HCS SB 109(RLS): "An Act repealing the statute that sets priorities for the Department of Health and Social Services to apply to administration of the medical assistance program when there are insufficient funds allocated in the state budget for that program; authorizing the department to make cost containment decisions that may include decisions about eligibility of persons and availability of services under the medical assistance program; and providing for an effective date."
00 HOUSE CS FOR SENATE BILL NO. 109(RLS) 01 "An Act repealing the statute that sets priorities for the Department of Health and 02 Social Services to apply to administration of the medical assistance program when there 03 are insufficient funds allocated in the state budget for that program; authorizing the 04 department to make cost containment decisions that may include decisions about 05 eligibility of persons and availability of services under the medical assistance program; 06 and providing for an effective date." 07 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 08 * Section 1. The uncodified law of the State of Alaska is amended by adding a new section 09 to read: 10 LEGISLATIVE INTENT. (a) It is the intent of the legislature that the Department of 11 Health and Social Services should have the authority to make cost containment decisions 12 related to the Medicaid program under AS 47.07 during any fiscal year when the department 13 finds that the cost of medical assistance for all persons eligible under the program will exceed
01 the amount allocated in the state budget for that fiscal year. Further, it is the intent of the 02 legislature that the department continue to provide coverage for all Medicaid approved 03 medications. If the department develops a preferred drug list to improve the Medicaid 04 program's efficiency, it is the legislature's intent that the department should work with 05 providers to develop the preferred drug list and that the department should establish an 06 authorization system that is minimally intrusive to the providers while protecting access to 07 medically necessary medications. The legislature encourages the department to develop case 08 management systems or tools that allow for the comparison of cost savings associated with a 09 preferred drug list or alternative cost containment methodologies. 10 (b) The legislature intends, with the enactment of sec. 3 of this Act, that the cost 11 containment decisions made by the Department of Health and Social Services should be those 12 that best reflect the needs and interests of the eligible recipients and the coverage options 13 available under AS 47.07 and that the department should take all reasonable measures to 14 effect cost containment in ways that least affect the recipients who are eligible for services 15 and the types of services that are available. 16 * Sec. 2. AS 47.07.030(c) is amended to read: 17 (c) Notwithstanding (b) of this section, the department may offer a service for 18 which the department has received a waiver from the federal government if the 19 department was authorized, directed, or requested to apply for the waiver by law or by 20 a concurrent or joint resolution of the legislature. [THE DEPARTMENT SHALL 21 ANNUALLY MAKE AVAILABLE TO THE LEGISLATURE ITS 22 RECOMMENDATIONS ABOUT WHERE A SERVICE OFFERED UNDER THIS 23 SUBSECTION SHOULD BE PLACED ON THE PRIORITY LIST IN AS 47.07.035. 24 THE DEPARTMENT SHALL NOTIFY THE LEGISLATURE THAT THE 25 RECOMMENDATIONS ARE AVAILABLE.] 26 * Sec. 3. AS 47.07 is amended by adding a new section to read: 27 Sec. 47.07.036. Cost containment measures authorized. (a) If the 28 department finds that the costs of medical assistance for all persons eligible under this 29 chapter will exceed the amount allocated in the state budget for a fiscal year, the 30 department may implement cost containment measures to reduce anticipated program 31 costs for that fiscal year as authorized under this section.
01 (b) The department, in implementing this section, shall take all reasonable 02 steps to implement cost containment measures that do not eliminate program 03 eligibility or the scope of services required or authorized under AS 47.07.020 and 04 47.07.030 before implementing cost containment measures under (c) of this section 05 that directly affect program eligibility or coverage of services. The cost containment 06 measures taken under this subsection may include new utilization review procedures, 07 changes in provider payment rates, pre-certification requirements for coverage of 08 services, and agreements with federal officials under which the federal government 09 will assume responsibility for coverage of some individuals or some services for some 10 individuals through such federal programs as the Indian Health Service or Medicare. 11 (c) If cost containment measures authorized under (b) of this section are 12 insufficient to reduce the anticipated program costs for a fiscal year to the amount 13 allocated in the state budget for the program for that fiscal year, the department may, 14 to the extent authorized under federal law and the state's constitution, deny any or all 15 optional services listed in AS 47.07.030(b) - (d) to a person eligible for services under 16 AS 47.07.020 or deny program eligibility to a person who is eligible for the medical 17 assistance program under the optional coverage provisions of AS 47.07.020(b) - (i). 18 However, the department may not eliminate program participation of a person who is 19 eligible for coverage under AS 47.07.020(a), nor may the department deny coverage 20 of a service described in AS 47.07.030(a) for a person who is eligible for the medical 21 assistance program under AS 47.07.020. 22 * Sec. 4. AS 47.07.035 is repealed. 23 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 24 read: 25 APPLICABILITY. AS 47.07.036, enacted by sec. 3 of this Act, applies only to 26 eligibility determinations made and medical services performed on or after July 1, 2003. 27 * Sec. 6. This Act takes effect July 1, 2003.