Legislature(2005 - 2006)SENATE FINANCE 532

05/03/2005 09:00 AM Senate FINANCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 187 AMERADA HESS INCOME; CAPITAL INCOME FUND TELECONFERENCED
Moved CSHB 187(FIN)(efd fld)Out Committee
+= SB 46 APPROP: CAPITAL BUDGET TELECONFERENCED
Heard & Held
+= SB 102 COASTAL MANAGEMENT PROGRAMS TELECONFERENCED
Moved CSSB 102(FIN) Out of Committee
*+ SB 192 SCHOOL CONSTRUCTION BOND REIMBURSEMENT TELECONFERENCED
Heard & Held
+ SB 22 MEDICAID COVERAGE FOR BIRTHING CENTERS TELECONFERENCED
Moved CSSB 22(FIN) Out of Committee
+ SB 78 SENIOR CARE PROGRAM TELECONFERENCED
Scheduled But Not Heard
+ SB 125 LICENSING MEDICAL OR CARE FACILITIES TELECONFERENCED
Moved CSSB 125(JUD) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
= HB 178 SPECIAL REQUEST LICENSE PLATES
Moved CSHB 178(STA) am Out of Committee
                                                                                                                                
     SENATE BILL NO. 22                                                                                                         
     "An Act adding birthing centers to the list of health                                                                      
     facilities eligible for payment of medical assistance for                                                                  
     needy persons."                                                                                                            
                                                                                                                                
                                                                                                                                
This  was the first  hearing  for this  bill in  the Senate  Finance                                                            
Committee.                                                                                                                      
                                                                                                                                
Co-Chair  Wilken moved  to adopt  committee substitute  Version  24-                                                            
LS0209\F as the working document.                                                                                               
                                                                                                                                
There being no  objection, the Version "F" committee  substitute was                                                            
ADOPTED as the working document.                                                                                                
                                                                                                                                
Co-Chair  Green  communicated  that  during  this  bill's  committee                                                            
hearing process,  the concern was "expressed about  the fact that we                                                            
have  no  doubt  a  very  very  legitimate  cause  for  support  for                                                            
midwifery  centers  and the  funding". She  noted  that the  State's                                                            
Medicaid  program  has been  based on  federal  Medicaid  standards;                                                            
consequently,  language has  been included  in Section 1(B)  on page                                                            
one,  lines  ten  through  twelve  of  the  Version   "F"  committee                                                            
substitute to  specify that birthing centers, which  are included in                                                            
the definition  of health facilities, would be eligible  for funding                                                            
"under  the State plan  approved under  AS 47.07.040  by the  United                                                            
States Department of Health and Human Services".                                                                                
                                                                                                                                
10:37:16 AM                                                                                                                   
                                                                                                                                
RICHARD  BENAVIDES,  Staff  to  Senator  Bettye  Davis,  the  bill's                                                            
sponsor, asked that clarification  be provided in regards to whether                                                            
the language in  Version "F" would require the Department  of Health                                                            
and Social Services  to develop an amendment to the  State's plan or                                                            
whether  the State should  wait for  a federal  determination  as to                                                            
whether they would fund midwifery centers.                                                                                      
                                                                                                                                
Co-Chair Green  voiced being uncertain  of the State's procedure  in                                                            
this  regard.  The State  might  be  able to  develop  the  required                                                            
language. She assumed that  the inclusion of midwifery centers would                                                            
require federal  policies to be rewritten  in regards to  what would                                                            
be deemed acceptable  for federal  Medicaid "reimbursables".  States                                                            
must be able to provide  input and ask that "various things be added                                                            
to the list".  She understood that the procedure in  this regard has                                                            
been a point of ongoing discussion.                                                                                             
                                                                                                                                
Co-Chair  Green stressed that  it is not the  desire of the  Finance                                                            
Committee  to  provide  "100  percent  State  Medicaid  dollars  for                                                            
programs that are not currently  funded with federal Medicaid." "The                                                            
list would  be endless and it would  be very very difficult."  Since                                                            
the  State "is  subject to  federal  Medicaid with  their  arbitrary                                                            
changes,  it's  very difficult"  for  the  State,  on its  own,  "to                                                            
expand"  what the State  would pay,  even though  that use might  be                                                            
considered "very legitimate"  and might save money. That point could                                                            
be argued.                                                                                                                      
                                                                                                                                
10:39:58 AM                                                                                                                   
                                                                                                                                
Mr. Benavides  noted that  during the bill's  hearing in the  Senate                                                            
Health, Education, and  Social Services Committee that Department of                                                            
Health and Social  Services had communicated that,  were the bill to                                                            
pass, the Department  would be required  to develop an amended  plan                                                            
in order to have  a determination made by the federal  government as                                                            
to whether  they would accept it.  Thus the reason for his  question                                                            
as to  whether  the Department  would be  directed  to further  that                                                            
endeavor  or   whether  the  federal   government  would   make  the                                                            
determination  as to whether they  would expand their coverage.  The                                                            
committee substitute is  unclear in its direction to the Department.                                                            
                                                                                                                                
10:40:54 AM                                                                                                                   
                                                                                                                                
Co-Chair  Green  stated  that  input from  the  Department  must  be                                                            
sought.  In the  meantime,  she voiced  the understanding  that  the                                                            
Department did  not object to the bill. Therefore,  she would not be                                                            
surprised  were  the  Department  to advance  an  amendment  to  the                                                            
federal Medicaid program.                                                                                                       
                                                                                                                                
Mr. Benavides asked that  he be allowed to clarify this further with                                                            
the Department and provide their response to the Committee.                                                                     
                                                                                                                                
Co-Chair Green agreed.                                                                                                          
                                                                                                                                
JERRY  FULLER,   Medicaid  Director,   Office  of  Program   Review,                                                            
Department   of   Health  and   Social   Services,   testified   via                                                            
teleconference  from an offnet site, and stated that,  were the bill                                                            
approved by  the Legislature, the  Department would submit  language                                                            
for federal  approval. He  concurred with  Co-Chair Green's  earlier                                                            
remarks  as  to the  fluidness  of  the policies  occurring  in  the                                                            
federal Medicaid program.                                                                                                       
                                                                                                                                
In response to a question  from Co-Chair Green, Mr. Benavides stated                                                            
that Mr. Fuller had answered his question.                                                                                      
                                                                                                                                
Co-Chair  Green   noted  her  intention  to  move   this  bill  from                                                            
Committee.  In the  interest  of time,  she  asked teleconferencing                                                             
participants to briefly state their position on the bill.                                                                       
                                                                                                                                
10:42:43 AM                                                                                                                   
                                                                                                                                
Mr. Fuller informed the  Committee that the Department has a neutral                                                            
position on this bill                                                                                                           
                                                                                                                                
10:43:01 AM                                                                                                                   
                                                                                                                                
TOM RYAN, testified via  teleconference from Mat-Su and communicated                                                            
that this  bill would provide  a "great benefit"  to both the  State                                                            
and  its  citizens.  It would  save  the  State  money  and  provide                                                            
Alaskans other health care options.                                                                                             
                                                                                                                                
10:43:29 AM                                                                                                                   
                                                                                                                                
TORA GERRICK testified  via teleconference from Anchorage in support                                                            
of the bill.                                                                                                                    
                                                                                                                                
10:43:45 AM                                                                                                                   
                                                                                                                                
Senator Dyson, noting that  he is one of bill's co-sponsors, thanked                                                            
Co-Chair Green  for her ability "to see things" that  he had missed.                                                            
                                                                                                                                
Senator  Dyson  moved  to  report  the  committee   substitute  from                                                            
Committee with individual recommendations and new fiscal note.                                                                  
                                                                                                                                
Co-Chair  Green noted  that a new  fiscal note  would accompany  the                                                            
bill,   as   the  previous   one   contained   language   that   was                                                            
"problematic".                                                                                                                  
                                                                                                                                
There being no objection,  CS SB 22(FIN) was REPORTED from Committee                                                            
with  a  new  zero  fiscal  note  dated  April  28,  2005  from  the                                                            
Department of Health and Social Services.                                                                                       
                                                                                                                                
10:45:10 AM 10:45:54 AM                                                                                                     
                                                                                                                                

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