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SENATE BILL NO. 45
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-FOURTH LEGISLATURE - FIRST SESSION
BY SENATORS DUNBAR, Gray-Jackson
Introduced: 1/22/25
Referred: Health and Social Services, Finance
A BILL
FOR AN ACT ENTITLED
"An Act relating to medical assistance services; relating to pa rity 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 disor der 10
benefits. The commissioner of health shall implement and ensure complian ce with the 11
provisions of 26 U.S.C. 9812, 29 U.S.C. 1185a, and 42 U.S.C. 30 0gg-26 that are 12
applicable to the state medical assistance program, including 13
(1) evaluating all consumer and provider complaints regarding mental 14
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health and substance use disorder coverage for possible parity violations; 1
(2) performing parity complia nce examinations on nonquantitati ve 2
treatment limitations, including p rior authorization, concurren t review, retrospective 3
review, step therapy time-based treatment plans, network admiss ion standards, 4
reimbursement rates, and geographic restrictions; and 5
(3) conducting comparative analyses of how the state medical 6
assistance program designs a nd applies nonquantitative treatmen t limitations, as 7
written and in operation, for ment al health and substance use d isorder 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 sub mit an annual report on mental hea lth and 11
substance use disorder coverage parity in the state medical ass istance program to the 12
senate secretary and the chief clerk of the house of representa tives 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 medic al 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 a nd surgical benefits 19
within each classification of benefits; 20
(3) analyze whether the medical necessity criteria and nonquan titative 21
treatment limitations applied to mental health and substance us e disorder benefits are 22
comparable to the medical n ecessity criteria and nonquantitativ e 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 be nefits than to medical 25
and surgical benefits within the corresponding classification o f 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, i ncluding factors 29
that were considered but rejected; 30
(B) identify and define the sp ecific evidentiary standards use d 31
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to define the factors and any other evidence relied on in desig ning each 1
nonquantitative treatment limitation; 2
(C) provide the comparative an alyses, including the results of 3
the analyses, performed to determine whether processes and stra tegies used to 4
design each nonquantitative tr eatment limitation, as written an d in operation, 5
applied to mental health and substance use disorder benefits ar e comparable to 6
and are not applied more stringently than the processes and str ategies used to 7
design each nonquantitative trea tment limitation to medical and s u r g i c a l 8
benefits; and 9
(D) disclose the specific findings and conclusions reached by 10
the department that indicate whether the state medical assistan ce 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 commis sioner 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 determ ine 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 heal th 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 commissio ner 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 th e Department of 28
Health and be made available to the public through any other me ans 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
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read: 1
MEDICAID STATE PLAN. The Department of Health shall submit, as necessary for 2
approval by the United States D epartment of Health and Human Se rvices, amendments to the 3
state plan under AS 47.07.040 to comply with the requirements o f the mental health or 4
substance use disorder benefits established under 26 U.S.C. 981 2, 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 Ac t take effect 9
only if, and to the extent that, the United States Department o f 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 da y 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