Legislature(2005 - 2006)HOUSE FINANCE 519
05/09/2005 08:30 AM House FINANCE
| Audio | Topic |
|---|---|
| Start | |
| SB153 | |
| HB68 | |
| SB22 | |
| SB164 | |
| SB22 | |
| SB135 | |
| SB73 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 153 | TELECONFERENCED | |
| + | SB 22 | TELECONFERENCED | |
| + | SB 164 | TELECONFERENCED | |
| + | SB 135 | TELECONFERENCED | |
| += | HB 68 | TELECONFERENCED | |
| += | SB 73 | TELECONFERENCED | |
| + | TELECONFERENCED |
CS FOR SENATE BILL NO. 22(FIN)
"An Act adding birthing centers to the list of health
facilities eligible for payment of medical assistance
for needy persons."
RICHARD BENAVIDES, STAFF, SENATOR BETTYE DAVIS, explained SB
22 would add birthing center fees to Medicaid
reimbursements.
9:03:07 AM
Co-Chair Chenault asked about fiscal note #2 by the
Department of Health and Social Services. He noted that
there is a great deal of uncertainty in calculating the cost
differential between birth center and hospital births. Mr.
Benavides explained problems that result from complicated
births.
Representative Hawker asked if birthing centers are eligible
for Medicaid. Mr. Benavides replied that if they were
approved they would be. Representative Hawker suggested
that this should be figured out first.
9:05:29 AM
JERRY FULLER, MEDICAID DIRECTOR, DEPARTMENT OF HEALTH AND
SOCIAL SERVICES, explained Medicaid services and how
approval is obtained. He explained the intent of the bill.
Representative Hawker referred to spies and the risks of
adding this authority in statute if Medicaid says no. Mr.
Fuller clarified the intent of the second part of the
amendment. The language needs clarification.
Representative Hawker suggested legal clarification
regarding an alternative to existing Medicaid coverage. Mr.
Benavides pointed out that that was the intent, so it is not
open to a need to use general funds. Representative Hawker
emphasized that it is unclear and needs work.
9:09:29 AM
Representative Croft noted that in the statute "if" is the
key to understanding the intent. He implied that it is
clear that birthing centers are a health facility only if
the plan is approved. Representative Hawker asked for legal
clarification on the state and federal regulations. Mr.
Benavides suggested that there is no such person who could
speak to both regulations, and the CS takes care of the
problem.
9:11:11 AM
Representative Holm inquired if the state, by reference, is
giving birthing center stays equal status to a hospital
stay, especially regarding C-sections. He wondered about
liability in that situation. Mr. Benavides replied that
birthing centers work out that situation with the closest
medical facility and assume that risk. Representative Holm
restated his question. Mr. Benavides said birthing center
births are comparable to births at a hospital.
Mr. Fuller added that he does not believe there is any
difference between liability of home births and birthing
center births. Representative Holm said it indicates that
there is a possible financial burden on the state.
9:14:56 AM
Representative Kelly asked if the law is necessary for the
program to continue. He asked why the law is needed in
advance of program approval. Mr. Benavides replied that
nothing can be added to Medicaid programs unless it has been
approved by the legislature. Birthing centers are growing
in Alaska and this is an attempt to make them eligible for
Medicaid services.
Representative Hawker referred to the optional services list
and opined that the bill does not address it. Mr. Benavides
agreed.
Representative Croft agreed with Representative Kelly's
interpretation about which came first. He opined that the
bill does allow for an option which is not currently
offered.
9:19:19 AM
Representative Kelly asked if this bill covers mid-wife
delivery. Mr. Benavides explained that the bill does not
address home birth services, because that is already
covered. It addresses the birthing facility, which is
currently not covered.
Vice-Chair Stoltze noted that it contains a zero fiscal note
with red flags.
Co-Chair Meyer wondered if a letter of intent would be
helpful.
9:21:46 AM
Representative Hawker noted that Medicaid is already paying
for more than half of all births in Alaska. He said he is
not in favor of expanding this service.
SB 22 was set aside for later consideration.
9:23:17 AM
CS FOR SENATE BILL NO. 22(FIN)
"An Act adding birthing centers to the list of health
facilities eligible for payment of medical assistance
for needy persons."
9:59:54 AM
Representative Hawker requested a legal opinion about the
fiscal notes and an assurance that this bill would do no
more than offer an alternative to the existing Medicaid
obligations.
SENATOR BETTYE DAVIS, sponsor, stated that the manner in
which the bill is written, will give the department an
opportunity to ask for an amendment to the state plan. It
does not obligate the state to do anything.
10:01:24 AM
STACY KRALY, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW,
(via teleconference) explained that testimony by Senator
Davis was correct. There would not be a federal Medicaid
match unless the services were authorized under the state
plan.
10:02:17 AM
Representative Hawker reiterated his query. He wondered if
this legislation would create a new, expanded Medicaid
service. Ms. Kraly replied that the way that the proposal
was being offered, it would be in lieu of a hospital stay.
It would not be an expansion of a service, there would not
be an additional service, but rather an offset.
10:03:42 AM
Senator Davis added that the bill is an opportunity to
provide a choice of using birthing centers for delivery.
The facility fee would cost less than it would cost in a
hospital. The services would be paid for regardless, and
would not obligate the state for any other monies. She
stressed that nothing will happen on the bill at this time,
and that she expected members to pass the bill.
10:05:56 AM
Representative Foster MOVED to report CSSB 22 (FIN) out of
Committee with individual recommendations and with the
accompanying fiscal note.
CSSB 22 (FIN) was REPORTED out of Committee with a "no
recommendation" recommendation and with a zero fiscal impact
note by the Department of Health and Social Services.
10:06:40 AM
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