Legislature(2015 - 2016)BUTROVICH 205

04/08/2015 01:30 PM Senate HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 53 ADVANCED PRACTICE REGISTERED NURSES TELECONFERENCED
Heard & Held
*+ SB 90 MEDICAID: USED DURABLE MEDICAL EQUIPMENT TELECONFERENCED
Heard & Held
+ HB 4 AUTOMATED EXTERNAL DEFIBRILLATOR TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled:
+= SB 74 MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES TELECONFERENCED
Heard & Held
         SB 74-MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES                                                                      
                                                                                                                                
1:31:12 PM                                                                                                                    
CHAIR  STEDMAN announced  the  consideration of  SB  74. He  noted                                                              
that his  staff, the sponsor's staff,  and the Departments  of Law                                                              
and Health and Social  Services have been working hard  on the new                                                              
CS for SB 74.                                                                                                                   
                                                                                                                                
REPRESENTATIVE  KELLY moved  to adopt  the CS  for SB 74,  labeled                                                              
29-LS0692\I, as the working document.                                                                                           
                                                                                                                                
CHAIR STEDMAN objected for discussion.                                                                                          
                                                                                                                                
RANDY   RUARO,  Staff,   Senator   Bert  Stedman,   Alaska   State                                                              
Legislature,  addressed the  changes  in version  I of  SB 74.  He                                                              
read from the following:                                                                                                        
                                                                                                                                
The  committee  substitute  for   SB  74,  version  I,  makes  the                                                              
following substantive changes:                                                                                                  
                                                                                                                                
   · Deletes Sections 1 and 3 of SB 74 related to health savings                                                                
     accounts and funding the accounts with 10% of a recipients                                                                 
     permanent fund dividend.                                                                                                   
                                                                                                                                
   · As a conforming change, deletes language in Section 4 of SB
     74 that would have put a sunset date on the health savings                                                                 
     account provisions.                                                                                                        
                                                                                                                                
   · Adds a new Section 1 related to false claims for medical                                                                   
     assistance and providing for a civil penalty to be imposed                                                                 
     by either a court or an administrative agency and providing                                                                
     for enhanced damages to be awarded to the state.                                                                           
                                                                                                                                
   · Amends Section 2 of SB 74 to make a conforming change by                                                                   
     deleting subparagraph (1) which related to health savings                                                                  
     accounts and renumbering the remaining subparagraphs.                                                                      
                                                                                                                                
   · Amends Section 2, subparagraph (2) of SB 74 by adding                                                                      
     language requiring the DHSS reform program to include                                                                      
     referrals for career and education services.                                                                               
                                                                                                                                
   · Amends Section 2, subparagraph (4) of SB 74 by adding                                                                      
     "behavioral health" to the list of services that                                                                           
     telemedicine should be expanded to include.                                                                                
                                                                                                                                
   · Amends Section 2, subparagraph (9) of SB 74 by adding                                                                      
     language providing that the payment process should be                                                                      
     reformed by implementing fee agreements based on                                                                           
     performance measures that include premium payments for                                                                     
    centers of excellence and penalties for certain hospital                                                                    
    related outcomes, such as hospital acquired infections,                                                                     
     readmissions, and failures of outcomes.                                                                                    
                                                                                                                                
   · Amends Section 2, of SB 74 by adding a new section (b) that                                                                
    requires the identify areas where access to telemedicine                                                                    
     would be most effective and to coordinate with Indian                                                                      
     Health Services providers where appropriate to gain access                                                                 
     to telemedicine equipment.                                                                                                 
                                                                                                                                
   · Amends Section 2(b) of SB 74, the report section on reforms                                                                
     by changing the annual report due date from 10 days after                                                                  
     session starts to October 15 of each year, and adds a                                                                      
     number of subparagraphs in (4) - (13) that are designed to                                                                 
     provide information to the legislature on the progress of                                                                  
     reforms and other information relevant to management of the                                                                
     program.                                                                                                                   
                                                                                                                                
  · Amends Section 2 of SB 74 by adding a new section (d) that                                                                  
     is a definition of telemedicine.                                                                                           
                                                                                                                                
   · Section 3 of version I relates to direction to the                                                                         
     department on reducing use of emergency room services.                                                                     
     This was Section 6 in the original version of SB 74.  There                                                                
     was no change between the two sections other than                                                                          
     numbering.                                                                                                                 
                                                                                                                                
   · Section 4, the repeal section of SB 74 is deleted.  It                                                                     
     repealed the health savings account sections and the reform                                                                
     sections.  While reform provisions are included in version                                                                 
     I, they are not subject to sunset.                                                                                         
                                                                                                                                
  · It is replaced with a new Section 4 relating to efforts at                                                                  
     fighting fraud or waste of Medicaid funds and reporting the                                                                
     results to the Legislature.                                                                                                
                                                                                                                                
   · Section 5 of SB 75, the section on managed care and a                                                                      
     demonstration project using persons enrolled in Denali                                                                     
     KidCare has been amended to be broader in scope in terms of                                                                
     both the types of actions the Commissioner can take and the                                                                
     population groups in Medicaid that can be included.  This                                                                  
     provides flexibility to the department to obtain the                                                                       
     greatest possible coverage and savings.                                                                                    
                                                                                                                                
   · The rest of the sections in the CS are not substantively                                                                   
    different than SB 74 or are related to implementation of                                                                    
    the bill, Section 7 (Medicaid Choice Waiver); Section 8                                                                     
     (Transition Regulations); Section 9 (Conditional Effect),                                                                  
     and Sections 6, 7, 8 have an immediate effective date.                                                                     
                                                                                                                                
1:38:43 PM                                                                                                                    
CHAIR  STEDMAN withdrew  his  objection.  There being  no  further                                                              
objections, version I was adopted.                                                                                              
                                                                                                                                
SENATOR   GIESSEL  requested   clarification  of   Section  2   on                                                              
telemedicine  and  the  cooperation  with  Indian  Health  Service                                                              
(IHS)  providers.   She  understood   that  IHS  has   been  using                                                              
telemedicine  for several years.  She asked  if the bill  suggests                                                              
providing private sector  access to the IHS structure  and if non-                                                              
beneficiaries would be charged for the service.                                                                                 
                                                                                                                                
MR. RUARO  explained that  the intent is  more general  than that.                                                              
The IHS  facilities have  been building  up telemedicine  capacity                                                              
over the years,  whereas the state doesn't have it  in some areas.                                                              
The idea in Section  2 is to urge the department  to work with IHS                                                              
and  take advantage  of  opportunities  of sharing  equipment  and                                                              
working together.                                                                                                               
                                                                                                                                
1:40:41 PM                                                                                                                    
SENATOR  GIESSEL summarized  that it  is more  of a  philosophical                                                              
statement of working together, rather than a contract.                                                                          
                                                                                                                                
MR.  RUARO  said  that  is  correct;   they  anticipate  that  the                                                              
department and IHS will work together.                                                                                          
                                                                                                                                
SENATOR GIESSEL  thought that was  realistic. She  appreciated not                                                              
duplicating services and costs.                                                                                                 
                                                                                                                                
1:41:57 PM                                                                                                                    
SENATOR GIESSEL  asked about new  subsection (d) which  includes a                                                              
definition of telemedicine.  She asked about other  definitions of                                                              
telemedicine in statute.                                                                                                        
                                                                                                                                
MR. RUARO did not know of any other definitions of telemedicine.                                                                
                                                                                                                                
SENATOR GIESSEL said  there are other definitions  and she offered                                                              
to compare them so they coincide.                                                                                               
                                                                                                                                
CHAIR STEDMAN held SB 74 in committee.                                                                                          
                                                                                                                                

Document Name Date/Time Subjects
APRN bill_diagram_for core message.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
APRN bill_core message 09_07_2014.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
AaNA Letter of Support for SB53 to Senator Stedman.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
APRN Info page.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
Letter re SB 53_Stedman_APRN-A_Juneau.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Fiscal Note APRN vsn N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Hearing Request SEN HSS.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Sectional Analysis vsn N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Sponsor Statement vsn N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AaNA 3-9-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AARP 3-3-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AK Affiliate ACNM 2-23-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AK Pharmacists 3-6-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support AKANA 2-22-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support ANPA 2-24-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support APRN Alliance 2-22-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support ASHNHA 3-5-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Bd of Nursing 3-9-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Dooley 3-6-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support FASDx Services 2-26-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Hartz 2-26-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Hiles 3-16-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Myers 2-24-2015.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Support Rader 2-22-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Version N.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
HB 4 Information Services Request.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB 04 Hearing Request Senate HSS.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB 4 Fiscal Note.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB 4 Testimony.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 AED Bill Power Point Presentation.pptx SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support for AED's AFCA.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support for AEDs Michael Levy MD.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 1 - Heart Rhythm Society Sudden Cardiac Arrest Fact Sheet.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 2 - What Is an Automated External Defibrillator.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 3 - Research report_ Effects of AED device features on performance by untrained laypersons.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Supporting Document 4 - Research report_ Automated external defibrillator use by untrained bystanders can the public use model work.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support - AHA.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Letter of Support - Dr BradleyAlaskaLtr2-4-15.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Sectional Analysis.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Sponsor Statement.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
HB04 Ver. A.pdf SHSS 4/8/2015 1:30:00 PM
HB 4
SB90 Support Material.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB90 Sponsor Statement.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB90 Hearing Request.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB90 ver A.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
SB53 Backup States Adopting APRN Consensus Model.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Backup Benefits of APRN model.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB53 Fiscal Note DCCED 4-7-15.pdf SHSS 4/8/2015 1:30:00 PM
SB 53
SB 90 Letter from AK PT Association.pdf SHSS 4/8/2015 1:30:00 PM
SB 90
CS SB 74 Version I.pdf SHSS 4/8/2015 1:30:00 PM
SB 74