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.