Legislature(2015 - 2016)BUTROVICH 205

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

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Public Testimony --
+= SB 74 MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES TELECONFERENCED
Heard & Held
+= SB 78 MEDICAL ASSISTANCE COVERAGE; REFORM TELECONFERENCED
Heard & Held
+ Presentations: TELECONFERENCED
+ DHSS Commissioner Davidson / Deputy Commissioner TELECONFERENCED
Jon Sherwood
+ Amanda Ryder, Legislative Finance (Medicaid TELECONFERENCED
Numbers)
+ Arnold Liebeldt / DHSS (Fiscal Notes) TELECONFERENCED
<Rescheduled from 3/30/15>
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         April 1, 2015                                                                                          
                           1:35 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Bert Stedman, Chair                                                                                                     
Senator Cathy Giessel, Vice Chair                                                                                               
Senator Bill Stoltze                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Pete Kelly                                                                                                              
Senator Johnny Ellis                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 78                                                                                                              
"An Act relating to medical  assistance reform measures; relating                                                               
to  eligibility  for  medical assistance  coverage;  relating  to                                                               
medical assistance  cost containment  measures by  the Department                                                               
of Health  and Social  Services; and  providing for  an effective                                                               
date."                                                                                                                          
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 74                                                                                                              
"An  Act relating  to  permanent fund  dividends;  relating to  a                                                               
medical  assistance  reform   program;  establishing  a  personal                                                               
health   savings   account   program   for   medical   assistance                                                               
recipients; relating  to the duties  of the Department  of Health                                                               
and    Social   Services;    establishing   medical    assistance                                                               
demonstration  projects;   and  relating   to  a  study   by  the                                                               
Department of Health and Social Services."                                                                                      
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 78                                                                                                                   
SHORT TITLE: MEDICAL ASSISTANCE COVERAGE; REFORM                                                                                
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
03/18/15       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/18/15       (S)       HSS, FIN                                                                                               
03/30/15       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/30/15       (S)       Heard & Held                                                                                           
03/30/15       (S)       MINUTE(HSS)                                                                                            
04/01/15       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB 74                                                                                                                   
SHORT TITLE: MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES                                                                            
SPONSOR(s): KELLY                                                                                                               
                                                                                                                                
03/13/15       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/13/15       (S)       HSS, STA, FIN                                                                                          
03/13/15       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/13/15       (S)       -- MEETING CANCELED --                                                                                 
03/23/15       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/23/15       (S)       Heard & Held                                                                                           
03/23/15       (S)       MINUTE(HSS)                                                                                            
04/01/15       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
AMANDA RYDER, Fiscal Analyst                                                                                                    
Legislative Finance Division                                                                                                    
Legislative Affairs Agency                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented information on SB 78.                                                                           
                                                                                                                                
JON SHERWOOD, Deputy Commissioner                                                                                               
Department of Health and Social Services (DHSS)                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Presented information on SB 78.                                                                           
                                                                                                                                
ROSS BEILING, CEO                                                                                                               
Medical Bidline, LLC                                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified on SB 74.                                                                                       
                                                                                                                                
BECKY HULTBERG, President/CEO                                                                                                   
Alaska State Hospital and Nursing Home Association                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified in favor of reform and expansion                                                                
concepts in SB 78.                                                                                                              
                                                                                                                                
JEFF JESSEE, CEO                                                                                                                
Alaska Mental Health Trust Authority (AMHTA)                                                                                    
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Testified in  favor of Medicaid  reform and                                                             
expansion in SB 78.                                                                                                             
                                                                                                                                
FRANK MCQUERY, representing himself                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in  opposition to the expansion of                                                             
Medicaid.                                                                                                                       
                                                                                                                                
JEREMY PRICE, State Director                                                                                                    
Americans for Prosperity                                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified  against further implementation of                                                             
the Affordable Care Act in Alaska.                                                                                              
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:35:07 PM                                                                                                                    
CHAIR BERT STEDMAN  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:35 p.m.  Present at the                                                               
call to order were Senators Stoltz, Giessel, and Chair Stedman.                                                                 
                                                                                                                                
           SB 78-MEDICAL ASSISTANCE COVERAGE; REFORM                                                                        
                                                                                                                                
1:36:01 PM                                                                                                                    
CHAIR  STEDMAN announced  the consideration  of SB  78 and  noted                                                               
that Legislative Finance would give a presentation.                                                                             
                                                                                                                                
1:36:56 PM                                                                                                                    
AMANDA  RYDER,  Fiscal  Analyst,  Legislative  Finance  Division,                                                               
Legislative Affairs  Agency, presented information on  SB 78. She                                                               
said  she  is responding  to  the  request  by the  committee  to                                                               
produce  graphs related  to Medicaid  history,  growth rate,  and                                                               
inflation impacts. She showed graphs  comparing the fiscal impact                                                               
of the  Governor's amended budget  and SB 74  and SB 78  on state                                                               
general funding and on state and federal total spend.                                                                           
                                                                                                                                
1:39:40 PM                                                                                                                    
MS. RYDER  turned to two graphs  that show the budget  history of                                                               
Medicaid, for general funds and for  total funds, as well as cost                                                               
per recipient.                                                                                                                  
                                                                                                                                
She  showed  graphs   depicting  inflation-adjusted  numbers  for                                                               
Anchorage and for Anchorage health care.                                                                                        
                                                                                                                                
1:42:44 PM                                                                                                                    
MS. RYDER  discussed a  graph of  Alaska's population  growth and                                                               
Medicaid enrollee growth.                                                                                                       
                                                                                                                                
She turned to  graphs of historical Medicaid  growth adjusted for                                                               
Anchorage inflation and cost per enrollee.                                                                                      
                                                                                                                                
1:46:09 PM                                                                                                                    
She   showed  graphs   of  historical   and  projected   Medicaid                                                               
appropriations  adjusted  for  medical  inflation  and  cost  per                                                               
recipient.                                                                                                                      
                                                                                                                                
1:48:11 PM                                                                                                                    
She  highlighted graphs  of the  projected Medicaid  growth rates                                                               
for general funds  and for all funds from 2006  to 2016, and from                                                               
2012 to 2016.                                                                                                                   
                                                                                                                                
1:49:11 PM                                                                                                                    
CHAIR STEDMAN  commented that it  is not as scary  when inflation                                                               
and population  growth is  considered, but  state revenue  is not                                                               
tied to those, unfortunately.                                                                                                   
                                                                                                                                
1:49:41 PM                                                                                                                    
JON  SHERWOOD,  Deputy  Commissioner, Department  of  Health  and                                                               
Social Services (DHSS), presented information  on SB 78. He began                                                               
by answering  a previous question  from Senator Stoltz  about the                                                               
PFD hold harmless provision, a  complicated piece of the bill. He                                                               
provided  background about  changes  in the  Affordable Care  Act                                                               
(ACA)  that  dealt  with  old  Aid  to  Families  with  Dependent                                                               
Children rules. Under  ACA, rules were changed  from income rules                                                               
to those based on modified adjusted  gross income, as well as who                                                               
is considered  in the household.  One difference is that  the old                                                               
rules  would  take  a  gross   income  amount  and  apply  income                                                               
"disregards,"  like child  care  expenses  and other  deductions.                                                               
Alaska applied for the disregard of  the PFD and it also provided                                                               
for a hold  harmless provision that says if a  person is required                                                               
to count  the PFD  and it  makes them  ineligible for  a program,                                                               
they can  continue to receive  benefits at state expense,  but it                                                               
is  paid out  of the  dividend  account, not  general funds.  The                                                               
person can continue to receive benefits  for up to four months if                                                               
the "disregard" makes them ineligible.                                                                                          
                                                                                                                                
Under the  old rules  income was considered  at "point  of time."                                                               
Under the new modified gross  income rules, income is annualized.                                                               
That is  significant so people  can move back and  forth smoothly                                                               
between the  exchange and Medicaid  as their income  changes, and                                                               
not  lose  eligibility.  States were  required  to  raise  income                                                               
standards to reflect the loss of the "disregards.                                                                               
                                                                                                                                
Because the expansion  group was not an  existing category, there                                                               
is  no provision  for making  such a  conversion. Income  for the                                                               
expansion  group  is annualized  and  the  PFD hold  harmless  no                                                               
longer provides  protection. There was  no easy solution  to this                                                               
problem. If  members of the  expansion group received a  PFD that                                                               
made  them ineligible  for Medicaid,  they would  be eligible  to                                                               
receive subsidized  insurance coverage through the  exchange with                                                               
minimal premiums  or cost-sharing. It  would be a  relative minor                                                               
loss of  benefits and it  would solve a  difficult administrative                                                               
problem.                                                                                                                        
                                                                                                                                
MR. SHERWOOD summarized  that the most practical  solution was to                                                               
exempt  these individuals  from the  hold harmless  provision and                                                               
they  would receive  subsidized coverage  from the  exchange. All                                                               
existing  beneficiaries  would  not be  impacted;  the  expansion                                                               
group would be the only one this applies to.                                                                                    
                                                                                                                                
1:58:46 PM                                                                                                                    
SENATOR  STOLTZE clarified  that the  hold harmless  provision is                                                               
such that,  "We pay up  to four months  of benefits so  people on                                                               
welfare can continue  to receive the dividend. That  comes out of                                                               
every  other Alaskan's  dividend." He  asked Mr.  Sherwood if  he                                                               
would like to  extend that benefit to the  potentially new 42,000                                                               
beneficiaries.                                                                                                                  
                                                                                                                                
MR. SHERWOOD said  state law would compel them to  do it, so they                                                               
proposed the exemption to satisfy the requirement.                                                                              
                                                                                                                                
SENATOR  STOLTZE  asked if  the  first  approach  was to  try  to                                                               
continue the hold harmless provision.                                                                                           
                                                                                                                                
MR. SHERWOOD said yes.                                                                                                          
                                                                                                                                
SENATOR  STOLTZE  asked  if  the exemption  would  apply  to  all                                                               
dividend  recipients in  a family.  He wondered  if there  was an                                                               
option for declining a PFD.                                                                                                     
                                                                                                                                
MR. SHERWOOD explained that in  the Medicaid application there is                                                               
a requirement for a person to  apply for income they are eligible                                                               
for, which would include one's PFD.                                                                                             
                                                                                                                                
SENATOR  STOLTZE  asked if  families  can  decline to  apply  for                                                               
minor's PFD's, which they then can collect when they reach 18.                                                                  
                                                                                                                                
MR. SHERWOOD said  he would have to look into  that. It generally                                                               
does  not happen.  Expansion cases  are primarily  adults without                                                               
children.                                                                                                                       
                                                                                                                                
2:02:50 PM                                                                                                                    
SENATOR STOLTZE asked if a  dependent's dividend is calculated as                                                               
part of the family's income.                                                                                                    
                                                                                                                                
MR.  SHERWOOD said  for  the Medicaid  population  all income  is                                                               
included. There  are some  exceptions. Those who  do not  have to                                                               
file tax returns, their incomes don't count.                                                                                    
                                                                                                                                
SENATOR STOLTZE requested a written explanation.                                                                                
                                                                                                                                
CHAIR STEDMAN  asked the department  to prepare  that information                                                               
for the committee.                                                                                                              
                                                                                                                                
SB 78 was held in committee.                                                                                                    
                                                                                                                                
         SB 74-MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES                                                                      
                                                                                                                                
2:05:10 PM                                                                                                                    
CHAIR STEDMAN  announced the  consideration of  SB 74.  He opened                                                               
public testimony.                                                                                                               
                                                                                                                                
ROSS BEILING, CEO,  Medical Bidline, LLC, testified on  SB 74. He                                                               
provided  information about  his  business.  He discussed  reform                                                               
efforts  in  light of  the  economic  situation. He  listed  what                                                               
services  his  company provides.  He  suggested  looking at  cost                                                               
reforms in  health care. He  said there has not  been competition                                                               
in health care and it has  led to expensive equipment. He said we                                                               
cannot afford not to get Medicaid expansion right.                                                                              
                                                                                                                                
2:10:33 PM                                                                                                                    
CHAIR STEDMAN asked Mr. Beiling if  he is requesting the state to                                                               
lower  its costs  by using  used or  reconditioned equipment.  He                                                               
asked what his bottom line is.                                                                                                  
                                                                                                                                
MR. BEILING  stated that the  state should engage  in competitive                                                               
bidding because it levels the playing field.                                                                                    
                                                                                                                                
CHAIR STEDMAN asked for clarification.                                                                                          
                                                                                                                                
MR.  BEILING  said  it  should   be  for  new  and  used  medical                                                               
equipment.                                                                                                                      
                                                                                                                                
2:13:03 PM                                                                                                                    
BECKY HULTBERG, President/CEO, Alaska  State Hospital and Nursing                                                               
Home  Association  (ASHNHA), testified  in  favor  of reform  and                                                               
expansion concepts  in SB  78. She said  ASHNHA supports  many of                                                               
the reform concepts  in both bills. She opined  that expansion is                                                               
necessary as  part of  improving Medicaid.  She pointed  out that                                                               
hospitals  support Medicaid  expansion due  to the  potential for                                                               
reduction in  costs of uncompensated  care and to  provide fiscal                                                               
and economic benefits. Reforms are  also necessary to improve the                                                               
Medicaid system.                                                                                                                
                                                                                                                                
2:15:05 PM                                                                                                                    
MS. HULTBERG  pointed out  that the  department has  already been                                                               
involved in  reform. She stressed  the importance of  "paying for                                                               
value."  She  gave  two  examples   of  payment  reform,  one  in                                                               
Ketchikan and the other in Central Peninsula Hospital.                                                                          
                                                                                                                                
She  disagreed  with the  idea  that  reform should  come  before                                                               
expansion.  Reform is  an on-going  process. She  maintained that                                                               
Medicaid must  evolve at the  same pace as reform.  She disagreed                                                               
that  innovation  and  change require  resources.  Providers  are                                                               
going to have  to take risk and innovate to  create new models of                                                               
care. She  suggested capital for  change can come  from reduction                                                               
in uncompensated care.                                                                                                          
                                                                                                                                
She concluded that  reform is achievable and expansion  is key to                                                               
achieving reform.                                                                                                               
                                                                                                                                
2:19:04 PM                                                                                                                    
SENATOR  STOLTZE  requested  Ms.   Hultberg  to  comment  on  the                                                               
previous speaker's ideas.                                                                                                       
                                                                                                                                
MS. HULTBERG  said she is  not familiar  with the details  of Mr.                                                               
Beiling's  proposals.  She  agreed   competition  is  a  positive                                                               
principle.                                                                                                                      
                                                                                                                                
SENATOR STOLTZE questioned the role of competition in hospitals.                                                                
                                                                                                                                
2:20:33 PM                                                                                                                    
JEFF JESSEE,  CEO, Alaska Mental Health  Trust Authority (AMHTA),                                                               
testified in favor of Medicaid reform  and expansion in SB 78. He                                                               
explained that  the reform  elements in both  bills are  vital in                                                               
order to protect  AMHTA beneficiaries in the long  run. He stated                                                               
that expansion  is critically important to  beneficiaries because                                                               
there are  many beneficiaries that  do not have any  health care.                                                               
Reform  ideas in  both bills  would go  a long  way to  stabilize                                                               
Medicaid and would be a positive fiscal move.                                                                                   
                                                                                                                                
He said expansion should be looked  at because other parts of the                                                               
state budget  could also be brought  under the same kind  of cost                                                               
control. He  used Corrections  as an example  of a  department in                                                               
need  of sustainability.  Recidivism  is  prevented by  providing                                                               
support  for   recovery  and  health   care.  There  is   now  an                                                               
opportunity  to   have  90  percent   coverage  by   the  federal                                                               
government   of  support   for   recovery   in  the   Corrections                                                               
population.  He  stressed that  when  the  Corrections budget  is                                                               
controlled, then other departments'  budgets are affected; Public                                                               
Defender, Department of  Law, Court System, the  troopers and the                                                               
police.                                                                                                                         
                                                                                                                                
He concluded  that the Trust  is supportive of reform  efforts in                                                               
both bills, and the expansion in SB 78.                                                                                         
                                                                                                                                
2:26:38 PM                                                                                                                    
FRANK MCQUERY,  representing himself, testified in  opposition to                                                               
the expansion  of Medicaid.  He said the  bigger the  system, the                                                               
more difficult  it is to be  controlled. He gave an  example of a                                                               
problem  with checking  financial  eligibility  for Medicaid.  He                                                               
said reform  is needed before  expansion. He maintained  that the                                                               
system will not  work for the neediest beneficiaries.  He did not                                                               
believe expansion would work.                                                                                                   
                                                                                                                                
2:31:10 PM                                                                                                                    
JEREMY   PRICE,  State   Director,   Americans  for   Prosperity,                                                               
testified against  further implementation of the  Affordable Care                                                               
Act in Alaska.  He noted a portion of  Alaska's financial report,                                                               
noting  defects  in  Medicaid's accounting  system.  He  said  he                                                               
agrees with the reform ideas in SB 74.                                                                                          
                                                                                                                                
2:35:11 PM                                                                                                                    
SENATOR STOLTZE  asked Mr.  Price what  outreach he  has received                                                               
from DHSS.                                                                                                                      
                                                                                                                                
MR. PRICE said none.                                                                                                            
                                                                                                                                
SB 74 was held in committee.                                                                                                    
                                                                                                                                
2:36:09 PM                                                                                                                    
There  being  nothing  further  to  come  before  the  committee,                                                               
Chair  Stedman adjourned  the Senate  Health and  Social Services                                                               
Standing Committee at 2:36 p.m.                                                                                                 
                                                                                                                                

Document Name Date/Time Subjects
SB 74 Supporting Documents - Legislative Finance Graphs.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Sponsor Statement.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Supporting Documents - NPR HSAs for Medicaid.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Ver H.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Bill Hearing Request SHSS.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
Fiscal Note 17.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
Fiscal note narrative 031715.doc SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
Governor Walker Medicaid Expansion and Reform - House Bill.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
Governor Walker Medicaid Expansion and Reform - Senate Bill.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
Hearing Request from Governor Walker.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
SB 74 Supporting Documents - LRS Report 15.284.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
Medicaid expansion and reform fact sheet.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
SB 74 Sectional Analysis.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB078 S HSS hearing request.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
Fiscal Note SB 23.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 23
SB 78 S-HSS.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
SB 74 Fiscal Notes 233.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 242.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
Walker_Medicaid_Fiscal_Note_Overview.PDF SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74 Fiscal Notes 317.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 354.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 2077.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 2660.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 78 Sectional.docx SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
SB 74 Fiscal Notes 2662.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 2663.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 2696.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 2787.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 2880.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 3099.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Congregation Sukkat Shalom.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 74 Fiscal Notes 309.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
Supporters of Medicaid Reform.docx SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78
SB 74 Supporting Document - Aetna Letter 3.27.15.pdf SHSS 3/23/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
3-30-15 Medicaid History and Projection PPT (SB74 and SB78).pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 74
SB 78
APRN Info page.pdf SHSS 3/30/2015 1:30:00 PM
SHSS 4/1/2015 1:30:00 PM
SB 78