00 Enrolled SB 74 01 Relating to diagnosis, treatment, and prescription of drugs without a physical examination by 02 a physician; relating to the delivery of services by a licensed audiologist, speech-language 03 pathologist, professional counselor, marriage and family therapist, psychologist, 04 psychological associate, social worker, physical therapist, occupational therapist, and 05 registered speech-language pathologist assistant by audio, video, or data communications; 06 relating to the duties of the State Medical Board; relating to limitations of actions; 07 establishing the Alaska Medical Assistance False Claim and Reporting Act; relating to 08 medical assistance programs administered by the Department of Health and Social Services; 09 relating to the controlled substance prescription database; relating to the duties of the Board of 10 Pharmacy; relating to the duties of the Board of Dental Examiners; relating to the duties of 11 the Board of Nursing; relating to the duties of the Board of Examiners in Optometry; relating 01 to the duties of the Department of Commerce, Community, and Economic Development; 02 relating to the duties of the Department of Corrections; relating to accounting for program 03 receipts; relating to public record status of records related to the Alaska Medical Assistance 04 False Claim and Reporting Act; establishing a telemedicine business registry; relating to 05 verification of eligibility for public assistance programs administered by the Department of 06 Health and Social Services; relating to annual audits of state medical assistance providers; 07 relating to reporting overpayments of medical assistance payments; establishing authority to 08 assess civil penalties for violations of medical assistance program requirements; relating to 09 the duties of the Department of Health and Social Services; establishing medical assistance 10 demonstration projects; relating to Alaska Pioneers' Homes and Alaska Veterans' Homes; 11 relating to the duties of the Department of Administration; relating to the Alaska Mental 12 Health Trust Authority; relating to feasibility studies for the provision of specified state 13 services; relating to a report by the Board of Pharmacy, Board of Examiners in Optometry, 14 Board of Dental Examiners, Board of Nursing, and State Medical Board; amending Rules 4, 15 5, 7, 12, 24, 26, 27, 41, 77, 79, and 82, Alaska Rules of Civil Procedure; and providing for an 16 effective date. 17 _______________ 18  * Section 1. AS 08.11.080 is amended by adding new subsections to read: 19 (b) The department may not impose disciplinary sanctions on an audiologist 20 for the evaluation, diagnosis, or treatment of a person through audio, video, or data 21 communications when physically separated from the person if the audiologist 22 (1) or another licensed health care provider is available to provide 23 follow-up care; 24 (2) requests that the person consent to sending a copy of all records of 25 the encounter to a primary care provider if the audiologist is not the person's primary 01 care provider and, if the person consents, the audiologist sends the records to the 02 person's primary care provider; and 03 (3) meets the requirements established by the department in regulation. 04 (c) The department shall adopt regulations restricting the evaluation, 05 diagnosis, supervision, and treatment of a person as authorized under (b) of this 06 section by establishing standards of care, including standards for training, 07 confidentiality, supervision, practice, and related issues. 08  * Sec. 2. AS 08.11.083 is amended by adding new subsections to read: 09 (b) The department may not impose disciplinary sanctions on a speech- 10 language pathologist assistant for the evaluation, diagnosis, or treatment of a person 11 through audio, video, or data communications when physically separated from the 12 person if the speech-language pathologist assistant 13 (1) or another licensed health care provider is available to provide 14 follow-up care; 15 (2) requests that the person consent to sending a copy of all records of 16 the encounter to a primary care provider if the speech-language pathologist assistant is 17 not the person's primary care provider and, if the person consents, the speech-language 18 pathologist assistant sends the records to the person's primary care provider; and 19 (3) meets the requirements established by the board in regulation. 20 (c) The department shall adopt regulations restricting the evaluation, 21 diagnosis, supervision, and treatment of a person as authorized under (b) of this 22 section by establishing standards of care, including standards for training, 23 confidentiality, supervision, practice, and related issues. 24  * Sec. 3. AS 08.11.085 is amended by adding new subsections to read: 25 (b) The department may not impose disciplinary sanctions on a speech- 26 language pathologist for the evaluation, diagnosis, or treatment of a person through 27 audio, video, or data communications when physically separated from the person if the 28 speech-language pathologist 29 (1) or another licensed health care provider is available to provide 30 follow-up care; 31 (2) requests that the person consent to sending a copy of all records of 01 the encounter to a primary care provider if the speech-language pathologist is not the 02 person's primary care provider and, if the person consents, the speech-language 03 pathologist sends the records to the person's primary care provider; and 04 (3) meets the requirements established by the board in regulation. 05 (c) The department shall adopt regulations restricting the evaluation, 06 diagnosis, supervision, and treatment of a person as authorized under (b) of this 07 section by establishing standards of care, including standards for training, 08 confidentiality, supervision, practice, and related issues. 09  * Sec. 4. AS 08.29.400 is amended by adding new subsections to read: 10 (b) The board may not impose disciplinary sanctions on a licensee for the 11 evaluation, diagnosis, or treatment of a person through audio, video, or data 12 communications when physically separated from the person if 13 (1) the licensee or another licensed health care provider is available to 14 provide follow-up care; 15 (2) the licensee requests that the person consent to sending a copy of 16 all records of the encounter to a primary care provider if the licensee is not the 17 person's primary care provider and, if the person consents, the licensee sends the 18 records to the person's primary care provider; and 19 (3) the licensee meets the requirements established by the board in 20 regulation. 21 (c) The board shall adopt regulations restricting the evaluation, diagnosis, 22 supervision, and treatment of a person as authorized under (b) of this section by 23 establishing standards of care, including standards for training, confidentiality, 24 supervision, practice, and related issues. 25  * Sec. 5. AS 08.36.070(a) is amended to read: 26 (a) The board shall 27 (1) provide for the examination of applicants and the credentialing, 28 registration, and licensure of those applicants it finds qualified; 29 (2) maintain a registry of licensed dentists, licensed dental hygienists, 30 and registered dental assistants who are in good standing; 31 (3) affiliate with the American Association of Dental Boards and pay 01 annual dues to the association; 02 (4) hold hearings and order the disciplinary sanction of a person who 03 violates this chapter, AS 08.32, or a regulation of the board; 04 (5) supply forms for applications, licenses, permits, certificates, 05 registration documents, and other papers and records; 06 (6) enforce the provisions of this chapter and AS 08.32 and adopt or 07 amend the regulations necessary to make the provisions of this chapter and AS 08.32 08 effective; 09 (7) adopt regulations ensuring that renewal of a license, registration, or 10 certificate under this chapter or a license, certificate, or endorsement under AS 08.32 11 is contingent upon proof of continued professional competence; 12 (8) at least annually, cause to be published on the Internet and in a 13 newspaper of general circulation in each major city in the state a summary of 14 disciplinary actions the board has taken during the preceding calendar year; 15 (9) issue permits or certificates to licensed dentists, licensed dental 16 hygienists, and dental assistants who meet standards determined by the board for 17 specific procedures that require specific education and training; 18 (10) require that a licensed dentist who has a federal Drug  19 Enforcement Administration registration number register with the controlled  20 substance prescription database under AS 17.30.200(o). 21  * Sec. 6. AS 08.63.210 is amended by adding new subsections to read: 22 (c) The board may not impose disciplinary sanctions on a licensee for the 23 evaluation, diagnosis, supervision, or treatment of a person through audio, video, or 24 data communications when physically separated from the person if 25 (1) the licensee or another licensed health care provider is available to 26 provide follow-up care; 27 (2) the licensee requests that the person consent to sending a copy of 28 all records of the encounter to a primary care provider if the licensee is not the 29 person's primary care provider and, if the person consents, the licensee sends the 30 records to the person's primary care provider; and 31 (3) the licensee meets the requirements established by the board in 01 regulation. 02 (d) The board shall adopt regulations restricting the evaluation, diagnosis, 03 supervision, and treatment of a person as authorized under (c) of this section by 04 establishing standards of care, including standards for training, confidentiality, 05 supervision, practice, and related issues. 06  * Sec. 7. AS 08.64.101 is amended to read: 07 Sec. 08.64.101. Duties. The board shall 08 (1) examine and issue licenses to applicants; 09 (2) develop written guidelines to ensure that licensing requirements are 10 not unreasonably burdensome and the issuance of licenses is not unreasonably 11 withheld or delayed; 12 (3) after a hearing, impose disciplinary sanctions on persons who 13 violate this chapter or the regulations or orders of the board; 14 (4) adopt regulations ensuring that renewal of licenses is contingent on 15 [UPON] proof of continued competency on the part of the licensee; [AND] 16 (5) under regulations adopted by the board, contract with private 17 professional organizations to establish an impaired medical professionals program to 18 identify, confront, evaluate, and treat persons licensed under this chapter who abuse 19 alcohol, other drugs, or other substances or are mentally ill or cognitively impaired;  20 (6) adopt regulations that establish guidelines for a physician who  21 is rendering a diagnosis, providing treatment, or prescribing, dispensing, or  22 administering a prescription drug to a person without conducting a physical  23 examination under AS 08.64.364; the guidelines must include a nationally  24 recognized model policy for standards of care of a patient who is at a different  25 location than the physician; 26 (7) require that a licensee who has a federal Drug Enforcement  27 Administration registration number register with the controlled substance  28 prescription database under AS 17.30.200(o). 29  * Sec. 8. AS 08.64.364(a) is amended to read: 30 (a) The board may not impose disciplinary sanctions on a physician for 31 rendering a diagnosis, providing treatment, or prescribing, dispensing, or 01 administering a prescription drug that is not a controlled substance to a person 02 without conducting a physical examination if 03 (1) [THE PRESCRIPTION DRUG IS 04 (A) NOT A CONTROLLED SUBSTANCE; OR 05 (B) A CONTROLLED SUBSTANCE AND IS PRESCRIBED, 06 DISPENSED, OR ADMINISTERED BY A PHYSICIAN WHEN AN 07 APPROPRIATE LICENSED HEALTH CARE PROVIDER IS PRESENT 08 WITH THE PATIENT TO ASSIST THE PHYSICIAN WITH 09 EXAMINATION, DIAGNOSIS, AND TREATMENT; 10 (2) THE PHYSICIAN IS LOCATED IN THIS STATE AND] the 11 physician or another licensed health care provider or physician in the physician's 12 group practice is available to provide follow-up care; and 13 (2) the physician requests that [(3)] the person consent 14 [CONSENTS] to sending a copy of all records of the encounter to the person's primary 15 care provider if the prescribing physician is not the person's primary care provider, 16 and, if the patient consents, the physician sends the records to the person's primary 17 care provider. 18  * Sec. 9. AS 08.64.364 is amended by adding new subsections to read: 19 (c) The board may not impose disciplinary sanctions on a physician for 20 prescribing, dispensing, or administering a prescription drug that is a controlled 21 substance or botulinum toxin if the requirements under (a) of this section are met and 22 the physician prescribes, dispenses, or administers the controlled substance or 23 botulinum toxin when an appropriate licensed health care provider is present with the 24 patient to assist the physician with examination, diagnosis, and treatment. 25 (d) Notwithstanding (a) and (c) of this section, a physician may not 26 (1) prescribe, dispense, or administer an abortion-inducing drug under 27 (a) of this section unless the physician complies with AS 18.16.010; or 28 (2) prescribe, dispense, or administer a prescription drug in response to 29 an Internet questionnaire or electronic mail message to a person with whom the 30 physician does not have a prior physician-patient relationship. 31  * Sec. 10. AS 08.68.100(a) is amended to read: 01 (a) The board shall 02 (1) adopt regulations necessary to implement this chapter, including 03 regulations 04 (A) pertaining to practice as an advanced nurse practitioner and 05 a certified registered nurse anesthetist; 06 (B) necessary to implement AS 08.68.331 - 08.68.336 relating 07 to certified nurse aides in order to protect the health, safety, and welfare of 08 clients served by nurse aides; 09 (C) pertaining to retired nurse status; and 10 (D) establishing criteria for approval of practical nurse 11 education programs that are not accredited by a national nursing accrediting 12 body; 13 (2) approve curricula and adopt standards for basic education programs 14 that prepare persons for licensing under AS 08.68.190; 15 (3) provide for surveys of the basic nursing education programs in the 16 state at the times it considers necessary; 17 (4) approve education programs that meet the requirements of this 18 chapter and of the board, and deny, revoke, or suspend approval of education 19 programs for failure to meet the requirements; 20 (5) examine, license, and renew the licenses of qualified applicants; 21 (6) prescribe requirements for competence before a former nurse may 22 resume the practice of nursing under this chapter; 23 (7) define by regulation the qualifications and duties of the executive 24 administrator and delegate authority to the executive administrator that is necessary to 25 conduct board business; 26 (8) develop reasonable and uniform standards for nursing practice; 27 (9) publish advisory opinions regarding whether nursing practice 28 procedures or policies comply with acceptable standards of nursing practice as defined 29 under this chapter; 30 (10) require applicants under this chapter to submit fingerprints and the 31 fees required by the Department of Public Safety under AS 12.62.160 for criminal 01 justice information and a national criminal history record check; the department shall 02 submit the fingerprints and fees to the Department of Public Safety for a report of 03 criminal justice information under AS 12.62 and a national criminal history record 04 check under AS 12.62.400; 05 (11) require that a licensed advanced nurse practitioner who has a  06 federal Drug Enforcement Administration registration number register with the  07 controlled substance prescription database under AS 17.30.200(o). 08  * Sec. 11. AS 08.72.060(c) is amended to read: 09 (c) The board shall 10 (1) elect a chair and secretary from among its members; 11 (2) order a licensee to submit to a reasonable physical examination if 12 the licensee's physical capacity to practice safely is at issue;  13 (3) require that a licensee who has a federal Drug Enforcement  14 Administration registration number register with the controlled substance  15 prescription database under AS 17.30.200(o). 16  * Sec. 12. AS 08.80.030(b) is amended to read: 17 (b) In order to fulfill its responsibilities, the board has the powers necessary 18 for implementation and enforcement of this chapter, including the power to 19 (1) elect a president and secretary from its membership and adopt rules 20 for the conduct of its business; 21 (2) license by examination or by license transfer the applicants who are 22 qualified to engage in the practice of pharmacy; 23 (3) assist the department in inspections and investigations for 24 violations of this chapter, or of any other state or federal statute relating to the practice 25 of pharmacy; 26 (4) adopt regulations to carry out the purposes of this chapter; 27 (5) establish and enforce compliance with professional standards and 28 rules of conduct for pharmacists engaged in the practice of pharmacy; 29 (6) determine standards for recognition and approval of degree 30 programs of schools and colleges of pharmacy whose graduates shall be eligible for 31 licensure in this state, including the specification and enforcement of requirements for 01 practical training, including internships; 02 (7) establish for pharmacists and pharmacies minimum specifications 03 for the physical facilities, technical equipment, personnel, and procedures for the 04 storage, compounding, and dispensing of drugs or related devices, and for the 05 monitoring of drug therapy; 06 (8) enforce the provisions of this chapter relating to the conduct or 07 competence of pharmacists practicing in the state, and the suspension, revocation, or 08 restriction of licenses to engage in the practice of pharmacy; 09 (9) license and regulate the training, qualifications, and employment of 10 pharmacy interns and pharmacy technicians; 11 (10) issue licenses to persons engaged in the manufacture and 12 distribution of drugs and related devices; 13 (11) establish and maintain a controlled substance prescription 14 database as provided in AS 17.30.200; 15 (12) establish standards for the independent administration by a 16 pharmacist of vaccines and related emergency medications under AS 08.80.168, 17 including the completion of an immunization training program approved by the board;  18 (13) require that a licensed pharmacist who has a federal Drug  19 Enforcement Administration registration number register with the controlled  20 substance prescription database under AS 17.30.200(o).  21  * Sec. 13. AS 08.84.120 is amended by adding new subsections to read: 22 (c) The board may not impose disciplinary sanctions on a licensee for the 23 evaluation, diagnosis, or treatment of a person through audio, video, or data 24 communications when physically separated from the person if the licensee 25 (1) or another licensed health care provider is available to provide 26 follow-up care; 27 (2) requests that the person consent to sending a copy of all records of 28 the encounter to a primary care provider if the licensee is not the person's primary care 29 provider and, if the person consents, the licensee sends the records to the person's 30 primary care provider; and 31 (3) meets the requirements established by the board in regulation. 01 (d) The board shall adopt regulations restricting the evaluation, diagnosis, 02 supervision, and treatment of a person as authorized under (c) of this section by 03 establishing standards of care, including standards for training, confidentiality, 04 supervision, practice, and related issues. 05  * Sec. 14. AS 08.86.204 is amended by adding new subsections to read: 06 (c) The board may not impose disciplinary sanctions on a licensee for the 07 evaluation, diagnosis, or treatment of a person through audio, video, or data 08 communications when physically separated from the person if 09 (1) the licensee or another licensed health care provider is available to 10 provide follow-up care; 11 (2) the licensee requests that the person consent to sending a copy of 12 all records of the encounter to a primary care provider if the licensee is not the 13 person's primary care provider and, if the person consents, the licensee sends the 14 records to the person's primary care provider; and 15 (3) the licensee meets the requirements established by the board in 16 regulation. 17 (d) The board shall adopt regulations restricting the evaluation, diagnosis, 18 supervision, and treatment of a person as authorized under (c) of this section by 19 establishing standards of care, including standards for training, confidentiality, 20 supervision, practice, and related issues. 21  * Sec. 15. AS 08.95.050 is amended by adding new subsections to read: 22 (b) The board may not impose disciplinary sanctions on a licensee for the 23 evaluation, diagnosis, or treatment of a person through audio, video, or data 24 communications when physically separated from the person if 25 (1) the licensee or another licensed health care provider is available to 26 provide follow-up care; 27 (2) the licensee requests that the person consent to sending a copy of 28 all records of the encounter to a primary care provider if the licensee is not the 29 person's primary care provider and, if the person consents, the licensee sends the 30 records to the person's primary care provider; and 31 (3) the licensee meets the requirements established by the board in 01 regulation. 02 (c) The board shall adopt regulations restricting the evaluation, diagnosis, 03 supervision, and treatment of a person as authorized under (b) of this section by 04 establishing standards of care, including standards for training, confidentiality, 05 supervision, practice, and related issues.  06  * Sec. 16. AS 09.10 is amended by adding a new section to read: 07 Sec. 09.10.075. Actions related to claims based on medical assistance  08 payment fraud. Except as provided in AS 09.58.070, a person may not bring an 09 action under AS 09.58.010 - 09.58.060 unless the action is commenced by (1) six 10 years after the act or omission was committed, or (2) three years after the date when 11 facts material to the action were known, or reasonably should have been known, by 12 the attorney general or the Department of Health and Social Services, whichever is 13 later, but in no event more than 10 years after the date the violation under 14 AS 09.58.010 occurred. 15  * Sec. 17. AS 09.10.120(a) is amended to read: 16 (a) Except as provided in AS 09.10.075, an [AN] action brought in the name 17 of or for the benefit of the state, any political subdivision, or public corporation may 18 be commenced only within six years after [OF] the date of accrual of the cause of 19 action. However, if the action is for relief on the ground of fraud, the limitation 20 commences from the time of discovery by the aggrieved party of the facts constituting 21 the fraud. 22  * Sec. 18. AS 09 is amended by adding a new chapter to read: 23 Chapter 58. Alaska Medical Assistance False Claim and Reporting Act.  24 Sec. 09.58.010. False claims for medical assistance; civil penalty. (a) A 25 medical assistance provider or medical assistance recipient may not 26 (1) knowingly submit, authorize, or cause to be submitted to an officer 27 or employee of the state a false or fraudulent claim for payment or approval under the 28 medical assistance program; 29 (2) knowingly make, use, or cause to be made or used, directly or 30 indirectly, a false record or statement to get a false or fraudulent claim for payment 31 paid or approved by the state under the medical assistance program; 01 (3) conspire to defraud the state by getting a false or fraudulent claim 02 paid or approved under the medical assistance program; 03 (4) knowingly make, use, or cause to be made or used, a false record or 04 statement to conceal, avoid, increase, or decrease an obligation to pay or transmit 05 money or property to the medical assistance program; 06 (5) knowingly enter into an agreement, contract, or understanding with 07 an officer or employee of the state for approval or payment of a claim under the 08 medical assistance program knowing that the information in the agreement, contract, 09 or understanding is false or fraudulent. 10 (b) A beneficiary of an intentional or inadvertent submission of a false or 11 fraudulent claim under the medical assistance program who later discovers the claim is 12 false or fraudulent shall disclose the false or fraudulent claim to the state not later than 13 60 days after discovering the false claim. 14 (c) In addition to any criminal penalties under AS 47.05, a medical assistance 15 provider or medical assistance recipient who violates (a) or (b) of this section shall be 16 liable to the state in a civil action for 17 (1) a civil penalty of not less than $5,500 and not more than $11,000; 18 (2) three times the amount of actual damages sustained by the state; 19 (3) full reasonable attorney fees and costs in a case involving a 20 fraudulent claim, agreement, contract, or understanding; and 21 (4) reasonable attorney fees and costs calculated under applicable court 22 rules in a case that does not involve a fraudulent claim, agreement, contract, or 23 understanding. 24 (d) Liability for actual damages under (c) of this section may be reduced to not 25 less than twice the amount of actual damages that the state sustains if the court finds 26 that a person liable for an act under (a) or (b) of this section 27 (1) furnished the attorney general or the Department of Health and 28 Social Services with all information known to the person about the violation not later 29 than 30 days after the date the information was obtained; 30 (2) fully cooperated with the investigation of the violation under 31 AS 09.58.020; 01 (3) at the time the person furnished the attorney general with the 02 information about the violation, no criminal prosecution, civil action, investigation, or 03 administrative action had been started in this state with respect to the violation, and the 04 person did not have actual knowledge of the existence of an investigation of the 05 violation. 06 (e) A corporation, partnership, or other individual is liable under this section 07 for acts of its agents if the agent acted with apparent authority, regardless of whether 08 the agent acted, in whole or in part, to benefit the principal and regardless of whether 09 the principal adopted or ratified the agent's claims, representations, statement, or other 10 action or conduct. 11 (f) Notwithstanding (e) of this section, a corporation, partnership, or other 12 individual is not liable under this section for acts of its agents if the evidence shows 13 that the agent or apparent agent acted with intent to deceive the principal. 14 Sec. 09.58.015. Attorney general investigation; civil action. (a) The attorney 15 general or the Department of Health and Social Services may investigate an alleged 16 violation of AS 09.58.010. The attorney general may request assistance from the 17 Department of Health and Social Services in an investigation under this section. 18 (b) The attorney general may bring a civil action in superior court under 19 AS 09.58.010 - 09.58.060. 20 Sec. 09.58.020. Private plaintiff; civil action. (a) Notwithstanding 21 AS 09.58.015, a person may bring an action under this section for a violation of 22 AS 09.58.010 in the name of the person and the state. 23 (b) To bring an action under this section, a person shall file a complaint, in 24 camera and under seal, and serve on the attorney general 25 (1) a copy of the complaint; and 26 (2) written disclosure of substantially all material evidence and 27 information the person possesses that pertains to the claim. 28 (c) A complaint filed under this section must remain under seal for at least 60 29 days and may not be served on the defendant until the court so orders. The attorney 30 general may elect to intervene and proceed with the action within 60 days after the 31 attorney general receives the complaint, the material evidence, and the information 01 required under (b) of this section. The attorney general may, for good cause shown, 02 move the court, under seal, for an extension of the time during which the complaint 03 remains under seal under this subsection. 04 (d) Before the expiration of the 60-day period or an extension of time granted 05 under (c) of this section, the attorney general shall conduct an investigation and make 06 a written determination as to whether substantial evidence exists that a violation of 07 AS 09.58.010 has occurred. After the investigation and determination are complete, 08 the attorney general shall provide the person who brought the action and the 09 Department of Health and Social Services with a copy of the determination unless the 10 action has been referred to the division of the Department of Law that has 11 responsibility for criminal cases. 12 (e) Before the expiration of the 60-day period or an extension obtained under 13 (c) of this section, the attorney general shall 14 (1) intervene in the action and proceed with the action on behalf of the 15 state; 16 (2) notify the court that the attorney general declines to take over the 17 action, in which case the person bringing the action has the right to conduct the action; 18 or 19 (3) if the attorney general determines that substantial evidence does not 20 exist that a violation of AS 09.58.010 has occurred, or that the action is barred under 21 AS 09.58.050, the attorney general shall move the court to dismiss the action. 22 (f) The named defendant in a complaint filed under this section is not required 23 to respond to a complaint filed under this section until after the complaint is unsealed 24 by the court and a copy of the summons and complaint are served on the defendant 25 under the applicable Alaska Rules of Civil Procedure. 26 (g) When a person brings an action under this section, only the attorney 27 general may intervene or bring a related action based on similar facts to the underlying 28 action. 29 Sec. 09.58.025. Subpoenas. In conducting an investigation under 30 AS 09.58.015 or 09.58.020, the attorney general may issue subpoenas to compel the 31 production of books, papers, correspondence, memoranda, and other records in 01 connection with an investigation under or the administration of AS 09.58.010 - 02 09.58.060. If a medical assistance provider or a medical assistance recipient fails or 03 refuses, without just cause, to obey a subpoena issued under this section, the superior 04 court may, upon application by the attorney general, issue an order requiring the 05 medical assistance provider or medical assistance recipient to appear before the 06 attorney general to produce evidence. 07 Sec. 09.58.030. Rights in false or fraudulent claims actions. (a) If the 08 attorney general elects to intervene and proceed with an action under AS 09.58.020, 09 the attorney general has exclusive authority for prosecuting the action and is not bound 10 by an act of the person bringing the action. The person who brought the action has the 11 right to continue as a nominal party to the action, but does not have the right to 12 participate in the action except as a witness or as otherwise directed by the attorney 13 general. If the attorney general elects to intervene under AS 09.58.020, the attorney 14 general may file a new complaint or amend the complaint filed by the person who 15 brought the action under AS 09.58.020(b). 16 (b) Notwithstanding the objections of the person who brought the action, the 17 attorney general may 18 (1) move to dismiss the action at any time under this chapter if the 19 attorney general has notified the person who brought the action of the intent to seek 20 dismissal and the court has provided the person who brought the action with an 21 opportunity to respond to the motion; 22 (2) settle the action with the defendant at any time, if the court 23 determines, after a hearing, that the proposed settlement is fair, adequate, and 24 reasonable under all the circumstances; upon a showing of good cause, the hearing 25 described in this paragraph shall be held in camera. 26 (c) If the attorney general elects not to proceed under AS 09.58.020 with the 27 action, the person who brought the action has the right to proceed and conduct the 28 action. The attorney general may request at any time during the proceedings to be 29 served with copies of all documents related to the action, including pleadings, 30 motions, and discovery. The attorney general shall pay for the reasonable copying 31 charges for documents provided under this subsection. If the person who brought the 01 action proceeds with the action, the court, without limiting the status and rights of the 02 person who brought the action, shall allow the attorney general to intervene at any 03 time. 04 (d) Whether or not the attorney general proceeds with the action under this 05 chapter, on a showing by the attorney general that certain actions of discovery by the 06 person bringing the action would interfere with pending investigation or prosecution 07 of a criminal or civil proceeding arising out of the same matter, the court may stay the 08 discovery for not more than 90 days. The court may extend the 90-day period on a 09 further showing, in camera, that the state has pursued the criminal or civil 10 investigation or proceedings with reasonable diligence and that proposed discovery in 11 the civil action under AS 09.58.010 - 09.58.060 may interfere with the ongoing 12 criminal or civil investigation or proceedings. 13 Sec. 09.58.040. Award to false or fraudulent claim plaintiff. (a) If the 14 attorney general proceeds with an action brought by a person for a violation of 15 AS 09.58.010, the person who brought the action shall receive at least 15 percent but 16 not more than 25 percent of the proceeds of the action or settlement of the claim, 17 depending on the extent to which the person bringing the action contributed to the 18 prosecution of the action. The court order or settlement agreement shall state the 19 percentage and the amount to be received by the person who brought the action. A 20 payment under this subsection to the person who brought the action may be paid only 21 from proceeds received from a judgment or settlement under this section. 22 (b) If the attorney general does not proceed with an action brought under 23 AS 09.58.020, the person bringing the action to judgment or settlement by court order 24 shall receive an amount that the court decides is reasonable for collecting the civil 25 penalty and damages based on the person's effort to prosecute the action successfully. 26 The amount shall be at least 25 percent but not more than 30 percent of the proceeds 27 of the action or settlement of the claim. A payment under this subsection to the person 28 who brought the action may be paid only from proceeds received from a judgment or 29 settlement received under this section. In addition, if the person bringing the action 30 prevails, the person is entitled to 31 (1) full reasonable attorney fees and court costs in a case involving a 01 fraudulent claim, agreement, contract, or understanding; or 02 (2) reasonable attorney fees and court costs calculated under applicable 03 court rules in a case that does not involve a fraudulent claim, agreement, contract, or 04 understanding. 05 (c) Whether or not the attorney general participates in the action, if the court 06 finds that the action was brought by a person who planned or initiated the violation 07 alleged in the action brought under AS 09.58.020, the court may, to the extent the 08 court considers appropriate, reduce the share of the proceeds of the action that the 09 person would otherwise receive under (a) or (b) of this section, taking into account the 10 role of that person in advancing the case to litigation and any relevant circumstances 11 pertaining to the violation. If the person bringing the action is convicted of criminal 12 conduct arising from the person's role in the violation of AS 09.58.010, the court shall 13 dismiss the person from the civil action and the person may not receive any share of 14 the proceeds of the action or settlement. A dismissal under this subsection does not 15 prejudice the right of the attorney general to continue the action. 16 (d) In this section, "proceeds of the action or settlement" 17 (1) includes damages, civil penalties, payment for cost of compliance, 18 and other economic benefits realized by the state as a result of a civil action brought 19 under AS 09.58.010 - 09.58.060; 20 (2) does not include attorney fees and costs awarded to the state. 21 Sec. 09.58.050. Certain actions barred. A person may not bring an action 22 under AS 09.58.020 if the action is 23 (1) based on evidence or information known to the state when the 24 action was brought; 25 (2) based on allegations or transactions that are the subject of a civil or 26 criminal action or an administrative proceeding in which the state is already a party; 27 (3) based on the public disclosure of allegations or actions in a 28 criminal or civil action or an administrative hearing, or from the news media, unless 29 the action is brought by the attorney general or the person bringing the action is an 30 original source of the information that was publicly disclosed; in this paragraph, a 31 person is an original source of the information that was publicly disclosed if the 01 person has independent knowledge, including knowledge based on personal 02 investigation of the defendant's conduct, of the information on which the allegations 03 are based, and has voluntarily provided or verified the information on which the 04 allegations are based or voluntarily provided the information to the attorney general 05 before filing an action under AS 09.58.020 that is based on the information; or 06 (4) against the state or current or former state employees. 07 Sec. 09.58.060. State not liable for attorney fees, costs, and other expenses. 08 The state, its agencies, current or former officers, and current or former employees are 09 not liable for attorney fees, costs, and other expenses that a person incurs in bringing 10 an action under AS 09.58.020. 11 Sec. 09.58.070. Employee protection for retaliation. (a) An employee of a 12 medical assistance provider who is discharged, demoted, suspended, threatened, 13 harassed, or discriminated against in the terms and conditions of employment by the 14 employee's employer because of lawful acts done by the employee on behalf of the 15 employee or others in furtherance of an action under this chapter, including 16 investigation for, initiation of, testimony for or assistance in an action filed or to be 17 filed under this chapter, is entitled to the same relief authorized under AS 39.90.120. 18 (b) Notwithstanding (a) of this section, a state employee who is discharged, 19 demoted, suspended, threatened, harassed, or discriminated against in the terms and 20 conditions of employment because of lawful acts done by the employee on behalf of 21 the employee or a person who brings an action under AS 09.58.020 or in furtherance 22 of an action under this chapter, including investigation, initiation of, testimony for or 23 assistance in an action filed or to be filed under this chapter, is entitled to relief under 24 AS 39.90.100 - 39.90.150 (Alaska Whistleblower Act). 25 (c) A person may not bring an action under this section unless the action is 26 commenced not later than three years after the date the employee was subject to 27 retaliation under (a) or (b) of this section. 28 Sec. 09.58.080. Regulations. The attorney general may adopt regulations 29 under AS 44.62 as necessary to carry out the purposes of this chapter. 30 Sec. 09.58.090. Special provisions. (a) This chapter does not apply to any 31 controversy involving damages to the state of less than $5,500 in value. 01 (b) No punitive damages may be awarded in an action brought under 02 AS 09.58.010 - 09.58.060. 03 Sec. 09.58.100. Definitions. In this chapter, 04 (1) "attorney general" includes a designee of the attorney general; 05 (2) "claim" means a request for payment of health care services or 06 equipment, whether made to a contractor, grantee, or other person, when the state 07 provides, directly or indirectly, a portion of the money, property, or services requested 08 or demanded, or when the state will, directly or indirectly, reimburse the contractor, 09 grantee, or other recipient for a portion of the money, property, or services requested 10 or demanded; 11 (3) "controversy" means the aggregate of one or more false claims 12 submitted by the same medical assistance provider or medical assistance recipient 13 under this chapter; 14 (4) "knowingly" means that a person, with or without specific intent to 15 defraud, 16 (A) has actual knowledge of the information; 17 (B) acts in deliberate ignorance of the truth or falsity of the 18 information; or 19 (C) acts in reckless disregard of the truth or falsity of the 20 information; 21 (5) "medical assistance program" means the federal-state program 22 administered by the Department of Health and Social Services under AS 47.05 and 23 AS 47.07 and regulations adopted under AS 47.05 and AS 47.07; 24 (6) "medical assistance provider" has the meaning given in 25 AS 47.05.290; 26 (7) "medical assistance recipient" has the meaning given in 27 AS 47.05.290; 28 (8) "obligation" means an established duty, whether or not fixed, 29 arising from 30 (A) an express or implied contractual grantor or grantee or 31 licensor or licensee relationship; 01 (B) a fee-based or similar relationship; 02 (C) a statute or regulation; or 03 (D) the retention of any overpayment. 04 Sec. 09.58.110. Short title. This chapter may be cited as the Alaska Medical 05 Assistance False Claim and Reporting Act. 06  * Sec. 19. AS 09.58.025, added by sec. 18 of this Act, is amended to read: 07 Sec. 09.58.025. Subpoenas. In conducting an investigation under 08 AS 09.58.015 [OR 09.58.020], the attorney general may issue subpoenas to compel 09 the production of books, papers, correspondence, memoranda, and other records in 10 connection with an investigation under or the administration of AS 09.58.010 - 11 09.58.060. If a medical assistance provider or a medical assistance recipient fails or 12 refuses, without just cause, to obey a subpoena issued under this section, the superior 13 court may, upon application by the attorney general, issue an order requiring the 14 medical assistance provider or medical assistance recipient to appear before the 15 attorney general to produce evidence. 16  * Sec. 20. AS 09.58.070(b), added by sec. 18 of this Act, is amended to read: 17 (b) Notwithstanding (a) of this section, a state employee who is discharged, 18 demoted, suspended, threatened, harassed, or discriminated against in the terms and 19 conditions of employment because of lawful acts done by the employee on behalf of 20 the employee [OR A PERSON WHO BRINGS AN ACTION UNDER AS 09.58.020] 21 or in furtherance of an action under AS 09.58.010 - 09.58.060, including investigation, 22 initiation of, testimony for or assistance in an action filed or to be filed under 23 AS 09.58.010 - 09.58.060, is entitled to relief under AS 39.90.100 - 39.90.150 (Alaska 24 Whistleblower Act). 25  * Sec. 21. AS 17.30.200(a) is amended to read: 26 (a) The controlled substance prescription database is established in the Board 27 of Pharmacy. The purpose of the database is to contain data as described in this 28 section regarding every prescription for a schedule [IA, IIA, IIIA, IVA, OR VA 29 CONTROLLED SUBSTANCE UNDER STATE LAW OR A SCHEDULE I,] II, III, 30 or IV [, OR V] controlled substance under federal law dispensed in the state to a 31 person other than those administered to a patient at a health care facility. [THE 01 DEPARTMENT OF COMMERCE, COMMUNITY, AND ECONOMIC 02 DEVELOPMENT SHALL ASSIST THE BOARD AND PROVIDE NECESSARY 03 STAFF AND EQUIPMENT TO IMPLEMENT THIS SECTION.] 04  * Sec. 22. AS 17.30.200(a), as amended by sec. 21 of this Act, is amended to read: 05 (a) The controlled substance prescription database is established in the Board 06 of Pharmacy. The purpose of the database is to contain data as described in this 07 section regarding every prescription for a schedule II, III, or IV controlled substance 08 under federal law dispensed in the state to a person other than those administered to a 09 patient at a health care facility. The Department of Commerce, Community, and  10 Economic Development shall assist the board and provide necessary staff and  11 equipment to implement this section. 12  * Sec. 23. AS 17.30.200(b) is amended to read: 13 (b) The pharmacist-in-charge of each licensed or registered pharmacy, 14 regarding each schedule [IA, IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE 15 UNDER STATE LAW OR A SCHEDULE I,] II, III, or IV [, OR V] controlled 16 substance under federal law dispensed by a pharmacist under the supervision of the 17 pharmacist-in-charge, and each practitioner who directly dispenses a schedule [IA, 18 IIA, IIIA, IVA, OR VA CONTROLLED SUBSTANCE UNDER STATE LAW OR A 19 SCHEDULE I,] II, III, or IV [, OR V] controlled substance under federal law other 20 than those administered to a patient at a health care facility, shall submit to the board, 21 by a procedure and in a format established by the board, the following information for 22 inclusion in the database on at least a weekly basis: 23 (1) the name of the prescribing practitioner and the practitioner's 24 federal Drug Enforcement Administration registration number or other appropriate 25 identifier; 26 (2) the date of the prescription; 27 (3) the date the prescription was filled and the method of payment; this 28 paragraph does not authorize the board to include individual credit card or other 29 account numbers in the database; 30 (4) the name, address, and date of birth of the person for whom the 31 prescription was written; 01 (5) the name and national drug code of the controlled substance; 02 (6) the quantity and strength of the controlled substance dispensed; 03 (7) the name of the drug outlet dispensing the controlled substance; 04 and 05 (8) the name of the pharmacist or practitioner dispensing the controlled 06 substance and other appropriate identifying information. 07  * Sec. 24. AS 17.30.200(b), as amended by sec. 23 of this Act, is amended to read: 08 (b) The pharmacist-in-charge of each licensed or registered pharmacy, 09 regarding each schedule II, III, or IV controlled substance under federal law dispensed 10 by a pharmacist under the supervision of the pharmacist-in-charge, and each 11 practitioner who directly dispenses a schedule II, III, or IV controlled substance under 12 federal law other than those administered to a patient at a health care facility, shall 13 submit to the board, by a procedure and in a format established by the board, the 14 following information for inclusion in the database [ON AT LEAST A WEEKLY 15 BASIS]: 16 (1) the name of the prescribing practitioner and the practitioner's 17 federal Drug Enforcement Administration registration number or other appropriate 18 identifier; 19 (2) the date of the prescription; 20 (3) the date the prescription was filled and the method of payment; this 21 paragraph does not authorize the board to include individual credit card or other 22 account numbers in the database; 23 (4) the name, address, and date of birth of the person for whom the 24 prescription was written; 25 (5) the name and national drug code of the controlled substance; 26 (6) the quantity and strength of the controlled substance dispensed; 27 (7) the name of the drug outlet dispensing the controlled substance; 28 and 29 (8) the name of the pharmacist or practitioner dispensing the controlled 30 substance and other appropriate identifying information. 31  * Sec. 25. AS 17.30.200(d) is amended to read: 01 (d) The database and the information contained within the database are 02 confidential, are not public records, [AND] are not subject to public disclosure, and  03 may not be shared with the federal government. The board shall undertake to 04 ensure the security and confidentiality of the database and the information contained 05 within the database. The board may allow access to the database only to the following 06 persons, and in accordance with the limitations provided and regulations of the board: 07 (1) personnel of the board regarding inquiries concerning licensees or 08 registrants of the board or personnel of another board or agency concerning a 09 practitioner under a search warrant, subpoena, or order issued by an administrative law 10 judge or a court; 11 (2) authorized board personnel or contractors as required for 12 operational and review purposes; 13 (3) a licensed practitioner having authority to prescribe controlled 14 substances or an agent or employee of the practitioner whom the practitioner has  15 authorized to access the database on the practitioner's behalf, to the extent the 16 information relates specifically to a current patient of the practitioner to whom the 17 practitioner is prescribing or considering prescribing a controlled substance; the agent  18 or employee must be licensed or registered under AS 08; 19 (4) a licensed or registered pharmacist having authority to dispense 20 controlled substances or an agent or employee of the pharmacist whom the  21 pharmacist has authorized to access the database on the pharmacist's behalf, to 22 the extent the information relates specifically to a current patient to whom the 23 pharmacist is dispensing or considering dispensing a controlled substance; the agent  24 or employee must be licensed or registered under AS 08; 25 (5) [FEDERAL,] state [,] and local law enforcement authorities may 26 receive printouts of information contained in the database under a search warrant [, 27 SUBPOENA,] or order issued by a court establishing probable cause for the access 28 and use of the information; [AND] 29 (6) an individual who is the recipient of a controlled substance 30 prescription entered into the database may receive information contained in the 31 database concerning the individual on providing evidence satisfactory to the board that 01 the individual requesting the information is in fact the person about whom the data 02 entry was made and on payment of a fee set by the board under AS 37.10.050 that 03 does not exceed $10;  04 (7) a licensed pharmacist employed by the Department of Health  05 and Social Services who is responsible for administering prescription drug  06 coverage for the medical assistance program under AS 47.07, to the extent that  07 the information relates specifically to prescription drug coverage under the  08 program;  09 (8) a licensed pharmacist, licensed practitioner, or authorized  10 employee of the Department of Health and Social Services responsible for  11 utilization review of prescription drugs for the medical assistance program under  12 AS 47.07, to the extent that the information relates specifically to utilization  13 review of prescription drugs provided to recipients of medical assistance;  14 (9) the state medical examiner, to the extent that the information  15 relates specifically to investigating the cause and manner of a person's death;  16 (10) an authorized employee of the Department of Health and  17 Social Services may receive information from the database that does not disclose  18 the identity of a patient, prescriber, dispenser, or dispenser location, for the  19 purpose of identifying and monitoring public health issues in the state; however,  20 the information provided under this paragraph may include the region of the  21 state in which a patient, prescriber, and dispenser are located and the specialty of  22 the prescriber; and  23 (11) a practitioner, pharmacist, or clinical staff employed by an  24 Alaska tribal health organization, including commissioned corps officers of the  25 United States Public Health Service employed under a memorandum of  26 agreement; in this paragraph, "Alaska tribal health organization" has the  27 meaning given to "tribal health program" in 25 U.S.C. 1603. 28  * Sec. 26. AS 17.30.200(d), as amended by sec. 25 of this Act, is amended to read: 29 (d) The database and the information contained within the database are 30 confidential, are not public records, are not subject to public disclosure, and may not 31 be shared with the federal government. The board shall undertake to ensure the 01 security and confidentiality of the database and the information contained within the 02 database. The board may allow access to the database only to the following persons, 03 and in accordance with the limitations provided and regulations of the board: 04 (1) personnel of the board regarding inquiries concerning licensees or 05 registrants of the board or personnel of another board or agency concerning a 06 practitioner under a search warrant, subpoena, or order issued by an administrative law 07 judge or a court; 08 (2) authorized board personnel or contractors as required for 09 operational and review purposes; 10 (3) a licensed practitioner having authority to prescribe controlled 11 substances [OR AN AGENT OR EMPLOYEE OF THE PRACTITIONER WHOM 12 THE PRACTITIONER HAS AUTHORIZED TO ACCESS THE DATABASE ON 13 THE PRACTITIONER'S BEHALF], to the extent the information relates specifically 14 to a current patient of the practitioner to whom the practitioner is prescribing or 15 considering prescribing a controlled substance; [THE AGENT OR EMPLOYEE 16 MUST BE LICENSED OR REGISTERED UNDER AS 08;] 17 (4) a licensed or registered pharmacist having authority to dispense 18 controlled substances [OR AN AGENT OR EMPLOYEE OF THE PHARMACIST 19 WHOM THE PHARMACIST HAS AUTHORIZED TO ACCESS THE DATABASE 20 ON THE PHARMACIST'S BEHALF], to the extent the information relates 21 specifically to a current patient to whom the pharmacist is dispensing or considering 22 dispensing a controlled substance; [THE AGENT OR EMPLOYEE MUST BE 23 LICENSED OR REGISTERED UNDER AS 08;] 24 (5) state and local law enforcement authorities may receive printouts of 25 information contained in the database under a search warrant, subpoena, or order 26 issued by a court establishing probable cause for the access and use of the information; 27 and 28 (6) an individual who is the recipient of a controlled substance 29 prescription entered into the database may receive information contained in the 30 database concerning the individual on providing evidence satisfactory to the board that 31 the individual requesting the information is in fact the person about whom the data 01 entry was made and on payment of a fee set by the board under AS 37.10.050 that 02 does not exceed $10 [; 03 (7) A LICENSED PHARMACIST EMPLOYED BY THE 04 DEPARTMENT OF HEALTH AND SOCIAL SERVICES WHO IS RESPONSIBLE 05 FOR ADMINISTERING PRESCRIPTION DRUG COVERAGE FOR THE 06 MEDICAL ASSISTANCE PROGRAM UNDER AS 47.07, TO THE EXTENT 07 THAT THE INFORMATION RELATES SPECIFICALLY TO PRESCRIPTION 08 DRUG COVERAGE UNDER THE PROGRAM; 09 (8) A LICENSED PHARMACIST, LICENSED PRACTITIONER, 10 OR AUTHORIZED EMPLOYEE OF THE DEPARTMENT OF HEALTH AND 11 SOCIAL SERVICES RESPONSIBLE FOR UTILIZATION REVIEW OF 12 PRESCRIPTION DRUGS FOR THE MEDICAL ASSISTANCE PROGRAM 13 UNDER AS 47.07, TO THE EXTENT THAT THE INFORMATION RELATES 14 SPECIFICALLY TO UTILIZATION REVIEW OF PRESCRIPTION DRUGS 15 PROVIDED TO RECIPIENTS OF MEDICAL ASSISTANCE; 16 (9) THE STATE MEDICAL EXAMINER, TO THE EXTENT THAT 17 THE INFORMATION RELATES SPECIFICALLY TO INVESTIGATING THE 18 CAUSE AND MANNER OF A PERSON'S DEATH; 19 (10) AN AUTHORIZED EMPLOYEE OF THE DEPARTMENT OF 20 HEALTH AND SOCIAL SERVICES MAY RECEIVE INFORMATION FROM 21 THE DATABASE THAT DOES NOT DISCLOSE THE IDENTITY OF A 22 PATIENT, PRESCRIBER, DISPENSER, OR DISPENSER LOCATION, FOR THE 23 PURPOSE OF IDENTIFYING AND MONITORING PUBLIC HEALTH ISSUES IN 24 THE STATE; HOWEVER, THE INFORMATION PROVIDED UNDER THIS 25 PARAGRAPH MAY INCLUDE THE REGION OF THE STATE IN WHICH A 26 PATIENT, PRESCRIBER, AND DISPENSER ARE LOCATED AND THE 27 SPECIALTY OF THE PRESCRIBER; AND 28 (11) A PRACTITIONER, PHARMACIST, OR CLINICAL STAFF 29 EMPLOYED BY AN ALASKA TRIBAL HEALTH ORGANIZATION, 30 INCLUDING COMMISSIONED CORPS OFFICERS OF THE UNITED STATES 31 PUBLIC HEALTH SERVICE EMPLOYED UNDER A MEMORANDUM OF 01 AGREEMENT; IN THIS PARAGRAPH, "ALASKA TRIBAL HEALTH 02 ORGANIZATION" HAS THE MEANING GIVEN TO "TRIBAL HEALTH 03 PROGRAM" IN 25 U.S.C. 1603]. 04  * Sec. 27. AS 17.30.200(e) is amended to read: 05 (e) The failure of a pharmacist-in-charge, pharmacist, or practitioner to 06 register or submit information to the database as required under this section is 07 grounds for the board to take disciplinary action against the license or registration of 08 the pharmacy or pharmacist or for another licensing board to take disciplinary action 09 against a practitioner. 10  * Sec. 28. AS 17.30.200(e), as amended by sec. 27 of this Act, is amended to read: 11 (e) The failure of a pharmacist-in-charge, pharmacist, or practitioner to 12 [REGISTER OR] submit information to the database as required under this section is 13 grounds for the board to take disciplinary action against the license or registration of 14 the pharmacy or pharmacist or for another licensing board to take disciplinary action 15 against a practitioner. 16  * Sec. 29. AS 17.30.200(h) is amended to read: 17 (h) An individual who has submitted information to the database in 18 accordance with this section may not be held civilly liable for having submitted the 19 information. [NOTHING IN THIS SECTION REQUIRES OR OBLIGATES A 20 DISPENSER OR PRACTITIONER TO ACCESS OR CHECK THE DATABASE 21 BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING A 22 MEDICATION, OR PROVIDING MEDICAL CARE TO A PERSON.] Dispensers or 23 practitioners may not be held civilly liable for damages for accessing or failing to 24 access the information in the database. 25  * Sec. 30. AS 17.30.200(h), as amended by sec. 29 of this Act, is amended to read: 26 (h) An individual who has submitted information to the database in 27 accordance with this section may not be held civilly liable for having submitted the 28 information. Nothing in this section requires or obligates a dispenser or  29 practitioner to access or check the database before dispensing, prescribing, or  30 administering a medication, or providing medical care to a person. Dispensers or 31 practitioners may not be held civilly liable for damages for accessing or failing to 01 access the information in the database. 02  * Sec. 31. AS 17.30.200(k) is amended to read: 03 (k) In the regulations adopted under this section, the board shall provide 04 (1) that prescription information in the database [SHALL] be purged 05 from the database after two years have elapsed from the date the prescription was 06 dispensed; 07 (2) a method for an individual to challenge information in the database 08 about the individual that the person believes is incorrect or was incorrectly entered by 09 a dispenser;  10 (3) a procedure and time frame for registration with the database;  11 (4) that a practitioner review the information in the database to  12 check a patient's prescription records before dispensing, prescribing, or  13 administering a schedule II or III controlled substance under federal law to the  14 patient; the regulations must provide that a practitioner is not required to review  15 the information in the database before dispensing, prescribing, or administering  16 (A) a controlled substance to a person who is receiving  17 treatment  18 (i) in an inpatient setting;  19 (ii) at the scene of an emergency or in an ambulance;  20 in this sub-subparagraph, "ambulance" has the meaning given in  21 AS 18.08.200;  22 (iii) in an emergency room;  23 (iv) immediately before, during, or within the first  24 48 hours after surgery or a medical procedure;  25 (v) in a hospice or nursing home that has an in- 26 house pharmacy; or  27 (B) a nonrefillable prescription of a controlled substance in  28 a quantity intended to last for not more than three days. 29  * Sec. 32. AS 17.30.200(k), as amended by sec. 31 of this Act, is amended to read: 30 (k) In the regulations adopted under this section, the board shall provide 31 (1) that prescription information in the database be purged from the 01 database after two years have elapsed from the date the prescription was dispensed; 02 (2) a method for an individual to challenge information in the database 03 about the individual that the person believes is incorrect or was incorrectly entered by 04 a dispenser [; 05 (3) A PROCEDURE AND TIME FRAME FOR REGISTRATION 06 WITH THE DATABASE; 07 (4) THAT A PRACTITIONER REVIEW THE INFORMATION IN 08 THE DATABASE TO CHECK A PATIENT'S PRESCRIPTION RECORDS 09 BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING A SCHEDULE II 10 OR III CONTROLLED SUBSTANCE UNDER FEDERAL LAW TO THE 11 PATIENT; THE REGULATIONS MUST PROVIDE THAT A PRACTITIONER IS 12 NOT REQUIRED TO REVIEW THE INFORMATION IN THE DATABASE 13 BEFORE DISPENSING, PRESCRIBING, OR ADMINISTERING 14 (A) A CONTROLLED SUBSTANCE TO A PERSON WHO 15 IS RECEIVING TREATMENT 16 (i) IN AN INPATIENT SETTING; 17 (ii) AT THE SCENE OF AN EMERGENCY OR IN 18 AN AMBULANCE; IN THIS SUB-SUBPARAGRAPH, 19 "AMBULANCE" HAS THE MEANING GIVEN IN AS 18.08.200; 20 (iii) IN AN EMERGENCY ROOM; 21 (iv) IMMEDIATELY BEFORE, DURING, OR 22 WITHIN THE FIRST 48 HOURS AFTER SURGERY OR A 23 MEDICAL PROCEDURE; 24 (v) IN A HOSPICE OR NURSING HOME THAT 25 HAS AN IN-HOUSE PHARMACY; OR 26 (B) A NONREFILLABLE PRESCRIPTION OF A 27 CONTROLLED SUBSTANCE IN A QUANTITY INTENDED TO LAST 28 FOR NOT MORE THAN THREE DAYS]. 29  * Sec. 33. AS 17.30.200(m) is amended to read: 30 (m) To assist in fulfilling the program responsibilities, performance measures 31 shall be reported to the legislature annually. Performance measures 01 (1) may include outcomes detailed in the federal prescription drug 02 monitoring program grant regarding efforts to 03 (A) [(1)] reduce the rate of inappropriate use of prescription 04 drugs by reporting education efforts conducted by the Board of Pharmacy; 05 (B) [(2)] reduce the quantity of pharmaceutical controlled 06 substances obtained by individuals attempting to engage in fraud and deceit; 07 (C) [(3)] increase coordination among prescription drug 08 monitoring program partners; 09 (D) [AND (4)] involve stakeholders in the planning process;  10 (2) shall include information related to the  11 (A) security of the database; and  12 (B) reductions, if any, in the inappropriate use or  13 prescription of controlled substances resulting from the use of the  14 database. 15  * Sec. 34. AS 17.30.200 is amended by adding new subsections to read: 16 (o) A pharmacist who dispenses or a practitioner who prescribes, administers, 17 or directly dispenses a schedule II, III, or IV controlled substance under federal law 18 shall register with the database by a procedure and in a format established by the 19 board. 20 (p) The board shall promptly notify the State Medical Board, the Board of 21 Nursing, the Board of Dental Examiners, and the Board of Examiners in Optometry 22 when a practitioner registers with the database under (o) of this section. 23 (q) The board is authorized to provide unsolicited notification to a pharmacist 24 or practitioner if a patient has received one or more prescriptions for controlled 25 substances in quantities or with a frequency inconsistent with generally recognized 26 standards of safe practice. 27 (r) The board shall update the database on at least a weekly basis with the 28 information submitted to the board under (b) of this section. 29 (s) The Department of Commerce, Community, and Economic Development 30 shall 31 (1) assist the board and provide necessary staff and equipment to 01 implement this section; and 02 (2) establish fees for registration with the database by a pharmacist or 03 practitioner required to register under (o) of this section so that the total amount of 04 fees collected by the department equals the total operational costs of the database 05 minus all federal funds acquired for the operational costs of the database; in setting the 06 fee levels, the department shall 07 (A) set the fees for registration with the database so that the 08 fees are the same for all practitioners and pharmacists required to register; and 09 (B) consult with the board to establish the fees under this 10 paragraph. 11  * Sec. 35. AS 33.30.028 is amended by adding new subsections to read: 12 (c) The commissioner shall apply for medical assistance under AS 47.07 and 13 for general relief assistance under AS 47.25.120 - 47.25.300 on behalf of a prisoner 14 incarcerated in a correctional facility to establish medical assistance coverage or 15 general relief assistance for the prisoner during a period of hospitalization outside of 16 the correctional facility. 17 (d) The commissioner may obtain information necessary to determine whether 18 a prisoner incarcerated in a correctional facility is eligible for medical assistance under 19 AS 47.07 or public assistance under AS 47.25. Information obtained under this 20 subsection may be used only for the purpose of applying for medical assistance or 21 public assistance under (c) of this section and may not be disclosed for any other 22 purpose without the permission of the prisoner. An employee of the commissioner 23 who discloses a prisoner's social security number in an application for medical 24 assistance or public assistance under this section is considered to be acting in the 25 performance of the employee's duties or responsibilities under AS 45.48.400(b). 26  * Sec. 36. AS 37.05.146(c) is amended by adding a new paragraph to read: 27 (88) monetary recoveries under AS 09.58 (Alaska Medical Assistance 28 False Claim and Reporting Act). 29  * Sec. 37. AS 40.25.120(a) is amended by adding a new paragraph to read: 30 (15) records relating to proceedings under AS 09.58 (Alaska Medical 31 Assistance False Claim and Reporting Act). 01  * Sec. 38. AS 44.33 is amended by adding a new section to read: 02 Article 5A. Telemedicine Business Registry.  03 Sec. 44.33.381. Telemedicine business registry. (a) The department shall 04 adopt regulations for establishing and maintaining a registry of businesses performing 05 telemedicine services in the state. 06 (b) The department shall maintain the registry of businesses performing 07 telemedicine services in the state. The registry must include the name, address, and 08 contact information of businesses performing telemedicine services in the state. 09 (c) In this section, 10 (1) "department" means the Department of Commerce, Community, 11 and Economic Development; 12 (2) "telemedicine services" means the delivery of health care services 13 using the transfer of medical data through audio, visual, or data communications that 14 are performed over two or more locations by a provider who is physically separated 15 from the recipient of the health care services. 16  * Sec. 39. AS 47.05 is amended by adding a new section to article 1 to read: 17 Sec. 47.05.105. Enhanced computerized eligibility verification system. (a) 18 The department shall establish an enhanced computerized income, asset, and identity 19 eligibility verification system for the purposes of verifying eligibility, eliminating 20 duplication of public assistance payments, and deterring waste and fraud in public 21 assistance programs administered by the department under AS 47.05.010. Nothing in 22 this section prohibits the department from verifying eligibility for public assistance 23 through additional procedures or authorizes the department or a third-party vendor to 24 use data to verify eligibility for a federal program if the use of that data is prohibited 25 by federal law. 26 (b) The department shall enter into a competitively bid contract with a third- 27 party vendor for the purpose of developing a system under this section to prevent 28 fraud, misrepresentation, and inadequate documentation when determining an 29 applicant's eligibility for public assistance before the payment of benefits and for 30 periodically verifying eligibility between eligibility redeterminations and during 31 eligibility redeterminations and reviews. The department may also contract with a 01 third-party vendor to provide information to facilitate reviews of recipient eligibility 02 and income verification. 03 (c) The annual savings to the state resulting from the use of the system under 04 this section must exceed the cost of implementing the system. A contract under this 05 section must require the third-party vendor to report annual savings to the state 06 realized from implementing the system. Payment to the third-party vendor may be 07 based on a fee for each applicant and may include incentives for achieving a rate of 08 success established by the department for identifying duplication, waste, and fraud in 09 public assistance programs. 10 (d) To avoid a conflict of interest, the department may not award a contract to 11 provide services for the enrollment of public assistance providers or applicants under 12 this title to a vendor that is awarded a contract under this section. 13  * Sec. 40. AS 47.05.200(a) is amended to read: 14 (a) The department shall annually contract for independent audits of a 15 statewide sample of all medical assistance providers in order to identify overpayments 16 and violations of criminal statutes. The audits conducted under this section may not be 17 conducted by the department or employees of the department. The number of audits 18 under this section may not be less than 50 each year [, AS A TOTAL FOR THE 19 MEDICAL ASSISTANCE PROGRAMS UNDER AS 47.07 AND AS 47.08, SHALL 20 BE 0.75 PERCENT OF ALL ENROLLED PROVIDERS UNDER THE 21 PROGRAMS, ADJUSTED ANNUALLY ON JULY 1, AS DETERMINED BY THE 22 DEPARTMENT, EXCEPT THAT THE NUMBER OF AUDITS UNDER THIS 23 SECTION MAY NOT BE LESS THAN 75]. The audits under this section must 24 include both on-site audits and desk audits and must be of a variety of provider types. 25 The department may not award a contract under this subsection to an organization that 26 does not retain persons with a significant level of expertise and recent professional 27 practice in the general areas of standard accounting principles and financial auditing 28 and in the specific areas of medical records review, investigative research, and Alaska 29 health care criminal law. The contractor, in consultation with the commissioner, shall 30 select the providers to be audited and decide the ratio of desk audits and on-site audits 31 to the total number selected. In identifying providers who are subject to an audit  01 under this section, the department shall attempt to minimize concurrent state or  02 federal audits.  03  * Sec. 41. AS 47.05.200(b) is amended to read: 04 (b) Within 90 days after receiving each audit report from an audit conducted 05 under this section, the department shall begin administrative procedures to recoup 06 overpayments identified in the audits and shall allocate the reasonable and necessary 07 financial and human resources to ensure prompt recovery of overpayments unless the 08 attorney general has advised the commissioner in writing that a criminal investigation 09 of an audited provider has been or is about to be undertaken, in which case, the 10 commissioner shall hold the administrative procedure in abeyance until a final 11 charging decision by the attorney general has been made. The commissioner shall 12 provide copies of all audit reports to the attorney general so that the reports can be 13 screened for the purpose of bringing criminal charges. The department may assess  14 interest and penalties on any identified overpayment. Interest under this  15 subsection shall be calculated using the statutory rates for postjudgment interest  16 accruing from the date of the issuance of the final agency decision to recoup  17 overpayments identified in the audit. In this subsection, the date of issuance of  18 the final agency decision is the later of the date of  19 (1) the department's written notification of the decision and the  20 provider's appeal rights; or  21 (2) if timely appealed by the provider, a final agency decision  22 under AS 44.64.060. 23  * Sec. 42. AS 47.05 is amended by adding a new section to read: 24 Sec. 47.05.235. Duty to identify and repay self-identified overpayments. (a) 25 Unless a provider is being audited under AS 47.05.200(a), an enrolled medical 26 assistance provider shall conduct a biennial review or audit of a statistically valid 27 sample of claims submitted to the department for reimbursement. If overpayments are 28 identified, the medical assistance provider shall report the overpayment to the 29 department not later than 10 business days after identification of the overpayment. The 30 report must also identify how the medical assistance provider intends to repay the 31 department. After the department receives the report, the medical assistance provider 01 and the department shall enter into an agreement establishing a schedule for 02 repayment of the identified overpayment. The agreement may authorize repayment in 03 a lump sum, in a payment plan, or by offsetting future billings, as approved by the 04 department. 05 (b) The department may not assess interest or penalties on an overpayment 06 identified and repaid by a medical assistance provider under this section. 07  * Sec. 43. AS 47.05 is amended by adding new sections to read: 08 Sec. 47.05.250. Civil penalties. (a) The department may assess a civil penalty 09 against a provider who violates this chapter, AS 47.07, or regulations adopted under 10 this chapter or AS 47.07. 11 (b) The department shall adopt regulations establishing a range of civil 12 penalties that the department may assess against a provider under this section. In 13 establishing the range of civil penalties, the department shall take into account 14 appropriate factors, including the seriousness of the violation, the service provided by 15 the provider, and the severity of the penalty. The regulations may not provide for a 16 civil penalty of less than $100 or more than $25,000 for each violation. 17 (c) The provisions of this section are in addition to any other remedies 18 available under this chapter, AS 47.07, or regulations adopted under this chapter or 19 AS 47.07. 20 (d) A provider against whom a civil penalty of less than $2,500 is assessed 21 may appeal the decision assessing the penalty to the commissioner or the 22 commissioner's designee. The commissioner shall, by regulation, establish time limits 23 and procedures for an appeal under this subsection. The decision of the commissioner 24 or the commissioner's designee may be appealed to the office of administrative 25 hearings established under AS 44.64. 26 (e) A provider against whom a civil penalty of $2,500 or more is assessed may 27 appeal the decision assessing the penalty to the office of administrative hearings 28 established under AS 44.64. 29 Sec. 47.05.270. Medical assistance reform program. (a) The department 30 shall adopt regulations to design and implement a program for reforming the state 31 medical assistance program under AS 47.07. The reform program must include 01 (1) referrals to community and social support services, including career 02 and education training services available through the Department of Labor and 03 Workforce Development under AS 23.15, the University of Alaska, or other sources; 04 (2) electronic distribution of an explanation of medical assistance 05 benefits to recipients for health care services received under the program; 06 (3) expanding the use of telehealth for primary care, behavioral health, 07 and urgent care; 08 (4) enhancing fraud prevention, detection, and enforcement; 09 (5) reducing the cost of behavioral health, senior, and disabilities 10 services provided to recipients of medical assistance under the state's home and 11 community-based services waiver under AS 47.07.045; 12 (6) pharmacy initiatives; 13 (7) enhanced care management; 14 (8) redesigning the payment process by implementing fee agreements 15 that include one or more of the following: 16 (A) premium payments for centers of excellence; 17 (B) penalties for hospital-acquired infections, readmissions, 18 and outcome failures; 19 (C) bundled payments for specific episodes of care; or 20 (D) global payments for contracted payers, primary care 21 managers, and case managers for a recipient or for care related to a specific 22 diagnosis; 23 (9) stakeholder involvement in setting annual targets for quality and 24 cost-effectiveness; 25 (10) to the extent consistent with federal law, reducing travel costs by 26 requiring a recipient to obtain medical services in the recipient's home community, to 27 the extent appropriate services are available in the recipient's home community; 28 (11) guidelines for health care providers to develop health care 29 delivery models supported by evidence-based practices that encourage wellness and 30 disease prevention. 31 (b) The department shall, in coordination with the Alaska Mental Health Trust 01 Authority, efficiently manage a comprehensive and integrated behavioral health 02 program that uses evidence-based, data-driven practices to achieve positive outcomes 03 for people with mental health or substance abuse disorders and children with severe 04 emotional disturbances. The goal of the program is to assist recipients of services 05 under the program to recover by achieving the highest level of autonomy with the least 06 dependence on state-funded services possible for each person. The program must 07 include 08 (1) a plan for providing a continuum of community-based services to 09 address housing, employment, criminal justice, and other relevant issues; 10 (2) services from a wide array of providers and disciplines, including 11 licensed or certified mental health and primary care professionals; and 12 (3) efforts to reduce operational barriers that fragment services, 13 minimize administrative burdens, and reduce the effectiveness and efficiency of the 14 program. 15 (c) The department shall identify the areas of the state where improvements in 16 access to telehealth would be most effective in reducing the costs of medical 17 assistance and improving access to health care services for medical assistance 18 recipients. The department shall make efforts to improve access to telehealth for 19 recipients in those locations. The department may enter into agreements with Indian 20 Health Service providers, if necessary, to improve access by medical assistance 21 recipients to telehealth facilities and equipment. 22 (d) On or before November 15 of each year, the department shall prepare a 23 report and submit the report to the senate secretary and the chief clerk of the house of 24 representatives and notify the legislature that the report is available. The report must 25 include 26 (1) realized cost savings related to reform efforts under this section; 27 (2) realized cost savings related to medical assistance reform efforts 28 undertaken by the department other than the reform efforts described in this section; 29 (3) a statement of whether the department has met annual targets for 30 quality and cost-effectiveness; 31 (4) recommendations for legislative or budgetary changes related to 01 medical assistance reforms during the next fiscal year; 02 (5) changes in federal laws that the department expects will result in a 03 cost or savings to the state of more than $1,000,000; 04 (6) a description of any medical assistance grants, options, or waivers 05 the department applied for in the previous fiscal year; 06 (7) the results of demonstration projects the department has 07 implemented; 08 (8) legal and technological barriers to the expanded use of telehealth, 09 improvements in the use of telehealth in the state, and recommendations for changes 10 or investments that would allow cost-effective expansion of telehealth; 11 (9) the percentage decrease in costs of travel for medical assistance 12 recipients compared to the previous fiscal year; 13 (10) the percentage decrease in the number of medical assistance 14 recipients identified as frequent users of emergency departments compared to the 15 previous fiscal year; 16 (11) the percentage increase or decrease in the number of hospital 17 readmissions within 30 days after a hospital stay for medical assistance recipients 18 compared to the previous fiscal year; 19 (12) the percentage increase or decrease in state general fund spending 20 for the average medical assistance recipient compared to the previous fiscal year; 21 (13) the percentage increase or decrease in uncompensated care costs 22 incurred by medical assistance providers compared to the percentage change in private 23 health insurance premiums for individual and small group health insurance; 24 (14) the cost, in state and federal funds, for providing optional services 25 under AS 47.07.030(b); 26 (15) the amount of state funds saved as a result of implementing 27 changes in federal policy authorizing 100 percent federal funding for services 28 provided to American Indian and Alaska Native individuals eligible for Medicaid, and 29 the estimated savings in state funds that could have been achieved if the department 30 had fully implemented the changes in policy. 31 (e) In this section, "telehealth" means the practice of health care delivery, 01 evaluation, diagnosis, consultation, or treatment, using the transfer of health care data 02 through audio, visual, or data communications, performed over two or more locations 03 between providers who are physically separated from the recipient or from each other 04 or between a provider and a recipient who are physically separated from each other. 05  * Sec. 44. AS 47.07.030(d) is amended to read: 06 (d) The department shall [MAY] establish as optional services a primary care 07 case management system or a managed care organization contract in which certain 08 eligible individuals are required to enroll and seek approval from a case manager or 09 the managed care organization before receiving certain services. The purpose of a  10 primary care case management system or managed care organization contract is  11 to increase the use of appropriate primary and preventive care by medical  12 assistance recipients while decreasing the unnecessary use of specialty care and  13 hospital emergency department services. The department shall 14 (1) establish enrollment criteria and determine eligibility for services 15 consistent with federal and state law; the department shall require recipients with  16 multiple hospitalizations to enroll in a primary care case management system or  17 with a managed care organization under this subsection, except that the  18 department may exempt recipients with chronic, acute, or terminal medical  19 conditions from the requirement under this paragraph;  20 (2) define the coordinated care services and the provider types  21 eligible to participate as primary care providers;  22 (3) create a performance and quality reporting system; and  23 (4) integrate the coordinated care demonstration projects  24 described under AS 47.07.039 and the demonstration projects described under  25 AS 47.07.036(e) with the primary care case management system or managed care  26 organization contract established under this subsection. 27  * Sec. 45. AS 47.07.036 is amended by adding new subsections to read: 28 (d) Notwithstanding (a) - (c) of this section, the department may 29 (1) apply for a section 1915(i) option under 42 U.S.C. 1396n to 30 improve services and care through home and community-based services to obtain, at a 31 minimum, a 50 percent federal match; 01 (2) apply for a section 1915(k) option under 42 U.S.C. 1396n to 02 provide home and community-based services and support to increase the federal match 03 for these programs from 50 percent to 56 percent; 04 (3) apply for a section 1945 option under 42 U.S.C. 1396w-4 to 05 provide coordinated care through health homes for individuals with chronic conditions 06 and to increase the federal match for the services to 90 percent for the first eight 07 quarters the required state plan amendment is in effect; 08 (4) evaluate and seek permission from the United States Department of 09 Health and Human Services, Centers for Medicare and Medicaid Services, to 10 participate in various demonstration projects, including payment reform, care 11 management programs, workforce development and innovation, and innovative 12 services delivery models; and 13 (5) provide incentives for telehealth, including increasing the 14 capability for and reimbursement of telehealth for recipients. 15 (e) Notwithstanding (a) - (c) of this section, and in addition to the projects and 16 services described under (d) and (f) of this section, the department shall apply for a 17 section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration 18 projects focused on innovative payment models for one or more groups of medical 19 assistance recipients in one or more specific geographic areas. The demonstration 20 project or projects may include 21 (1) managed care organizations as described under 42 U.S.C. 1396u-2; 22 (2) community care organizations; 23 (3) patient-centered medical homes as described under 42 U.S.C. 256a- 24 1; or 25 (4) other innovative payment models that ensure access to health care 26 without reducing the quality of care. 27 (f) Notwithstanding (a) - (c) of this section, and in addition to the projects and 28 services described under (d) and (e) of this section, the department shall apply for a 29 section 1115 waiver under 42 U.S.C. 1315(a) to establish one or more demonstration 30 projects focused on improving the state's behavioral health system for medical 31 assistance recipients. The department shall engage stakeholders and the community in 01 the development of a project or projects under this subsection. The demonstration 02 project or projects must 03 (1) be consistent with the comprehensive and integrated behavioral 04 health program described under AS 47.05.270(b); and 05 (2) include continuing cooperation with the grant-funded community 06 mental health clinics and drug and alcohol treatment centers that have historically 07 provided care to recipients of behavioral health services. 08 (g) In this section, "telehealth" has the meaning given in AS 47.05.270(e). 09  * Sec. 46. AS 47.07 is amended by adding new sections to read: 10 Sec. 47.07.038. Collaborative, hospital-based project to reduce use of  11 emergency department services. (a) On or before December 1, 2016, the department 12 shall collaborate with a statewide professional hospital association to establish a 13 hospital-based project to reduce the use of emergency department services by medical 14 assistance recipients. The statewide professional hospital association shall operate the 15 project. Subject to (b) of this section, the project may include shared savings for 16 participating hospitals. The project must include 17 (1) an interdisciplinary process for defining, identifying, and 18 minimizing the number of frequent users of emergency department services; 19 (2) to the extent consistent with federal law, a system for real-time 20 electronic exchange of patient information, including recent emergency department 21 visits, hospital care plans for frequent users of emergency departments, and data from 22 the controlled substance prescription database; 23 (3) a procedure for educating patients about the use of emergency 24 departments and appropriate alternative services and facilities for nonurgent care; 25 (4) a process for assisting users of emergency departments in making 26 appointments with primary care or behavioral health providers within 96 hours after 27 an emergency department visit; 28 (5) a collaborative process between the department and the statewide 29 professional hospital association to establish uniform statewide guidelines for 30 prescribing narcotics in an emergency department; and 31 (6) designation of health care personnel to review successes and 01 challenges regarding appropriate emergency department use. 02 (b) After January 1, 2022, the department may not compensate hospital 03 emergency departments, through shared savings, for a reduction in hospital fees 04 resulting from the project. 05 (c) The department shall adopt regulations necessary to implement this 06 section, request technical assistance from the United States Department of Health and 07 Human Services, and apply to the United States Department of Health and Human 08 Services for waivers or amendments to the state plan as necessary to implement the 09 project under this section. 10 Sec. 47.07.039. Coordinated care demonstration projects. (a) The 11 department shall contract with one or more third parties to implement one or more 12 coordinated care demonstration projects for recipients of medical assistance identified 13 by the department. The purpose of a demonstration project under this section is to 14 assess the efficacy of a proposed health care delivery model with respect to cost for, 15 access to, and quality of care for medical assistance recipients. The department may 16 contract for separate demonstration projects to coordinate care for different groups of 17 medical assistance recipients to achieve more effective care for recipients at greater 18 cost savings for the medical assistance program. The department shall request 19 proposals for at least one project under this section on or before December 31, 2016, 20 and may annually request proposals for additional projects under this section 21 thereafter. The department may use an innovative procurement process as described 22 under AS 36.30.308 to award a contract for a project under this section. A proposal for 23 a demonstration project under this section must be submitted to the committee 24 established under (b) of this section and must include three or more of the following 25 elements: 26 (1) comprehensive primary-care-based management for medical 27 assistance services, including behavioral health services and coordination of long-term 28 services and support; 29 (2) care coordination, including the assignment of a primary care 30 provider located in the local geographic area of the recipient, to the extent practical; 31 (3) health promotion; 01 (4) comprehensive transitional care and follow-up care after inpatient 02 treatment; 03 (5) referral to community and social support services, including career 04 and education training services available through the Department of Labor and 05 Workforce Development under AS 23.15, the University of Alaska, or other sources; 06 (6) sustainability and the ability to achieve similar results in other 07 regions of the state; 08 (7) integration and coordination of benefits, services, and utilization 09 management; 10 (8) local accountability for health and resource allocation; 11 (9) an innovative payment process, including bundled payments or 12 global payments. 13 (b) A project review committee is established in the department for the 14 purpose of reviewing proposals for demonstration projects under this section. The 15 project review committee consists of 16 (1) the commissioner of the department, or the commissioner's 17 designee; 18 (2) the commissioner of administration, or the commissioner's 19 designee; 20 (3) the chief executive officer of the Alaska Mental Health Trust 21 Authority, or the chief executive officer's designee, who shall serve as chair of the 22 committee; 23 (4) two representatives of stakeholder groups, appointed by the 24 governor for staggered three-year terms, as follows: 25 (A) one representative of a stakeholder group who has direct 26 experience with health plan management and cost control for the medical 27 assistance population; 28 (B) one representative of a stakeholder group who has direct 29 experience with health plan management and cost control for a nongovernment 30 employer of 500 or more employees in the state; 31 (5) a nonvoting member who is a member of the senate, appointed by 01 the president of the senate; and 02 (6) a nonvoting member who is a member of the house of 03 representatives, appointed by the speaker of the house of representatives. 04 (c) The department may contract with a managed care organization, primary 05 care case manager, accountable care organization, prepaid ambulatory health plan, or 06 provider-led entity to implement a demonstration project under this section. The fee 07 structure for a contract under this subsection may include global payments, bundled 08 payments, capitated payments, shared savings and risk, or other payment structures. 09 The department shall work with the division of insurance, Department of Commerce, 10 Community, and Economic Development, to streamline the application process for a 11 company to obtain a certificate of authority required under AS 21.09.010 as necessary 12 to participate in a demonstration project under this section. 13 (d) A proposal for a demonstration project under this section must include, in 14 addition to the elements required under (a) of this section, information demonstrating 15 how the project will implement additional cost-saving measures, including innovations 16 to reduce the cost of care for medical assistance recipients through the expanded use 17 of telehealth for primary care, urgent care, and behavioral health services. The 18 department shall identify legal or cost barriers preventing the expanded use of 19 telehealth and shall recommend remedies for identified barriers. 20 (e) The department shall contract with a third-party actuary to review 21 demonstration projects established under this section. The actuary shall review each 22 demonstration project after two years of implementation and make recommendations 23 for the implementation of a similar project on a statewide basis. The actuary shall 24 evaluate each project based on cost savings for the medical assistance program, health 25 outcomes for participants in the project, and the ability to achieve similar results on a 26 statewide basis. On or before December 31 of each year, starting in 2018, the actuary 27 shall submit a final report to the department regarding any demonstration project that 28 has been in operation for at least two years. 29 (f) The department shall prepare a plan regarding regional or statewide 30 implementation of a coordinated care project based on the results of the demonstration 31 projects under this section. On or before November 15, 2019, the department shall 01 submit the plan to the senate secretary and the chief clerk of the house of 02 representatives and notify the legislature that the plan is available. On or before 03 November 15 of each year thereafter, the department shall submit a report regarding 04 any changes or recommendations regarding the plan developed under this subsection 05 to the senate secretary and the chief clerk of the house of representatives and notify the 06 legislature that the report is available. 07 (g) In this section, "telehealth" has the meaning given in AS 47.05.270(e). 08  * Sec. 47. AS 47.07 is amended by adding a new section to read: 09 Sec. 47.07.076. Reports to legislature. (a) The department and the attorney 10 general shall annually prepare a report relating to the medical assistance program 11 under this chapter. The report must include the following information: 12 (1) the amount and source of funds used to prevent or prosecute fraud, 13 abuse, payment errors, and errors in eligibility determinations for the previous fiscal 14 year; 15 (2) actions taken to address fraud, abuse, payment errors, and errors in 16 eligibility determinations during the previous fiscal year; 17 (3) specific examples of fraud or abuse that were prevented or 18 prosecuted; 19 (4) identification of vulnerabilities in the medical assistance program, 20 including any vulnerabilities identified by independent auditors with whom the 21 department contracts under AS 47.05.200; 22 (5) initiatives the department has taken to prevent fraud or abuse; 23 (6) recommendations to increase effectiveness in preventing and 24 prosecuting fraud and abuse; 25 (7) the return to the state for every dollar expended by the department 26 and the attorney general to prevent and prosecute fraud and abuse; 27 (8) the most recent payment error rate measurement report for the 28 medical assistance program, including fee for service programs and pilot or 29 demonstration projects; the report must also explain the reasons for the payment errors 30 and the total amount of state and federal funds paid in error during the reporting period 31 and not recovered by the department at the time of the report; 01 (9) results from the Medicaid Eligibility Quality Control program. 02 (b) On or before November 15 of each year, the department shall submit the 03 report required under (a) of this section to the senate secretary and the chief clerk of 04 the house of representatives and notify the legislature that the report is available. 05 (c) On or before December 15 and June 15 of each year, the department shall 06 prepare a semi-annual report and submit the report to the senate secretary and the chief 07 clerk of the house of representatives and notify the legislature that the report is 08 available. The report must include 09 (1) updates and status reports on the Medicaid Management 10 Information System, including progress toward federal certification of the system, 11 current measurements of the accuracy of the system, timeliness of payment of claims, 12 and any backlog of claims; and 13 (2) information on the status of an administrative or legal proceeding 14 relating to resolution of claims against the system contractor and related financial 15 effects on the state. 16  * Sec. 48. AS 47.07.900(4) is amended to read: 17 (4) "clinic services" means services provided by state-approved 18 outpatient community mental health clinics [THAT RECEIVE GRANTS UNDER 19 AS 47.30.520 - 47.30.620], state-operated community mental health clinics, outpatient 20 surgical care centers, and physician clinics; 21  * Sec. 49. AS 47.07.900(17) is amended to read: 22 (17) "rehabilitative services" means services for substance abusers and 23 emotionally disturbed or chronically mentally ill adults provided by 24 (A) a drug or alcohol treatment center [THAT IS FUNDED 25 WITH A GRANT UNDER AS 47.30.475]; or 26 (B) an outpatient community mental health clinic [THAT HAS 27 A CONTRACT TO PROVIDE COMMUNITY MENTAL HEALTH 28 SERVICES UNDER AS 47.30.520 - 47.30.620]; 29  * Sec. 50. AS 47.55.020(e) is amended to read: 30 (e) As a condition for receipt of payment assistance under (d) of this section, 31 the department, under regulations adopted by the department, shall [MAY] require a 01 person to 02 (1) apply for other state or federally sponsored programs that may 03 reduce the amount of the payment assistance; and  04 (2) submit to the department a copy of the person's application for  05 medical assistance coverage under AS 47.07 and the decision letter the person  06 receives regarding the application. 07  * Sec. 51. AS 09.58.020, 09.58.030, 09.58.040, 09.58.050, and 09.58.060 are repealed 08 July 1, 2019. 09  * Sec. 52. AS 08.36.070(a)(10); AS 08.64.101(7); AS 08.68.100(a)(11); 10 AS 08.72.060(c)(3); AS 08.80.030(b)(13); AS 17.30.200(o), 17.30.200(p), 17.30.200(q), 11 17.30.200(r), and 17.30.200(s) are repealed July 1, 2021. 12  * Sec. 53. AS 47.07.076(c) is repealed. 13  * Sec. 54. The uncodified law of the State of Alaska is amended by adding a new section to 14 read: 15 INDIRECT COURT RULE AMENDMENTS. (a) AS 09.58.010, added by sec. 18 of 16 this Act, has the effect of amending Rules 79 and 82, Alaska Rules of Civil Procedure, by 17 providing that the state is entitled to full reasonable attorney fees and costs if the state prevails 18 in a civil action under AS 09.58.010 - 09.58.060 that involves fraud, or reasonable attorney 19 fees and costs if the state prevails in a civil action under AS 09.58.010 - 09.58.060 that does 20 not involve fraud. 21 (b) AS 09.58.020, added by sec. 18 of this Act and repealed by sec. 51 of this Act, has 22 the effect of amending the following court rules in the manner specified from the effective 23 date of sec. 18 of this Act until July 1, 2019: 24 (1) Rules 4, 5, 7, and 12, Alaska Rules of Civil Procedure, by requiring that a 25 complaint under AS 09.58 be filed in camera and under seal and not be served on the 26 defendant until unsealed and that a copy of the complaint be served on the attorney general; 27 (2) Rules 41 and 77, Alaska Rules of Civil Procedure, by authorizing the 28 attorney general to move for dismissal of a complaint filed by another person under 29 AS 09.58.020, added by sec. 18 of this Act and repealed by sec. 51 of this Act, and requiring 30 court approval for dismissal of the action. 31 (c) AS 09.58.025, added by sec. 18 of this Act and amended by sec. 19 of this Act, 01 has the effect of amending Rule 27, Alaska Rules of Civil Procedure, by authorizing the 02 attorney general to issue subpoenas as part of an investigation 03 (1) under AS 09.58.015, added by sec. 18 of this Act, from the effective date 04 of sec. 18 of this Act; and 05 (2) under AS 09.58.020, added by sec. 18 of this Act, from the effective date 06 of sec. 18 of this Act until July 1, 2019. 07 (d) AS 09.58.030, added by sec. 18 of this Act and repealed by sec. 51 of this Act, has 08 the effect of amending the following court rules in the manner specified from the effective 09 date of sec. 18 of this Act until July 1, 2019: 10 (1) Rule 24, Alaska Rules of Civil Procedure, by authorizing the attorney 11 general to intervene in a civil action filed by another person under AS 09.58.020, added by 12 sec. 18 of this Act and repealed by sec. 51 of this Act, and limiting the participation of a party 13 to the litigation; 14 (2) Rules 26 and 27, Alaska Rules of Civil Procedure, by authorizing the 15 attorney general to request that the court issue a stay of discovery for a 90-day period, or 16 longer upon a showing by the attorney general. 17 (e) AS 09.58.040, added by sec. 18 of this Act and repealed by sec. 51 of this Act, has 18 the effect of amending Rules 79 and 82, Alaska Rules of Civil Procedure, from the effective 19 date of sec. 18 of this Act until July 1, 2019, by giving a person who brings an action under 20 AS 09.58.020, added by sec. 18 of this Act and repealed by sec. 51 of this Act, the right to 21 reasonable attorney fees and costs in an action prosecuted by the attorney general, to full 22 reasonable attorney fees and costs if the person prevails in an action not prosecuted by the 23 attorney general that involves fraud, or to reasonable attorney fees and costs in a case that 24 does not involve fraud. 25  * Sec. 55. The uncodified law of the State of Alaska is amended by adding a new section to 26 read: 27 IMPLEMENT FEDERAL POLICY ON TRIBAL MEDICAID REIMBURSEMENT. 28 (a) The Department of Health and Social Services shall collaborate with Alaska tribal health 29 organizations and the United States Department of Health and Human Services to fully 30 implement changes in federal policy that authorize 100 percent federal funding for services 31 provided to American Indian and Alaska Native individuals eligible for Medicaid. 01 (b) Within 30 days after the date the Centers for Medicare and Medicaid Services 02 issues a final policy regarding the circumstances in which 100 percent federal funding is 03 available for medical assistance services received through the United States Indian Health 04 Service or tribal health facilities, the Department of Health and Social Services shall notify 05 and submit a report to the co-chairs of the house and senate finance committees of the Alaska 06 State Legislature that includes an estimate of the savings to the state resulting from the final 07 policy. Within six months after the date the Centers for Medicare and Medicaid Services 08 issues the final policy, the Department of Health and Social Services shall fully implement the 09 policy in the state. 10 (c) In this section, "Alaska tribal health organization" means an organization 11 recognized by the United States Indian Health Service to provide health-related services.  12  * Sec. 56. The uncodified law of the State of Alaska is amended by adding a new section to 13 read: 14 HEALTH INFORMATION INFRASTRUCTURE PLAN. (a) The Department of 15 Health and Social Services shall develop a health information infrastructure plan to strengthen 16 the health information infrastructure, including health data analytics capability. The purpose 17 of the health information infrastructure plan is to transform the health care system in the state 18 by providing 19 (1) data required by health care providers for care coordination and quality 20 improvement; and 21 (2) the information support required by the Department of Health and Social 22 Services and health care providers to enable development and implementation of the other 23 provisions of this Act. 24 (b) To the greatest extent practicable, the health information infrastructure plan must 25 leverage existing resources, including the health information exchange, and identify 26 opportunities for integrating and streamlining health data systems administered by the state. 27  * Sec. 57. The uncodified law of the State of Alaska is amended by adding a new section to 28 read: 29 FEASIBILITY STUDIES FOR THE PROVISION OF SPECIFIED STATE 30 SERVICES. (a) The Department of Health and Social Services, in conjunction with the 31 Alaska Mental Health Trust Authority, shall procure a study analyzing the feasibility of 01 privatizing services delivered at the Alaska Psychiatric Institute. The Department of Health 02 and Social Services and the Alaska Mental Health Trust Authority shall deliver a joint report 03 summarizing the conclusions of the Department of Health and Social Services and the Alaska 04 Mental Health Trust Authority to the senate secretary and the chief clerk of the house of 05 representatives and notify the legislature that the report is available within 10 days after the 06 convening of the First Regular Session of the Thirtieth Alaska State Legislature. 07 (b) The Department of Administration shall, in collaboration with the house and 08 senate finance committees, procure a study to be completed on or before June 30, 2017, to 09 determine the feasibility of creating a health care authority to coordinate health care plans and 10 consolidate purchasing effectiveness for all state employees, retired state employees, retired 11 teachers, medical assistance recipients, University of Alaska employees, employees of state 12 corporations, and school district employees and to develop appropriate benefit sets, rules, 13 cost-sharing, and payment structures for all employees and individuals whose health care 14 benefits are funded directly or indirectly by the state, with the goal of achieving the greatest 15 possible savings to the state through a coordinated approach administered by a single entity. 16 In developing the study, the Department of Administration shall seek input from the 17 Department of Health and Social Services, administrators familiar with managing government 18 employee health plans, and human resource professionals familiar with self-insured health 19 care plans. The study must 20 (1) identify cost-saving strategies that a health care authority could implement; 21 (2) analyze local government participation in the authority; 22 (3) analyze a phased approach to adding groups to the health care plans 23 coordinated by the health care authority; 24 (4) consider previous studies procured by the Department of Administration 25 and the legislature; 26 (5) assess the use of community-related health insurance risk pools and the use 27 of the private marketplace; 28 (6) identify organizational models for a health care authority, including private 29 for-profit, private nonprofit, government, and state corporations; and 30 (7) include a public review and comment opportunity for employers, 31 employees, medical assistance recipients, retirees, and health care providers. 01 (c) The Department of Health and Social Services shall procure a study analyzing the 02 feasibility of privatizing select facilities of the division of juvenile justice and privatizing 03 pharmacy services delivered at Alaska Pioneers' Homes. The Department of Health and 04 Social Services shall deliver a report summarizing the conclusions of the Department of 05 Health and Social Services to the senate secretary and the chief clerk of the house of 06 representatives and notify the legislature that the report is available within 10 days after the 07 convening of the First Regular Session of the Thirtieth Alaska State Legislature. 08 (d) In this section, "school district" has the meaning given in AS 14.30.350. 09  * Sec. 58. The uncodified law of the State of Alaska is amended by adding a new section to 10 read: 11 REPORT TO LEGISLATURE. (a) The Board of Pharmacy, Board of Examiners in 12 Optometry, Board of Dental Examiners, Board of Nursing, and State Medical Board shall 13 jointly prepare a report that describes recommended guidelines for the prescription of 14 schedule II controlled substances listed under federal law. The guidelines must be drafted 15 with the goal of reducing the over-prescription of pain killers and highly addictive schedule II 16 controlled substances. The report must include 17 (1) the following recommended guidelines for each schedule II controlled 18 substance listed under federal law: 19 (A) quantity and strength of each dosage; 20 (B) number of doses for each day; 21 (C) number of days the drug may be prescribed; and 22 (2) other recommendations related to reducing the over-prescription of 23 schedule II controlled substances. 24 (b) On or before January 1, 2017, the Board of Pharmacy, Board of Examiners in 25 Optometry, Board of Dental Examiners, Board of Nursing, and State Medical Board shall 26 jointly deliver the report required under (a) of this section to the senate secretary and the chief 27 clerk of the house of representatives and notify the legislature that the report is available.  28  * Sec. 59. The uncodified law of the State of Alaska is amended by adding a new section to 29 read: 30 MEDICAID STATE PLAN; WAIVERS; INSTRUCTIONS; NOTICE TO REVISOR 31 OF STATUTES. The Department of Health and Social Services shall amend and submit for 01 federal approval a state plan for medical assistance coverage consistent with this Act. The 02 Department of Health and Social Services shall apply to the United States Department of 03 Health and Human Services for any waivers necessary to implement this Act. The 04 commissioner of health and social services shall certify to the revisor of statutes if the 05 provisions of AS 47.05.270(a)(5), (8), and (10), added by sec. 43 of this Act, and the 06 provisions of AS 47.07.038, added by sec. 46 of this Act, are approved by the United States 07 Department of Health and Human Services. 08  * Sec. 60. The uncodified law of the State of Alaska is amended by adding a new section to 09 read: 10 TRANSITION: REGULATIONS. (a) The Department of Health and Social Services 11 may adopt regulations necessary to implement the changes made by this Act. The regulations 12 take effect under AS 44.62 (Administrative Procedure Act), but not before the effective date 13 of the relevant provision of this Act implemented by the regulation. 14 (b) The Department of Commerce, Community, and Economic Development and a 15 board that regulates an occupation that includes a practitioner who is required to register with 16 the controlled substance prescription database under AS 17.30.200 shall adopt regulations to 17 implement the changes made by AS 08.36.070(a), as amended by sec. 5 of this Act, 18 AS 08.64.101(7), added by sec. 7 of this Act, AS 08.68.100(a), as amended by sec. 10 of this 19 Act, AS 08.72.060(c), as amended by sec. 11 of this Act, AS 08.80.030(b), as amended by 20 sec. 12 of this Act, AS 17.30.200(a), as amended by sec. 21 of this Act, AS 17.30.200(b), as 21 amended by sec. 23 of this Act, AS 17.30.200(d), as amended by sec. 25 of this Act, 22 AS 17.30.200(e), as amended by sec. 27 of this Act, AS 17.30.200(h), as amended by sec. 29 23 of this Act, AS 17.30.200(k), as amended by sec. 31 of this Act, AS 17.30.200(m), as 24 amended by sec. 33 of this Act, and AS 17.30.200(o) - (s), enacted by sec. 34 of this Act. The 25 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the 26 effective date of the relevant provisions of secs. 5, 7, 10 - 12, 21, 23, 25, 27, 29, 31, 33, or 34 27 of this Act. In this subsection, 28 (1) "board" has the meaning given in AS 08.01.110; 29 (2) "occupation" has the meaning given in AS 08.01.110; 30 (3) "practitioner" has the meaning given in AS 11.71.900. 31  * Sec. 61. The uncodified law of the State of Alaska is amended by adding a new section to 01 read: 02 CONDITIONAL EFFECT. (a) AS 47.05.270(a)(5), enacted by sec. 43 of this Act, 03 takes effect only if the commissioner of health and social services certifies to the revisor of 04 statutes under sec. 59 of this Act, on or before October 1, 2017, that all of the provisions 05 added by AS 47.05.270(a)(5) have been approved by the United States Department of Health 06 and Human Services. 07 (b) AS 47.05.270(a)(8), enacted by sec. 43 of this Act, takes effect only if the 08 commissioner of health and social services certifies to the revisor of statutes under sec. 59 of 09 this Act, on or before October 1, 2017, that all of the provisions added by AS 47.05.270(a)(8) 10 have been approved by the United States Department of Health and Human Services. 11 (c) AS 47.05.270(a)(10), enacted by sec. 43 of this Act, takes effect only if the 12 commissioner of health and social services certifies to the revisor of statutes under sec. 59 of 13 this Act, on or before October 1, 2017, that all of the provisions added by 14 AS 47.05.270(a)(10) have been approved by the United States Department of Health and 15 Human Services. 16 (d) AS 47.07.038, enacted by sec. 46 of this Act, takes effect only if the commissioner 17 of health and social services certifies to the revisor of statutes under sec. 59 of this Act, on or 18 before October 1, 2017, that all of the provisions added by AS 47.07.038 have been approved 19 by the United States Department of Health and Human Services. 20 (e) AS 09.58.020, added by sec. 18 of this Act, AS 09.58.025, added by sec. 18 of this 21 Act, AS 09.58.030, added by sec. 18 of this Act, and AS 09.58.040, added by sec. 18 of this 22 Act, the amendment to AS 09.58.025 by sec. 19 of this Act, and the repeals of AS 09.58.020, 23 09.58.030, and 09.58.040 by sec. 51 of this Act, take effect only if sec. 54 of this Act receives 24 the two-thirds majority vote of each house required by art. IV, sec. 15, Constitution of the 25 State of Alaska. 26 (f) Section 53 of this Act takes effect only if the commissioner of health and social 27 services certifies to the revisor of statutes that the Medicaid Management Information System 28 has been certified by the United States Department of Health and Human Services. 29 (g) AS 09.58.010(f), enacted by sec. 18 of this Act, takes effect only if the 30 commissioner of health and social services certifies to the revisor of statutes, on or before 31 October 1, 2017, that the provisions added by AS 09.58.010(f) have been found by the Office 01 of Inspector General, United States Department of Health and Human Services, to meet the 02 requirements of 42 U.S.C. 1396h (Social Security Act). 03  * Sec. 62. If AS 47.05.270(a)(5), enacted by sec. 43 of this Act, takes effect, it takes effect 04 on the day after the date the commissioner of health and social services makes a certification 05 to the revisor of statutes under secs. 59 and 61(a) of this Act. 06  * Sec. 63. If AS 47.05.270(a)(8), enacted by sec. 43 of this Act, takes effect, it takes effect 07 on the day after the date the commissioner of health and social services makes a certification 08 to the revisor of statutes under secs. 59 and 61(b) of this Act. 09  * Sec. 64. If AS 47.05.270(a)(10), enacted by sec. 43 of this Act, takes effect, it takes effect 10 on the day after the date the commissioner of health and social services makes a certification 11 to the revisor of statutes under secs. 59 and 61(c) of this Act. 12  * Sec. 65. If AS 47.07.038, enacted by sec. 46 of this Act, takes effect, it takes effect on the 13 day after the date the commissioner of health and social services makes a certification to the 14 revisor of statutes under secs. 59 and 61(d) of this Act. 15  * Sec. 66. If sec. 53 of this Act takes effect, it takes effect on the day after the date the 16 commissioner of health and social services makes a certification to the revisor of statutes 17 under sec. 61(f) of this Act. 18  * Sec. 67. If AS 09.58.010(f), enacted by sec. 18 of this Act, takes effect, it takes effect on 19 the day after the date the commissioner of health and social services makes a certification to 20 the revisor of statutes under sec. 61(g) of this Act. 21  * Sec. 68. Sections 57 and 59 - 61 of this Act take effect immediately under 22 AS 01.10.070(c). 23  * Sec. 69. AS 47.07.076(c), enacted by sec. 47 of this Act, takes effect July 1, 2016. 24  * Sec. 70. AS 17.30.200(s), enacted by sec. 34 of this Act, takes effect September 1, 2016. 25  * Sec. 71. Sections 5, 10 - 12, 21, 23, 25, 27, 29, 31, and 33 of this Act, AS 08.64.101(7), 26 enacted by sec. 7 of this Act, and AS 17.30.200(o) - (r), enacted by sec. 34 of this Act, take 27 effect July 17, 2017. 28  * Sec. 72. Sections 19 and 20 of this Act take effect July 1, 2019. 29  * Sec. 73. Sections 22, 24, 26, 28, 30, and 32 of this Act take effect July 1, 2021.