04/01/2015 01:30 PM Senate HEALTH & SOCIAL SERVICES

         SB 74-MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES                                                                      
                                                                                                                                
2:05:10 PM                                                                                                                    
CHAIR STEDMAN  announced the  consideration of  SB 74.  He opened                                                               
public testimony.                                                                                                               
                                                                                                                                
ROSS BEILING, CEO,  Medical Bidline, LLC, testified on  SB 74. He                                                               
provided  information about  his  business.  He discussed  reform                                                               
efforts  in  light of  the  economic  situation. He  listed  what                                                               
services  his  company provides.  He  suggested  looking at  cost                                                               
reforms in  health care. He  said there has not  been competition                                                               
in health care and it has  led to expensive equipment. He said we                                                               
cannot afford not to get Medicaid expansion right.                                                                              
                                                                                                                                
2:10:33 PM                                                                                                                    
CHAIR STEDMAN asked Mr. Beiling if  he is requesting the state to                                                               
lower  its costs  by using  used or  reconditioned equipment.  He                                                               
asked what his bottom line is.                                                                                                  
                                                                                                                                
MR. BEILING  stated that the  state should engage  in competitive                                                               
bidding because it levels the playing field.                                                                                    
                                                                                                                                
CHAIR STEDMAN asked for clarification.                                                                                          
                                                                                                                                
MR.  BEILING  said  it  should   be  for  new  and  used  medical                                                               
equipment.                                                                                                                      
                                                                                                                                
2:13:03 PM                                                                                                                    
BECKY HULTBERG, President/CEO, Alaska  State Hospital and Nursing                                                               
Home  Association  (ASHNHA), testified  in  favor  of reform  and                                                               
expansion concepts  in SB  78. She said  ASHNHA supports  many of                                                               
the reform concepts  in both bills. She opined  that expansion is                                                               
necessary as  part of  improving Medicaid.  She pointed  out that                                                               
hospitals  support Medicaid  expansion due  to the  potential for                                                               
reduction in  costs of uncompensated  care and to  provide fiscal                                                               
and economic benefits. Reforms are  also necessary to improve the                                                               
Medicaid system.                                                                                                                
                                                                                                                                
2:15:05 PM                                                                                                                    
MS. HULTBERG  pointed out  that the  department has  already been                                                               
involved in  reform. She stressed  the importance of  "paying for                                                               
value."  She  gave  two  examples   of  payment  reform,  one  in                                                               
Ketchikan and the other in Central Peninsula Hospital.                                                                          
                                                                                                                                
She  disagreed  with the  idea  that  reform should  come  before                                                               
expansion.  Reform is  an on-going  process. She  maintained that                                                               
Medicaid must  evolve at the  same pace as reform.  She disagreed                                                               
that  innovation  and  change require  resources.  Providers  are                                                               
going to have  to take risk and innovate to  create new models of                                                               
care. She  suggested capital for  change can come  from reduction                                                               
in uncompensated care.                                                                                                          
                                                                                                                                
She concluded that  reform is achievable and expansion  is key to                                                               
achieving reform.                                                                                                               
                                                                                                                                
2:19:04 PM                                                                                                                    
SENATOR  STOLTZE  requested  Ms.   Hultberg  to  comment  on  the                                                               
previous speaker's ideas.                                                                                                       
                                                                                                                                
MS. HULTBERG  said she is  not familiar  with the details  of Mr.                                                               
Beiling's  proposals.  She  agreed   competition  is  a  positive                                                               
principle.                                                                                                                      
                                                                                                                                
SENATOR STOLTZE questioned the role of competition in hospitals.                                                                
                                                                                                                                
2:20:33 PM                                                                                                                    
JEFF JESSEE,  CEO, Alaska Mental Health  Trust Authority (AMHTA),                                                               
testified in favor of Medicaid reform  and expansion in SB 78. He                                                               
explained that  the reform  elements in both  bills are  vital in                                                               
order to protect  AMHTA beneficiaries in the long  run. He stated                                                               
that expansion  is critically important to  beneficiaries because                                                               
there are  many beneficiaries that  do not have any  health care.                                                               
Reform  ideas in  both bills  would go  a long  way to  stabilize                                                               
Medicaid and would be a positive fiscal move.                                                                                   
                                                                                                                                
He said expansion should be looked  at because other parts of the                                                               
state budget  could also be brought  under the same kind  of cost                                                               
control. He  used Corrections  as an example  of a  department in                                                               
need  of sustainability.  Recidivism  is  prevented by  providing                                                               
support  for   recovery  and  health   care.  There  is   now  an                                                               
opportunity  to   have  90  percent   coverage  by   the  federal                                                               
government   of  support   for   recovery   in  the   Corrections                                                               
population.  He  stressed that  when  the  Corrections budget  is                                                               
controlled, then other departments'  budgets are affected; Public                                                               
Defender, Department of  Law, Court System, the  troopers and the                                                               
police.                                                                                                                         
                                                                                                                                
He concluded  that the Trust  is supportive of reform  efforts in                                                               
both bills, and the expansion in SB 78.                                                                                         
                                                                                                                                
2:26:38 PM                                                                                                                    
FRANK MCQUERY,  representing himself, testified in  opposition to                                                               
the expansion  of Medicaid.  He said the  bigger the  system, the                                                               
more difficult  it is to be  controlled. He gave an  example of a                                                               
problem  with checking  financial  eligibility  for Medicaid.  He                                                               
said reform  is needed before  expansion. He maintained  that the                                                               
system will not  work for the neediest beneficiaries.  He did not                                                               
believe expansion would work.                                                                                                   
                                                                                                                                
2:31:10 PM                                                                                                                    
JEREMY   PRICE,  State   Director,   Americans  for   Prosperity,                                                               
testified against  further implementation of the  Affordable Care                                                               
Act in Alaska.  He noted a portion of  Alaska's financial report,                                                               
noting  defects  in  Medicaid's accounting  system.  He  said  he                                                               
agrees with the reform ideas in SB 74.                                                                                          
                                                                                                                                
2:35:11 PM                                                                                                                    
SENATOR STOLTZE  asked Mr.  Price what  outreach he  has received                                                               
from DHSS.                                                                                                                      
                                                                                                                                
MR. PRICE said none.                                                                                                            
                                                                                                                                
SB 74 was held in committee.