Legislature(2015 - 2016)SENATE FINANCE 532

04/13/2015 01:30 PM Senate FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 161 Presentation: Overview FY17 Operating Budget TELECONFERENCED
Heard & Held
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
CS FOR HOUSE BILL NO. 161(HSS)                                                                                                
     "An Act relating to the purchase of durable medical                                                                        
     equipment under Medicaid; and providing for an                                                                             
     effective date."                                                                                                           
2:50:57 PM                                                                                                                    
REPRESENTATIVE  LYNN  GATTIS, SPONSOR,  introduced  herself.                                                                    
She was not aware that there was a committee substitute.                                                                        
2:51:29 PM                                                                                                                    
AT EASE                                                                                                                         
2:51:34 PM                                                                                                                    
2:51:43 PM                                                                                                                    
Representative Gattis stated that  she was confused with her                                                                    
previous  statement.  She  introduced the  legislation,  and                                                                    
announced that  the idea for  the legislation  was presented                                                                    
to her  by the Key  Coalition. The  bill was a  cost savings                                                                    
measure, which  allowed the Department of  Health and Social                                                                    
Services  (DHSS) to  purchase  used  or refurbished  durable                                                                    
medical  equipment.  Currently,   DHSS  only  purchased  new                                                                    
medical  equipment.  She   explained  that  durable  medical                                                                    
equipment  would  include  items such  as  canes,  crutches,                                                                    
wheelchairs,  lifts,   braces,  and  many  other   types  of                                                                    
expensive  equipment that  can be  used multiple  times. The                                                                    
ability   to   purchase   used   equipment   would   provide                                                                    
substantial savings for Alaska.                                                                                                 
2:53:40 PM                                                                                                                    
MILLIE RYAN,  EXECUTIVE DIRECTOR, REACH,  ALASKA ASSOCIATION                                                                    
ON DEVELOPMENTAL DISABILITIES,  JUNEAU (via teleconference),                                                                    
testified in  support of the legislation.  She remarked that                                                                    
the  state   would  save  money,  but   also  benefit  those                                                                    
individuals  who need  safe and  durable medical  equipment.                                                                    
She shared  an anecdote regarding a  person who transitioned                                                                    
to living  on her own,  because of  the time and  expense of                                                                    
acquiring durable  medical equipment  from Seattle.  Had the                                                                    
program been available, she would  have had a less expensive                                                                    
and timelier transition.                                                                                                        
Senator  Dunleavy wondered  how the  used medical  equipment                                                                    
would  be  brokered.  Ms.  Ryan replied  that  there  was  a                                                                    
programs  that maintained  assistive technology  and a  loan                                                                    
closet with clean refurbished equipment.                                                                                        
Senator  Dunleavy  shared that  his  wife  had a  number  of                                                                    
specialized equipment  from her knee replacement.  He stated                                                                    
that they did  not know where to donate  the used equipment.                                                                    
Ms. Ryan replied that the  program would provide information                                                                    
about donation service locations.                                                                                               
Senator  Dunleavy  suggested  that the  doctor  may  provide                                                                    
donation recommendations. Ms. Ryan agreed.                                                                                      
2:57:34 PM                                                                                                                    
JOHN  CANNON, PRESIDENT,  KEY COALITION  OF ALASKA,  WASILLA                                                                    
(via teleconference),  spoke in support of  the legislation.                                                                    
He  shared  that  the federal  government  allowed  for  the                                                                    
purchase of  used medical equipment, but  the state Medicaid                                                                    
program   currently   prohibited   the  purchase   of   used                                                                    
equipment.  Other states  had implemented  reused equipment,                                                                    
and those  states had shown proved  cost-savings results. He                                                                    
felt  that the  language  of the  legislation should  remain                                                                    
simple, so  DHSS could  set up the  program. He  pointed out                                                                    
that other  states had utilized state-owned  equipment, with                                                                    
the condition  that the user  return the equipment  to state                                                                    
upon completion.  He announced  that Kansas  had one  of the                                                                    
most established  durable medical equipment  (DME) programs.                                                                    
He stated that  Kansas had cautioned states,  because of the                                                                    
impact on the  DME providers. He felt that  it was important                                                                    
to keep  healthy partnerships with DME  providers. He wanted                                                                    
to  ensure  that all  partnerships  were  supportive of  the                                                                    
program to  ensure an adequate  supply of equipment  for all                                                                    
users. He reiterated his support of the legislation.                                                                            
3:01:27 PM                                                                                                                    
PATRICK REINHART, EXECUTIVE  DIRECTOR, GOVERNOR'S COUNCIL ON                                                                    
DISABILITIES   AND   SPECIAL   EDUCATION,   ANCHORAGE   (via                                                                    
teleconference),  urged  support   of  the  legislation.  He                                                                    
remarked that  he had  seen a store  that provided  used and                                                                    
durable medical  equipment, and the  price of  the equipment                                                                    
was almost one-third  the cost of new  equipment. That store                                                                    
allowed  for  Medicaid to  purchase  the  equipment for  the                                                                    
patient. He shared that the  equipment could be state-owned,                                                                    
so  people would  know  where to  return  the equipment.  He                                                                    
shared that  many people  in the DME  stores in  the country                                                                    
had disabilities,  so the  program could  enhance employment                                                                    
opportunities. He shared that  Wisconsin used prison inmates                                                                    
to perform the refurbishment duties.                                                                                            
Co-Chair MacKinnon CLOSED public testimony.                                                                                     
Co-Chair  MacKinnon queried  the  process  of acquiring  the                                                                    
equipment.  Representative Gattis  replied that  the program                                                                    
allowed for  Medicaid to purchase the  equipment. She stated                                                                    
that the State of Alaska  may, not "shall", acquire the used                                                                    
equipment. She  stressed that the state  could not currently                                                                    
acquire the used equipment.                                                                                                     
3:06:44 PM                                                                                                                    
Senator  Dunleavy   surmised  that   the  law   allowed  for                                                                    
reimbursements  on   the  used  equipment.  He   would  like                                                                    
clarification on whether it was  illegal to use used medical                                                                    
equipment.  Representative  Gattis  responded  that  it  was                                                                    
currently against the law to state to use used equipment.                                                                       
Senator  Dunleavy   he  wondered  if  it   was  illegal  for                                                                    
individuals  in the  state to  use  used medical  equipment.                                                                    
Representative Gattis  replied that  it was illegal  for the                                                                    
state Medicaid program to purchase used medical equipment.                                                                      
Senator  Bishop  surmised  that   DHSS  was  only  currently                                                                    
allowed  to  purchase  new equipment.  He  wondered  if  the                                                                    
legislation  allowed  for  the  purchase  of  approved  used                                                                    
medical  equipment.   Representative Gattis  replied in  the                                                                    
Senator   Olson  wondered   why  DHSS   was  restricted   to                                                                    
purchasing only new  equipment. Representative Gattis opined                                                                    
that there  were companies that  wanted to continue  to sell                                                                    
the new equipment.                                                                                                              
Senator  Olson   asked  if  there  was   opposition  to  the                                                                    
legislation.  Representative  Gattis  responded  that  those                                                                    
that   sell  new   equipment  would   be   opposed  to   the                                                                    
Senator  Olson wondered  if those  sellers  had expressed  a                                                                    
position on  the bill. Representative Gattis  replied in the                                                                    
Vice-Chair  Micciche stated  that he  cosponsored the  bill,                                                                    
because he  felt that it  was good fiscal reform.  He shared                                                                    
that  he   knew  someone  who   had  an   extra  specialized                                                                    
wheelchair, sitting  unused in her home.  He appreciated the                                                                    
CHAD  HOPE,  PHARMACIST,  DEPARTMENT OF  HEALTH  AND  SOCIAL                                                                    
SERVICES,  ANCHORAGE (via  teleconference),  shared that  he                                                                    
was willing to respond to questions.                                                                                            
Co-Chair  MacKinnon wondered  why Alaska  did not  currently                                                                    
allow used  equipment to be  reimbursed under  Medicaid. Mr.                                                                    
Hope  replied  that  there   were  limited  situations  that                                                                    
allowed  for item  rentals.  He did  not  know the  specific                                                                    
history for the regulations. He  shared that the current fee                                                                    
schedule and  coverage regulations  were set up  to purchase                                                                    
new  equipment,  and  there  was no  fee  schedule  rate  or                                                                    
purchase  coverage for  used equipment.  He shared  that Mr.                                                                    
Reinhart  presented  the idea  in  the  previous summer.  He                                                                    
stated that  DHSS then worked  to establish  new regulations                                                                    
and fee  schedule to  allow for the  purchase or  rental for                                                                    
used equipment.                                                                                                                 
3:11:38 PM                                                                                                                    
Co-Chair MacKinnon  wondered if  there was liability  to the                                                                    
state for new  versus used equipment. Mr.  Hope replied that                                                                    
there  were  many operational  issues.  He  shared that  the                                                                    
operational  issues would  be developed  as the  program was                                                                    
implemented.  The  fee  schedule and  coverage  revision  to                                                                    
allow for  the used equipment would  require an intervention                                                                    
by DHSS. He stated that he  could not speak to the liability                                                                    
for the provider of the used equipment.                                                                                         
Representative Gattis  announced that  the bill  allowed for                                                                    
flexibility regulations to  be drafted at a  later date. She                                                                    
stressed  that  the bill  allowed  for  DHSS to  define  the                                                                    
Co-Chair  MacKinnon wondered  if there  were any  additional                                                                    
comments regarding  liability. Mr. Hope replied  that he did                                                                    
not have any additional comments.                                                                                               
CSHB 161(HSS)  was HEARD and  HELD in committee  for further                                                                    
3:13:35 PM                                                                                                                    
AT EASE                                                                                                                         
3:13:46 PM                                                                                                                    
Co-Chair MacKinnon discussed the following day's agenda.                                                                        

Document Name Date/Time Subjects
HB 161 DHSS Summary and Recommendations.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
HB 161 Explanation of Changes.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
HB 161 Sectional Analysis.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
HB 161 Sponsor Statement.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
HB 161 Support AK PT Association.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
HB 161 Support Governor's Council on Disabilities.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
HB 161 Support Key Coalition.pdf SFIN 4/13/2015 1:30:00 PM
HB 161
SB 82 Sponsor Statement.pdf SFIN 4/13/2015 1:30:00 PM
SB 82
SB 82 Supporting Doc_ Presentation 24.7 Sobriety program.ppt SFIN 4/13/2015 1:30:00 PM
SB 82
SB 82 Supporting Doc_WA Program.pdf SFIN 4/13/2015 1:30:00 PM
SB 82