State of Alaska
Fiscal Note
Bill Version: CSHB 111(FIN)
2022 Legislative Session
Fiscal Note Number: 4
(H) Publish Date: 2/4/2022
Identifier: HB111CS(LC)-DOH-MS-01-28-2022 Department: Department of Health
Title: DENTAL HYGIENIST ADVANCED PRAC PERMIT Appropriation: Medicaid Services
Sponsor: SPOHNHOLZ Allocation: Medicaid Services
Requester: (H) FIN OMB Component Number: 3234
Expenditures/Revenues
Note: Amounts do not include inflation unless otherwise noted below. (Thousands of Dollars)
Included in
FY2023 Governor's
Appropriation FY2023 Out-Year Cost Estimates
Requested Request
OPERATING EXPENDITURES FY 2023 FY 2023 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028
Personal Services
Travel
Services 275.3 275.3 275.3 275.3 275.3 275.3
Commodities
Capital Outlay
Grants & Benefits
Miscellaneous
Total Operating 275.3 0.0 275.3 275.3 275.3 275.3 275.3
Fund Source (Operating Only)
1002 Fed Rcpts (Fed) 206.5 206.5 206.5 206.5 206.5 206.5
1003 GF/Match (UGF) 68.8 68.8 68.8 68.8 68.8 68.8
Total 275.3 0.0 275.3 275.3 275.3 275.3 275.3
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 (FY2022) cost: 0.0 (separate supplemental appropriation required)
Estimated CAPITAL (FY2023) cost: 0.0 (separate capital appropriation required)
Does the bill create or modify a new fund or account? No
(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If yes, by what date are the regulations to be adopted, amended or repealed? 07/01/23
Why this fiscal note differs from previous version/comments:
This fiscal note has been updated to reflect FY23 and the change to the Department of Health.
Prepared By: Linnea Osborne, Manager Phone: (907)465-6333
Division: Finance and Management Services Date: 01/19/2022
Approved By: Sylvan Robb, Administrative Services Director Date:
OUT OF 01/28/22
Agency: Office of Management and Budget REPORTED
Printed 2/3/2022 Page 1 of 2 HFC 02/03/2 022
Control Code: fhsnW
 CSHB 111(FIN) - Fiscal Note 4
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. HB111
2022 LEGISLATIVE SESSION
Analysis
This bill establishes an advance practice permit for dental hygienists, prohibits unfair discrimination under group health
insurance, and relates to medical assistance for dental hygiene services.
The Division of Health Care Services (DHCS) would be responsible for configuration changes to the Medicaid Management
Information System (MMIS). Fiscal agent contract changes include accommodating an increase in codes for dental care,
coordination with current fiscal agent on provider enrollment, monitoring and evaluating Medicaid authorizations, and
claims processing and reimbursement for dental service providers to ensure compliance with state and federal laws and
regulations.
Costs associated with the fiscal agent contract changes:
Provider enrollment: $25.9
The current contract is a negotiated flat rate based on current volumes. Any increase in workload would require a contract
amendment and the division anticipates the renegotiated rate to increase the annual cost $25.9.
Increase claims processing: $248.2
All claims processing activities are performed by the fiscal agent (claims processing contractor). This includes additional
claims data entry, mailroom services, claims adjudication, and quality assurance for audit purposes. The current contract
is a negotiated flat rate based on current volumes. Any increase in workload would require a contract amendment, and
the division anticipates the renegotiated rate to increase the annual cost $248.2.
HIPAA compliant electronic claims: $1.2
Committee on Operating Rules Information Exchange requires that all electronic medical claims follow specific HIPAA
compliance rules when submitting from a provider to a payer. To ensure Alaska Medicaid is compliant with these rules,
CMS has authorized the use of the EDIFECS auditing tool for electronic claims transactions. Costs are related to each
individual transaction. Additional transactions will incur additional pertransaction costs estimated to be $1.2 annually.
Total annual cost: $275.3 ($206.5 Fed/$68.8 UGF)
These services are calculated at a 75% federal match blended rate to reflect the allowable federal financial participation
rate for a certified Medicaid Management Information System.
Possible increased costs in Medicaid benefits may exist but are considered immaterial. While adding additional providers,
the division does not anticipate additional benefit expenditures. DHCS agrees that some of these services will be provided
at a lower cost but also expects that Medicaid will see a higher volume of services that could negate each other.
Additionally, all services that may be provided by dental hygienists are currently covered services. It is unclear if additional
services would be added to benefit plans as a result of adding dental hygienists.
(Revised 11/23/2021 OMB/LFD) Page 2 of 2
HB111CS(LC)-DOH-MS-01-28-2022 Page 2 of 2 Control Code: fhsnW


Statutes affected:
HB0111A, AM HB 111, introduced 02/24/2021: 08.32.110, 08.32.085, 08.32.125, 08.32.115, 08.36.346, U.S.C, 08.32.071, 08.32.160, 21.36.090, 21.42.365, 47.07.030, 47.07.063, 21.42.375
HB0111B, AM CSHB 111(L&C), introduced 04/05/2021: 08.32.110, 08.32.085, 08.32.125, 08.32.115, 08.36.346, 08.36.075, U.S.C, 08.32.071, 08.32.160, 21.36.090, 21.42.365, 47.07.030, 47.07.063, 21.42.375
HB0111C, AM CSHB 111(FIN), introduced 02/04/2022: 08.32.110, 08.32.085, 08.32.125, 08.32.115, 08.36.346, 08.36.075, U.S.C, 08.32.071, 08.32.160, 21.36.090, 21.42.365, 47.07.030, 47.07.063, 21.42.375
HB0111D, AM SCS CSHB 111(L&C), introduced 03/30/2022: 08.32.110, 08.32.085, 08.32.125, 08.32.115, 08.36.346, 08.36.075, U.S.C, 08.32.071, 08.32.160, 21.36.090, 21.42.365, 47.07.030, 47.07.063, 21.42.375