Legislature(2017 - 2018)FAHRENKAMP 203

03/22/2018 08:15 AM RULES

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08:14:27 AM Start
08:14:53 AM SB169
08:19:47 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Uniform Rule 23 Waived --
Moved CSSB 169(RLS) Out of Committee
          SB 169-MEDICAID: BEHAVIORAL HEALTH COVERAGE                                                                       
8:14:53 AM                                                                                                                    
CHAIR MEYER announced consideration of SB 169.                                                                                  
SENATOR  MACKINNON  moved to  adopt  CSSB  169(RLS), version  30-                                                               
LS1283\U, as the  working document. There were  no objections and                                                               
it was so ordered.                                                                                                              
8:15:36 AM                                                                                                                    
SENATOR  GIESSEL, sponsor  of SB  169, Alaska  State Legislature,                                                               
explained that  the Rules [version \U]  committee substitute (CS)                                                               
removes  a  phrase  "or an  advanced  practice  registered  nurse                                                               
(APRN)  licensed  under AS  08.68  who  is certified  to  provide                                                               
psychiatric or  mental health services"  in two locations  of the                                                               
bill: on page 1, line 7, and on page 1, line 10.                                                                                
She explained  that these changes  are being proposed  because it                                                               
was noted in the Department  of Health and Social Services (DHSS)                                                               
under the Division of Behavioral  new fiscal note, dated 3/14/18,                                                               
that Federal  Rule 42 CFR  440.90 only allows clinic  services to                                                               
be supervised only by a physician  or a dentist. So, the addition                                                               
of the  licensed advanced practice registered  nurse certified in                                                               
psychiatric or  mental health practice  language does  not affect                                                               
the fiscal note  that is zero. Currently, it is  not possible for                                                               
an  APRN who  owns a  clinic providing  behavioral health  clinic                                                               
services to enroll the clinic  and bill Medicaid under the clinic                                                               
license, which was the purpose of the addition of the APRN.                                                                     
8:16:14 AM                                                                                                                    
SENATOR KELLY joined committee.                                                                                                 
8:16:48 AM                                                                                                                    
CHAIR MEYER  asked if this amendment  was made in the  Health and                                                               
Social Services Committee.                                                                                                      
SENATOR GIESSEL  replied no;  it was in  her original  bill whose                                                               
purpose  was  to  open  the  doors  for  more  behavioral  health                                                               
clinicians in the  state. She has multiple document  of how short                                                               
the  state  is; it  was  topic  of  huge  interest under  SB  74,                                                               
Medicaid reform.                                                                                                                
Alaska has a  rule that requires a psychiatrist  to be physically                                                               
present in  a clinic 30  percent of the  time that the  clinic is                                                               
open.  The  original  bill  would  remove  that  requirement  and                                                               
replace  the word  "psychiatrist" with  the word  "physician" and                                                               
included a psych-mental  health nurse practitioner as  one of the                                                               
supervisory  folks. This  would  open  the door  for  a lot  more                                                               
clinicians  to  provide  mental health  services  in  the  state.                                                               
Because  of the  federal  reimbursement  restrictions, the  nurse                                                               
practitioner needed to be removed from the bill.                                                                                
SENATOR MACKINNON asked if it is  fair to say this will align the                                                               
state definition with federal requirements.                                                                                     
SENATOR  GIESSEL replied  that  this language  will be  complying                                                               
with federal  requirements. She  added that  she spoke  with U.S.                                                               
Senator  Dan Sullivan  10  days  ago and  sent  a  letter to  the                                                               
secretary of  the U.S.  Department of  Health and  Human Services                                                               
pointing out  this huge flaw  in federal law that  is restricting                                                               
Alaska's mental health services  and requesting an exemption. But                                                               
that will be some time in coming.                                                                                               
SENATOR  GARDNER asked  if the  remainder  of the  bill allows  a                                                               
physician who is not a  psychiatrist to supervise in a behavioral                                                               
health clinic.                                                                                                                  
SENATOR GIESSEL  answered yes, or  a dentist, as the  federal law                                                               
8:19:09 AM                                                                                                                    
SENATOR  MACKINNON moved  to report  CSSB  169(RLS), version  30-                                                               
LS1283\U  from  committee  with  individual  recommendations  and                                                               
forthcoming  corrected   zero  fiscal  note(s).  There   were  no                                                               
objections and it was so ordered.                                                                                               

Document Name Date/Time Subjects