Alaska Department of Commerce, Communities and Economic Development Pushes Health Care Reimbursement Reform Package

Anchorage, Alaska (KINY) – As health care costs continue to rise, the Alaska Department of Commerce, Communities and Economic Development (DCCED) is advancing a comprehensive package of health care reimbursement reforms.

DCCED and the Department of Health (DOH) developed this approach to improve health care affordability for all Alaskans.

“My experience as a patient, as a manager, and as a long-time member of the local hospital’s steering committee has allowed me to look at this issue from multiple perspectives,” said Commissioner Julie Sande. ‚ÄúThis initiative seeks a balance between recognizing that the health care industry is also a business and an important economic driver for the state, while patients need more affordable health care coverage. As a result, we are confident that we will be able to address the pay gap across Alaska’s healthcare industry.”

A comprehensive reform package includes:
1. Request voluntary agreements from major Alaskan insurers to maintain in-network policies at current reimbursement rates through calendar year 2025.
2. Require out-of-network payment calculation methods to be provided in June 2023 for 2024 rate filings.
3. Add allocation for Medicaid rate review to fiscal 2024 capital budget.
4. Establish a Medical Costs and Reimbursement Working Group.
5. Abolish the 80th percentile rule. The repeal will not take effect until January 1, 2024. As part of the repeal, insurers will be required to submit alternative grounds for reimbursement of out-of-network claims for approval as part of their 2024 rate filings.
6. State hosts City Hall/ECHO on regulatory role, consumer protection, network adequacy, pricing/approval, and payments including limited billing database going forward.
7. Include a general funding request for Ministry of Health coordination
Demonstration project in 2025 budget submission.

Alaska Governor Mike Dunleavy said, “This will bring together a group of stakeholders to reduce and stabilize health care costs, and create systems that are affordable, sustainable, and deliver better health outcomes for all Alaskans. It’s an opportunity to build.”

“The Department of Health will continue to monitor provider reimbursement and access to healthcare in Alaska,” said Lori Wing Hire, director of the Department of Health. According to state law, health insurance premiums “must not be excessive, insufficient, or unfairly discriminatory.”

To ensure this, the department can review and approve plans and premium rates and disapprove applications that do not comply with the law.

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