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
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
16 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to
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
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).