State of Alaska
Fiscal Note
Bill Version: HB 113
2021 Legislative Session
Fiscal Note Number: 3
(H) Publish Date: 2/24/2021
Identifier: LL0530-2-DHSS-MAA-2-23-2021 Department: Department of Health and Social Services
Title: HEALTH INS. ALL-PAYER CLAIMS DATABASE Appropriation: Health Care Services
Sponsor: RLS BY REQUEST OF THE GOVERNOR Allocation: Medical Assistance Administration
Requester: Governor OMB Component Number: 242
Expenditures/Revenues
Note: Amounts do not include inflation unless otherwise noted below. (Thousands of Dollars)
Included in
FY2022 Governor's
Appropriation FY2022 Out-Year Cost Estimates
Requested Request
OPERATING EXPENDITURES FY 2022 FY 2022 FY 2023 FY 2024 FY 2025 FY 2026 FY 2027
Personal Services 358.8 358.8 239.2 239.2 239.2 239.2
Travel 3.5 3.5 3.5 3.5 3.5 3.5
Services 3,876.7 726.7 605.0 605.0 605.0 605.0
Commodities 9.6 2.0 1.5 1.5 1.5 1.5
Capital Outlay
Grants & Benefits
Miscellaneous
Total Operating 4,248.6 0.0 1,091.0 849.2 849.2 849.2 849.2
Fund Source (Operating Only)
1002 Fed Rcpts (Fed) 3,524.3 545.5 424.6 424.6 424.6 424.6
1003 GF/Match (UGF) 724.3 545.5 424.6 424.6 424.6 424.6
Total 4,248.6 0.0 1,091.0 849.2 849.2 849.2 849.2
Positions
Full-time 3.0 3.0 2.0 2.0 2.0 2.0
Part-time
Temporary
Change in Revenues
None
Total 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Estimated SUPPLEMENTAL (FY2021) cost: 0.0 (separate supplemental appropriation required)
Estimated CAPITAL (FY2022) 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? No
If yes, by what date are the regulations to be adopted, amended or repealed? N/A
Why this fiscal note differs from previous version/comments:
Not applicable; initial version
Prepared By: Renee Gayhart, Director Phone: (907)465-1617
Division: Health Care Services Date: 02/23/2021 12:45 PM
Approved By: Sylvan Robb, Administrative Services Director Date: 02/23/21
Agency: Office of Management and Budget
Printed 2/24/2021 Page 1 of 4 Control Code: OxuuA
 HB 113 - Fiscal Note 3
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. LL0530\2
2021 LEGISLATIVE SESSION
Analysis
This bill establishes a statewide allpayer health claims database in the Department of Commerce, Community and
Economic Development, Division of Insurance. The Division of Insurance would be responsible for mandating health care
claims data reporting through the allpayer claims database. Health care claims data includes Medicaid claims from the
Medicaid Management Information System and Administrative Services Organization system. The Department of Health &
Social Services would report Medicaid claims data from these two systems to the Division of Insurance (DOI).
In order to comply with this bill, the Division of Health Care Services (DHCS) would be responsible for building new
interfaces in the Medicaid Management Information System (MMIS) to meet the data collection standards created by the
DOI. This is assuming that no new data elements will be required by the DOI data standards that are not currently
collected in MMIS. This fiscal note includes costs based on similar interfaces built for the MMIS by the current contractor,
similar activities performed by department staff, and DHCS staff time and costs for completing testing and validation of
the interfaces and the metrics would that would be required.
DHCS responsibilities related to this bill (e.g. data mapping and defining specifications) are parallel to an existing
Transformed Medicaid Statistical Information System (TMSIS) project. TMSIS is a federal requirement under the Centers
for Medicare & Medicaid Services (CMS), the Medicaid programs primary funding source. Because TMSIS is a federal
requirement, CMS funds that project at 90% federal/10% state match, otherwise known as Federal Financial Participation
(FFP). CMS currently receives a similar subset of Medicaid claims data through TMSIS. Additional Medicaid claims data will
also become available to patients through the Interoperability Rule later this year. This fiscal note was calculated at the
90% federal/10% state match FFP on the assumption that the Interoperability Rule standard, USCDI, would be reused for
an All Payer Claims Database.
Interfaces
The previously undertaken TMSIS project required a work effort similar to the details in this bill. There was significant
data identification and mapping needed to build the 7 required interfaces for claims data, member data, provider data,
and thirdparty liability data. This project ultimately cost DHCS/CMS $4.7 million and extended across 3 federal fiscal
years. During this project, the estimated budget increased by 15 percent and the work timeline was extended by 1 full
year.
To prevent duplicating the interface work (and costs), the department recommends using a version of the existing TMSIS
process until a new fiscal agent has been implemented for the Medicaid program. The expected implementation of the
new fiscal agent is early 2023.
Staff
To comply with the bill as written, additional DHCS staff resources are required because Alaskas Medicaid program is
feeforservice." The work conducted by DHCS staff is not managed by a contractor or actuary, as in a managed care
organization or private insurer, respectively. The current routine workload, with new federal requirements, has consumed
existing staff time in order to maintain federal funding and current operations. In order to meet the requirements of this
bill, DHSS would require additional staff as work cannot be absorbed by existing staff.
The MMIS Systems Unit would work on cohesive development (approx. 918 months), including testing and validating the
new interfaces. Successful implementation would require three new FTEs in Heath Care Services and 85% FTE of IT
resources over that same time period through a reimbursable service agreement. In the postimplementation phase
(beginning in FY2024), maintaining the interfaces would take approximately two FTEs. The third FTE would no longer be
needed for maintenance.
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 HB 113 - Fiscal Note 3
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. LL0530\2
2021 LEGISLATIVE SESSION
Analysis
The three fulltime Medicaid Program Specialist IIIs will handle the coordination of the database. Database coordination
includes, but is not limited to, liaising with the DOI, Conduent (MMIS claims contractor), the DHSS Regulations
Coordinator, the DHSS State Plan Coordinator, other Divisions, and outside entities. These positions would be responsible
for the implementation of policies, programs, and systems as it relates to this project. Additional administrative work
generated by this project would be absorbed within existing staffing levels. Administrative work encompasses tracking
documents, scanning projects, invoicing, and general administrative support.
Staffing Cost Breakdown
Three fulltime Medicaid Program Specialist III (including benefits): Range 20, Juneau: $358.8 first and second year
annually and two postion $239.2 annually after golive.
Travel: $3.5 annually for security review and compliance audit of IT staff
Services: Amendment to contract for MMIS contractor to create 37 interfaces at database start up $3,500.0 first year;
Office space, phone, reimbursable services agreements for position support costs: $10.0 annually for each position;
Ongoing updates and maintenance of interfaces $350.0 annually
Commodities: Office supplies: $2.0 annually for the first two years and then $1.5 annually
OneTime Commodities Cost: Computer, software, and office equipment: $7.6
Reimbursable Services Agreement (RSA) Costs, budgeted in the services line (50% UGF/50% Federal):
RSA between DHSS Health Care Services and DHSS Departmental Support Services
The department would be responsible for building new interfaces in the Enterprise Service Bus/Master Client Index
(ESB/MCI) to meet the data collection standards created by DOI. The ESB/MCI would collect relevant Medicaid data
elements to submit to the DOI. This fiscal note represents the cost given the following assumptions:
There are no new data elements required by the DOI data standards that are not currently collected.
The deidentification of the data is performed by the DOI.
The actuarial work and analysis are performed by the DOI.
The requirements affect the MMIS and ASO systems.
Based on similar interfaces built for the ESB/MCI by the current IT staff resources, and similar activities performed by
department IT staff, it is estimated that this work will require 85% FTE, the cost would be $111.7 for the RSA. An
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 HB 113 - Fiscal Note 3
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. LL0530\2
2021 LEGISLATIVE SESSION
Analysis
additional $20.0 for IT Security to review for compliance.
RSA between DHSS Health Care Services and Department of Law
To ensure compliance with federal and state security/privacy laws, the division estimates the need of approximately $15.0
for legal services from the Department of Law annually.
RSA between DHSS Health Care Services and DHSS Division of Behavioral Health
Health Care Services will coordinate with Division of Behavioral Health to support data exchange needed for the all claims
payer database; quality control of the data to make sure it is clean prior to interfacing and coordination of retransmission
of clean files.
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Statutes affected:
HB0113A, AM HB 113, introduced 02/24/2021: 21.92.020, C.F.R, 21.92.030, 40.25.100, 40.25.295, 21.92.040
HB0113A, AM HB 113, introduced 02/23/2021: 21.92.020, C.F.R, 21.92.030, 40.25.100, 40.25.295, 21.92.040