HB 227 Summary

• Legislature declares Alaska's Medicaid program unsustainable and directs the Department of Health and Social Services to evaluate and implement reform measures, including seeking federal waivers and working with tribal and community partners to develop innovative practices.

• Department shall conduct annual independent audits of at least 0.75 percent of medical assistance providers (minimum 75 audits) to identify overpayments, with authority to assess civil penalties of $100-$25,000 per violation and collect interest on identified overpayments.

• Department must establish a primary care case management or managed care system for "super-utilizers" and apply for federal waivers to implement demonstration projects using innovative payment models including managed care organizations, community care organizations, and patient-centered medical homes.

• Establishes a pre-term birth reduction pilot project providing care coordination, nutritional counseling, and vitamin D supplementation to approximately 500 eligible pregnant women, with reporting requirements on outcomes and state savings.

• Directs department to collaborate with Alaska tribal health organizations to implement 100 percent federal funding for services to American Indian and Alaska Native individuals eligible for Medicaid, and removes restrictions limiting clinic and rehabilitative services coverage to grant-funded providers.