03/19/2024 03:00 PM House HEALTH & SOCIAL SERVICES

         HB 361-BENEFIT REQS: MENTAL HLTH & SUBST ABUSE                                                                     
                                                                                                                                
4:42:23 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX  announced that  the next order  of business  would be                                                               
HOUSE BILL  NO. 361, "An  Act relating to the  medical assistance                                                               
program  and  mental health  or  substance  use disorder  benefit                                                               
requirements; and providing for an effective date."                                                                             
                                                                                                                                
RILEY  NYE,   Staff,  Representative  Mike  Prax,   Alaska  State                                                               
Legislature,  on  behalf  of   Representative  Mike  Prax,  prime                                                               
sponsor,  presented HB  361.   He  began by  reading the  sponsor                                                               
statement  [included   in  committee   packet],  which   read  as                                                               
follows[original punctuation provided]:                                                                                         
                                                                                                                                
         House bill 361 seeks to change the burdensome                                                                          
       requirements placed on behavioral health services                                                                        
     under the  State of Alaska  Medicaid program.  In 2000,                                                                    
     Congress passed  the Paul  Wellstone and  Pete Domenici                                                                    
     Mental Health  Parity and Addiction Equity  Act of 2008                                                                    
     (MHPAEA).  This law  prevents  group  health plans  and                                                                    
     health   insurers  that   provide   mental  health   or                                                                    
     substance use disorder  (MH/SUD) benefits from imposing                                                                    
     less  favorable  benefit limitations  and  requirements                                                                    
     than  on medical/surgical  benefits.  Today, 37  states                                                                    
     have enacted  parity laws of  widely varying  scope and                                                                    
     efficacy. Since  the beginning of 2018,  17 states have                                                                    
     passed  legislation requiring  insurers to  demonstrate                                                                    
     compliance on an annual basis.                                                                                             
                                                                                                                                
     The  State of  Alaska Medicaid  Program is  exempt from                                                                    
     federal MH/SUD Parity requirements  because Alaska is a                                                                    
     'Fee-for-Service'  State.  This  exemption has  led  to                                                                    
     ineffective   payment    rates   for    providers   AND                                                                    
     overbearing regulatory requirements  that further erode                                                                    
     access  to  life-saving  treatments.  While  commercial                                                                    
     insurers   are   required   to  meet   Federal   parity                                                                    
     requirements, House  bill 361 seeks the  same access to                                                                    
     behavioral health services for Medicaid beneficiaries.                                                                     
                                                                                                                                
     To the  extent the  State law  mandates that  an issuer                                                                    
     provide some  coverage for any mental  health condition                                                                    
     or substance use disorder,  benefits for that condition                                                                    
     or   disorder  must   be   provided   in  parity   with                                                                    
     medical/surgical  benefits  under   MHPAEA."  In  other                                                                    
     words,  state laws  can  strengthen parity  protections                                                                    
     but not weaken them.                                                                                                       
                                                                                                                                
     House   bill  361   requires  parity   to  reduce   the                                                                    
     administrative  burden   and  less   favorable  benefit                                                                    
     limitations for behavioral health services Alaska.                                                                         
                                                                                                                                
4:44:58 PM                                                                                                                    
                                                                                                                                
LANCE  JOHNSON,   COO,  Alaska  Behavioral   Health  Association,                                                               
provided  invited testimony  during the  hearing on  HB 361.   He                                                               
began  by describing  the necessity  of the  proposed legislation                                                               
and why it was separate from  HCR 9.  He explained the difference                                                               
in healthcare  scenarios in which  parity was present in  one and                                                               
not  in  the  other.    He highlighted  the  narrow  window  that                                                               
currently exists for someone experiencing  a mental health crisis                                                               
to  seek  proper  healthcare  and explained  the  need  to  align                                                               
integrated  healthcare with  what  currently exists.   He  opined                                                               
that HB  361 would be  a good starting  point to align  those two                                                               
aspects of the system.                                                                                                          
                                                                                                                                
4:50:47 PM                                                                                                                    
                                                                                                                                
TRACY  DOMPELING,   Director,  Division  of   Behavioral  Health,                                                               
Department  of Health,  as invited  testifier, remarked  that Mr.                                                               
Johnson  had covered  the most  important parts  of the  proposed                                                               
legislation and  informed the committee  that DOH is  prepared to                                                               
work with the  legislature in the implementation  of the policies                                                               
proposed under HB 361.                                                                                                          
                                                                                                                                
4:51:44 PM                                                                                                                    
                                                                                                                                
CHAIR  PRAX   opened  public   testimony  on   HB  361.     After                                                               
ascertaining  that there  was no  one who  wished to  testify, he                                                               
closed public testimony.                                                                                                        
                                                                                                                                
4:52:39 PM                                                                                                                    
                                                                                                                                
CHAIR PRAX announced that HB 361 was held over.