00 CS FOR HOUSE BILL NO. 58(HSS) 01 "An Act relating to insurance coverage for contraceptives and related services; relating 02 to medical assistance coverage for contraceptives and related services; and providing for 03 an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 21.42 is amended by adding a new section to read: 06 Sec. 21.42.427. Coverage for contraceptives. (a) A health care insurer that 07 offers, issues for delivery, delivers, or renews in the state a health care insurance plan 08 in the group or individual market shall 09 (1) provide coverage for 10 (A) prescription contraceptives; 11 (B) emergency contraception, including over-the-counter 12 emergency contraception, approved by the United States Food and Drug 13 Administration; the insurer may not require a prescription for coverage of 14 over-the-counter emergency contraception under this subparagraph; 01 (C) voluntary sterilization procedures; and 02 (D) consultations, examinations, procedures, and medical 03 services that are necessary to prescribe, dispense, insert, deliver, distribute, 04 administer, or remove the drugs, devices, and other products or services 05 provided under this paragraph; 06 (2) reimburse a health care provider or dispensing entity for dispensing 07 prescription contraceptives intended to last for a 12-month period for subsequent 08 dispensings of the same prescription contraceptive to the insured regardless of whether 09 the insured was enrolled in the health care insurance plan at the time of the first 10 dispensing. 11 (b) A health care insurer may not deny coverage or reimbursement under (a) 12 of this section because an insured changed contraceptive methods within a 12-month 13 period. 14 (c) Except as provided in (d) of this section, a health care insurer may not 15 offset the costs of compliance with (a) of this section and may not require copayments 16 or deductibles for contraceptives or services covered under (a) of this section. 17 (d) A health care insurer shall establish cost sharing for the coverage provided 18 under (a) of this section to the extent necessary to qualify a plan as a high deductible 19 health plan eligible for a health savings account tax deduction under 26 U.S.C. 223 20 (Internal Revenue Code). 21 (e) A health care insurer may not restrict or delay the coverage or 22 reimbursement required under (a) of this section, including use of medical 23 management techniques, such as denials, step therapy, or prior authorization, that limit 24 an insured's choice in accessing a full range of prescription contraceptives. Nothing in 25 this subsection prevents a health care insurer from enacting reasonable cost 26 containment measures in relation to the coverage required under (a) of this section if 27 the cost containment measure does not unreasonably limit choice in access to 28 coverage. In this subsection, "cost containment" means incentivizing the use of 29 generic or lower cost medications or the use of health care providers or pharmacies 30 that offer services or prescriptions at a lower negotiated rate. 31 (f) If the covered therapeutically equivalent version of a prescription 01 contraceptive is not available or is considered medically inadvisable by the health care 02 provider of the insured, a health care insurer shall provide coverage without cost 03 sharing for an alternative therapeutically equivalent version of the prescription 04 contraceptive that is prescribed for the insured. 05 (g) A health care insurer shall provide coverage and reimbursement under (a) 06 of this section to all insureds enrolled in a health care insurance plan, including 07 enrolled spouses and dependents. 08 (h) A health care insurer that offers, issues for delivery, delivers, or renews in 09 the state a health care insurance plan in the group market to a religious employer is 10 exempt from the requirements of this section with respect to the health care insurance 11 plan of the religious employer if the religious employer opposes the coverage required 12 under this section and is an organization that meets the criteria set out in 26 U.S.C. 13 6033(a)(3)(A)(i) or (iii) (Internal Revenue Code of 1986), as amended. 14 (i) In this section, "prescription contraceptive" means a drug or device that 15 requires a prescription and is approved by the United States Food and Drug 16 Administration to prevent pregnancy. 17 * Sec. 2. AS 29.10.200 is amended by adding a new paragraph to read: 18 (68) AS 29.20.420 (health care insurance plans). 19 * Sec. 3. AS 29.20 is amended by adding a new section to article 5 to read: 20 Sec. 29.20.420. Health insurance policies. (a) If a municipality offers a group 21 health care insurance plan covering municipal employees, including by means of self- 22 insurance, the municipal health care insurance plan is subject to the requirements of 23 AS 21.42.427. 24 (b) This section applies to home rule and general law municipalities. 25 (c) In this section "health care insurance plan" has the meaning given in 26 AS 21.54.500. 27 * Sec. 4. AS 39.30.090(a) is amended to read: 28 (a) The Department of Administration may obtain a policy or policies of group 29 insurance covering state employees, persons entitled to coverage under AS 14.25.168, 30 14.25.480, AS 22.25.090, AS 39.35.535, 39.35.880, or former AS 39.37.145, 31 employees of other participating governmental units, or persons entitled to coverage 01 under AS 23.15.136, subject to the following conditions: 02 (1) a group insurance policy shall provide one or more of the following 03 benefits: life insurance, accidental death and dismemberment insurance, weekly 04 indemnity insurance, hospital expense insurance, surgical expense insurance, dental 05 expense insurance, audiovisual insurance, or other medical care insurance; 06 (2) each eligible employee of the state, the spouse and the unmarried 07 children chiefly dependent on the eligible employee for support, and each eligible 08 employee of another participating governmental unit shall be covered by the group 09 policy, unless exempt under regulations adopted by the commissioner of 10 administration; 11 (3) a governmental unit may participate under a group policy if 12 (A) its governing body adopts a resolution authorizing 13 participation and payment of required premiums; 14 (B) a certified copy of the resolution is filed with the 15 Department of Administration; and 16 (C) the commissioner of administration approves the 17 participation in writing; 18 (4) in procuring a policy of group health or group life insurance as 19 provided under this section or excess loss insurance as provided in AS 39.30.091, the 20 Department of Administration shall comply with the dual choice requirements of 21 AS 21.86.310, and shall obtain the insurance policy from an insurer authorized to 22 transact business in the state under AS 21.09, a hospital or medical service corporation 23 authorized to transact business in this state under AS 21.87, or a health maintenance 24 organization authorized to operate in this state under AS 21.86; an excess loss 25 insurance policy may be obtained from a life or health insurer authorized to transact 26 business in this state under AS 21.09 or from a hospital or medical service corporation 27 authorized to transact business in this state under AS 21.87; 28 (5) the Department of Administration shall make available bid 29 specifications for desired insurance benefits or for administration of benefit claims and 30 payments to (A) all insurance carriers authorized to transact business in this state 31 under AS 21.09 and all hospital or medical service corporations authorized to transact 01 business under AS 21.87 who are qualified to provide the desired benefits; and (B) 02 insurance carriers authorized to transact business in this state under AS 21.09, hospital 03 or medical service corporations authorized to transact business under AS 21.87, and 04 third-party administrators licensed to transact business in this state and qualified to 05 provide administrative services; the specifications shall be made available at least once 06 every five years; the lowest responsible bid submitted by an insurance carrier, hospital 07 or medical service corporation, or third-party administrator with adequate servicing 08 facilities shall govern selection of a carrier, hospital or medical service corporation, or 09 third-party administrator under this section or the selection of an insurance carrier or a 10 hospital or medical service corporation to provide excess loss insurance as provided in 11 AS 39.30.091; 12 (6) if the aggregate of dividends payable under the group insurance 13 policy exceeds the governmental unit's share of the premium, the excess shall be 14 applied by the governmental unit for the sole benefit of the employees; 15 (7) a person receiving benefits under AS 14.25.110, AS 22.25, 16 AS 39.35, or former AS 39.37 may continue the life insurance coverage that was in 17 effect under this section at the time of termination of employment with the state or 18 participating governmental unit; 19 (8) a person electing to have insurance under (7) of this subsection 20 shall pay the cost of this insurance; 21 (9) for each permanent part-time employee electing coverage under 22 this section, the state shall contribute one-half the state contribution rate for permanent 23 full-time state employees, and the permanent part-time employee shall contribute the 24 other one-half; 25 (10) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, 26 or former AS 39.37 may obtain auditory, visual, and dental insurance for that person 27 and eligible dependents under this section; the level of coverage for persons over 65 28 shall be the same as that available before reaching age 65 except that the benefits 29 payable shall be supplemental to any benefits provided under the federal old age, 30 survivors, and disability insurance program; a person electing to have insurance under 31 this paragraph shall pay the cost of the insurance; the commissioner of administration 01 shall adopt regulations implementing this paragraph; 02 (11) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, 03 or former AS 39.37 may obtain long-term care insurance for that person and eligible 04 dependents under this section; a person who elects insurance under this paragraph 05 shall pay the cost of the insurance premium; the commissioner of administration shall 06 adopt regulations to implement this paragraph; 07 (12) each licensee holding a current operating agreement for a vending 08 facility under AS 23.15.010 - 23.15.210 shall be covered by the group policy that 09 applies to governmental units other than the state; 10 (13) a group health insurance policy covering employees of a 11 participating governmental unit is subject to the requirements of AS 21.42.427. 12 * Sec. 5. AS 39.30.091 is amended to read: 13 Sec. 39.30.091. Authorization for self-insurance and excess loss insurance. 14 Notwithstanding AS 21.86.310 or AS 39.30.090, the Department of Administration 15 may provide, by means of self-insurance, one or more of the benefits listed in 16 AS 39.30.090(a)(1) for state employees eligible for the benefits by law or under a 17 collective bargaining agreement and for persons receiving benefits under AS 14.25, 18 AS 22.25, AS 39.35, or former AS 39.37, and their dependents. The department shall 19 procure any necessary excess loss insurance under AS 39.30.090. A self-insured 20 group medical plan covering active state employees provided under this section is 21 subject to the requirements of AS 21.42.427. 22 * Sec. 6. AS 47.07.065 is amended by adding new subsections to read: 23 (c) The department shall pay for 24 (1) prescription contraceptives intended to last for a 12-month period 25 for subsequent dispensings of the same prescription contraceptive if prescribed to and 26 requested by the recipient, regardless of whether the recipient was receiving medical 27 assistance at the time of the first dispensing; 28 (2) emergency contraception, including over-the-counter emergency 29 contraception, approved by the United States Food and Drug Administration; the 30 department may not require a prescription for coverage of over-the-counter emergency 31 contraception under this paragraph; and 01 (3) consultations, examinations, procedures, and medical services that 02 are necessary to 03 (A) prescribe, dispense, insert, distribute, or administer 04 prescription contraceptives; or 05 (B) remove prescription contraceptives. 06 (d) Nothing in this section requires itemized reimbursement when a service is 07 reimbursable as part of a bundled or composite rate. 08 (e) In this section, "prescription contraceptive" means a drug or device that 09 requires a prescription and is approved by the United States Food and Drug 10 Administration to prevent pregnancy. 11 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 12 read: 13 MEDICAID STATE PLAN FEDERAL APPROVAL. The Department of Health and 14 Social Services shall amend and submit for federal approval the state plan for medical 15 assistance coverage consistent with AS 47.07.065(c) - (e), enacted by sec. 6 of this Act. 16 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 17 read: 18 CONDITIONAL EFFECT; NOTIFICATION. (a) The commissioner of health and 19 social services shall notify the revisor of statutes in writing, on or before January 1, 2022, if 20 the United States Department of Health and Human Services approves the amendments to the 21 state plan for medical assistance coverage under AS 47.07.065(c) - (e), enacted by sec. 6 of 22 this Act. 23 (b) Section 6 of this Act takes effect only if the commissioner of health and social 24 services notifies the revisor of statutes in writing as required under (a) of this section. 25 * Sec. 9. If sec. 6 of this Act takes effect, it takes effect on the day after the date the revisor 26 of statutes receives notice from the commissioner of health and social services under sec. 8 of 27 this Act.