CSHB 369(FIN) AM: "An Act relating to Medicaid coverage for certain eligible children and pregnant women; relating to primary care case management and managed care services as optional services under the Medicaid program; relating to premiums and cost-sharing contributions under the Medicaid program; and providing for an effective date."
00CS FOR HOUSE BILL NO. 369(FIN) am 01 "An Act relating to Medicaid coverage for certain eligible children and pregnant 02 women; relating to primary care case management and managed care services 03 as optional services under the Medicaid program; relating to premiums and cost- 04 sharing contributions under the Medicaid program; and providing for an 05 effective date." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. AS 47.07.020(b) is amended by adding new paragraphs to read: 08 (12) persons under age 19 who are not covered under (a) of this section 09 and whose household income does not exceed 200 percent of the federal poverty 10 guideline as defined by the federal office of management and budget and revised under 11 42 U.S.C. 9902(2); 12 (13) pregnant women who are not covered under (a) of this section and 13 whose household income does not exceed 200 percent of the federal poverty line as 14 defined by the federal office of management and budget and revised under
01 42 U.S.C. 9902(2). 02 * Sec. 2. AS 47.07.020 is amended by adding a new subsection to read: 03 (i) The department may allow a person under 19 years of age who is 04 determined to be eligible for benefits under this chapter to remain eligible for those 05 benefits for up to 11 calendar months following the month that the person is 06 determined eligible for benefits or until the person is 19 years old, whichever occurs 07 earlier. 08 * Sec. 3. AS 47.07.030(b) is amended to read: 09 (b) In addition to the mandatory services specified in (a) of this section and 10 the services provided under (d) of this section , the department may offer only the 11 following optional services: case management and nutrition services for pregnant 12 women; personal care services in a recipient's home; emergency hospital services; 13 long-term care noninstitutional services; medical supplies and equipment; advanced 14 nurse practitioner services; clinic services; rehabilitative services for substance abusers 15 and emotionally disturbed or chronically mentally ill adults; targeted case management 16 services for substance abusers, chronically mentally ill adults, and severely emotionally 17 disturbed persons under the age of 21; inpatient psychiatric facility services for 18 individuals age 65 or older and individuals under age 21; psychologists' services; 19 clinical social workers' services; midwife services; prescribed drugs; physical therapy; 20 occupational therapy; chiropractic services; low-dose mammography screening, as 21 defined in AS 21.42.375(e); hospice care; treatment of speech, hearing, and language 22 disorders; adult dental services; prosthetic devices and eyeglasses; optometrists' 23 services; intermediate care facility services, including intermediate care facility services 24 for the mentally retarded; skilled nursing facility services for individuals under age 21; 25 and reasonable transportation to and from the point of medical care. 26 * Sec. 4. AS 47.07.030(d) is repealed and reenacted to read: 27 (d) The department may establish as optional services a primary care case 28 management system or a managed care organization contract in which certain eligible 29 individuals are required to enroll and seek approval from a case manager or the 30 managed care organization before receiving certain services. The department shall 31 establish enrollment criteria and determine eligibility for services consistent with
01 federal and state law. 02 * Sec. 5. AS 47.07.042(a) is amended to read: 03 (a) Except as provided in (b) - (d) [(b) AND (c)] of this section, the state plan 04 developed under AS 47.07.040 shall impose deductible, coinsurance, and copayment 05 requirements [OR SIMILAR CHARGES] on persons eligible for assistance under this 06 chapter to the maximum extent allowed under federal law and regulations. The plan 07 must provide that health care providers shall collect the allowable charge. The 08 department shall reduce payments to each provider by the amount of the allowable 09 charge. A provider may not deny services because a recipient is unable to share costs, 10 but an inability to share costs imposed under this section does not relieve the recipient 11 of liability for the costs. 12 * Sec. 6. AS 47.07.042 is amended by adding a new subsection to read: 13 (d) In addition to the requirements established under (a) and (b) of this section, 14 the department may require premiums or cost-sharing contributions from recipients 15 who are eligible for benefits under AS 47.07.020(b)(12) and whose household income 16 is between 150 and 200 percent of the federal poverty guideline. If the department 17 requires premiums or cost-sharing contributions under this subsection, the department 18 (1) shall adopt in regulation a sliding scale for those premiums or 19 contributions based on household income; 20 (2) may not exceed the maximums allowed under federal law; and 21 (3) shall implement a system by which the department or its designee 22 collects those premiums or contributions. 23 * Sec. 7. TRANSITION: REGULATIONS. Notwithstanding sec. 9 of this Act, the 24 Department of Health and Social Services may proceed to adopt regulations necessary to 25 implement the changes made by this Act. The regulations take effect under AS 44.62 26 (Administrative Procedure Act), but not before the effective date of secs. 1 - 6 of this Act. 27 * Sec. 8. Section 7 of this Act takes effect immediately under AS 01.10.070(c). 28 * Sec. 9. Except as provided in sec. 8 of this Act, this Act takes effect July 1, 1998.