05/05/2006 09:00 AM Senate FINANCE

9:08:36 AM                                                                                                                    
                                                                                                                                
                                                                                                                                
     CS FOR HOUSE BILL NO. 105(FIN)                                                                                             
     "An  Act  relating to  coverage  for  adult dental  services                                                               
     under Medicaid; and providing for an effective date."                                                                      
                                                                                                                                
                                                                                                                                
This was the  second hearing for this bill in  the Senate Finance                                                               
Committee.                                                                                                                      
                                                                                                                                
Co-Chair Green noted Co-Chair Wilken  had raised questions at the                                                               
previous hearing and has drafted  language with assistance of the                                                               
bill sponsor.                                                                                                                   
                                                                                                                                
9:09:11 AM                                                                                                                    
                                                                                                                                
Amendment #1:  This amendment inserts "Subject  to appropriation,                                                               
the"  to subsection  (a)  of Sec.  47.07.067.  Payment for  adult                                                               
dental services., added through Section 2 on page 2, line 5.                                                                    
                                                                                                                                
This amendment  also inserts a  new subsection to  Sec. 47.07.067                                                               
on page 2, following line 13 to read as follows.                                                                                
                                                                                                                                
          (b) On or before June 30 of each fiscal year, the                                                                     
     department  shall review  appropriations  available for  the                                                               
     purposes of this section for  the following fiscal year, and                                                               
     estimate  the scope  of services  to be  used and  number of                                                               
     eligible  recipients anticipated  to  be  served during  the                                                               
     following  fiscal year.  Notwithstanding the  maximum amount                                                               
     of  benefits  specified  in  (a)(1)  of  this  section,  the                                                               
     department  shall  reduce,  by  regulation,  that  specified                                                               
     maximum amount of benefits for  the following fiscal year if                                                               
     the  department's  estimates  under  this  subsection  would                                                               
     exceed  appropriations  available   for  that  fiscal  year.                                                               
     Notwithstanding any  contrary provision of AS  44.62.250 and                                                               
     44.62.260,  the department  may adopt  emergency regulations                                                               
     to implement this subsection.                                                                                              
                                                                                                                                
Co-Chair  Wilken moved  for adopted  and objected  to provide  an                                                               
explanation.                                                                                                                    
                                                                                                                                
Co-Chair Wilken expressed concern about  the cost of this program                                                               
and his intent  that it not "grow uncontrolled",  as has occurred                                                               
with other  programs. He  informed the  Department of  Health and                                                               
Social  Services  that  he  would   not  support  a  supplemental                                                               
appropriation, if requested, the following legislative session.                                                                 
                                                                                                                                
9:10:37 AM                                                                                                                    
                                                                                                                                
JANET CLARKE,  Assistant Commissioner,  Department of  Health and                                                               
Social Services,  testified that in meeting  with Co-Chair Wilken                                                               
she learned  his intent to  consider language that would  place a                                                               
tighter restraint on  spending. He also wanted a  letter from the                                                               
commissioner  outlining a  plan to  operate the  proposed program                                                               
within  the  allocated  funding   amount.  Co-Chair  Wilken  also                                                               
intended to allocate  these funds in a  separate appropriation to                                                               
allow the legislature to track the funds independently.                                                                         
                                                                                                                                
Ms. Clarke stated that a new  fiscal note was prepared to reflect                                                               
the  intentions of  Co-Chair Wilken.  She explained  that funding                                                               
allocated  through   a  separate   appropriation  could   not  be                                                               
transferred to another Budget Request Unit (BRU) component.                                                                     
                                                                                                                                
STACIE  KRALY,   Chief  Assistant  Attorney   General,  Statewide                                                               
Section  Supervisor,  Human  Services  Section,  Civil  Division,                                                               
Department  of  Law,  testified that  the  amendment  before  the                                                               
Committee would provide  for a yearly adjustment  of the program.                                                               
At the conclusion  of each fiscal year, the  Department of Health                                                               
and  Social  Services  make  a determination  of  the  number  of                                                               
participants  of  the  program  the  previous  fiscal  year,  the                                                               
services  provided and  the amount  expended.  If costs  exceeded                                                               
allocation, the maximum benefit amount  for each patient would be                                                               
reduced on  a pro rata  basis. All  patients would be  allowed to                                                               
participate;  however,   fewer  funds  would  be   available  for                                                               
preventive maintenance procedures.                                                                                              
                                                                                                                                
9:14:26 AM                                                                                                                    
                                                                                                                                
Co-Chair  Green asked  if the  provisions of  the amendment  were                                                               
consistent   with  the   letter  of   intent  accompanying   this                                                               
legislation that was adopted by the House of Representatives.                                                                   
                                                                                                                                
Ms. Clarke affirmed.                                                                                                            
                                                                                                                                
9:14:45 AM                                                                                                                    
                                                                                                                                
Co-Chair  Wilken removed  his objection  to the  adoption of  the                                                               
amendment.                                                                                                                      
                                                                                                                                
Without further objection the amendment was ADOPTED.                                                                            
                                                                                                                                
9:14:54 AM                                                                                                                    
                                                                                                                                
Co-Chair Wilken commented  that many people would  be eligible to                                                               
receive services  through this program;  however, it  was brought                                                               
to  his  attention  that  an   insufficient  number  of  dentists                                                               
operating in the state accept  Medicaid. Some dentists list their                                                               
reasons as  Medicaid reimbursement for services  is inadequate to                                                               
cover the  cost of delivery,  too many Medicaid  covered patients                                                               
fail  to  keep  appointments,  and   liability.  He  intended  to                                                               
collaborate  with the  Department to  entice dentists  to provide                                                               
this care.  Such enticement would  not be possible  under current                                                               
statute and he did not intend  to include any relevant changes in                                                               
this  legislation. However,  he would  address the  issue in  the                                                               
future. He supported the proposed program.                                                                                      
                                                                                                                                
9:17:03 AM                                                                                                                    
                                                                                                                                
Co-Chair Wilken moved  for adoption of a letter  of intent signed                                                               
by the Committee's co-chairs.                                                                                                   
                                                                                                                                
Co-Chair Wilken  offered a  motion to report  CS HB  105(FIN), as                                                               
amended, from  Committee with individual  recommendations, letter                                                               
of intent, and a new fiscal note.                                                                                               
                                                                                                                                
There was  no objection and  SCS CS HB  105 (FIN) was  MOVED from                                                               
Committee with  a letter of  intent and  a new fiscal  note dated                                                               
5/4/06 in the amount of  $2,633,000 from the Department of Health                                                               
and Social Services.