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HB 135: "An Act relating to medical assistance for needy persons; relating to material incorporated by reference; relating to payment for prescribed drugs; and providing for an effective date."

00                             HOUSE BILL NO. 135                                                                          
01 "An Act relating to medical assistance for needy persons; relating to material                                          
02 incorporated by reference; relating to payment for prescribed drugs; and providing for                                  
03 an effective date."                                                                                                     
04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
05    * Section 1.  AS 47.05.012 is amended by adding new paragraphs to read:                                            
06                 (15) the preferred drug list established and adopted by the department,                                 
07       as defined in AS 47.07.065(b);                                                                                    
08                 (16) prior authorization medications list under a state program                                         
09       permitted under 42 U.S.C. 1396r-8.                                                                                
10    * Sec. 2.  AS 47.07.020(a) is amended to read:                                                                     
11 (a)  All residents of the state for whom the Social Security Act requires                                               
12 Medicaid coverage are eligible to receive medical assistance under 42 U.S.C. 1396 -                                     
13 1396p (Title XIX, Social Security Act), except the department is not required to                                    
14 cover individuals who are eligible for medical assistance under this section as a                                   
01       result of the expansion authorized by P.L. 111-148 (Patient Protection and                                    
02       Affordable Care Act).                                                                                         
03    * Sec. 3.  AS 47.07.020 is amended by adding a new subsection to read:                                             
04            (o)  Notwithstanding (a) and (b) of this section, the department may not add a                               
05       new category of eligible persons to the medical assistance program unless authorized                              
06       by law.                                                                                                           
07    * Sec. 4.  AS 47.07 is amended by adding a new section to read:                                                    
08            Sec. 47.07.022. Coverage for eligible individuals. If the department covers                                
09       individuals who are eligible for medical assistance under AS 47.07.020 as a result of                             
10 the expansion authorized by 42 U.S.C. 18001 (2010) (Patient Protection and                                              
11       Affordable Care Act), it shall                                                                                    
12 (1)  provide third party payer coverage through a state-paid premium                                                    
13       authorized by a waiver obtained under AS 47.07.030(c); or                                                         
14 (2)  provide coverage through the state-paid medical assistance                                                         
15       program.                                                                                                          
16    * Sec. 5.  AS 47.07.030(c) is amended to read:                                                                     
17 (c)  Notwithstanding (b) of this section, unless legislative approval is                                            
18 required under federal law, the department may offer a service for which the                                        
19 department has received a waiver from the federal government [IF THE                                                    
20 DEPARTMENT WAS AUTHORIZED, DIRECTED, OR REQUESTED TO APPLY                                                              
21 FOR THE WAIVER BY LAW OR BY A CONCURRENT OR JOINT                                                                       
22       RESOLUTION OF THE LEGISLATURE].                                                                                   
23    * Sec. 6.  AS 47.07.036(b) is amended to read:                                                                     
24 (b)  The department, in implementing this section, shall take all reasonable                                            
25 steps to implement cost containment measures, including regulations, that do not                                    
26 eliminate program eligibility or the scope of services required or authorized under                                     
27 AS 47.07.020 and 47.07.030 before implementing cost containment measures under                                          
28 (c) of this section that directly affect program eligibility or coverage of services. The                               
29 cost containment measures taken under this subsection may include new utilization                                       
30 review procedures, changes in provider payment rates, precertification requirements                                     
31 for coverage of services, and agreements with federal officials under which the federal                                 
01       government will assume responsibility for coverage of some individuals or some                                    
02       services for some individuals through such federal programs as the Indian Health                                  
03       Service or Medicare.                                                                                              
04    * Sec. 7.  AS 47.07.065 is amended by adding a new section to read:                                                
05 (b)  The department shall take reasonable measures to capture cost savings and                                          
06 cost containment for prescribed drugs under the medical assistance program through                                      
07 the adoption and updating of a preferred drug list and a prior authorization                                            
08 medications list under a state program permitted under 42 U.S.C. 1396r-8 (Title XIX,                                    
09       Social Security Act). For the purposes of this section,                                                           
10 (1)  a preferred drug list means a list of prescription medications within                                              
11 a therapeutic class and suggested as the first choice when prescribed for individuals                                   
12       within the medical assistance program;                                                                            
13 (2)  cost savings and cost containment measures include pursuing and                                                    
14 securing negotiated rates, rebates, contracts or other agreements on covered outpatient                                 
15       drugs.                                                                                                            
16    * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to                          
17 read:                                                                                                                   
18 EMERGENCY REGULATIONS AUTHORIZED. In implementing the necessary cost                                                    
19 containment measures to ensure that persons eligible for medical assistance under AS 47.07                              
20 continue to receive essential medical care, the Department of Health and Social Services may                            
21 adopt emergency regulations under AS 44.62.250 necessary to implement the changes made                                  
22 by this Act.                                                                                                            
23    * Sec. 9.  The uncodified law of the State of Alaska is amended by adding a new section to                         
24 read:                                                                                                                   
25 MEDICAID: WAIVERS. The Department of Health and Social Services shall amend                                             
26 and apply for a section 1115 waiver under 42 U.S.C. 1315(a) to provide coverage through the                             
27 individual marketplace for individuals who are or may become eligible for medical assistance                            
28 under AS 47.07.020, as amended by secs. 2 and 3 of this Act, except that elderly, disabled, or                          
29 medically fragile recipients of medical assistance or other recipients of medical assistance                            
30 identified by the department will not be included in the section 1115 waiver.                                           
31    * Sec. 10. This Act takes effect immediately under AS 01.10.070(c).