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SENATE BILL NO. 45
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-FOURTH LEGISLATURE - FIRST SESSION
BY SENATOR DUNBAR
Introduced: 1/17/25
Referred: Prefiled
A BILL
FOR AN ACT ENTITLED
"An Act relating to medical assistance services; relating to parity in mental health and 1
substance use disorder coverage in the state medical assistance program; and providing 2
for an effective date." 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 4
* Section 1. AS 47.07.030 is amended by adding a new subsection to read: 5
(i) In providing the services required under this section, the department shall 6
comply with the mental health or substance use disorder benefit requirements 7
established under 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26. 8
* Sec. 2. AS 47.07 is amended by adding a new section to read: 9
Sec. 47.07.033. Parity in mental health and substance use disorder 10
benefits. The commissioner of health shall implement and ensure compliance with the 11
provisions of 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26 that are 12
applicable to the state medical assistance program, including 13
(1) evaluating all consumer and provider complaints regarding mental 14 34-LS0146\A
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health and substance use disorder coverage for possible parity violations; 1
(2) performing parity compliance examinations on nonquantitative 2
treatment limitations, including prior authorization, concurrent review, retrospective 3
review, step therapy time-based treatment plans, network admission standards, 4
reimbursement rates, and geographic restrictions; and 5
(3) conducting comparative analyses of how the state medical 6
assistance program designs and applies nonquantitative treatment limitations, as 7
written and in operation, for mental health and substance use disorder coverage and 8
medical and surgical benefits. 9
* Sec. 3. AS 47.07.076 is amended by adding a new subsection to read: 10
(d) The department shall submit an annual report on mental health and 11
substance use disorder coverage parity in the state medical assistance program to the 12
senate secretary and the chief clerk of the house of representatives on or before 13
March 1 and shall notify the legislature that the report is available. The report must 14
(1) describe the processes used to develop or select the medical 15
necessity criteria for mental health and substance use disorder benefits and for medical 16
and surgical benefits; 17
(2) identify all nonquantitative treatment limitations that are applied to 18
mental health and substance use disorder benefits and medical and surgical benefits 19
within each classification of benefits; 20
(3) analyze whether the medical necessity criteria and nonquantitative 21
treatment limitations applied to mental health and substance use disorder benefits are 22
comparable to the medical necessity criteria and nonquantitative treatment limitations 23
for medical and surgical benefits, and whether the criteria and limitations are applied 24
more stringently to mental health and substance use disorder benefits than to medical 25
and surgical benefits within the corresponding classification of benefits; at a 26
minimum, the results of the analysis must 27
(A) identify the factors used to determine when a 28
nonquantitative treatment limitation will apply to a benefit, including factors 29
that were considered but rejected; 30
(B) identify and define the specific evidentiary standards use
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to define the factors and any other evidence relied on in designing each 1
nonquantitative treatment limitation; 2
(C) provide the comparative analyses, including the results of 3
the analyses, performed to determine whether processes and strategies used to 4
design each nonquantitative treatment limitation, as written and in operation, 5
applied to mental health and substance use disorder benefits are comparable to 6
and are not applied more stringently than the processes and strategies used to 7
design each nonquantitative treatment limitation to medical and surgical 8
benefits; and 9
(D) disclose the specific findings and conclusions reached by 10
the department that indicate whether the state medical assistance program is in 11
compliance with this section, 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 12
300gg-26. 13
* Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 14
read: 15
REPORT TO LEGISLATURE. Not later than March 1, 2026, the commissioner of 16
health shall prepare and submit a report to the senate secretary and the chief clerk of the house 17
of representatives and notify the legislature that the report is available. The report must 18
(1) explain the methodology used by the commissioner to determine 19
compliance with 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26; 20
(2) identify market examinations conducted or completed during the preceding 21
12-month period regarding compliance with parity in mental health and substance use 22
disorder benefits under state and federal laws and summarize the results of the market conduct 23
examinations; 24
(3) detail any educational or corrective actions the commissioner has taken to 25
ensure compliance with 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 300gg-26; 26
(4) be written in nontechnical, readily understandable language; and 27
(5) be posted on the publicly available Internet website of the Department of 28
Health and be made available to the public through any other means the commissioner finds 29
appropriate. 30
* Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 31 34-LS0146\A
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read: 1
MEDICAID STATE PLAN. The Department of Health shall submit, as necessary for 2
approval by the United States Department of Health and Human Services, amendments to the 3
state plan under AS 47.07.040 to comply with the requirements of the mental health or 4
substance use disorder benefits established under 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 5
U.S.C. 300gg-26. 6
* Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 7
read: 8
CONDITIONAL EFFECT; NOTIFICATION. (a) Sections 1 - 4 of this Act take effect 9
only if, and to the extent that, the United States Department of Health and Human Services 10
approves amendments submitted in accordance with sec. 5 of this Act on or before 11
December 31, 2025. 12
(b) The commissioner of health shall notify the revisor of statutes in writing within 30 13
days after the United States Department of Health and Human Services approves amendments 14
to the state plan. 15
* Sec. 7. If secs. 1 - 4 of this Act take effect, they take effect the day after the United States 16
Department of Health and Human Services approves the amendments to the state plan under 17
sec. 6 of this Act. 18