Legislature(1995 - 1996)
04/12/1996 08:20 AM House FIN
Audio | Topic |
---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE BILL NO. 393 "An Act relating to managed care for recipients of medical assistance; and providing for an effective date." REPRESENTATIVE NORMAN ROKEBERG, sponsor of HB 393, spoke in support of the legislation. He noted that the bill asks the Department to draft legislation establishing a pilot program for Medicaid recipients in the state of Alaska. He emphasized that the legislation will expedite and give direction to the implementation of managed care. He noted that Medicaid is the second largest component in the State's budget after education. He observed that Medicaid funding has escalated. Over the past five years it has increased annually by 13.9 percent. He observed that Congress is focused on replacing Medicaid with MediGrants. MediGrants would be issued as block grants on a per capita basis. He emphasized the importance of planning for the implementation of national Medicaid and welfare legislation. He pointed out that 94 percent of all states have managed care principals. Alaska does not have any. Representative Rokeberg noted that the Department of Health & Social Services has awarded a contract to develop a report and plan for the development of a managed care program. He observed that the state of Oregon expanded services through savings realized by a managed care program. He emphasized that nationally 30 percent of the population is uninsured. He maintained that managed care will work in Alaska. He observed that there are examples of managed care programs in other small areas. He noted interest in rural areas. He asserted that managed care is coming. He maintained that the Legislature should be involved in the development and implementation of this major state policy. Representative Rokeberg provided members with a proposed committee substitute, Work Draft 9-LS1451\K, dated 4/10/96 (copy on file). He explained that the committee substitute would clarify the steps needed to implement the pilot program. "Competition" was also deleted. Representative Kelly noted that the Department of Health & Social Services intends to implement the program mandated by 4 HB 393 in June, 1996. Representative Rokeberg stressed that the Department intends to incrementally implement many of the procedures that are part of managed care. He noted the lack of debate regarding the issues surrounding managed care. He stated that the legislation would mandate that the process be hastened and that the legislature be involved. He emphasized the need to review statutes to assure that the State is capable of implementing a large managed care system. In response to a question by Representative Brown, Representative Rokeberg reiterated that Alaska does not have any managed care models. He envisioned the establishment of at least two population groups. He stated that the pilot could be set in an urban area with a rural component. He stressed that the group should contain single mothers. He noted that the program will take many years to implement. The pilot program will probably not incorporate mental health and developmentally disabled concerns. Representative Rokeberg discussed programs in Montana. He noted that information systems were installed to track information regarding the program. In response to a question by Representative Brown, Representative Rokeberg pointed out that the Medicaid fee schedule does not reimburse physicians for one hundred percent of their services. Representative Brown asked how the single mother in the pilot program would be affected. Representative Rokeberg noted that the primary care case management system (PPCCM) assigns patients a specific physician to manage their entire care. The physician will be the patients "gatekeeper" in the utilization of the plan. They would be the primary provider in addition to managing the patient's health care. Representative Brown asked if the gatekeeper/doctor will be able to decide without restrictions what the patient needs. She asked if the legislation would provide that the Governor or Department introduce draft legislation as a result of HB 393. Representative Rokeberg noted that the amendment would require that the Department work through the Governor (copy on file). Amendment 1 would also delete "authorize" and insert "provide for" on page 2, line 17. HARLAN KNUDSON, EXECUTIVE DIRECTOR, ALASKA HOSPITAL AND NURSING HOME ASSOCIATION testified in support of HB 393. He stressed that the cost of health care must be contained. He noted that the strength of managed care is that it provides an incentive for maintaining the patient's health. He asserted that managed care can work in Alaska. He 5 emphasized that the legislation directs the Department to work with the provider community. Representative Therriault MOVED to adopt Work Draft 9- LS1451\K, dated 4/10/96. There being NO OBJECTION, it was so ordered. Representative Therriault referred to a letter from the Tanana Chiefs Conference, dated 2/16/96 (copy on file). He noted that the letter raises questions regarding the participation of the Indian Health Service. Mr. Knudson emphasized that no one should be excluded. Representative Parnell asked if there is a compelling reason to keep the findings section in HB 393. BOB LABBE, DIRECTOR, DIVISION OF MEDICAL ASSISTANCE stated that the findings section directs the Department regarding the implementation of the pilot. He stated that the information is helpful. He emphasized the need to make Alaska's program specific to Alaska. (Tape Change, HFC 96-115, Side 2) Mr. Labbe stressed that HB 393 fits with the Department's plan. Representative Rokeberg stated that the intent of section 1 is to provide further direction to the Department. He noted that HB 393 mandates that the Governor bring back to the Legislature draft legislation. He observed that HB 393 will essentially sunset after January 1, 1997. Mr. Labbe pointed out that CSHB 393 (FIN) could be read to imply that the Department does not have authority to move forward on its current planning if HB 393 is enacted. This could inhibit the Department's attempts to manage Medicaid expenditures. Representative Parnell MOVED to adopt Amendment 1. There being NO OBJECTION, it was so ordered. Representative Parnell MOVED to report CSHB 393 (FIN) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. CSHB 393 (FIN) was reported out of Committee with a "do pass" recommendation and with a fiscal impact note by the Department of Health & Social Services, 3/27/97.
Document Name | Date/Time | Subjects |
---|