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).