State of Alaska
Fiscal Note
Bill Version: CSHB 176(L&C)
2022 Legislative Session
Fiscal Note Number: 2
(H) Publish Date: 4/25/2022
Identifier: HB176-DOH-MAA-3-18-2022 Department: Department of Health
Title: DIRECT HEALTH AGREEMENT: NOT Appropriation: Health Care Services
INSURANCE Allocation: Medical Assistance Administration
Sponsor: RASMUSSEN OMB Component Number: 242
Requester: (H) L&C
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
Commodities
Capital Outlay
Grants & Benefits
Miscellaneous
Total Operating *** 0.0 *** *** *** *** ***
Fund Source (Operating Only)
None
Total *** 0.0 *** *** *** *** ***
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 (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If yes, by what date are the regulations to be adopted, amended or repealed? 07/01/23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: Renee Gayhart, Director Phone: (907)465-1184
Division: Health Care Services Date: 01/11/2022
Approved By: Sylvan Robb, Assistant Commissioner Date: 03/18/2022
Agency: Department of Health and Social Services
Printed 4/21/2022 Page 1 of 2 Control Code: bPWYn
 CSHB 176(L&C) - Fiscal Note 2
FISCAL NOTE ANALYSIS
STATE OF ALASKA BILL NO. HB176
2022 LEGISLATIVE SESSION
Analysis
This bill creates direct health care agreements that would primarily benefit consumers of health care services who do not
have health insurance, employers of individuals who do not have health insurance, and government entities that must
provide for health care services for individuals in government care or custody who do not have health insurance. It is
possible that a direct health care agreement could provide for cosmetic, experimental, and other services not covered by
an individuals health insurance.
The bill allows a patient to submit a health insurance claim for services not included in the agreement but does not include
language that would allow the provider to submit a claim to a patients insurance for a service that is not covered under a
direct health care agreement. The existence of a direct health care agreement will result in a Medicaid recipient being
unable to utilize their Medicaid coverage, as federal and state regulations allow Medicaid claims to be submitted only by
an enrolled provider; a Medicaid recipient cannot submit claims for Medicaid coverage.
The department is unable to accurately project the cost of implementing the provisions of this bill because it cannot
project how many people may enter into direct health care agreements and the additional staff that will be needed to
manage the manual processing of claims that will result.
(Revised 11/23/2021 OMB/LFD) Page 2 of 2
HB176-DOH-MAA-3-18-2022 Page 2 of 2 Control Code: bPWYn


Statutes affected:
HB0176A, AM HB 176, introduced 04/16/2021: 45.45.915, 21.03.025, 45.50.471
HB0176B, AM CSHB 176(L&C), introduced 04/25/2022: 45.45.915, 21.03.025, 45.50.471