
18       assistance recipients, while decreasing the unnecessary use of specialty care and                             
19       hospital emergency department services. The department shall                                                  
20                 (1)  establish enrollment criteria and determine eligibility for services                           
21       consistent with federal and state law; the department shall require recipients with                           
22       multiple hospitalizations to enroll in a primary care case management system or                               
23       with a managed care organization under this subsection, except that the                                       
24       department may exempt recipients with chronic, acute, or terminal medical                                     
25       conditions from the requirement under this paragraph;                                                         
26                 (2)  define the coordinated care services and provider types eligible                               
27       to participate as primary care providers;                                                                     
28                 (3)  create a performance and quality reporting system; and                                         
29                 (4)  integrate the coordinated care demonstration projects                                          
30       described under AS 47.07.039 and the demonstration projects described under                                   
31       AS 47.07.036(e) with the primary care case management system or managed care                                  
01       organization contract established under this subsection.                                                      
02    * Sec. 45. AS 47.07.036 is amended by adding new subsections to read:                                              
03            (d)  Notwithstanding (a) - (c) of this section, the department may                                           
04                 (1)  apply for a section 1915(i) option under 42 U.S.C. 1396n to                                        
05       improve services and care through home and community-based services to obtain, at a                               
06       minimum, a 50 percent federal match;                                                                              
07                 (2)  apply for a section 1915(k) option under 42 U.S.C. 1396n to                                        
08       provide home and community-based services and support to increase the federal match                               
09       for these programs from 50 percent to 56 percent;                                                                 
10                 (3)  apply for a section 1945 option under 42 U.S.C. 1396w-4 to                                         
11       provide coordinated care through health homes for individuals with chronic conditions                             
12       and to increase the federal match for the services to 90 percent for the first eight                              
13       quarters the required state plan amendment is in effect;                                                          
14                 (4)  evaluate and seek permission from the United States Department of                                  
15       Health and Human Services Centers for Medicare and Medicaid Services to participate                               
16       in various demonstration projects, including payment reform, care management                                      
17       programs, workforce development and innovation, and innovative services delivery                                  
18       models; and                                                                                                       
19                 (5)  provide incentives for telehealth, including increasing the                                        
20       capability for and reimbursement of telehealth for recipients.                                                    
21            (e)  Notwithstanding (a) - (c) of this section, and in addition to the projects and                          
22       services described under (d) and (f) of this section, the department shall apply for a                            
23       section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration                                
24       projects focused on innovative payment models for one or more groups of medical                                   
25       assistance recipients in one or more specific geographic areas. The demonstration                                 
26       project or projects may include                                                                                   
27                 (1)  managed care organizations as described under 42 U.S.C. 1396u-2;                                   
28                 (2)  community care organizations;                                                                      
29                 (3)  patient-centered medical homes as described under 42 U.S.C. 256a-                                  
30       1; or                                                                                                             
31                 (4)  other innovative payment models that ensure access to health care                                  
01       without reducing the quality of care.                                                                             
02            (f)  Notwithstanding (a) - (c) of this section, and in addition to the projects and                          
03       services described under (d) and (e) of this section, the department shall apply for a                            
04       section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration                                
05       projects focused on improving the state's behavioral health system for medical                                    
06       assistance recipients. The department shall engage stakeholders and the community in                              
07       the development of a project or projects under this subsection. The demonstration                                 
08       project or projects must                                                                                          
09                 (1)  be consistent with the comprehensive and integrated behavioral                                     
10       health program described under AS 47.05.270(b); and                                                               
11                 (2)  include continuing cooperation with the grant-funded community                                     
12       mental health clinics and drug and alcohol treatment centers that have historically                               
13       provided care to recipients of behavioral health services.                                                        
14            (g)  In this section, "telehealth" has the meaning given in AS 47.05.270(e).                                 
15    * Sec. 46. AS 47.07 is amended by adding new sections to read:                                                     
16            Sec. 47.07.038. Collaborative, hospital-based project to reduce use of                                     
17       emergency department services. (a) On or before December 1, 2016, the department                                
18       shall collaborate with a statewide professional hospital association to establish a                               
19       hospital-based project to reduce the use of emergency department services by medical                              
20       assistance recipients. The statewide professional hospital association shall operate the                          
21       project. Subject to (b) of this section, the project may include shared savings for                               
22       participating hospitals. The project must include                                                                 
23                 (1)  an interdisciplinary process for defining, identifying, and                                        
24       minimizing the number of frequent users of emergency department services;                                         
25                 (2)  to the extent consistent with federal law, a system for real-time                                  
26       electronic exchange of patient information, including recent emergency department                                 
27       visits, hospital care plans for frequent users of emergency departments, and data from                            
28       the controlled substance prescription database;                                                                   
29                 (3)  a procedure for educating patients about the use of emergency                                      
30       departments and appropriate alternative services and facilities for nonurgent care;                               
31                 (4)  a process for assisting users of emergency departments in making                                   
01       appointments with primary care or behavioral health providers within 96 hours after                               
02       an emergency department visit;                                                                                    
03                 (5)  a collaborative process between the department and the statewide                                   
04       professional hospital association to establish uniform statewide guidelines for                                   
05       prescribing narcotics in an emergency department; and                                                             
06                 (6)  designation of health care personnel to review successes and                                       
07       challenges regarding appropriate emergency department use.                                                        
08            (b)  After January 1, 2022, the department may not compensate hospital                                       
09       emergency departments, through shared savings, for a reduction in hospital fees                                   
10       resulting from the project.                                                                                       
11            (c)  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                 (9)  an innovative payment process, including bundled payments or                                       
18       global payments.                                                                                                  
19            (b)  A project review committee is established in the department for the                                     
20       purpose of reviewing proposals for demonstration projects under this section. The                                 
21       project review committee consists of                                                                              
22                 (1)  the commissioner of the department, or the commissioner's                                          
23       designee;                                                                                                         
24                 (2)  the commissioner of administration, or the commissioner's                                          
25       designee;                                                                                                         
26                 (3)  the chief executive officer of the Alaska Mental Health Trust                                      
27       Authority, or the chief executive officer's designee, who shall serve as chair of the                             
28       committee;                                                                                                        
29                 (4)  two representatives of stakeholder groups, appointed by the                                        
30       governor for staggered three-year terms, as follows:                                                              
31                      (A)  one representative of a stakeholder group who has direct                                      
01            experience with health plan management and cost control for the medical                                      
02            assistance population;                                                                                       
03                      (B)  one representative of a stakeholder group who has direct                                      
04            experience with health plan management and cost control for a nongovernment                                  
05            employer of 500 or more employees in the state;                                                              
06                 (5)  a nonvoting member who is a member of the senate, appointed by                                     
07       the president of the senate; and                                                                                  
08                 (6)  a nonvoting member who is a member of the house of                                                 
09       representatives, appointed by the speaker of the house of representatives.                                        
10            (c)  The department may contract with a managed care organization, primary                                   
11       care case manager, accountable care organization, prepaid ambulatory health plan, or                              
12       provider-led entity to implement a demonstration project under this section. The fee                              
13       structure for a contract under this subsection may include global payments, bundled                               
14       payments, capitated payments, shared savings and risk, or other payment structures.                               
15       The department shall work with the division of insurance, Department of Commerce,                                 
16       Community, and Economic Development, to streamline the application process for a                                  
17       company to obtain a certificate of authority required under AS 21.09.010 as necessary                             
18       to participate in a demonstration project under this section.                                                     
19            (d)  A proposal for a demonstration project under this section must include, in                              
20       addition to the elements required under (a) of this section, information demonstrating                            
21       how the project will implement additional cost-saving measures including innovations                              
22       to reduce the cost of care for medical assistance recipients through the expanded use                             
23       of telehealth for primary care, urgent care, and behavioral health services. The                                  
24       department shall identify legal or cost barriers preventing the expanded use of                                   
25       telehealth and shall recommend remedies for identified barriers.                                                  
26            (e)  The department shall contract with a third-party actuary to review                                      
27       demonstration projects established under this section. The actuary shall review each                              
28       demonstration project after two years of implementation and make recommendations                                  
29       for the implementation of a similar project on a statewide basis. The actuary shall                               
30       evaluate each project based on cost savings for the medical assistance program, health                            
31       outcomes for participants in the project, and the ability to achieve similar results on a                         
01       statewide basis. On or before December 31 of each year starting in 2018, the actuary                              
02       shall submit a final report to the department regarding any demonstration project that                            
03       has been in operation for at least two years.                                                                     
04            (f)  The department shall prepare a plan regarding regional or statewide                                     
05       implementation of a coordinated care project based on the results of the demonstration                            
06       projects under this section. On or before November 15, 2019, the department shall                                 
07       submit the plan to the senate secretary and the chief clerk of the house of                                       
08       representatives and notify the legislature that the plan is available. On or before                               
09       November 15 of each year thereafter, the department shall submit a report regarding                               
10       any changes or recommendations regarding the plan developed under this subsection                                 
11       to the senate secretary and the chief clerk of the house of representatives and notify the                        
12       legislature that the report is available.                                                                         
13            (g)  In this section, "telehealth" has the meaning given in AS 47.05.270(e).                                 
14    * Sec. 47. AS 47.07 is amended by adding a new section to read:                                                    
15            Sec. 47.07.076. Reports to legislature. (a) The department and the attorney                                
16       general shall annually prepare a report relating to the medical assistance program                                
17       under AS 47.07. The report must include the following information:                                                
18                 (1)  the amount and source of funds used to prevent or prosecute fraud,                                 
19       abuse, payment errors, and errors in eligibility determinations for the previous fiscal                           
20       year;                                                                                                             
21                 (2)  actions taken to address fraud, abuse, payment errors, and errors in                               
22       eligibility determinations during the previous fiscal year;                                                       
23                 (3)  specific examples of fraud or abuse that were prevented or                                         
24       prosecuted;                                                                                                       
25                 (4)  identification of vulnerabilities in the medical assistance program,                               
26       including any vulnerabilities identified by independent auditors with whom the                                    
27       department contracts under AS 47.05.200;                                                                          
28                 (5)  initiatives the department has taken to prevent fraud or abuse;                                    
29                 (6)  recommendations to increase effectiveness in preventing and                                        
30       prosecuting fraud and abuse;                                                                                      
31                 (7)  the return to the state for every dollar expended by the department                                
01       and the attorney general to prevent and prosecute fraud and abuse;                                                
02                 (8)  the most recent payment error rate measurement report for the                                      
03       medical assistance program, including fee for service programs and pilot or                                       
04       demonstration projects; the report must also explain the reasons for the payment errors                           
05       and the total amount of state and federal funds paid in error during the reporting period                         
06       and not recovered by the department at the time of the report;                                                    
07                 (9)  results from the Medicaid Eligibility Quality Control program.                                     
08            (b)  On or before November 15 of each year, the department shall submit the                                  
09       report required under (a) of this section to the senate secretary and the chief clerk of                          
10       the house of representatives and notify the legislature that the report is available.                             
11            (c)  On or before December 15 and June 15 of each year, the department shall                                 
12       prepare a semi-annual report and submit the report to the senate secretary and the chief                          
13       clerk of the house of representatives and notify the legislature that the report is                               
14       available. The report must include                                                                                
15                 (1)  updates and status reports on the Medicaid Management                                              
16       Information System, including progress toward federal certification of the system,                                
17       current measurements of the accuracy of the system, timeliness of payment of claims,                              
18       and any backlog of claims; and                                                                                    
19                 (2)  information on the status of an administrative or legal proceeding                                 
20       relating to resolution of claims against the system contractor and related financial                              
21       effects on the state.                                                                                             
22    * Sec. 48. AS 47.07.900(4) is amended to read:                                                                     
23                 (4)  "clinic services" means services provided by state-approved                                        
24       outpatient community mental health clinics [THAT RECEIVE GRANTS UNDER                                             
25       AS 47.30.520 - 47.30.620], state-operated community mental health clinics, outpatient                             
26       surgical care centers, and physician clinics;                                                                     
27    * Sec. 49. AS 47.07.900(17) is amended to read:                                                                    
28                 (17)  "rehabilitative services" means services for substance abusers and                                
29       emotionally disturbed or chronically mentally ill adults provided by                                              
30                      (A)  a drug or alcohol treatment center [THAT IS FUNDED                                            
31            WITH A GRANT UNDER AS 47.30.475]; or                                                                         
01                      (B)  an outpatient community mental health clinic [THAT HAS                                        
02            A CONTRACT TO PROVIDE COMMUNITY MENTAL HEALTH                                                                
03            SERVICES UNDER AS 47.30.520 - 47.30.620];                                                                    
04    * Sec. 50. AS 47.55.020(e) is amended to read:                                                                     
05            (e)  As a condition for receipt of payment assistance under (d) of this section,                             
06       the department, under regulations adopted by the department, shall [MAY] require a                            
07       person to                                                                                                         
08                 (1)  apply for other state or federally sponsored programs that may                                 
09       reduce the amount of the payment assistance; and                                                              
10                 (2)  submit to the department a copy of the person's application for                                
11       medical assistance coverage under AS 47.07 and the decision letter the person                                 
12       receives regarding the application.                                                                           
13    * Sec. 51. AS 09.58.020, 09.58.030, 09.58.040, 09.58.050, and 09.58.060 are repealed                               
14 July 1, 2019.                                                                                                           
15    * Sec. 52. AS 08.36.070(a)(10); AS 08.64.101(7); AS 08.68.100(a)(11);                                              
16 AS 08.72.060(c)(3); AS 08.80.030(b)(13); AS 17.30.200(o), 17.30.200(p), 17.30.200(q),                                   
17 17.30.200(r), and 17.30.200(s) are repealed July 1, 2021.                                                               
18    * Sec. 53. AS 47.07.076(c) is repealed.                                                                            
19    * Sec. 54. The uncodified law of the State of Alaska is amended by adding a new section to                         
20 read:                                                                                                                   
21       INDIRECT COURT RULE AMENDMENTS. (a) AS 09.58.010, added by sec. 18 of                                             
22 this Act, has the effect of amending Rules 79 and 82, Alaska Rules of Civil Procedure, by                               
23 providing that the state is entitled to full reasonable attorney fees and costs if the state prevails                   
24 in a civil action under AS 09.58.010 - 09.58.060 that involves fraud, or reasonable attorney                            
25 fees and costs if the state prevails in a civil action under AS 09.58.010 - 09.58.060 that does                         
26 not involve fraud.                                                                                                      
27       (b)  AS 09.58.020, added by sec. 18 of this Act, and repealed by sec. 51 of this Act,                             
28 has the effect of amending the following court rules in the manner specified from the effective                         
29 date of sec. 18 of this Act until July 1, 2019:                                                                         
30            (1)  Rules 4, 5, 7, and 12, Alaska Rules of Civil Procedure, by requiring that a                             
31 complaint under AS 09.58 be filed in camera and under seal and may not be served on the                                 
01 defendant until unsealed and that a copy of the complaint be served on the attorney general;                            
02            (2)  Rules 41 and 77, Alaska Rules of Civil Procedure, by authorizing the                                    
03 attorney general to move for dismissal of a complaint filed by another person under                                     
04 AS 09.58.020, added by sec. 18 of this Act and repealed by sec. 51 of this Act, and requiring                           
05 court approval for dismissal of the action.                                                                             
06       (c)  AS 09.58.025, added by sec. 18 of this Act, and amended by sec. 19 of this Act,                              
07 has the effect of amending Rule 27, Alaska Rules of Civil Procedure, by authorizing the                                 
08 attorney general to issue subpoenas as part of an investigation                                                         
09            (1)  under AS 09.58.015, added by sec. 18 of this Act, from the effective date                               
10 of sec. 18 of this Act; and                                                                                             
11            (2)  under AS 09.58.020, added by sec. 18 of this Act, from the effective date                               
12 of sec. 18 of this Act until July 1, 2019.                                                                              
13       (d)  AS 09.58.030, added by sec. 18 of this Act, and repealed by sec. 51 of this Act,                             
14 has the effect of amending the following court rules in the manner specified from the effective                         
15 date of sec. 18 of this Act until July 1, 2019:                                                                         
16            (1)  Rule 24, Alaska Rules of Civil Procedure, by authorizing the attorney                                   
17 general to intervene in a civil action filed by another person under AS 09.58.020 added by                              
18 sec. 18 of this Act, and repealed by sec. 51 of this Act, and limiting the participation of a party                     
19 to the litigation;                                                                                                      
20            (2)  Rules 26 and 27, Alaska Rules of Civil Procedure, by authorizing the                                    
21 attorney general to request that the court issue a stay of discovery for a 90-day period, or                            
22 longer upon a showing by the attorney general.                                                                          
23       (e)  AS 09.58.040, added by sec. 18 of this Act, and repealed by sec. 51 of this Act,                             
24 has the effect of amending Rules 79 and 82, Alaska Rules of Civil Procedure, from the                                   
25 effective date of sec. 18 of this Act until July 1, 2019, by giving a person who brings an action                       
26 under AS 09.58.020, added by sec. 18 of this Act, and repealed by sec. 51 of this Act, the                              
27 right to reasonable attorney fees and costs in an action prosecuted by the attorney general, and                        
28 to full reasonable attorney fees and costs if the person prevails in an action not prosecuted by                        
29 the attorney general that involves fraud, or reasonable attorney fees and costs in a case that                          
30 does not involve fraud.                                                                                                 
31    * Sec. 55. The uncodified law of the State of Alaska is amended by adding a new section to                         
01 read:                                                                                                                   
02       IMPLEMENT FEDERAL POLICY ON TRIBAL MEDICAID REIMBURSEMENT.                                                        
03 (a) The Department of Health and Social Services shall collaborate with Alaska tribal health                            
04 organizations and the United States Department of Health and Human Services to fully                                    
05 implement changes in federal policy that authorize 100 percent federal funding for services                             
06 provided to American Indian and Alaska Native individuals eligible for Medicaid.                                        
07       (b)  Within 30 days after the date the Centers for Medicare and Medicaid Services                                 
08 issues a final policy regarding the circumstances in which 100 percent federal funding is                               
09 available for medical assistance services received through the United States Indian Health                              
10 Service or tribal health facilities, the Department of Health and Social Services shall notify                          
11 and submit a report to the co-chairs of the house and senate finance committees of the Alaska                           
12 State Legislature that includes an estimate of the savings to the state resulting from the final                        
13 policy. Within six months after the date the Centers for Medicare and Medicaid Services                                 
14 issues the final policy, the Department of Health and Social Services shall fully implement the                         
15 policy in the state.                                                                                                    
16       (c)  In this section, "Alaska tribal health organization" means an organization                                   
17 recognized by the United States Indian Health Service to provide health-related services.                             
18    * Sec. 56. The uncodified law of the State of Alaska is amended by adding a new section to                         
19 read:                                                                                                                   
20       HEALTH INFORMATION INFRASTRUCTURE PLAN. (a) The Department of                                                     
21 Health and Social Services shall develop a health information infrastructure plan to strengthen                         
22 the health information infrastructure, including health data analytics capability. The purpose                          
23 of the health information infrastructure plan is to transform the health care system in the state                       
24 by providing                                                                                                            
25            (1)  data required by health care providers for care coordination and quality                                
26 improvement; and                                                                                                        
27            (2)  the information support required by the Department of Health and Social                                 
28 Services and health care providers to enable development and implementation of the other                                
29 provisions of this Act.                                                                                                 
30       (b)  To the greatest extent practicable, the health information infrastructure plan will                          
31 leverage existing resources, including the health information exchange, and will identify                               
01 opportunities for integrating and streamlining health data systems administered by the state.                           
02    * Sec. 57. The uncodified law of the State of Alaska is amended by adding a new section to                         
03 read:                                                                                                                   
04       FEASIBILITY STUDIES FOR THE PROVISION OF SPECIFIED STATE                                                          
05 SERVICES. (a)  The Department of Health and Social Services, in conjunction with the                                    
06 Alaska Mental Health Trust Authority, shall procure a study analyzing the feasibility of                                
07 privatizing services delivered at the Alaska Psychiatric Institute. The Department of Health                            
08 and Social Services and the Alaska Mental Health Trust Authority shall deliver a joint report                           
09 summarizing the conclusions of the Department of Health and Social Services and the Alaska                              
10 Mental Health Trust Authority to the senate secretary and the chief clerk of the house of                               
11 representatives and notify the legislature that the report is available within 10 days after the                        
12 convening of the First Regular Session of the Thirtieth Alaska State Legislature.                                       
13       (b)  The Department of Administration shall, in collaboration with the house and                                  
14 senate finance committees, procure a study to be completed on or before June 30, 2017, to                               
15 determine the feasibility of creating a health care authority to coordinate health care plans and                       
16 consolidate purchasing effectiveness for all state employees, retired state employees, retired                          
17 teachers, medical assistance recipients, University of Alaska employees, employees of state                             
18 corporations, and school district employees and to develop appropriate benefit sets, rules,                             
19 cost-sharing, and payment structures for all employees and individuals whose health care                                
20 benefits are funded directly or indirectly by the state, with the goal of achieving the greatest                        
21 possible savings to the state through a coordinated approach administered by a single entity.                           
22 In developing the study, the Department of Administration shall seek input from the                                     
23 Department of Health and Social Services, administrators familiar with managing government                              
24 employee health plans, and human resource professionals familiar with self-insured health                               
25 care plans. The study must                                                                                              
26            (1)  identify cost-saving strategies that a health care authority could implement;                           
27            (2)  analyze local government participation in the authority;                                                
28            (3)  analyze a phased approach to adding groups to the health care plans                                     
29 coordinated by the health care authority;                                                                               
30            (4)  consider previous studies procured by the Department of Administration                                  
31 and the legislature;                                                                                                    
01            (5)  assess the use of community-related health insurance risk pools and the use                             
02 of the private marketplace;                                                                                             
03            (6)  identify organizational models for a health care authority, including private                           
04 for-profit, private nonprofit, government, and state corporations; and                                                  
05            (7)  include a public review and comment opportunity for employers,                                          
06 employees, medical assistance recipients, retirees, and health care providers.                                          
07       (c)  The Department of Health and Social Services shall procure a study analyzing the                             
08 feasibility of privatizing select facilities of the division of juvenile justice and privatizing                        
09 pharmacy services delivered at Alaska Pioneers' Homes. The Department of Health and                                     
10 Social Services shall deliver a report summarizing the conclusions of the Department of                                 
11 Health and Social Services to the senate secretary and the chief clerk of the house of                                  
12 representatives and notify the legislature that the report is available within 10 days after the                        
13 convening of the First Regular Session of the Thirtieth Alaska State Legislature.                                       
14       (d)  In this section, "school district" has the meaning given in AS 14.30.350.                                    
15    * Sec. 58. The uncodified law of the State of Alaska is amended by adding a new section to                         
16 read:                                                                                                                   
17       REPORT TO LEGISLATURE. (a) The Board of Pharmacy, Board of Examiners in                                           
18 Optometry, Board of Dental Examiners, Board of Nursing, and State Medical Board shall                                   
19 jointly prepare a report that describes recommended guidelines for the prescription of                                  
20 schedule II controlled substances listed under federal law. The guidelines must be drafted                              
21 with the goal of reducing the over-prescription of pain killers and highly addictive schedule II                        
22 controlled substances. The report must include                                                                          
23            (1)  the following recommended guidelines for each schedule II controlled                                    
24 substance listed under federal law:                                                                                     
25                 (A)  quantity and strength of each dosage;                                                              
26                 (B)  number of doses for each day;                                                                      
27                 (C)  number of days the drug may be prescribed; and                                                     
28            (2)  other recommendations related to reducing the over-prescription of                                      
29 schedule II controlled substances.                                                                                      
30       (b)  On or before January 1, 2017, the Board of Pharmacy, Board of Examiners in                                   
31 Optometry, Board of Dental Examiners, Board of Nursing, and State Medical Board shall                                   
01 jointly deliver the report required under (a) of this section to the senate secretary and the chief                     
02 clerk of the house of representatives and notify the legislature that the report is available.                        
03    * Sec. 59. The uncodified law of the State of Alaska is amended by adding a new section to                         
04 read:                                                                                                                   
05       MEDICAID STATE PLAN; WAIVERS; INSTRUCTIONS; NOTICE TO REVISOR                                                     
06 OF STATUTES. The Department of Health and Social Services shall amend and submit for                                    
07 federal approval a state plan for medical assistance coverage consistent with this Act. The                             
08 Department of Health and Social Services shall apply to the United States Department of                                 
09 Health and Human Services for any waivers necessary to implement this Act. The                                          
10 commissioner of health and social services shall certify to the revisor of statutes if the                              
11 provisions of AS 47.05.270(a)(5), (8), and (10), added by sec. 43 of this Act, and the                                  
12 provisions of AS 47.07.038, added by sec. 46 of this Act, are approved by the United States                             
13 Department of Health and Human Services.                                                                                
14    * Sec. 60. The uncodified law of the State of Alaska is amended by adding a new section to                         
15 read:                                                                                                                   
16       TRANSITION: REGULATIONS. (a) The Department of Health and Social Services                                         
17 may adopt regulations necessary to implement the changes made by this Act. The regulations                              
18 take effect under AS 44.62 (Administrative Procedure Act), but not before the effective date                            
19 of the relevant provision of this Act implemented by the regulation.                                                    
20       (b)  The Department of Commerce, Community, and Economic Development and a                                        
21 board that regulates an occupation that includes a practitioner who is required to register with                        
22 the controlled substances database under AS 17.30.200 shall adopt regulations to implement                              
23 the changes made by AS 08.36.070(a), as amended by sec. 5 of this Act, AS 08.64.101(7),                                 
24 added by sec. 7 of this Act, AS 08.68.100(a), as amended by sec. 10 of this Act,                                        
25 AS 08.72.060(c), as amended by sec. 11 of this Act, AS 08.80.030(b), as amended by sec. 12                              
26 of this Act, AS 17.30.200(a), as amended by sec. 21 of this Act, AS 17.30.200(b), as amended                            
27 by sec. 23 of this Act, AS 17.30.200(d), as amended by sec. 25 of this Act, AS 17.30.200(e),                            
28 as amended by sec. 27 of this Act, AS 17.30.200(h), as amended by sec. 29 of this Act,                                  
29 AS 17.30.200(k), as amended by sec. 31 of this Act, AS 17.30.200(m), as amended by sec. 33                              
30 of this Act, and AS 17.30.200(o) - (s), enacted by sec. 34 of this Act. The regulations take                            
31 effect under AS 44.62 (Administrative Procedure Act), but not before the effective date of the                          
01 relevant provisions of secs. 5, 7, 10, 11, 12, 21, 23, 25, 27, 29, 31, 33, or 34 of this Act. In this                   
02 subsection,                                                                                                             
03            (1)  "board" has the meaning given in AS 08.01.110;                                                          
04            (2)  "occupation" has the meaning given in AS 08.01.110;                                                     
05            (3)  "practitioner" has the meaning given in AS 11.71.900.                                                   
06    * Sec. 61. The uncodified law of the State of Alaska is amended by adding a new section to                         
07 read:                                                                                                                   
08       CONDITIONAL EFFECT. (a) AS 47.05.270(a)(5), enacted by sec. 43 of this Act,                                       
09 takes effect only if the commissioner of health and social services certifies to the revisor of                         
10 statutes under sec. 59 of this Act, on or before October 1, 2017, that all of the provisions                            
11 added by AS 47.05.270(a)(5) have been approved by the United States Department of Health                                
12 and Human Services.                                                                                                     
13       (b)  AS 47.05.270(a)(8), enacted by sec. 43 of this Act, takes effect only if the                                 
14 commissioner of health and social services certifies to the revisor of statutes under sec. 59 of                        
15 this Act, on or before October 1, 2017, that all of the provisions added by AS 47.05.270(a)(8)                          
16 have been approved by the United States Department of Health and Human Services.                                        
17       (c)  AS 47.05.270(a)(10), enacted by sec. 43 of this Act, takes effect only if the                                
18 commissioner of health and social services certifies to the revisor of statutes under sec. 59 of                        
19 this Act, on or before October 1, 2017, that all of the provisions added by                                             
20 AS 47.05.270(a)(10) have been approved by the United States Department of Health and                                    
21 Human Services.                                                                                                         
22       (d)  AS 47.07.038, enacted by sec. 46 of this Act, takes effect only if the commissioner                          
23 of health and social services certifies to the revisor of statutes under sec. 59 of this Act, on or                     
24 before October 1, 2017, that all of the provisions added by AS 47.07.038 have been approved                             
25 by the United States Department of Health and Human Services.                                                           
26       (e)  AS 09.58.020, added by sec. 18 of this Act, AS 09.58.025, added by sec. 18 of this                           
27 Act, AS 09.58.030, added by sec. 18 of this Act, and AS 09.58.040, added by sec. 18 of this                             
28 Act, the amendment to AS 09.58.025 by sec. 19 of this Act, and the repeals of AS 09.58.020,                             
29 09.58.030, and 09.58.040, by sec. 51 of this Act, take effect only if sec. 54 of this Act receives                      
30 the two-thirds majority vote of each house required by art. IV, sec. 15, Constitution of the                            
31 State of Alaska.                                                                                                        
01       (f)  Section 53 of this Act takes effect only if the commissioner of health and social                            
02 services certifies to the revisor of statutes that the Medicaid Management Information System                           
03 has been certified by the United States Department of Health and Human Services.                                        
04    * Sec. 62. If AS 47.05.270(a)(5), enacted by sec. 43 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. 59 and 61(a) of this Act.                                                        
07    * Sec. 63. If AS 47.05.270(a)(8), enacted by sec. 43 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. 59 and 61(b) of this Act.                                                        
10    * Sec. 64. If AS 47.05.270(a)(10), enacted by sec. 43 of this Act, takes effect, it takes effect                   
11 on the day after the date the commissioner of health and social services makes a certification                          
12 to the revisor of statutes under secs. 59 and 61(c) of this Act.                                                        
13    * Sec. 65. If AS 47.07.038, enacted by sec. 46 of this Act, takes effect, it takes effect on the                   
14 day after the date the commissioner of health and social services makes a certification to the                          
15 revisor of statutes under secs. 59 and 61(d) of this Act.                                                               
16    * Sec. 66. If sec. 53 of this Act takes effect, it takes effect on the day after the date the                      
17 commissioner of health and social services makes a certification to the revisor of statutes                             
18 under sec. 61(f) of this Act.                                                                                           
19    * Sec. 67. Sections 57 and 59 - 61 of this Act take effect immediately under                                       
20 AS 01.10.070(c).                                                                                                        
21    * Sec. 68. AS 47.07.076(c), enacted by sec. 47 of this Act, takes effect July 1, 2016.                             
22    * Sec. 69. AS 17.30.200(s), enacted by sec. 34 of this Act, takes effect September 1, 2016.                        
23    * Sec. 70. Sections 5, 10 - 12, 21, 23, 25, 27, 29, 31, and 33 of this Act, AS 08.64.101(7),                       
24 enacted by sec. 7 of this Act, and AS 17.30.200(o) - (r), enacted by sec. 34 of this Act, take                          
25 effect July 17, 2017.                                                                                                   
26    * Sec. 71. Sections 19 and 20 of this Act take effect July 1, 2019.                                                
27    * Sec. 72. Sections 22, 24, 26, 28, 30, and 32 of this Act take effect January 1, 2021.