SCS CSHB 17(HSS): "An Act relating to insurance coverage for contraceptives and related services; relating to medical assistance coverage for contraceptives and related services; and providing for an effective date."
00 SENATE CS FOR CS FOR HOUSE BILL NO. 17(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 ended 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; and 11 (B) consultations, examinations, procedures, and medical 12 services that are necessary to prescribe, dispense, insert, deliver, distribute, 13 administer, or remove the drugs, devices, and other products or services 14 provided under this paragraph; 15 (2) reimburse a health care provider or dispensing entity for dispensing
01 prescription contraceptives intended to last for a 12-month period for subsequent 02 dispensings of the same prescription contraceptive to the insured regardless of whether 03 the insured was enrolled in the health care insurance plan at the time of the first 04 dispensing. 05 (b) A health care insurer may not deny coverage or reimbursement under (a) 06 of this section because an insured changed contraceptive methods within a 12-month 07 period. 08 (c) Except as provided in (d) of this section, a health care insurer may not 09 require cost sharing for contraceptives or services covered under (a) of this section 10 when provided by a participating health care provider or dispensing entity. 11 (d) A health care insurer shall establish cost sharing for the coverage provided 12 under (a) of this section to the extent necessary to qualify a plan as a high deductible 13 health plan eligible for a health savings account tax deduction under 26 U.S.C. 223 14 (Internal Revenue Code). 15 (e) A health care insurer that applies medical management techniques, 16 including step therapy or prior authorization, must provide without delay a simple and 17 easy to understand exception procedure for a covered person to access contraceptives 18 covered under (a) of this section. 19 (f) If the covered therapeutically equivalent version of a prescription 20 contraceptive is not available or is considered medically inadvisable by the health care 21 provider of the insured, a health care insurer shall provide coverage without cost 22 sharing for an alternative therapeutically equivalent version of the prescription 23 contraceptive that is prescribed by a participating health care provider for the insured. 24 (g) A health care insurer shall provide coverage and reimbursement under (a) 25 of this section to all insureds enrolled in a health care insurance plan, including 26 enrolled spouses and dependents. 27 (h) A health care insurer that offers, issues for delivery, delivers, or renews in 28 the state a health care insurance plan in the group market to a religious employer is 29 exempt from the requirements of this section with respect to the health care insurance 30 plan of the religious employer if the religious employer opposes the coverage required 31 under this section and is an organization that meets the criteria set out in 26 U.S.C.
01 6033(a)(3)(A)(i) or (iii) (Internal Revenue Code of 1986), as amended. 02 (i) When enforcing health care insurance coverage regarding contraceptive 03 methods as provided in this section in a manner that burdens a person's religious 04 practices, the state must demonstrate that enforcement is 05 (1) in furtherance of a compelling government interest; and 06 (2) the least restrictive means of furthering that interest. 07 (j) In this section, "prescription contraceptive" means a drug or device that 08 requires a prescription and is approved by the United States Food and Drug 09 Administration to prevent pregnancy. 10 * Sec. 2. AS 29.10.200 is amended by adding a new paragraph to read: 11 (68) AS 29.20.420 (health care insurance plans). 12 * Sec. 3. AS 29.20 is amended by adding a new section to article 5 to read: 13 Sec. 29.20.420. Health insurance policies. (a) If a municipality offers a group 14 health care insurance plan covering municipal employees, including by means of self- 15 insurance, the municipal health care insurance plan is subject to the requirements of 16 AS 21.42.427. 17 (b) This section applies to home rule and general law municipalities. 18 (c) In this section, "health care insurance plan" has the meaning given in 19 AS 21.54.500. 20 * Sec. 4. AS 39.30.090(a) is amended to read: 21 (a) The Department of Administration may obtain a policy or policies of group 22 insurance covering state employees, persons entitled to coverage under AS 14.25.168, 23 14.25.480, AS 22.25.090, AS 39.35.535, 39.35.880, or former AS 39.37.145, 24 employees of other participating governmental units, or persons entitled to coverage 25 under AS 23.15.136, subject to the following conditions: 26 (1) a group insurance policy shall provide one or more of the following 27 benefits: life insurance, accidental death and dismemberment insurance, weekly 28 indemnity insurance, hospital expense insurance, surgical expense insurance, dental 29 expense insurance, audiovisual insurance, or other medical care insurance; 30 (2) each eligible employee of the state, the spouse and the unmarried 31 children chiefly dependent on the eligible employee for support, and each eligible
01 employee of another participating governmental unit shall be covered by the group 02 policy, unless exempt under regulations adopted by the commissioner of 03 administration; 04 (3) a governmental unit may participate under a group policy if 05 (A) its governing body adopts a resolution authorizing 06 participation and payment of required premiums; 07 (B) a certified copy of the resolution is filed with the 08 Department of Administration; and 09 (C) the commissioner of administration approves the 10 participation in writing; 11 (4) in procuring a policy of group health or group life insurance as 12 provided under this section or excess loss insurance as provided in AS 39.30.091, the 13 Department of Administration shall comply with the dual choice requirements of 14 AS 21.86.310, and shall obtain the insurance policy from an insurer authorized to 15 transact business in the state under AS 21.09, a hospital or medical service corporation 16 authorized to transact business in this state under AS 21.87, or a health maintenance 17 organization authorized to operate in this state under AS 21.86; an excess loss 18 insurance policy may be obtained from a life or health insurer authorized to transact 19 business in this state under AS 21.09 or from a hospital or medical service corporation 20 authorized to transact business in this state under AS 21.87; 21 (5) the Department of Administration shall make available bid 22 specifications for desired insurance benefits or for administration of benefit claims and 23 payments to (A) all insurance carriers authorized to transact business in this state 24 under AS 21.09 and all hospital or medical service corporations authorized to transact 25 business under AS 21.87 who are qualified to provide the desired benefits; and (B) 26 insurance carriers authorized to transact business in this state under AS 21.09, hospital 27 or medical service corporations authorized to transact business under AS 21.87, and 28 third-party administrators licensed to transact business in this state and qualified to 29 provide administrative services; the specifications shall be made available at least once 30 every five years; the lowest responsible bid submitted by an insurance carrier, hospital 31 or medical service corporation, or third-party administrator with adequate servicing
01 facilities shall govern selection of a carrier, hospital or medical service corporation, or 02 third-party administrator under this section or the selection of an insurance carrier or a 03 hospital or medical service corporation to provide excess loss insurance as provided in 04 AS 39.30.091; 05 (6) if the aggregate of dividends payable under the group insurance 06 policy exceeds the governmental unit's share of the premium, the excess shall be 07 applied by the governmental unit for the sole benefit of the employees; 08 (7) a person receiving benefits under AS 14.25.110, AS 22.25, 09 AS 39.35, or former AS 39.37 may continue the life insurance coverage that was in 10 effect under this section at the time of termination of employment with the state or 11 participating governmental unit; 12 (8) a person electing to have insurance under (7) of this subsection 13 shall pay the cost of this insurance; 14 (9) for each permanent part-time employee electing coverage under 15 this section, the state shall contribute one-half the state contribution rate for permanent 16 full-time state employees, and the permanent part-time employee shall contribute the 17 other one-half; 18 (10) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, 19 or former AS 39.37 may obtain auditory, visual, and dental insurance for that person 20 and eligible dependents under this section; the level of coverage for persons over 65 21 shall be the same as that available before reaching age 65 except that the benefits 22 payable shall be supplemental to any benefits provided under the federal old age, 23 survivors, and disability insurance program; a person electing to have insurance under 24 this paragraph shall pay the cost of the insurance; the commissioner of administration 25 shall adopt regulations implementing this paragraph; 26 (11) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, 27 or former AS 39.37 may obtain long-term care insurance for that person and eligible 28 dependents under this section; a person who elects insurance under this paragraph 29 shall pay the cost of the insurance premium; the commissioner of administration shall 30 adopt regulations to implement this paragraph; 31 (12) each licensee holding a current operating agreement for a vending
01 facility under AS 23.15.010 - 23.15.210 shall be covered by the group policy that 02 applies to governmental units other than the state; 03 (13) a group health insurance policy covering employees of a 04 participating governmental unit must meet the requirements of AS 21.42.427. 05 * Sec. 5. AS 39.30.091 is amended to read: 06 Sec. 39.30.091. Authorization for self-insurance and excess loss insurance. 07 Notwithstanding AS 21.86.310 or AS 39.30.090, the Department of Administration 08 may provide, by means of self-insurance, one or more of the benefits listed in 09 AS 39.30.090(a)(1) for state employees eligible for the benefits by law or under a 10 collective bargaining agreement and for persons receiving benefits under AS 14.25, 11 AS 22.25, AS 39.35, or former AS 39.37, and their dependents. The department shall 12 procure any necessary excess loss insurance under AS 39.30.090. A self-insured 13 group medical plan covering active state employees provided under this section is 14 subject to the requirements of AS 21.42.427. 15 * Sec. 6. AS 47.07.065 is amended by adding new subsections to read: 16 (c) The department shall pay for 17 (1) prescription contraceptives intended to last for a 12-month period 18 for subsequent dispensings of the same prescription contraceptive if prescribed to and 19 requested by the recipient, regardless of whether the recipient was receiving medical 20 assistance at the time of the first dispensing; and 21 (2) consultations, examinations, procedures, and medical services that 22 are necessary to 23 (A) prescribe, dispense, insert, distribute, or administer 24 prescription contraceptives; or 25 (B) remove prescription contraceptives. 26 (d) Nothing in this section requires itemized reimbursement when a service is 27 reimbursable as part of a bundled or composite rate. 28 (e) In this section, "prescription contraceptive" means a drug or device that 29 requires a prescription and is approved by the United States Food and Drug 30 Administration to prevent pregnancy. 31 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to
01 read: 02 MEDICAID STATE PLAN FEDERAL APPROVAL. To the extent necessary to 03 implement this Act, the Department of Health shall amend and submit for federal approval the 04 state plan for medical assistance coverage consistent with AS 47.07.065(c) - (e), enacted by 05 sec. 6 of this Act. 06 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 07 read: 08 CONDITIONAL EFFECT; NOTIFICATION. (a) Section 6 of this Act takes effect 09 only if, on or before January 1, 2026, the United States Department of Health and Human 10 Services 11 (1) approves the amendments to the state plan for medical assistance coverage 12 under AS 47.07.065(c) - (e), enacted by sec. 6 of this Act; or 13 (2) determines that its approval of the amendments to the state plan for 14 medical assistance coverage under AS 47.07.065(c) - (e), enacted by sec. 6 of this Act, is not 15 necessary. 16 (b) The commissioner of health shall notify the revisor of statutes in writing within 30 17 days after the United States Department of Health and Human Services approves amendments 18 to the state plan under (a)(1) of this section or determines that approval is not necessary under 19 (a)(2) of this section. 20 * Sec. 9. Section 1 of this Act takes effect January 1, 2025.