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HB 21: "An Act relating to insurance coverage for contraceptives and related services; and relating to medical assistance coverage for contraceptives and related services."

00                              HOUSE BILL NO. 21                                                                          
01 "An Act relating to insurance coverage for contraceptives and related services; and                                     
02 relating to medical assistance coverage for contraceptives and related services."                                       
03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
04    * Section 1. AS 21.42 is amended by adding a new section to read:                                                  
05            Sec. 21.42.427. Coverage for contraceptives. (a) A health care insurer that                                
06       offers, issues for delivery, delivers, or renews in the state a health care insurance plan                        
07       in the group or individual market shall                                                                           
08                 (1)  provide coverage for                                                                               
09                      (A)  prescription contraceptives;                                                                  
10                      (B)  voluntary sterilization procedures; and                                                       
11 (C)  consultations, examinations, procedures, and medical                                                               
12 services that are necessary to prescribe, dispense, insert, deliver, distribute,                                        
13 administer, or remove the drugs, devices, and other products or services                                                
14            provided under this paragraph;                                                                               
01 (2)  reimburse a health care provider or dispensing entity for dispensing                                               
02 prescription contraceptives intended to last for a 12-month period for subsequent                                       
03 dispensings of the same prescription contraceptive to the insured regardless of whether                                 
04 the insured was enrolled in the health care insurance plan at the time of the first                                     
05       dispensing.                                                                                                       
06 (b)  A health care insurer may not deny coverage or reimbursement under (a)                                             
07 of this section because an insured changed contraceptive methods within a 12-month                                      
08       period.                                                                                                           
09 (c)  A health care insurer may not offset the costs of compliance with (a) of                                           
10 this section and may not require copayments or deductibles for contraceptives or                                        
11       services covered under (a) of this section.                                                                       
12 (d)  A health care insurer may not restrict or delay the coverage or                                                    
13 reimbursement required under (a) of this section, including use of medical                                              
14 management techniques, such as denials, step therapy, or prior authorization, that limit                                
15 an insured's choice in accessing a full range of prescription contraceptives. Nothing in                                
16 this subsection prevents a health care insurer from enacting reasonable cost                                            
17 containment measures in relation to the coverage required under (a) of this section if                                  
18 the cost containment measure does not unreasonably limit choice in access to                                            
19 coverage. In this subsection, "cost containment" means incentivizing the use of                                         
20 generic or lower cost medications or the use of health care providers or pharmacies                                     
21       that offer services or prescriptions at a lower negotiated rate.                                                  
22 (e)  If the covered therapeutically equivalent version of a prescription                                                
23 contraceptive is not available or is considered medically inadvisable by the health care                                
24 provider of the insured, a health care insurer shall provide coverage without cost                                      
25 sharing for an alternative therapeutically equivalent version of the prescription                                       
26       contraceptive that is prescribed for the insured.                                                                 
27 (f)  A health care insurer shall provide coverage and reimbursement under (a)                                           
28 of this section to all insureds enrolled in a health care insurance plan, including                                     
29       enrolled spouses and dependents.                                                                                  
30 (g)  A health care insurer that offers, issues for delivery, delivers, or renews in                                     
31 the state a health care insurance plan in the group market to a religious employer is                                   
01 exempt from the requirements of this section with respect to the health care insurance                                  
02 plan of the religious employer if the religious employer opposes the coverage required                                  
03 under this section and is an organization that meets the criteria set out in 26 U.S.C.                                  
04       6033(a)(3)(A)(i) or (iii) (Internal Revenue Code of 1986), as amended.                                            
05            (h)  In this section, "prescription contraceptive" means a drug or device that                               
06       requires a prescription and is approved by the United States Food and Drug                                        
07       Administration to prevent pregnancy.                                                                              
08    * Sec. 2. AS 29.10.200 is amended by adding a new paragraph to read:                                               
09                 (68)  AS 29.20.420 (health care insurance plans).                                                       
10    * Sec. 3. AS 29.20 is amended by adding a new section to article 5 to read:                                        
11 Sec. 29.20.420. Health insurance policies. (a) If a municipality offers a group                                       
12 health care insurance plan covering municipal employees, including by means of self-                                    
13 insurance, the municipal health care insurance plan is subject to the requirements of                                   
14       AS 21.42.427.                                                                                                     
15            (b)  This section applies to home rule and general law municipalities.                                       
16 (c)  In this section "health care insurance plan" has the meaning given in                                              
17       AS 21.54.500.                                                                                                     
18    * Sec. 4. AS 39.30.090(a) is amended to read:                                                                      
19 (a)  The Department of Administration may obtain a policy or policies of group                                          
20 insurance covering state employees, persons entitled to coverage under AS 14.25.168,                                    
21 14.25.480, AS 22.25.090, AS 39.35.535, 39.35.880, or former AS 39.37.145,                                               
22 employees of other participating governmental units, or persons entitled to coverage                                    
23       under AS 23.15.136, subject to the following conditions:                                                          
24 (1)  a group insurance policy shall provide one or more of the following                                                
25 benefits: life insurance, accidental death and dismemberment insurance, weekly                                          
26 indemnity insurance, hospital expense insurance, surgical expense insurance, dental                                     
27       expense insurance, audiovisual insurance, or other medical care insurance;                                        
28 (2)  each eligible employee of the state, the spouse and the unmarried                                                  
29 children chiefly dependent on the eligible employee for support, and each eligible                                      
30 employee of another participating governmental unit shall be covered by the group                                       
31 policy, unless exempt under regulations adopted by the commissioner of                                                  
01       administration;                                                                                                   
02                 (3)  a governmental unit may participate under a group policy if                                        
03                      (A)  its governing body adopts a resolution authorizing                                            
04            participation and payment of required premiums;                                                              
05                      (B)  a certified copy of the resolution is filed with the                                          
06            Department of Administration; and                                                                            
07                      (C)  the commissioner of administration approves the                                               
08            participation in writing;                                                                                    
09                 (4)  in procuring a policy of group health or group life insurance as                                   
10 provided under this section or excess loss insurance as provided in AS 39.30.091, the                                   
11 Department of Administration shall comply with the dual choice requirements of                                          
12 AS 21.86.310, and shall obtain the insurance policy from an insurer authorized to                                       
13 transact business in the state under AS 21.09, a hospital or medical service corporation                                
14 authorized to transact business in this state under AS 21.87, or a health maintenance                                   
15 organization authorized to operate in this state under AS 21.86; an excess loss                                         
16 insurance policy may be obtained from a life or health insurer authorized to transact                                   
17 business in this state under AS 21.09 or from a hospital or medical service corporation                                 
18       authorized to transact business in this state under AS 21.87;                                                     
19 (5)  the Department of Administration shall make available bid                                                          
20 specifications for desired insurance benefits or for administration of benefit claims and                               
21 payments to (A) all insurance carriers authorized to transact business in this state                                    
22 under AS 21.09 and all hospital or medical service corporations authorized to transact                                  
23 business under AS 21.87 who are qualified to provide the desired benefits; and (B)                                      
24 insurance carriers authorized to transact business in this state under AS 21.09, hospital                               
25 or medical service corporations authorized to transact business under AS 21.87, and                                     
26 third-party administrators licensed to transact business in this state and qualified to                                 
27 provide administrative services; the specifications shall be made available at least once                               
28 every five years; the lowest responsible bid submitted by an insurance carrier, hospital                                
29 or medical service corporation, or third-party administrator with adequate servicing                                    
30 facilities shall govern selection of a carrier, hospital or medical service corporation, or                             
31 third-party administrator under this section or the selection of an insurance carrier or a                              
01       hospital or medical service corporation to provide excess loss insurance as provided in                           
02       AS 39.30.091;                                                                                                     
03                 (6)  if the aggregate of dividends payable under the group insurance                                    
04       policy exceeds the governmental unit's share of the premium, the excess shall be                                  
05       applied by the governmental unit for the sole benefit of the employees;                                           
06 (7)  a person receiving benefits under AS 14.25.110, AS 22.25,                                                          
07 AS 39.35, or former AS 39.37 may continue the life insurance coverage that was in                                       
08 effect under this section at the time of termination of employment with the state or                                    
09       participating governmental unit;                                                                                  
10 (8)  a person electing to have insurance under (7) of this subsection                                                   
11       shall pay the cost of this insurance;                                                                             
12 (9)  for each permanent part-time employee electing coverage under                                                      
13 this section, the state shall contribute one-half the state contribution rate for permanent                             
14 full-time state employees, and the permanent part-time employee shall contribute the                                    
15       other one-half;                                                                                                   
16 (10)  a person receiving benefits under AS 14.25, AS 22.25, AS 39.35,                                                   
17 or former AS 39.37 may obtain auditory, visual, and dental insurance for that person                                    
18 and eligible dependents under this section; the level of coverage for persons over 65                                   
19 shall be the same as that available before reaching age 65 except that the benefits                                     
20 payable shall be supplemental to any benefits provided under the federal old age,                                       
21 survivors, and disability insurance program; a person electing to have insurance under                                  
22 this paragraph shall pay the cost of the insurance; the commissioner of administration                                  
23       shall adopt regulations implementing this paragraph;                                                              
24 (11)  a person receiving benefits under AS 14.25, AS 22.25, AS 39.35,                                                   
25 or former AS 39.37 may obtain long-term care insurance for that person and eligible                                     
26 dependents under this section; a person who elects insurance under this paragraph                                       
27 shall pay the cost of the insurance premium; the commissioner of administration shall                                   
28       adopt regulations to implement this paragraph;                                                                    
29 (12)  each licensee holding a current operating agreement for a vending                                                 
30 facility under AS 23.15.010 - 23.15.210 shall be covered by the group policy that                                       
31       applies to governmental units other than the state;                                                           
01 (13)  a group health insurance policy covering employees of a                                                       
02       participating governmental unit is subject to the requirements of AS 21.42.427.                               
03    * Sec. 5. AS 39.30.091 is amended to read:                                                                         
04 Sec. 39.30.091. Authorization for self-insurance and excess loss insurance.                                           
05 Notwithstanding AS 21.86.310 or AS 39.30.090, the Department of Administration                                          
06 may provide, by means of self-insurance, one or more of the benefits listed in                                          
07 AS 39.30.090(a)(1) for state employees eligible for the benefits by law or under a                                      
08 collective bargaining agreement and for persons receiving benefits under AS 14.25,                                      
09 AS 22.25, AS 39.35, or former AS 39.37, and their dependents. The department shall                                      
10 procure any necessary excess loss insurance under AS 39.30.090. A self-insured                                      
11 group medical plan covering active state employees provided under this section is                                   
12       subject to the requirements of AS 21.42.427.                                                                  
13    * Sec. 6. AS 47.07.065 is amended by adding new subsections to read:                                               
14            (b)  The department shall pay for                                                                            
15 (1)  prescription contraceptives intended to last for a 12-month period                                                 
16 for subsequent dispensings of the same prescription contraceptive if prescribed to and                                  
17 requested by the recipient, regardless of whether the recipient was receiving medical                                   
18       assistance at the time of the first dispensing; and                                                               
19 (2)  consultations, examinations, procedures, and medical services that                                                 
20       are necessary to                                                                                                  
21 (A)  prescribe, dispense, insert, distribute, or administer                                                             
22            prescription contraceptives; or                                                                              
23                      (B)  remove prescription contraceptives.                                                           
24 (c)  Nothing in this section requires itemized reimbursement when a service is                                          
25       reimbursable as part of a bundled or composite rate.                                                              
26 (d)  In this section, "prescription contraceptive" means a drug or device that                                          
27 requires a prescription and is approved by the United States Food and Drug                                              
28       Administration to prevent pregnancy.                                                                              
29    * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to                          
30 read:                                                                                                                   
31 MEDICAID STATE PLAN INSTRUCTIONS; NOTICE TO REVISOR OF                                                                  
01 STATUTES. The Department of Health and Social Services shall immediately amend and                                      
02 submit for federal approval a state plan for medical assistance coverage consistent with                                
03 AS 47.07.065(b) - (d), added by sec. 6 of this Act. The Department of Health and Social                                 
04 Services shall apply to the United States Department of Health and Human Services for any                               
05 waivers necessary to implement AS 47.07.065(b) - (d), added by sec. 6 of this Act. The                                  
06 commissioner of health and social services shall notify the revisor of statutes in writing if the                       
07 United States Department of Health and Human Services approves the provisions of                                        
08 AS 47.07.065(b) - (d), added by sec. 6 of this Act.                                                                     
09    * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to                          
10 read:                                                                                                                   
11 CONDITIONAL EFFECT. AS 47.07.065(b) - (d), added by sec. 6 of this Act, take                                            
12 effect only if the commissioner of health and social services notifies the revisor of statutes in                       
13 writing under sec. 7 of this Act, on or before January 1, 2020, that the provisions of                                  
14 AS 47.07.065(b) - (d), added by sec. 6 of this Act, have been approved by the United States                             
15 Department of Health and Human Services.