HB 14 — An Act relating to health care insurance; relating to insurance reimbursement for health care services provided through telehealth; relating to telehealth; relating to workers' compensation coverage for disability from diseases for certain firefighters; repealing programs for catastrophic illness assistance and medical assistance for chronic and acute medical conditions; relating to occupational disability benefits and medical benefits available under the public employees' retirement system; providing for an effective date by amending the effective date of secs. 9 and 10, ch. 38, SLA 2022; and providing for an effective date.

(iv) non-Hodgkin's lymphoma;

(v) bladder cancer;

(vi) ureter cancer;

(vii) kidney cancer;

(viii) prostate cancer;

and (ix) breast cancer;

(2) notwithstanding AS 23.30.100(a), following termination of service, the presumption established in (1) of this subsection extends to the firefighter for a period of six [THREE] calendar months for each year of requisite service but may not extend more than 120 [60] calendar months following the last date of employment;

(3) the presumption established in (1) of this subsection applies only to an active or former firefighter who has a disease described in (1) of this subsection that develops or manifests itself after the firefighter has served in the state for at least six [SEVEN] years and who (A) underwent [WAS GIVEN] a qualifying medical Enrolled HB 14 -2- examination (i) upon the first employment as [BECOMING] a firefighter that did not show evidence of the disease;

(ii) at least once every twoyears [(B) WAS GIVENAN ANNUAL MEDICAL EXAM] during [EACH OF] the first six [SEVEN] years of employment as a firefighter that did not show evidence of the disease;

and (B) [(C)] with regard to diseases described in (1)(C) of this subsection, demonstrates that, while in the course of employment as a firefighter, the firefighter was exposed to a known carcinogen, as defined by the International Agency for Research on Cancer or the National Toxicology Program, and the carcinogen is associated with a disabling cancer.

* Sec.

4.

AS 29.10.200 is amended by adding a new paragraph to read:

(68) AS 29.20.420 (health care insurance plans).

* Sec.

5.

AS 29.20 is amended by adding a new section to article 5 to read:

Sec.

29.20.420.

Health care insurance plans.

(a) If a municipality offers a group health care insurance plan covering municipal employees, including by means of self-insurance, the municipal health care insurance plan is subject to the requirements of AS 21.42.422(c).

(b) This section applies to home rule and general law municipalities.

(c) In this section, "health care insurance plan" has the meaning given in AS 21.54.500.

* Sec.

6.

2.7.

AS 39.30.090(a) is amended to read:

(a) The Department of Administration may obtain a policy or policies of group insurance covering state employees, persons entitled to coverage under AS 14.25.168, 14.25.480, AS 22.25.090, AS 39.35.535, 39.35.880, or former AS 39.37.145, employees of other participating governmental units, or persons entitled to coverage -3- Enrolled HB 14 under AS 23.15.136, subject to the following conditions:

(1) a group insurance policy shall provide one or more of the following benefits:

life insurance, accidental death and dismemberment insurance, weekly indemnity insurance, hospital expense insurance, surgical expense insurance, dental expense insurance, audiovisual insurance, or other medical care insurance;

(2) each eligible employee of the state, the spouse and the unmarried children chiefly dependent on the eligible employee for support, and each eligible employee of another participating governmental unit shall be covered by the group policy, unlessexempt underregulations adoptedby thecommissionerofadministration;

(3) a governmental unit may participate under a group policy if (A) its governing body adopts a resolution authorizing participation and payment of required premiums;

(B) a certified copy of the resolution is filed with the Department of Administration;

and (C) the commissioner of administration approves the participation in writing;

(4) in procuring a policy of group health or group life insurance as provided under this section or excess loss insurance as provided in AS 39.30.091, the Department of Administration shall comply with the dual choice requirements of AS 21.86.310, and shall obtain the insurance policy from an insurer authorized to transact business in the state under AS 21.09, a hospital or medical service corporation authorized to transact business in this state under AS 21.87, or a health maintenance organization authorized to operate in this state under AS 21.86;

an excess loss insurance policy may be obtained from a life or health insurer authorized to transact business in this state under AS 21.09 or from a hospital or medical service corporation authorized to transact business in this state under AS 21.87;

(5) the Department of Administration shall make available bid specifications for desired insurance benefits or for administration of benefit claims and payments to (A) all insurance carriers authorized to transact business in this state under AS 21.09andallhospitalormedicalservicecorporationsauthorizedtotransactbusiness under AS 21.87 who are qualified to provide the desired benefits;

and (B) insurance Enrolled HB 14 -4- carriers authorized to transact business in this state under AS 21.09, hospital or medical service corporations authorized to transact business under AS 21.87, and third-party administrators licensed to transact business in this state and qualified to provide administrative services;

the specifications shall be made available at least once every five years;

the lowest responsible bid submitted by an insurance carrier, hospital or medical service corporation, or third-party administrator with adequate servicing facilities shall govern selection of a carrier, hospital or medical service corporation, or third-party administrator under this section or the selection of an insurance carrier or a hospital or medical service corporation to provide excess loss insurance as provided in AS 39.30.091;

(6) if the aggregate of dividends payable under the group insurance policy exceeds thegovernmental unit's shareof thepremium, theexcess shall be applied by the governmental unit for the sole benefit of the employees;

(7) a person receiving benefits under AS 14.25.110, AS 22.25, AS 39.35, or former AS 39.37 may continue the life insurance coverage that was in effect under this section at the time of termination of employment with the state or participating governmental unit;

(8) a person electing to have insurance under (7) of this subsection shall pay the cost of this insurance;

(9) for each permanent part-time employee electing coverage under this section, the state shall contribute one-half the state contribution rate for permanent full- time state employees, and the permanent part-time employee shall contribute the other one-half;

(10) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, or former AS 39.37 may obtain auditory, visual, and dental insurance for that person and eligible dependents under this section;

the level of coverage for persons over 65 shall be the same as that available before reaching age 65 except that the benefits payable shall be supplemental to any benefits provided under the federal old age, survivors, and disability insurance program;

a person electing to have insurance under this paragraph shall pay the cost of the insurance;

the commissioner of administration shall adopt regulations implementing this paragraph;

-5- Enrolled HB 14 (11) a person receiving benefits under AS 14.25, AS 22.25, AS 39.35, or former AS 39.37 may obtain long-term care insurance for that person and eligible dependents under this section;

a person who elects insurance under this paragraph shall pay the cost of the insurance premium;

the commissioner of administration shall adopt regulations to implement this paragraph;

(12) each licensee holding a current operating agreement for a vending facilityunderAS 23.15.010-23.15.210shallbecoveredbythegrouppolicy thatapplies to governmental units other than the state;

(13) a group health insurance policy covering employees of a participating governmental unit must meet the requirements of AS 21.42.422(c).

* Sec.

8.

AS 39.30.091 is amended to read:

Sec.

39.30.091.

Authorization for self-insurance and excess loss insurance.

Notwithstanding AS 21.86.310 or AS 39.30.090, the Department of Administration may provide, by means of self-insurance, one or more of the benefits listed in AS 39.30.090(a)(1) for state employees eligible for the benefits by law or under a collective bargaining agreement and for persons receiving benefits under AS 14.25, AS 22.25, AS 39.35, or former AS 39.37, and their dependents.

The department shall procure any necessary excess loss insurance under AS 39.30.090.

A self-insured group health insurance plan covering active state employees provided under this section is subject to the requirements of AS 21.42.422(c).

* Sec.

9.

AS 39.35.410(d) is amended to read:

(d) The monthly amount of an occupational disability benefit is 75 [40] percent of the disabled employee's gross monthly compensation at the time of termination due to disability.

* Sec.

10.

AS 39.35.870 is amended by adding a new subsection to read:

(h) Notwithstanding (a) and (g) of this section, a disabled employee who is eligible to obtain a disability benefit under AS 39.35.890 is eligible to obtain retiree major medical insurance benefits under AS 39.35.880.

* Sec.

11.

AS 39.35.880(g) is amended to read:

(g) Except as provided under (l) of this section, the [THE] cost of premiums forretireemajor medical insurance coverage for an eligiblememberorsurviving spouse Enrolled HB 14 -6- who is (1) not eligible for Medicare is an amount equal to the full monthly group premiums for retiree major medical insurance coverage;

(2) eligible for Medicare is the following percentage of the premium amounts established for retirees who are eligible for Medicare:

(A) 30 percent if the member had 10 or more, but less than 15, years of service;

(B) 25 percent if the member had 15 or more, but less than 20, years of service;

(C) 20 percent if the member had 20 or more, but less than 25, years of service;

(D) 15 percent if the member had 25 or more, but less than 30, years of service;

(E) 10 percent if the member had 30 or more years of service.

* Sec.

12.

AS 39.35.880 is amended by adding a new subsection to read:

(l) An eligible member or surviving spouse who receives a disability benefit as provided under AS 39.35.890 or 39.35.891 and is not eligible for Medicare is not required to pay a premium for retiree major medical insurance coverage.

* Sec.

13.

AS 39.35.890(d) is amended to read:

(d) The monthly amount of an occupational disability benefit is 75 [40] percent of the disabled employee's gross monthly compensation at the time of termination due to disability.

Notwithstanding AS 39.35.790(b), at the time a member is appointed to disability, the member becomes fully vested in the employer contributions made under AS 39.35.750(a).Adisabledmemberis fully vested inthecontributions tothemember's individual account made under this subsection.

An employee is not entitled to elect distributions from the employee's individual contribution account under AS 39.35.810 while the employee is receiving disability benefits under this section.

While an employee is receiving disability benefits, based on the disabled employee's gross monthly compensation at the time of termination due to disability, the employer shall make contributions (1) to the employee's individual account under AS 39.35.730 on behalf -7- Enrolled HB 14 of the employee, without deduction from the employee's disability payments;

and (2) on behalf of the employee under AS 39.35.750.

* Sec.

14.

(a) The commissioner or the commissioner's designee at the director level may issue subpoenas to compel the production of books, papers, correspondence, memoranda, and other records considered necessary as evidence in connection with an investigation under or the administration of AS 47.07 (medical assistance), [AS 47.08 (ASSISTANCE FOR CATASTROPHIC ILLNESSES AND ACUTE OR CHRONIC MEDICAL CONDITIONS),] AS 47.25 (child care assistance, child care grants, HB0014a -1- HB 14 New Text Underlined [DELETED TEXT BRACKETED] 34-LS0211\A general relief, adult public assistance, and food stamps), and AS 47.27 (Alaska temporary assistance program).

3.15.

(d) As a condition of obtaining payment under AS 47.07 [AND AS 47.08] and for purposes of this section, a provider shall allow (1) thethedepartment department reasonable access to thetherecordsofmedical records of medical assistance recipients and providers;

4.16.

or (B) for providing health care to a medical assistance recipient if Enrolled HB 14 -8- the property, services, or benefit is in addition to payment by a medical assistance agency;

or HB 14 -2- HB0014a New Text Underlined [DELETED TEXT BRACKETED] 34-LS0211\A (7) violates a provision of AS 47.07 [OR AS 47.08] or a regulation adopted under AS 47.07 [OR AS 47.08].

5.17.

6.18.

7.19.

(10) "medical assistance provider" or "provider" means a person or organization that provides, attempts to provide, or claims to have provided services or products to a medical assistance recipient that may qualify for reimbursement under -9- Enrolled HB 14 AS 47.07 [OR AS 47.08] or a person or organization that participates in or has applied to participate in a medical assistance program as a supplier of a service or product;

8.20.

HB0014a -3- HB 14 New Text Underlined [DELETED TEXT BRACKETED] 34-LS0211\A * Sec.

9.21.

(5) who, ininthe the course of employment with thethestate, state, has been terminated from employment or has had an allegation of assaultive, abusive, neglectful, or Enrolled HB 14 -10- exploitive behavior or actions substantiated;

(7) whom another state or jurisdiction has identified on a civil registry HBordatabasesubstantially 14similartothedatabasesidentifiedunderthissection -4-forreasons HB0014a New Text Underlined [DELETED TEXT BRACKETED] 34-LS0211\A or database substantially similar to the databases identified under this section for reasons substantially similar to the reasons identified in (1) - (6) of this subsection.

10.22.

11.23.

416 of this Act, applies to offenses committed on or after the effective date of thissec. Act.

16 of this Act.

12.24.

214 of this Act, the commissioner of health or the commissioner's designee at the director level may issue subpoenas to compel the production of books, papers, correspondence, memoranda, and other records considered necessary as evidence in connection with an investigation under AS 47.08 that began before the effective date of thissec. Act or for an investigation of a violation of AS 47.08 that occurred before the effective date of this Act.

14 of this Act or for an investigation of a violation of AS 47.08 that occurred before the effective date of sec.

14 of this Act.

315 of this Act, a provider shall allow the department reasonable access to the records of medical assistance recipients and providers and allow audit and inspection of the records by state and federal agencies (1) in order to receive payment for a service provided under AS 47.08 before the effective date of thissec. Act;

and15 (2) in connection with an audit under AS 47.05.200 for activities that occurred before the effective date of this Act.Act;

HB0014aand -5-(2) in connection with an audit under AS 47.05.200 for activities that occurred -11- Enrolled HB 14 Newbefore Textthe Underlinedeffective [DELETEDdate TEXTof BRACKETED]sec.

15 of this Act.

* Sec.

25.

Section 14, ch.

38, SLA 2022, is amended to read:

Sec.

14.

If secs.

9 and 10, ch.

38, SLA 2022, [OF THIS ACT] take effect under sec.

13, ch.

38, SLA 2022 [OF THIS ACT], they take effect June 30, 2040 [2030].

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26.

Sections 1, 2, 4, 5, 7, 8, and 25 of this Act take effect January 1, 2027.

* Sec.

27.

Sections 3 and 9 - 13 of this Act take effect immediately under AS 01.10.070(c).

Enrolled HB 14 -12-