MED ASSIST;INSURANCE;DISABILITY/WORK COMP, the official text

00Enrolled HB 14
01Relating to health care insurance; relating to insurance reimbursement for health care services 
02 provided through telehealth; relating to telehealth; relating to workers' compensation coverage 
03 for disability from diseases for certain firefighters; repealing programs for catastrophic illness 
04 assistance and medical assistance for chronic and acute medical conditions; relating to 
05 occupational disability benefits and medical benefits available under the public employees' 
06 retirement system; providing for an effective date by amending the effective date of secs. 9 
07 and 10, ch. 38, SLA 2022; and providing for an effective date. 
08 _______________ 
09 * Section 1. AS 21.42.422(b) is amended by adding a new paragraph to read: 
10 (3) "health care provider" has the meaning given in AS 21.07.250. 
11 * Sec. 2. AS 21.42.422 is amended by adding a new subsection to read:

01(c) A health care insurer shall reimburse a health care provider for health care 
02 services, including behavioral health services, provided through telehealth on the same 
03 basis and at least at the same rate as for comparable health care services provided in 
04 person. A health care insurer may use a geographic pay differential to reimburse out- 
05 of-state health care providers. 
06 * Sec. 3. AS 23.30.121(b) is amended to read: 
07 (b) For a firefighter covered under AS 23.30.243, 
08 (1) there is a presumption that a claim for compensation for disability 
09 as a result of the following diseases is within the provisions of this chapter: 
10 (A) respiratory disease; 
11 (B) cardiovascular events that are experienced within 72 hours 
12 after exposure to smoke, fumes, or toxic substances; and 
13 (C) the following cancers: 
14 (i) primary brain cancer; 
15 (ii) malignant melanoma; 
16 (iii) leukemia; 
17 (iv) non-Hodgkin's lymphoma; 
18 (v) bladder cancer; 
19 (vi) ureter cancer; 
20 (vii) kidney cancer; 
21 (viii) prostate cancer; and 
22 (ix) breast cancer; 
23 (2) notwithstanding AS 23.30.100(a), following termination of service, 
24 the presumption established in (1) of this subsection extends to the firefighter for a 
25 period of six [THREE] calendar months for each year of requisite service but may not 
26 extend more than 120 [60] calendar months following the last date of employment; 
27 (3) the presumption established in (1) of this subsection applies only to 
28 an active or former firefighter who has a disease described in (1) of this subsection 
29 that develops or manifests itself after the firefighter has served in the state for at least 
30 six [SEVEN] years and who 
31 (A) underwent [WAS GIVEN] a qualifying medical

01 examination 
02 (i) upon the first employment as [BECOMING] a 
03 firefighter that did not show evidence of the disease; 
04 (ii) at least once every two years [(B) WAS GIVEN 
05 AN ANNUAL MEDICAL EXAM] during [EACH OF] the first six 
06 [SEVEN] years of employment as a firefighter that did not show 
07 evidence of the disease; and 
08 (B) [(C)] with regard to diseases described in (1)(C) of this 
09 subsection, demonstrates that, while in the course of employment as a 
10 firefighter, the firefighter was exposed to a known carcinogen, as defined by 
11 the International Agency for Research on Cancer or the National Toxicology 
12 Program, and the carcinogen is associated with a disabling cancer. 
13 * Sec. 4. AS 29.10.200 is amended by adding a new paragraph to read: 
14 (68) AS 29.20.420 (health care insurance plans). 
15 * Sec. 5. AS 29.20 is amended by adding a new section to article 5 to read: 
16 Sec. 29.20.420. Health care insurance plans. (a) If a municipality offers a 
17 group health care insurance plan covering municipal employees, including by means 
18 of self-insurance, the municipal health care insurance plan is subject to the 
19 requirements of AS 21.42.422(c). 
20 (b) This section applies to home rule and general law municipalities. 
21 (c) In this section, "health care insurance plan" has the meaning given in 
22 AS 21.54.500. 
23 * Sec. 6. AS 36.30.850(b)(11) is amended to read: 
24 (11) agreements with providers of services under AS 47.25.071 - 
25 47.25.095; AS 47.07; [AS 47.08;] AS 47.10; AS 47.12; AS 47.14; AS 47.17; 
26 AS 47.24; and AS 47.27, including contractors under AS 47.27.050; 
27 * Sec. 7. AS 39.30.090(a) is amended to read: 
28 (a) The Department of Administration may obtain a policy or policies of group 
29 insurance covering state employees, persons entitled to coverage under AS 14.25.168, 
30 14.25.480, AS 22.25.090, AS 39.35.535, 39.35.880, or former AS 39.37.145, 
31 employees of other participating governmental units, or persons entitled to coverage

01 under AS 23.15.136, subject to the following conditions: 
02 (1) a group insurance policy shall provide one or more of the following 
03 benefits: life insurance, accidental death and dismemberment insurance, weekly 
04 indemnity insurance, hospital expense insurance, surgical expense insurance, dental 
05 expense insurance, audiovisual insurance, or other medical care insurance; 
06 (2) each eligible employee of the state, the spouse and the unmarried 
07 children chiefly dependent on the eligible employee for support, and each eligible 
08 employee of another participating governmental unit shall be covered by the group 
09 policy, unless exempt under regulations adopted by the commissioner of 
10 administration; 
11 (3) a governmental unit may participate under a group policy if 
12 (A) its governing body adopts a resolution authorizing 
13 participation and payment of required premiums; 
14 (B) a certified copy of the resolution is filed with the 
15 Department of Administration; and 
16 (C) the commissioner of administration approves the 
17 participation in writing; 
18 (4) in procuring a policy of group health or group life insurance as 
19 provided under this section or excess loss insurance as provided in AS 39.30.091, the 
20 Department of Administration shall comply with the dual choice requirements of 
21 AS 21.86.310, and shall obtain the insurance policy from an insurer authorized to 
22 transact business in the state under AS 21.09, a hospital or medical service corporation 
23 authorized to transact business in this state under AS 21.87, or a health maintenance 
24 organization authorized to operate in this state under AS 21.86; an excess loss 
25 insurance policy may be obtained from a life or health insurer authorized to transact 
26 business in this state under AS 21.09 or from a hospital or medical service corporation 
27 authorized to transact business in this state under AS 21.87; 
28 (5) the Department of Administration shall make available bid 
29 specifications for desired insurance benefits or for administration of benefit claims and 
30 payments to (A) all insurance carriers authorized to transact business in this state 
31 under AS 21.09 and all hospital or medical service corporations authorized to transact

01business under AS 21.87 who are qualified to provide the desired benefits; and (B) 
02 insurance carriers authorized to transact business in this state under AS 21.09, hospital 
03 or medical service corporations authorized to transact business under AS 21.87, and 
04 third-party administrators licensed to transact business in this state and qualified to 
05 provide administrative services; the specifications shall be made available at least once 
06 every five years; the lowest responsible bid submitted by an insurance carrier, hospital 
07 or medical service corporation, or third-party administrator with adequate servicing 
08 facilities shall govern selection of a carrier, hospital or medical service corporation, or 
09 third-party administrator under this section or the selection of an insurance carrier or a 
10 hospital or medical service corporation to provide excess loss insurance as provided in 
11 AS 39.30.091; 
12 (6) if the aggregate of dividends payable under the group insurance 
13 policy exceeds the governmental unit's share of the premium, the excess shall be 
14 applied by the governmental unit for the sole benefit of the employees; 
15 (7) a person receiving benefits under AS 14.25.110, AS 22.25, 
16 AS 39.35, or former AS 39.37 may continue the life insurance coverage that was in 
17 effect under this section at the time of termination of employment with the state or 
18 participating governmental unit; 
19 (8) a person electing to have insurance under (7) of this subsection 
20 shall pay the cost of this insurance; 
21 (9) for each permanent part-time employee electing coverage under 
22 this section, the state shall contribute one-half the state contribution rate for permanent 
23 full-time state employees, and the permanent part-time employee shall contribute the 
24 other one-half; 
25 (10) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, 
26 or former AS 39.37 may obtain auditory, visual, and dental insurance for that person 
27 and eligible dependents under this section; the level of coverage for persons over 65 
28 shall be the same as that available before reaching age 65 except that the benefits 
29 payable shall be supplemental to any benefits provided under the federal old age, 
30 survivors, and disability insurance program; a person electing to have insurance under 
31 this paragraph shall pay the cost of the insurance; the commissioner of administration

01 shall adopt regulations implementing this paragraph; 
02 (11) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, 
03 or former AS 39.37 may obtain long-term care insurance for that person and eligible 
04 dependents under this section; a person who elects insurance under this paragraph 
05 shall pay the cost of the insurance premium; the commissioner of administration shall 
06 adopt regulations to implement this paragraph; 
07 (12) each licensee holding a current operating agreement for a vending 
08 facility under AS 23.15.010 - 23.15.210 shall be covered by the group policy that 
09 applies to governmental units other than the state; 
10 (13) a group health insurance policy covering employees of a 
11 participating governmental unit must meet the requirements of AS 21.42.422(c). 
12 * Sec. 8. AS 39.30.091 is amended to read: 
13 Sec. 39.30.091. Authorization for self-insurance and excess loss insurance. 
14 Notwithstanding AS 21.86.310 or AS 39.30.090, the Department of Administration 
15 may provide, by means of self-insurance, one or more of the benefits listed in 
16 AS 39.30.090(a)(1) for state employees eligible for the benefits by law or under a 
17 collective bargaining agreement and for persons receiving benefits under AS 14.25, 
18 AS 22.25, AS 39.35, or former AS 39.37, and their dependents. The department shall 
19 procure any necessary excess loss insurance under AS 39.30.090. A self-insured 
20 group health insurance plan covering active state employees provided under this 
21 section is subject to the requirements of AS 21.42.422(c). 
22 * Sec. 9. AS 39.35.410(d) is amended to read: 
23 (d) The monthly amount of an occupational disability benefit is 75 [40] 
24 percent of the disabled employee's gross monthly compensation at the time of 
25 termination due to disability. 
26 * Sec. 10. AS 39.35.870 is amended by adding a new subsection to read: 
27 (h) Notwithstanding (a) and (g) of this section, a disabled employee who is 
28 eligible to obtain a disability benefit under AS 39.35.890 is eligible to obtain retiree 
29 major medical insurance benefits under AS 39.35.880. 
30 * Sec. 11. AS 39.35.880(g) is amended to read: 
31 (g) Except as provided under (l) of this section, the [THE] cost of

01 premiums for retiree major medical insurance coverage for an eligible member or 
02 surviving spouse who is 
03 (1) not eligible for Medicare is an amount equal to the full monthly 
04 group premiums for retiree major medical insurance coverage; 
05 (2) eligible for Medicare is the following percentage of the premium 
06 amounts established for retirees who are eligible for Medicare: 
07 (A) 30 percent if the member had 10 or more, but less than 15, 
08 years of service; 
09 (B) 25 percent if the member had 15 or more, but less than 20, 
10 years of service; 
11 (C) 20 percent if the member had 20 or more, but less than 25, 
12 years of service; 
13 (D) 15 percent if the member had 25 or more, but less than 30, 
14 years of service; 
15 (E) 10 percent if the member had 30 or more years of service. 
16 * Sec. 12. AS 39.35.880 is amended by adding a new subsection to read: 
17 (l) An eligible member or surviving spouse who receives a disability benefit as 
18 provided under AS 39.35.890 or 39.35.891 and is not eligible for Medicare is not 
19 required to pay a premium for retiree major medical insurance coverage. 
20 * Sec. 13. AS 39.35.890(d) is amended to read: 
21 (d) The monthly amount of an occupational disability benefit is 75 [40] 
22 percent of the disabled employee's gross monthly compensation at the time of 
23 termination due to disability. Notwithstanding AS 39.35.790(b), at the time a member 
24 is appointed to disability, the member becomes fully vested in the employer 
25 contributions made under AS 39.35.750(a). A disabled member is fully vested in the 
26 contributions to the member's individual account made under this subsection. An 
27 employee is not entitled to elect distributions from the employee's individual 
28 contribution account under AS 39.35.810 while the employee is receiving disability 
29 benefits under this section. While an employee is receiving disability benefits, based 
30 on the disabled employee's gross monthly compensation at the time of termination due 
31 to disability, the employer shall make contributions

01 (1) to the employee's individual account under AS 39.35.730 on behalf 
02 of the employee, without deduction from the employee's disability payments; and 
03 (2) on behalf of the employee under AS 39.35.750. 
04 * Sec. 14. AS 47.05.085(a) is amended to read: 
05 (a) The commissioner or the commissioner's designee at the director level may 
06 issue subpoenas to compel the production of books, papers, correspondence, 
07 memoranda, and other records considered necessary as evidence in connection with an 
08 investigation under or the administration of AS 47.07 (medical assistance), [AS 47.08 
09 (ASSISTANCE FOR CATASTROPHIC ILLNESSES AND ACUTE OR CHRONIC 
10 MEDICAL CONDITIONS),] AS 47.25 (child care assistance, child care grants, 
11 general relief, adult public assistance, and food stamps), and AS 47.27 (Alaska 
12 temporary assistance program). 
13 * Sec. 15. AS 47.05.200(d) is amended to read: 
14 (d) As a condition of obtaining payment under AS 47.07 [AND AS 47.08] and 
15 for purposes of this section, a provider shall allow 
16 (1) the department reasonable access to the records of medical 
17 assistance recipients and providers; and 
18 (2) audit and inspection of the records by state and federal agencies. 
19 * Sec. 16. AS 47.05.210(a) is amended to read: 
20 (a) A person commits the crime of medical assistance fraud if the person 
21 (1) knowingly submits or authorizes the submission of a claim to a 
22 medical assistance agency for property, services, or a benefit with reckless disregard 
23 that the claimant is not entitled to the property, services, or benefit; 
24 (2) knowingly prepares or assists another person to prepare a claim for 
25 submission to a medical assistance agency for property, services, or a benefit with 
26 reckless disregard that the claimant is not entitled to the property, services, or benefit; 
27 (3) except as otherwise authorized under the medical assistance 
28 program, confers, offers to confer, solicits, agrees to accept, or accepts property, 
29 services, or a benefit 
30 (A) to refer a medical assistance recipient to a health care 
31 provider; or

01 (B) for providing health care to a medical assistance recipient if 
02 the property, services, or benefit is in addition to payment by a medical 
03 assistance agency; 
04 (4) does not produce medical assistance records to a person authorized 
05 to request the records; 
06 (5) knowingly makes a false entry in or falsely alters a medical 
07 assistance record; 
08 (6) knowingly destroys, mutilates, suppresses, conceals, removes, or 
09 otherwise impairs the verity, legibility, or availability of a medical assistance record 
10 knowing that the person lacks the authority to do so; or 
11 (7) violates a provision of AS 47.07 [OR AS 47.08] or a regulation 
12 adopted under AS 47.07 [OR AS 47.08]. 
13 * Sec. 17. AS 47.05.240 is amended to read: 
14 Sec. 47.05.240. Exclusion from medical assistance programs. (a) The 
15 commissioner may exclude an applicant to or disenroll a medical assistance provider 
16 in the medical assistance program in AS 47.07 [OR AS 47.08, OR BOTH,] for a 
17 period of up to 10 years after unconditional discharge on a conviction 
18 (1) for medical assistance fraud under AS 47.05.210 or misconduct 
19 involving a controlled substance under AS 11.71; or 
20 (2) in a court of the United States or a court of another state or 
21 territory, for a crime with elements similar to the crimes included under (1) of this 
22 subsection. 
23 (b) After a period of exclusion under (a) of this section, an applicant may not 
24 participate in a medical assistance program under AS 47.07 [OR AS 47.08] until the 
25 applicant establishes to the commissioner by clear and convincing evidence that the 
26 applicant possesses all required licenses and certificates and is qualified to participate. 
27 * Sec. 18. AS 47.05.290(9) is amended to read: 
28 (9) "medical assistance program" means a program under AS 47.07 
29 [OR AS 47.08]; 
30 * Sec. 19. AS 47.05.290(10) is amended to read: 
31 (10) "medical assistance provider" or "provider" means a person or

01organization that provides, attempts to provide, or claims to have provided services or 
02 products to a medical assistance recipient that may qualify for reimbursement under 
03 AS 47.07 [OR AS 47.08] or a person or organization that participates in or has applied 
04 to participate in a medical assistance program as a supplier of a service or product; 
05 * Sec. 20. AS 47.05.290(17) is amended to read: 
06 (17) "services" or "medical assistance services" means a health care 
07 benefit that may qualify for reimbursement under AS 47.07 [OR AS 47.08], including 
08 health care benefits provided, attempted to be provided, or claimed to have been 
09 provided to another, by a medical assistance provider, or "services" as defined in 
10 AS 11.81.900; 
11 * Sec. 21. AS 47.05.330(a) is amended to read: 
12 (a) The Department of Health and the Department of Family and Community 
13 Services shall by regulation identify each database that department will review when 
14 conducting a civil history check under AS 47.05.325 to identify each individual 
15 (1) whom a court or the applicable department has found 
16 (A) to have committed abuse, neglect, undue influence, or 
17 exploitation of a vulnerable adult; 
18 (B) under AS 47.32 or regulations adopted under AS 47.32, to 
19 have significantly adversely affected the health, safety, or welfare of an 
20 individual who is receiving a service from an entity licensed under AS 47.32; a 
21 finding described in this subparagraph includes a decision to revoke, suspend, 
22 or deny a license or license renewal, or the relinquishment of a license as part 
23 of a settlement agreement; 
24 (2) who has been subject to criminal or civil penalties for a violation of 
25 AS 09.58, AS 47.05, AS 47.06, AS 47.07, former AS 47.08, or regulations adopted 
26 under AS 09.58, AS 47.05, AS 47.06, AS 47.07, or former AS 47.08; 
27 (3) about whom the applicable department or a court has made a 
28 substantiated finding of child abuse or neglect under AS 47.10 or AS 47.14; 
29 (4) who was a biological or adoptive parent, guardian, custodian, or 
30 Indian custodian of a child at the time the child was the subject of a child-in-need-of- 
31 aid petition under AS 47.10;

01(5) who, in the course of employment with the state, has been 
02 terminated from employment or has had an allegation of assaultive, abusive, 
03 neglectful, or exploitive behavior or actions substantiated; 
04 (6) who, in this state or another jurisdiction, for reasons related to 
05 abuse, neglect, undue influence, exploitation, or other reasons that are inconsistent 
06 with standards for the protection of public health, safety, or welfare, has had a 
07 professional license, certification, or similar professional designation revoked, 
08 suspended, or denied, or has had a request for renewal of a professional license, 
09 certification, or similar professional designation denied; 
10 (7) whom another state or jurisdiction has identified on a civil registry 
11 or database substantially similar to the databases identified under this section for 
12 reasons substantially similar to the reasons identified in (1) - (6) of this subsection. 
13 * Sec. 22. AS 47.08.010, 47.08.020, 47.08.030, 47.08.040, 47.08.050, 47.08.060, 47.08.070, 
14 47.08.080, 47.08.090, 47.08.100, 47.08.110, 47.08.120, 47.08.130, 47.08.140, and 47.08.150 
15 are repealed. 
16 * Sec. 23. The uncodified law of the State of Alaska is amended by adding a new section to 
17 read: 
18 APPLICABILITY. AS 47.05.210(a), as amended by sec. 16 of this Act, applies to 
19 offenses committed on or after the effective date of sec. 16 of this Act. 
20 * Sec. 24. The uncodified law of the State of Alaska is amended by adding a new section to 
21 read: 
22 TRANSITION. (a) Notwithstanding AS 47.05.085(a), as amended by sec. 14 of this 
23 Act, the commissioner of health or the commissioner's designee at the director level may issue 
24 subpoenas to compel the production of books, papers, correspondence, memoranda, and other 
25 records considered necessary as evidence in connection with an investigation under AS 47.08 
26 that began before the effective date of sec. 14 of this Act or for an investigation of a violation 
27 of AS 47.08 that occurred before the effective date of sec. 14 of this Act. 
28 (b) Notwithstanding AS 47.05.200(d), as amended by sec. 15 of this Act, a provider 
29 shall allow the department reasonable access to the records of medical assistance recipients 
30 and providers and allow audit and inspection of the records by state and federal agencies 
31 (1) in order to receive payment for a service provided under AS 47.08 before

01the effective date of sec. 15 of this Act; and 
02 (2) in connection with an audit under AS 47.05.200 for activities that occurred 
03 before the effective date of sec. 15 of this Act. 
04 * Sec. 25. Section 14, ch. 38, SLA 2022, is amended to read: 
05 Sec. 14. If secs. 9 and 10, ch. 38, SLA 2022, [OF THIS ACT] take effect under 
06 sec. 13, ch. 38, SLA 2022 [OF THIS ACT], they take effect June 30, 2040 [2030]. 
07 * Sec. 26. Sections 1, 2, 4, 5, 7, 8, and 25 of this Act take effect January 1, 2027. 
08 * Sec. 27. Sections 3 and 9 - 13 of this Act take effect immediately under AS 01.10.070(c).