SB 45: "An Act relating to medical assistance services; relating to parity in mental health and substance use disorder coverage in the state medical assistance program; and providing for an effective date."
00 SENATE BILL NO. 45 01 "An Act relating to medical assistance services; relating to parity in mental health and 02 substance use disorder coverage in the state medical assistance program; and providing 03 for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 47.07.030 is amended by adding a new subsection to read: 06 (i) In providing the services required under this section, the department shall 07 comply with the mental health or substance use disorder benefit requirements 08 established under 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26. 09 * Sec. 2. AS 47.07 is amended by adding a new section to read: 10 Sec. 47.07.033. Parity in mental health and substance use disorder 11 benefits. The commissioner of health shall implement and ensure compliance with the 12 provisions of 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26 that are 13 applicable to the state medical assistance program, including 14 (1) evaluating all consumer and provider complaints regarding mental
01 health and substance use disorder coverage for possible parity violations; 02 (2) performing parity compliance examinations on nonquantitative 03 treatment limitations, including prior authorization, concurrent review, retrospective 04 review, step therapy time-based treatment plans, network admission standards, 05 reimbursement rates, and geographic restrictions; and 06 (3) conducting comparative analyses of how the state medical 07 assistance program designs and applies nonquantitative treatment limitations, as 08 written and in operation, for mental health and substance use disorder coverage and 09 medical and surgical benefits. 10 * Sec. 3. AS 47.07.076 is amended by adding a new subsection to read: 11 (d) The department shall submit an annual report on mental health and 12 substance use disorder coverage parity in the state medical assistance program to the 13 senate secretary and the chief clerk of the house of representatives on or before 14 March 1 and shall notify the legislature that the report is available. The report must 15 (1) describe the processes used to develop or select the medical 16 necessity criteria for mental health and substance use disorder benefits and for medical 17 and surgical benefits; 18 (2) identify all nonquantitative treatment limitations that are applied to 19 mental health and substance use disorder benefits and medical and surgical benefits 20 within each classification of benefits; 21 (3) analyze whether the medical necessity criteria and nonquantitative 22 treatment limitations applied to mental health and substance use disorder benefits are 23 comparable to the medical necessity criteria and nonquantitative treatment limitations 24 for medical and surgical benefits, and whether the criteria and limitations are applied 25 more stringently to mental health and substance use disorder benefits than to medical 26 and surgical benefits within the corresponding classification of benefits; at a 27 minimum, the results of the analysis must 28 (A) identify the factors used to determine when a 29 nonquantitative treatment limitation will apply to a benefit, including factors 30 that were considered but rejected; 31 (B) identify and define the specific evidentiary standards used
01 to define the factors and any other evidence relied on in designing each 02 nonquantitative treatment limitation; 03 (C) provide the comparative analyses, including the results of 04 the analyses, performed to determine whether processes and strategies used to 05 design each nonquantitative treatment limitation, as written and in operation, 06 applied to mental health and substance use disorder benefits are comparable to 07 and are not applied more stringently than the processes and strategies used to 08 design each nonquantitative treatment limitation to medical and surgical 09 benefits; and 10 (D) disclose the specific findings and conclusions reached by 11 the department that indicate whether the state medical assistance program is in 12 compliance with this section, 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 13 300gg-26. 14 * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 15 read: 16 REPORT TO LEGISLATURE. Not later than March 1, 2026, the commissioner of 17 health shall prepare and submit a report to the senate secretary and the chief clerk of the house 18 of representatives and notify the legislature that the report is available. The report must 19 (1) explain the methodology used by the commissioner to determine 20 compliance with 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26; 21 (2) identify market examinations conducted or completed during the preceding 22 12-month period regarding compliance with parity in mental health and substance use 23 disorder benefits under state and federal laws and summarize the results of the market conduct 24 examinations; 25 (3) detail any educational or corrective actions the commissioner has taken to 26 ensure compliance with 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26; 27 (4) be written in nontechnical, readily understandable language; and 28 (5) be posted on the publicly available Internet website of the Department of 29 Health and be made available to the public through any other means the commissioner finds 30 appropriate. 31 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to
01 read: 02 MEDICAID STATE PLAN. The Department of Health shall submit, as necessary for 03 approval by the United States Department of Health and Human Services, amendments to the 04 state plan under AS 47.07.040 to comply with the requirements of the mental health or 05 substance use disorder benefits established under 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 06 U.S.C. 300gg-26. 07 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 08 read: 09 CONDITIONAL EFFECT; NOTIFICATION. (a) Sections 1 - 4 of this Act take effect 10 only if, and to the extent that, the United States Department of Health and Human Services 11 approves amendments submitted in accordance with sec. 5 of this Act on or before 12 December 31, 2025. 13 (b) The commissioner of health shall notify the revisor of statutes in writing within 30 14 days after the United States Department of Health and Human Services approves amendments 15 to the state plan. 16 * Sec. 7. If secs. 1 - 4 of this Act take effect, they take effect the day after the United States 17 Department of Health and Human Services approves the amendments to the state plan under 18 sec. 6 of this Act.