AK HB148

Legislature finds Alaska's Medicaid program unsustainable despite annual growth falling from 6.45 percent to 4.8 percent, and directs Department of Health and Social Services to pursue cost-effective reform measures including waivers, cost sharing, and utilization controls.

Department must submit proposal by January 25, 2016, to authorize a provider tax up to the maximum extent allowed by federal law, with an independent third party contracted to advise on development.

Expands Medicaid eligibility for children under 19 years of age from 175 percent to 203 percent of federal poverty line and for pregnant women from 175 percent to 200 percent of federal poverty line.

Authorizes department to impose a primary care case management system or managed care organization contracts for Medicaid recipients, including super-utilizers, and requires annual legislative reporting on optional versus mandatory service costs.

Increases provider accountability by raising minimum annual audits from 50 to 0.75 percent of enrolled providers, authorizes civil fines up to $25,000 per violation, and allows assessment of interest and penalties on overpayments.