Senator Giessel discusses work accomplished last session

Last week, Senator Cathy Giessel spoke to Commonwealth North on Alaska’s health care issues. She highlighted the work accomplished in the last legislative session, and the topics that will likely appear moving forward.

When asked if she was satisfied with the work accomplished during the last session, she said “I felt like more progress was made than ever and the discussions are definitely robust.”

Senator Giessel highlighted two bills that passed which are expected to decrease costs at the pharmacy for patients. Beginning next year under Senate Bill 32, pharmacists will be allowed to dispense an FDA approved interchangeable biological product as a substitute for a proprietary biological product. Pharmacists were already allowed to substitute a generic drug for brand name drugs to decrease costs for patients. House Bill 240 requires pharmacies to inform patients when a less costly alternative is available.

The legislature also passed a number of bills related to behavioral health issues, which Senator Giessel highlighted.

Senate Bill 169 changes the requirements of direct supervision for behavioral health clinics in order to increase access to care. Instead of requiring a psychiatrist to be physically present in clinics 30 percent of the time in order to bill Medicaid, supervision can now be provided by a physician.

Senator Giessel praised House Bill 159, which passed in 2017 and restricts the length of prescriptions for opioids. Patients can execute a Voluntary Nonopioid Directive so they are not administered an opioid, or request smaller prescription amounts from the pharmacist. The bill also requires the controlled substance prescription database to be updated daily.

 “The opioid prescribing database, this is a huge step forward for the state,” said Senator Giessel. “I was part of the stakeholder discussions back in 2008 when we started talking about having this prescription database and there was a lot of concern about privacy issues and would law enforcement come after prescribers. People have gotten more comfortable with it. It is a huge help, especially for emergency rooms… I’m thrilled to have this database. Now an ER doctor can go on that database and see if this patient has actually just gotten an opioid prescription somewhere else. It is updated daily now by the pharmacist who fills the prescription.”

Senator Giessel was disappointed her bill (SB 129) to change the 80th percentile rule to a percentage of Medicare did not pass this session.

 “I have talked with the Director of the Division of Insurance and she strongly, and I know all of you probably know, she strongly supports this,” said Senator Giessel. “It is, by the way again, a rule. It was put in place by a bureaucracy back in the day with the intention of drawing more clinicians to Alaska. It’s done that, we have more clinicians per capita than the majority of the major cities in the US. It was meant to protect the consumer from balance billing… It’s worked… Director Lori Wing-Heier and I have had lots of conversations about this and I actually think we found a middle ground. It’s not everything that I would want, not everything she would want. And I’m hoping that by the time State of Reform [Health Policy Conference] comes in October, we’ll be able to say “Here’s how we’d like to proceed.” And I think it will be very positive.”

Senator Giessel criticized the recent decision by the Alaska Department of Health and Social Services to recoup about $15 million in Medicaid payments from about 1,1000 providers. A ten percent reduction in Medicaid reimbursements was supposed to go into effect October 1, 2017, but the rate was never changed in the computer system. The reduction is being applied retroactively.

“You probably saw that the Division of Medicaid is wanting to pull money back from providers because their computer system did not institute the change in reimbursement. This is a government error… I am grieved by this. I do think state government should take the hit, not the providers.”