AK SB78

Legislature finds current Medicaid program unsustainable and directs Department of Health and Social Services to implement reform measures including waivers, cost sharing, and utilization controls to capture federal revenues and offset state general funds.

Department must submit proposal to legislature by January 25, 2016, to authorize provider tax up to maximum allowed by federal law to help offset Medicaid costs.

Reduces annual medical assistance provider audits from 75 to minimum of 50, with audits conducted by independent contractors with expertise in accounting, financial auditing, and Alaska health care law.

Authorizes department to assess interest penalties on identified overpayments using statutory post-judgment interest rates and to impose civil fines between $100-$25,000 per occurrence for violations of medical assistance regulations.

Increases Medicaid eligibility for children under 19 from 175% to 203% of federal poverty line and for pregnant women from 175% to 200% of federal poverty line; adds coverage for persons under 65 at 138% of poverty line if federal match is at least 90%.

Directs department to apply for federal waivers and demonstration projects for telemedicine expansion, home and community-based services, and innovative service delivery models; effective date July 1, 2015.