Legislature(2017 - 2018)ADAMS ROOM 519
04/19/2018 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB105 | |
| SB104 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | SB 105 | TELECONFERENCED | |
| += | SB 104 | TELECONFERENCED | |
CS FOR SENATE BILL NO. 105(FIN)
"An Act relating to the licensure of marital and
family therapists; relating to medical assistance for
marital and family therapy services; and providing for
an effective date."
1:35:47 PM
Co-Chair Foster indicated that bill had been heard the
prior day, April 18, 2018.
1:36:20 PM
SENATOR DAVID WILSON, SPONSOR, he did not have any comments
but was available for questions.
1:37:04 PM
Vice-Chair Gara referenced Page 3 of the legislation, which
said that Marital and Family Therapy Services would be
covered. He asked whether that included marriage
counseling. He stated that the covered items in the bill
were limited to what was covered under Medicaid and the
things covered by Medicaid were mental health related. He
contended that the bill would not expand services to
include traditional, non-mental health related marital
counseling.
Co-Chair Foster recognized Representative Pruitt at the
table.
1:38:14 PM
Co-Chair Seaton MOVED to ADOPT Amendment 1 (copy on file):
Page 4, following line 8:
Insert a new bill section to read:
"* Sec. 5. The uncodified law of the State of Alaska
is amended by adding a new section to read:
REPORT TO LEGISLATURE. (a) The Department of
Health and Social Services shall prepare a report that
describes the effectiveness and cost-effectiveness of
the coverage of marital and family therapy services as
provided in AS 47.07.030(b). as amended by sec. 3 of
this Act. The report must include the distribution of
services provided by billing code and the diversion
from more expensive alternatives.
(b) On or before November 30, 2020, the
Department of Health and Social Services shall deliver
the report under (a) of this section to the senate
secretary and the chief clerk of the house of
representatives and notify the legislature that the
report is available."
Renumber the following bill sections accordingly.
Page 4, line I 0:
Delete "sec. 511
Insert "sec. 6"
Representative Wilson OBJECTED.
Co-Chair Seaton asked whether the department could comment
on the date of November 30, 2020.
1:38:44 PM
MARGARET BRODIE, DIRECTOR, DIVISION OF HEALTH CARE
SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES (via
teleconference), indicated that November 30th an acceptable
date.
1:39:29 PM
Co-Chair Seaton asked whether the year should be 2021,
rather than 2020.
Ms. Brodie indicated the 2020 report would be preliminary
data but would not be a good foundation on which to base
any decisions. A comprehensive report could be completed by
2021 and would include all the information necessary for
sound decision making.
1:40:25 PM
Co-Chair Seaton MOVED to ADOPT Conceptual Amendment 1:
Line 10:
Change the date to 2021 rather than 2020.
There being NO OBJECTION, it was so ordered.
Co-Chair Foster asked whether the sponsor of the House
companion bill wished to comment.
1:41:09 PM
REPRESENTATIVE IVY SPOHNHOLZ, supported the conceptual
amendment.
Representative Wilson WITHDREW her OBJECTION.
There being NO OBJECTION, it was so ordered.
1:42:02 PM
Representative Wilson MOVED to ADOPT Amendment 2 (copy on
file).
Representative Gara OBJECTED.
Representative Wilson explained that the amendment
addressed the concern that once something had been added to
Medicaid it could not be removed. She said that she wanted
the report to have meaningful impact and a sunset date
would force the legislature to regularly audit programs.
Co-Chair Foster invited the bill sponsor to comment on the
amendment.
Senator Wilson respectfully opposed the amendment. He felt
that if the amendment were to pass, he would want to see an
effective date change so that providers could meet
requirements. He worried that the amendment would
negatively affect family therapists.
1:45:14 PM
Vice-Chair Gara asked how difficult it was to become a
certified Medicaid biller.
Ms. Brodie explained that the first thing a medical
provider had to do was to enroll in the program, which
included at $500, out of pocket, fee. She furthered that
providers then had to provide proof of their business and
occupational licenses. A recent issue was that the
providers had to provide full ownership and disclosure
information; including all the social security numbers of
their owners and board members. Individuals that worked for
Medicaid had to have background checks. Additionally,
individuals would need to be certified by the Division of
Behavioral Health and would have to have proof of insurance
and an MPI number. Some providers had to have first aid and
CPR certification. Providers also had to provide proof of
liability insurance and sign a Medicaid providers
agreement. Some providers could be required to perform a
pre-enrollment site visit. She said that the state would
put the provider into one of three categories: low risk,
medium risk, or high risk; she believed that these
providers would fall into the medium risk category and
would be on a 5-year revalidation schedule. She clarified
that all those requirements were just to sign up. Billing
was another story; electronic billing would require new
software and the building of interfaces for the Enterprise
system. She stressed that electronic billing significantly
ramped up the security and auditing requirements required
for computer systems. Annual billing by paper would be
available but would add to payment delays.
1:48:39 PM
Vice-Chair Gara asked whether training was required to be
able to do Medicaid billing.
Ms. Brodie responded that there was ongoing training
required; regularly changing codes required continual
training. She said that additional administrative staff
could be needed. She shared that there were over 10,000
denial messages that a provider could get and that
providers would need to review the list each time in order
to understand the nature of a denial.
1:49:59 PM
Vice-Chair Gara thought the legislature had to make a
choice of whether to include the listed programs. He was
also uncertain whether therapists would want to go through
all the hoops again with a sunset date in place. He warned
that a sunsetted bill was not easy to reenact; the bill
would disappear, and the legislature would have to go
through the entire process again.
Representative Wilson clarified that the sunset date only
applied to the Medicaid a portion of the bill.
1:51:31 PM
Representative Ortiz asked about the upfront fee to
providers for enrollment. He asked whether the fee was
annual and who received the fee.
Ms. Brodie indicated that the fee was not an annual charge
but did have to be paid again during the revalidation
process. She said that the fee offset the cost of
enrollment with the state and the federal government
because it had become onerous for all entities involved.
Representative Ortiz asked who received the fees.
Ms. Brodie responded that the money was paid to the state
then the state paid 50 percent back to the federal
government.
Representative Wilson asked how many years it would take to
find out whether the additional services had none what was
expected.
Ms. Brodie thought that it would take a minimum of 3 years.
She believed more enrollment would be seen after 24 months.
Representative Wilson asked whether 2024 would be a better
sunset date.
Ms. Brodie responded that the department would have the
full documentation and data analytics by 2024.
1:54:21 PM
Representative Wilson MOVED to ADOPT Conceptual Amendment 1
to Amendment 2. The amendment would change the date on Line
9, from 2021 to 2024.
There being NO OBJECTION, Conceptual Amendment 1 to
Amendment 2 was ADOPTED.
1:55:20 PM
Representative Tilton asked about Medicaid billing courses
that were already available.
Ms. Brodie responded that there were individuals who
trained in medical coding, the only individuals that
trained in Medicaid coding were the division and Conduent.
1:56:08 PM
Co-Chair Seaton referred to Amendment 1. He wondered
whether the date should be changed to November 30th in
Amendment 2.
Ms. Brodie responded that notice to stop a benefit was
usually given to all providers and recipients ahead of
time, typically July 1st or January 1st. She said that
other dates could be considered but were not typical of the
Medicaid program.
1:57:08 PM
Representative Wilson did not want to kill a program, but
rather to force the legislature to look at it periodically.
She worried that unsuccessful programs would be added that
did not produce the intended results. She noted that the
program was costly and believed that it should be audited
at least once before renewal.
Vice-Chair Gara MAINTAINED his OBJECTION.
A roll call vote was taken on the motion.
IN FAVOR: Tilton, Wilson, Ortiz, Pruitt, Thompson,
OPPOSED: Gara, Grenn, Guttenberg, Kawasaki, Seaton,
Foster
The MOTION FAILED (5/6).
2:00:06 PM
AT EASE
2:00:39 PM
RECONVENED
Vice-Chair Gara reviewed the previously publish fiscal
notes:
FN3 - Fiscal Impact Note
Department: Department of Commerce, Community and
Economic Development
Appropriation: Corporations, Business and Professional
Licensing
Allocation: Corporations, Business and Professional
Licensing
OMB Component Number: 2360
FN4 - Fiscal Impact Note
Department: Department of Health and Social Services
Appropriation: Medicaid Services
Allocation: Behavioral Health Medicaid Services
OMB Component Number: 2660
2:02:19 PM
Co-Chair Seaton MOVED to report HCSCSSB 105 (FIN) out of
Committee with individual recommendations and the
accompanying fiscal notes.
Representative Wilson OBJECTED.
Representative Wilson reiterated her concern about the
addition of a possibly unsuccessful program to the Medicaid
program.
Co-Chair Seaton shared that he supported a sunset date for
the program.
2:05:40 PM
Representative Pruitt lamented that the state did not have
a fiscal plan, but it was adding services to Medicaid. He
expressed concern for adding to long-term costs.
2:07:15 PM
Representative Guttenberg commented that the bill
represented the ability to deliver services to keep people
out of higher cost situations. He thought it was cost
avoidance and was part of a plan to deal with healthcare in
the state.
A roll call vote was taken on the motion.
IN FAVOR: Gara, Grenn, Guttenberg, Kawasaki, Ortiz, Foster,
Seaton
OPPOSED: Wilson, Pruitt, Thompson, Tilton
The MOTION PASSED (7/4).
HCS CSSB 105 (FIN) was REPORTED out of committee with a "do
pass" recommendation and with two previously published
fiscal impact notes: FN3 (CED) and FN4 (DHS).
2:09:29 PM
AT EASE
2:10:50 PM
RECONVENED
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 105 - Marital & Family Therapy Q & A Summary.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 105 |
| CSSB 105(FIN) - Mat Su Health Foundation testimony.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 105 |
| CSSB 105(FIN) AK Behavioral Health System Assessment 2016.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 105 |
| SB 105 Amendments.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 105 |
| SB 105 - New amendment #1 N.4.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 105 |
| SB 102 FY16 Broadband Totals and District Subsidies 4.18.18.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 102 |
| SB 105 Response to HFIN Questions DHSS Brodie 041918.pdf |
HFIN 4/19/2018 1:30:00 PM |
SB 105 |