Bill Summary – FastDemocracy

State of Alaska
                                                               Fiscal Note
                                                                                                  Bill Version:                    HCS CSSB 44(FIN)
 2019 Legislative Session
                                                                                                  Fiscal Note Number:              3
                                                                                                  (H) Publish Date:                5/14/2019
 Identifier:        SB044-DHSS-MS-5-10-2019                                         Department:       Department of Health and Social Services
 Title:             TELEHEALTH: PHYSICIAN ASSISTANTS;                               Appropriation: Medicaid Services
                    DRUGS                                                           Allocation:       Medicaid Services
 Sponsor:           GIESSEL BY REQUEST                                              OMB Component Number:              3234
 Requester: (H)FIN
 Expenditures/Revenues
 Note: Amounts do not include inflation unless otherwise noted below.                                                                    (Thousands of Dollars)
                                                 Included in
                                    FY2020       Governor's
                                Appropriation      FY2020                                                Out-Year Cost Estimates
                                  Requested       Request
 OPERATING EXPENDITURES               FY 2020        FY 2020        FY 2021                         FY 2022           FY 2023            FY 2024       FY 2025
 Personal Services
 Travel
 Services
 Commodities
 Capital Outlay
 Grants & Benefits                                  (1,000.0)      (2,000.0)                       (2,000.0)          (2,000.0)         (2,000.0)      (2,000.0)
 Miscellaneous
 Total Operating                            0.0     (1,000.0)      (2,000.0)                       (2,000.0)          (2,000.0)         (2,000.0)      (2,000.0)
 Fund Source (Operating Only)
 1002 Fed Rcpts (Fed)                                           (700.0)         (1,400.0)          (1,400.0)          (1,400.0)         (1,400.0)      (1,400.0)
 1003 GF/Match (UGF)                                            (300.0)           (600.0)            (600.0)            (600.0)           (600.0)        (600.0)
 Total                                              0.0       (1,000.0)         (2,000.0)          (2,000.0)          (2,000.0)         (2,000.0)      (2,000.0)
 Positions
 Full-time
 Part-time
 Temporary
 Change in Revenues
 None
 Total                                              0.0              0.0                 0.0              0.0                0.0              0.0           0.0
 Estimated SUPPLEMENTAL (FY2019) cost:                                        0.0              (separate supplemental appropriation required)
 Estimated CAPITAL (FY2020) cost:                                             0.0              (separate capital appropriation required)
 Does the bill create or modify a new fund or account?       N/A
 (Supplemental/Capital/New Fund - discuss reasons and fund source(s) in analysis section)
 ASSOCIATED REGULATIONS
 Does the bill direct, or will the bill result in, regulation changes adopted by your agency?                     Yes
 If yes, by what date are the regulations to be adopted, amended or repealed?                                     12/31/19
 Why this fiscal note differs from previous version/comments:
 Version O amendments include changes to the Medicaid pharmacy and now require a fiscal note. This is the initial version based on
 the Governor's February 13, 2019 FY202 amended budget request.
 Prepared By:               Linnea Osborne, Manager                                                                     Phone:         (907)465-6333
 Division:                  Finance and Management Services                                                             Date:          05/09/2019
 Approved By:               Sana P. Efird, Administrative Services Director                                             Date:
                                                                                                                                OUT OF 05/09/19
 Agency:                    Office of Management and Budget                                                           REPORTED
Printed 5/13/2019                                                          Page 1 of 2                                 HFC 05/13/2 019
                                                                                                                                Control Code: BsnrJ
                                                                                                    HCS CSSB 44(FIN) - Fiscal Note 3
                                                FISCAL NOTE ANALYSIS
STATE OF ALASKA                                                                 BILL NO. SB 44
2019 LEGISLATIVE SESSION
Analysis
   Senate Bill 44, through the changes to AS 47.05.012 and AS 47.07.065, will provide authority for the Department of Health
   and Social Services (DHSS) to more frequently update the Alaska Medicaid Preferred Drug List (PDL) and Prior
   Authorization (PA) Medications List. The department uses the Preferred Drug List (PDL) to assist in the guidance of
   prescribing clinically beneficial medications for specific drug classes to promote positive health outcomes and cost
   savings. The department uses the PA Medications List to ensure clinically appropriate use at the individual level.
   The department relies on advisory committees (the Alaska Medicaid Drug Utilization Review Committee and the Alaska
   Medicaid Pharmacy & Therapeutics Committee) to guide decisions by the department in the selection of drugs for the PDL
   and PA Medications list. The committees meet on a state fiscal year cycle in September, November, January, and April
   and are publically noticed and open to the public.
   The PDL aids in supporting a financially sustainable program through the negotiation of supplemental rebates under the
   States participation in the National Medicaid Pooling Initiative, a multi-state contracting pool with 10 states and the
   District of Columbia.
   The projected savings estimate is based on supplemental rebate negotiated contracts, historical utilization patterns, and
   projected shifts in prescribing which will approach $1,000.0 during FY2020 and $2,000.0 in the following years as a result
   of being able to adopt PDL changes more frequently. The savings are calculated to be split as 70% federal/30% state
   general funds. Regulations are expected to take six months to be written and finalized.
(Revised 9/05/18 OMB/LFD)                                                                                         Page 2 of 2
SB044-DHSS-MS-5-10-2019                                       Page 2 of 2                                               Control Code: BsnrJ
Statutes affected: 
SB0044A, AM SB 44, introduced 02/04/2019: 08.64.101, 08.64.364, 17.30.200, 08.64.363
SB0044B, AM CSSB 44(L&C), introduced 03/29/2019: 08.64.101, 08.64.364, 17.30.200, 08.64.363
SB0044C, AM CSSB 44(FIN), introduced 04/15/2019, passed Senate 05/08/2019: 08.64.101, 08.64.364, 17.30.200, 08.64.363, 18.16.010
SB0044D, AM HCS CSSB 44(FIN), introduced 05/14/2019, passed House 05/15/2019, passed Senate 05/15/2019: 08.64.101, 08.64.364, 17.30.200, 08.64.363, 18.16.010, 47.05.012, 44.62.245, 47.07.065, U.S.C
SB0044Z, AM Enrolled SB 44, introduced 05/15/2019: 08.64.101, 08.64.364, 17.30.200, 08.64.363, 18.16.010, 47.05.012, 44.62.245, 47.07.065, U.S.C