04/08/2014 03:00 PM House HEALTH & SOCIAL SERVICES

        SB 169-IMMUNIZATION PROGRAM; VACCINE ASSESSMENTS                                                                    
                                                                                                                                
3:04:10 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  announced that the  first order of  business would                                                               
be CS FOR  SENATE BILL NO. 169(FIN), "An Act  establishing in the                                                               
Department   of   Health   and  Social   Services   a   statewide                                                               
immunization program  and the  State Vaccine  Assessment Council;                                                               
creating  a  vaccine  assessment  account;  requiring  a  vaccine                                                               
assessment   from   assessable   entities   and   other   program                                                               
participants for statewide  immunization purchases; repealing the                                                               
temporary  child and  adult immunization  program; and  providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
3:04:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER   moved  to  adopt  the   House  committee                                                               
substitute  (HCS) for  CSSB  169,  labeled 28-LS1219\D,  Mischel,                                                               
4/7/14.  There being no objection, it was so ordered.                                                                           
                                                                                                                                
3:04:46 PM                                                                                                                    
                                                                                                                                
TOM  STUDLER, Staff,  Representative Pete  Higgins, Alaska  State                                                               
Legislature,  paraphrased from  the  Sectional  Analysis for  the                                                               
house committee substitute  for CSSB 169, Version  D [Included in                                                               
members' packets], which read:                                                                                                  
                                                                                                                                
     Section 1. Establishes a Statewide Immunization                                                                          
     Program with a State Vaccine Assessment Council; sets                                                                      
     requirements for vaccine assessments, reporting and                                                                        
     penalties for assessable entities and other program                                                                        
     participants; and creates a vaccine assessment                                                                             
     account.                                                                                                                   
     Section 2. Definitions.                                                                                                  
     Section 3. Amends Title 21 (Insurance) to require                                                                        
     assessable entities to provide information and pay                                                                         
     assessments.                                                                                                               
     Section 4. Adds the vaccine assessment account to the                                                                    
     list of program receipts authorized in the budget.                                                                         
     Section 5. Repeals this act on January 1, 2021.                                                                          
     Section 6. Repeals Ch. 24 SLA 2012.                                                                                      
     Section 7. Redirects the unobligated funds from Ch. 24                                                                   
      SLA 2012 to be deposited into the vaccine assessment                                                                      
     account.                                                                                                                   
     Section 8. Makes the effective date January 1, 2015.                                                                     
                                                                                                                                
CHAIR HIGGINS asked for clarification  that the January 1 date, a                                                               
calendar  year, was  for accounting  purposes for  the assessable                                                               
entities.                                                                                                                       
                                                                                                                                
MR. STUDLER  explained that the  effective date would  allow this                                                               
to  coincide with  the assessable  entities and  providers fiscal                                                               
year.   It  would  also  allow Department  of  Health and  Social                                                               
Services the opportunity  to use the existing funds  in the House                                                               
Bill 301 account before this effective date.                                                                                    
                                                                                                                                
3:07:38 PM                                                                                                                    
                                                                                                                                
MR. STUDLER paraphrased from the Explanation of changes for the                                                                 
House CS for CS SB 169\D [Included in members' packets], which                                                                  
read:                                                                                                                           
                                                                                                                                
     Section 1. Adds Article 1A Statewide Immunization                                                                          
     Program to AS 18.09.                                                                                                       
                                                                                                                                
     Sec. 18.09.200(a). Establishes a statewide                                                                                 
     immunization program in the Department for the purpose                                                                     
     of monitoring, purchasing, and distributing vaccines                                                                       
     to providers.                                                                                                              
                                                                                                                                
     Sec. 18.09.200(b). The Department of Health and Social                                                                     
     Services shall maintain a list of recommended vaccines                                                                     
     for inclusion in the program; establish the 1st year's                                                                     
     assessment & thereafter make annual assessments based                                                                      
     on commission determinations; notify insurers and                                                                          
     other program participants of the assessment amount;                                                                       
     devise a method for crediting overpayments; coordinate                                                                     
     the bulk purchase of vaccine; set procedures for                                                                           
     distributing vaccines; and review appeals for errors.                                                                      
                                                                                                                                
     Sec. 18.09.210. Establishes the State Vaccine                                                                              
     Assessment Council within HSS for the purpose of                                                                           
     determining the assessment amount. The council has 8                                                                       
     members appointed by the Commissioner: the state's                                                                         
     Chief Medical Officer (chair); Director of Division                                                                        
     Insurance; 3 health care insurers, one of whom must be                                                                     
     a plan administrator; 2 health care providers, one of                                                                      
     which must be a pediatrician; and 1 representing a                                                                         
     tribal or public health insurance plan who serve                                                                           
     without compensation or reimbursement of expenses.                                                                         
     Terms are 3 years with a 2- term limit. HSS will                                                                           
     provide staff and other assistance to the council. The                                                                     
     commission establishes and implements a plan of                                                                            
     operation, submits an annual financial report to HSS                                                                       
     each July 1st, and monitors compliance with the                                                                            
     program.                                                                                                                   
                                                                                                                                
     Sec. 18.09.210(b)(1) the department's chief medical                                                                        
     officer for public health or the chief medical                                                                             
     officer's designee, who shall serve as the chair;                                                                          
                                                                                                                                
     Sec. 18.09.210(f)(2). Requires an annual financial                                                                         
     report to the commissioner and legislature.                                                                                
                                                                                                                                
      Sec. 18.09.220(a) Establishes the vaccine assessment                                                                      
     and reporting requirements after being phased into the                                                                     
     program by the commissioner.                                                                                               
                                                                                                                                
     Sec.18.09.220(e). An assessable entity may opt out of                                                                      
     the program during the three year phase-in period.                                                                         
                                                                                                                                
     Sec. 18.09.225(a). Allows health care providers to opt                                                                     
     into the program to purchase vaccine.                                                                                      
                                                                                                                                
     Sec. 18.09.225(b) a health care provider who did not                                                                       
     opt into the program may not be denied a claim from an                                                                     
     assessable entity.                                                                                                         
                                                                                                                                
     Sec. 18.09.225(c) a health care provider cannot bill a                                                                     
     payer or resell a vaccine distributed under the                                                                            
     program.                                                                                                                   
                                                                                                                                
     Sec. 18.09.230. Creates a special account in the                                                                           
     general fund for the purpose of purchasing vaccines.                                                                       
     The legislature may appropriate program receipts from                                                                      
     vaccine assessments, money from other sources, and                                                                         
     interest earned. Appropriations do not lapse.                                                                              
                                                                                                                                
     Sec. 18.09.240. Allows the commissioner to determine a                                                                     
     monetary penalty for noncompliance.                                                                                        
                                                                                                                                
     Section 2. 18.09.990. Defines the terms assessable                                                                       
     entity, commissioner (Health & Social Services),                                                                         
     council, covered individual, other program                                                                               
     participant, program, provider, recommended vaccine,                                                                     
     and vaccine.                                                                                                             
                                                                                                                              
     Section 3. Requires assessable entities to provide                                                                       
     information to the department under (AS 21.09.242)                                                                       
                                                                                                                              
     Section 4. Adds the vaccine assessment account to the                                                                    
     list of special accounts for program receipts in (AS                                                                     
     37.05.146(c)                                                                                                             
                                                                                                                              
     Section 5. repeals this act on January 1, 2021                                                                           
                                                                                                                              
     Section6. Repeals Ch. 24, SLA 2012 (HB310), a                                                                            
     temporary statewide immunization program.                                                                                
                                                                                                                              
     Section 7. Redirects the remaining HB310 funds to be                                                                     
     deposited to the vaccine account.                                                                                        
                                                                                                                              
     Section 8. Makes the act effective January 1, 2015.                                                                      
                                                                                                                                
3:09:17 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS referred  to an  earlier discussion  regarding the                                                               
window of opportunity for an assessable  entity to opt out of the                                                               
program, pointing out  that the opt out was  no longer voluntary,                                                               
but would  now be up  to the  discretion of the  commissioner for                                                               
determination of the time period.                                                                                               
                                                                                                                                
3:10:18 PM                                                                                                                    
                                                                                                                                
[Chair Higgins closed public testimony.]                                                                                        
                                                                                                                                
SENATOR CATHY  GIESSEL, Alaska State Legislature,  said that this                                                               
was a small but important step  in reducing the health care costs                                                               
for Alaskans, as  well as a step toward fulfillment  of the goals                                                               
of the Alaska Health Care Commission.                                                                                           
                                                                                                                                
3:11:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER moved  to report HCS CSSB  169, Version 28-                                                               
LS1219\D,  Mischel,  4/7/14,  out of  committee  with  individual                                                               
recommendations and  the accompanying fiscal notes.   There being                                                               
no objection  HCS CSSB 169(HSS)  was moved from the  House Health                                                               
and Social Services Standing Committee.