00 HOUSE BILL NO. 260 01 "An Act repealing programs for catastrophic illness assistance and medical assistance 02 for chronic and acute medical conditions." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 36.30.850(b)(11) is amended to read: 05 (11) agreements with providers of services under AS 47.25.071 - 06 47.25.095; AS 47.07; [AS 47.08;] AS 47.10; AS 47.12; AS 47.14; AS 47.17; 07 AS 47.24; and AS 47.27, including contractors under AS 47.27.050; 08 * Sec. 2. AS 47.05.085(a) is amended to read: 09 (a) The commissioner or the commissioner's designee at the director level may 10 issue subpoenas to compel the production of books, papers, correspondence, 11 memoranda, and other records considered necessary as evidence in connection with an 12 investigation under or the administration of AS 47.07 (medical assistance), [AS 47.08 13 (ASSISTANCE FOR CATASTROPHIC ILLNESSES AND ACUTE OR CHRONIC 14 MEDICAL CONDITIONS),] AS 47.25 (day care assistance, child care grants, general 01 relief, adult public assistance, and food stamps), and AS 47.27 (Alaska temporary 02 assistance program). 03 * Sec. 3. AS 47.05.200(d) is amended to read: 04 (d) As a condition of obtaining payment under AS 47.07 [AND AS 47.08] and 05 for purposes of this section, a provider shall allow 06 (1) the department reasonable access to the records of medical 07 assistance recipients and providers; and 08 (2) audit and inspection of the records by state and federal agencies. 09 * Sec. 4. AS 47.05.210(a) is amended to read: 10 (a) A person commits the crime of medical assistance fraud if the person 11 (1) knowingly submits or authorizes the submission of a claim to a 12 medical assistance agency for property, services, or a benefit with reckless disregard 13 that the claimant is not entitled to the property, services, or benefit; 14 (2) knowingly prepares or assists another person to prepare a claim for 15 submission to a medical assistance agency for property, services, or a benefit with 16 reckless disregard that the claimant is not entitled to the property, services, or benefit; 17 (3) except as otherwise authorized under the medical assistance 18 program, confers, offers to confer, solicits, agrees to accept, or accepts property, 19 services, or a benefit 20 (A) to refer a medical assistance recipient to a health care 21 provider; or 22 (B) for providing health care to a medical assistance recipient if 23 the property, services, or benefit is in addition to payment by a medical 24 assistance agency; 25 (4) does not produce medical assistance records to a person authorized 26 to request the records; 27 (5) knowingly makes a false entry in or falsely alters a medical 28 assistance record; 29 (6) knowingly destroys, mutilates, suppresses, conceals, removes, or 30 otherwise impairs the verity, legibility, or availability of a medical assistance record 31 knowing that the person lacks the authority to do so; or 01 (7) violates a provision of AS 47.07 [OR AS 47.08] or a regulation 02 adopted under AS 47.07 [OR AS 47.08]. 03 * Sec. 5. AS 47.05.240 is amended to read: 04 Sec. 47.05.240. Exclusion from medical assistance programs. (a) The 05 commissioner may exclude an applicant to or disenroll a medical assistance provider 06 in the medical assistance program in AS 47.07 [OR AS 47.08, OR BOTH,] for a 07 period of up to 10 years after unconditional discharge on a conviction 08 (1) for medical assistance fraud under AS 47.05.210 or misconduct 09 involving a controlled substance under AS 11.71; or 10 (2) in a court of the United States or a court of another state or 11 territory, for a crime with elements similar to the crimes included under (1) of this 12 subsection. 13 (b) After a period of exclusion under (a) of this section, an applicant may not 14 participate in a medical assistance program under AS 47.07 [OR AS 47.08] until the 15 applicant establishes to the commissioner by clear and convincing evidence that the 16 applicant possesses all required licenses and certificates and is qualified to participate. 17 * Sec. 6. AS 47.05.290(9) is amended to read: 18 (9) "medical assistance program" means a program under AS 47.07 19 [OR AS 47.08]; 20 * Sec. 7. AS 47.05.290(10) is amended to read: 21 (10) "medical assistance provider" or "provider" means a person or 22 organization that provides, attempts to provide, or claims to have provided services or 23 products to a medical assistance recipient that may qualify for reimbursement under 24 AS 47.07 [OR AS 47.08] or a person or organization that participates in or has applied 25 to participate in a medical assistance program as a supplier of a service or product; 26 * Sec. 8. AS 47.05.290(17) is amended to read: 27 (17) "services" or "medical assistance services" means a health care 28 benefit that may qualify for reimbursement under AS 47.07 [OR AS 47.08], including 29 health care benefits provided, attempted to be provided, or claimed to have been 30 provided to another, by a medical assistance provider, or "services" as defined in 31 AS 11.81.900; 01 * Sec. 9. AS 47.05.330(a) is amended to read: 02 (a) The Department of Health and the Department of Family and Community 03 Services shall by regulation identify each database that department will review when 04 conducting a civil history check under AS 47.05.325 to identify each individual 05 (1) whom a court or the applicable department has found 06 (A) to have committed abuse, neglect, undue influence, or 07 exploitation of a vulnerable adult; 08 (B) under AS 47.32 or regulations adopted under AS 47.32, to 09 have significantly adversely affected the health, safety, or welfare of an 10 individual who is receiving a service from an entity licensed under AS 47.32; a 11 finding described in this subparagraph includes a decision to revoke, suspend, 12 or deny a license or license renewal, or the relinquishment of a license as part 13 of a settlement agreement; 14 (2) who has been subject to criminal or civil penalties for a violation of 15 AS 09.58, AS 47.05, AS 47.06, AS 47.07, former AS 47.08, or regulations adopted 16 under AS 09.58, AS 47.05, AS 47.06, AS 47.07, or former AS 47.08; 17 (3) about whom the applicable department or a court has made a 18 substantiated finding of child abuse or neglect under AS 47.10 or AS 47.14; 19 (4) who was a biological or adoptive parent, guardian, custodian, or 20 Indian custodian of a child at the time the child was the subject of a child-in-need-of- 21 aid petition under AS 47.10; 22 (5) who, in the course of employment with the state, has been 23 terminated from employment or has had an allegation of assaultive, abusive, 24 neglectful, or exploitive behavior or actions substantiated; 25 (6) who, in this state or another jurisdiction, for reasons related to 26 abuse, neglect, undue influence, exploitation, or other reasons that are inconsistent 27 with standards for the protection of public health, safety, or welfare, has had a 28 professional license, certification, or similar professional designation revoked, 29 suspended, or denied, or has had a request for renewal of a professional license, 30 certification, or similar professional designation denied; 31 (7) whom another state or jurisdiction has identified on a civil registry 01 or database substantially similar to the databases identified under this section for 02 reasons substantially similar to the reasons identified in (1) - (6) of this subsection. 03 * Sec. 10. AS 47.08.010, 47.08.020, 47.08.030, 47.08.040, 47.08.050, 47.08.060, 47.08.070, 04 47.08.080, 47.08.090, 47.08.100, 47.08.110, 47.08.120, 47.08.130, 47.08.140, and 47.08.150 05 are repealed. 06 * Sec. 11. The uncodified law of the State of Alaska is amended by adding a new section to 07 read: 08 APPLICABILITY. AS 47.05.210(a), as amended by sec. 4 of this Act, applies to 09 offenses committed on or after the effective date of this Act. 10 * Sec. 12. The uncodified law of the State of Alaska is amended by adding a new section to 11 read: 12 TRANSITION. (a) Notwithstanding AS 47.05.085(a), as amended by sec. 2 of this 13 Act, the commissioner of health or the commissioner's designee may issue subpoenas to 14 compel the production of books, papers, correspondence, memoranda, and other records 15 considered necessary as evidence in connection with an investigation under AS 47.08 that 16 began before the effective date of this Act or for an investigation of a violation of AS 47.08 17 that occurred before the effective date of this Act. 18 (b) Notwithstanding AS 47.05.200(d), as amended by sec. 3 of this Act, a provider 19 shall allow the department reasonable access to the records of medical assistance recipients 20 and providers and allow audit and inspection of the records by state and federal agencies 21 (1) in order to receive payment for a service provided under AS 47.08 before 22 the effective date of this Act; and 23 (2) in connection with an audit under AS 47.05.200 for activities that occurred 24 before the effective date of this Act.