Senator Berta Gardner

March 14, 2016

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Medicaid Reform Legislation Passes Unanimously in the Senate

Dear Friends and Neighbors,

Senator Gardner during an at ease on the Senate Floor.
Senator Gardner during an at ease on the Senate Floor.

I am proud to report that, on Friday morning, the Senate unanimously passed SB 74, a sweeping and well-developed legislative plan that I expect will curb costs and eliminate redundancies within our Medicaid program.  I was pleasantly surprised that Medicaid--an issue that deeply divided legislators last session-- served to unite both parties through two common goals:  addressing the ballooning Department of Health and Social Services (DHSS) budget, and streamlining and improving care delivery for all Alaskans. 

Among other things, SB 74 includes provisions to ferret out fraud and abuse, as well as the establishment of  “medical homes” that might help us move from a fee-for-service to a coordinated care model.  It also calls for establishing a case management system to reduce unnecessary use of emergency and specialty care services, reforms our Prescription Drug Monitoring Database, and allows for reducing travel costs by requiring that recipients receive care in their own communities, whenever possible. 

Other notable provisions included in SB 74:

  • strong new Medicaid anti-fraud provisions, including a new false claims whistleblower protection in reporting fraud and a fraud-recovery sharing;
  • more extensive controls and oversight of controlled substances prescriptions with requirements that a prescription database be consulted before prescriptions are written;
  • sections that require coordinated primary care for hospital emergency room “super-users” and, in a separate section, a larger managed care demonstration project for a sub-group of Medicaid recipients;
  • telemedicine provisions that allow out-of-state health providers to do consultations and order prescriptions for Alaskan patients;
  • feasibility studies of potential privatization of the state-run Pioneer Homes and the Alaska Psychiatric Institute; and
  • a feasibility study on the merging of health plans for public employees, ASD employees and retirees with the state-managed Medicaid program.

While DHSS cannot determine exactly how much the state will save after implementation of these new provisions, a modest estimate is at least $31.4 million next year alone.  But perhaps most importantly, this bill also focuses on coordination of behavioral health care with primary care providers.  DHSS expects that this coordination effort will do wonders in improving the rampant mental health issues faced by many Alaskans. 

I want to thank Senator Kelly, Senator MacKinnon, their hard-working staff, and all of the dedicated people at DHSS.  The passage of this legislation is a remarkable achievement during this pivotal time in Alaska’s history, and I applaud the efforts of everyone that helped to make this happen.

I’m Berta and I’m still listening,

If you have any questions, please feel free to contact my office.

signed: Berta

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