HCS CSSB 105(FIN) am H: "An Act relating to the licensure of marital and family therapists; providing for a state policy relating to children; relating to medical assistance for marital and family therapy services; relating to disclosure of health care services and price information; relating to health care insurers; and providing for an effective date."
00 HOUSE CS FOR CS FOR SENATE BILL NO. 105(FIN) am H 01 "An Act relating to the licensure of marital and family therapists; providing for a state 02 policy relating to children; relating to medical assistance for marital and family therapy 03 services; relating to disclosure of health care services and price information; relating to 04 health care insurers; and providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. AS 08.63.100(a) is amended to read: 07 (a) The board shall issue a license to practice marital and family therapy to a 08 person who 09 (1) applies on a form provided by the board; 10 (2) pays the fee established under AS 08.01.065; 11 (3) furnishes evidence satisfactory to the board that the person 12 (A) has not engaged in conduct that is a ground for imposing 13 disciplinary sanctions under AS 08.63.210; 14 (B) holds a master's degree or doctorate in marital and family
01 therapy or allied mental health field from a regionally accredited educational 02 institution approved by the board for which the person completed a course of 03 study that included instruction substantially equivalent to the following: 04 (i) three courses or nine semester or 12 quarter hours of 05 course work in marital and family therapy; 06 (ii) three courses or nine semester or 12 quarter hours of 07 course work in marital and family studies; 08 (iii) three courses or nine semester or 12 quarter hours 09 of course work in human development; 10 (iv) one course or three semester or four quarter hours 11 of course work in professional studies or professional ethics and law; 12 (v) one course or three semester or four quarter hours of 13 course work in research; and 14 (vi) one year of supervised clinical practice in marital 15 and family therapy; 16 (C) after receiving a degree described in (B) of this paragraph, 17 has 18 [(i)] practiced supervised marital and family therapy, 19 including 1,700 [1,500] hours of [DIRECT] clinical contact with 20 couples, individuals, and families; the 1,700 hours of [AND 21 (ii) BEEN SUPERVISED IN THE] clinical contact 22 must include [FOR] at least [200 HOURS, INCLUDING] 100 hours 23 of individual supervision and 100 hours of group supervision approved 24 by the board; the 100 hours of individual supervision and 100 hours 25 of group supervision may be conducted by one or more 26 supervisors; 27 (D) has received training related to domestic violence; and 28 (E) has passed a written or oral examination administered by 29 the board. 30 * Sec. 2. AS 08.63.120(b) is amended to read: 31 (b) A person who supervises a licensee under this section during
01 (1) individual supervision must 02 (A) [(1)] have practiced marital and family therapy for five 03 years; 04 (B) [(2)] be licensed under this chapter; and 05 (C) [(3)] meet the minimum standards established by the board 06 for approved supervisors; or 07 (2) group supervision must be licensed to practice as 08 (A) a professional counselor under AS 08.29; 09 (B) a marital and family therapist under AS 08.63; 10 (C) a physician under AS 08.64 who is a psychiatrist; 11 (D) an advanced practice registered nurse under AS 08.68 12 who is certified to provide psychiatric or mental health services by an 13 entity recognized by the Board of Nursing; 14 (E) a psychologist under AS 08.86; or 15 (F) a clinical social worker under AS 08.95. 16 * Sec. 3. AS 18.15.360(a) is amended to read: 17 (a) The department is authorized to collect, analyze, and maintain databases of 18 information related to 19 (1) risk factors identified for conditions of public health importance; 20 (2) morbidity and mortality rates for conditions of public health 21 importance; 22 (3) community indicators relevant to conditions of public health 23 importance; 24 (4) longitudinal data on traumatic or acquired brain injury from the 25 registry established under AS 47.80.500(c)(1); [AND] 26 (5) health care services and price information collected under 27 AS 18.23.400; and 28 (6) any other data needed to accomplish or further the mission or goals 29 of public health or provide essential public health services and functions. 30 * Sec. 4. AS 18.23 is amended by adding a new section to read: 31 Article 4. Health Care Services and Price Information.
01 Sec. 18.23.400. Disclosure and reporting of health care services, price, and 02 fee information. (a) A health care provider shall annually compile a list, including a 03 brief description in plain language that an individual with no medical training can 04 understand, of the 10 health care services most commonly performed by the health 05 care provider in the state in the previous calendar year from each of the six sections of 06 Category I, Current Procedural Terminology, adopted by the American Medical 07 Association and, for each of those services, state 08 (1) the procedure code; 09 (2) the undiscounted price; and 10 (3) any facility fees. 11 (b) A health care facility in the state shall annually compile a list, including a 12 brief description in plain language that an individual with no medical training can 13 understand, of the 10 health care services most commonly performed at the health care 14 facility in the previous calendar year from each of the six sections of Category I, 15 Current Procedural Terminology, adopted by the American Medical Association and, 16 for each of those services, state 17 (1) the procedure code; 18 (2) the undiscounted price; and 19 (3) any facility fees. 20 (c) If, in the annual reporting period under this section, fewer than the number 21 of health care services described under (a) or (b) of this section are performed by a 22 health care provider or at a health care facility in the state, the provider or facility shall 23 include in the list required under this section all of the health care services performed 24 by the provider or at the facility from each of the six sections described under (a) or 25 (b) of this section. 26 (d) A health care provider who provides health care services at a health care 27 facility in a group practice is not required to compile and publish a list under (a) and 28 (e) of this section if 29 (1) the health care facility where the provider is in a group practice 30 compiles and publishes a list in compliance with (b) and (e) of this section; and 31 (2) the prices and fees that the provider charges are reflected in the list
01 compiled and published by the health care facility. 02 (e) A health care provider and health care facility shall publish the lists 03 compiled under (a) and (b) of this section by January 31 each year 04 (1) by providing the list to the department for entry in the department's 05 database under AS 18.15.360 along with the name and location of the health care 06 provider or health care facility; 07 (2) by posting a copy of the list 08 (A) in a font not smaller than 20 points; 09 (B) in a conspicuous public reception area at the health care 10 provider's office or health care facility where the services are performed; 11 (C) that includes the address for the department's Internet 12 website; 13 (D) that may include a statement explaining that the 14 undiscounted price may be higher or lower than the amount an individual 15 actually pays for the health care services described in the list; 16 (E) that includes a statement substantially similar to the 17 following: "You will be provided with an estimate of the anticipated charges 18 for your nonemergency care upon request. Please do not hesitate to ask for 19 information."; and 20 (F) that lists any health care insurers with which the health care 21 provider or health care facility has a contract to provide health care services as 22 an in-network preferred provider; and 23 (3) if the health care provider or health care facility has an Internet 24 website, by posting the list on the website. 25 (f) The department shall annually compile the lists provided under (a) and (b) 26 of this section by health care service and, where relevant, health care provider and 27 health care facility name and location, post the information on the department's 28 Internet website, and enter the information in the database maintained under 29 AS 18.15.360. 30 (g) If a patient who is receiving nonemergency health care services requests an 31 estimate from a health care provider, health care facility, or health care insurer of the
01 reasonably anticipated charges for treating the patient's specific condition, the health 02 care provider, health care facility, or health care insurer 03 (1) shall provide a good faith estimate before the nonemergency health 04 care services are provided and not later than 10 business days after receiving the 05 request; 06 (2) shall provide the estimate in whichever of the following formats 07 the patient requests: orally, in writing, or by electronic means; if the estimate is 08 provided orally, the health care provider, health care facility, or health care insurer 09 shall keep a record of the estimate; 10 (3) is not required to disclose the charges for the total anticipated 11 course of treatment for the patient, but if the estimate does not include charges for the 12 total anticipated course of treatment, the estimate must include a statement explaining 13 that the estimate only includes charges for a portion of the total anticipated course of 14 treatment; and 15 (4) may provide an estimate that includes a reasonable range of 16 charges for anticipated health care services if the charges for the services will vary 17 significantly in response to conditions that the health care provider, health care 18 facility, or health care insurer cannot reasonably assess before the services are 19 provided. 20 (h) A good faith estimate provided by a health care provider or health care 21 facility under (g) of this section must include 22 (1) a brief description in plain language that an individual with no 23 medical training can understand of the health care services, products, procedures, and 24 supplies that are included in the estimate; 25 (2) a notice disclosing the health care provider's or health care facility's 26 in-network or out-of-network status that is substantially similar to one of the following 27 forms: 28 (A) "(Name of health care provider or health care facility) is a 29 contracted, in-network preferred provider for ONLY the following plan 30 networks: (list each network or state 'NONE. YOU MAY INCUR OUT-OF- 31 NETWORK CHARGES.')";
01 (B) "(Name of health care provider or health care facility) is a 02 contracted, in-network preferred provider for your insurance plan."; or 03 (C) "(Name of health care provider or health care facility) is 04 NOT a contracted, in-network preferred provider for your insurance plan. 05 YOU MAY INCUR OUT-OF-NETWORK CHARGES."; 06 (3) the procedure code for each health care service included in the 07 estimate; 08 (4) any facility fees, along with an explanation of the facility fees; and 09 (5) the identity, or suspected identity, of any other person that may 10 charge the patient for a service, product, procedure, or supply in connection with the 11 health care services included in the estimate, along with an explanation of whether the 12 charges are included in the estimate. 13 (i) A health care provider or health care facility that provides a good faith 14 estimate to a patient under (g) and (h) of this section or a health care insurer that 15 provides a good faith estimate to a patient under (g) of this section is not liable for 16 damages or other relief if the estimate differs from the amount actually charged to the 17 patient. 18 (j) The requirement for a health care facility to provide a good faith estimate 19 of reasonably anticipated charges for nonemergency health care services under 20 (e)(2)(E), (g), and (h) of this section does not apply to a health care facility that is an 21 emergency department. 22 (k) A health care provider or a health care facility that fails to comply with the 23 requirements of (a) - (e), (g), or (h) of this section or a health care insurer that fails to 24 comply with the requirements of (g) of this section is liable for a civil penalty not to 25 exceed $10,000 for each violation. The department may impose a penalty, 26 (1) for failure to comply with (a) - (e) of this section, of not more than 27 $100 for each day of noncompliance after March 31; or 28 (2) for failure to provide a good faith estimate under (g) or (h) of this 29 section, of not more than $100 for each day of noncompliance. 30 (l) A health care provider, health care facility, or health care insurer penalized 31 under (k) of this section is entitled to a hearing conducted by the office of
01 administrative hearings under AS 44.64. 02 (m) A municipality may not enact or enforce an ordinance that is inconsistent 03 with or imposes health care price or fee disclosure requirements in addition to the 04 requirements under this section or regulations adopted under this section. 05 (n) In this section, 06 (1) "department" means the Department of Health and Social Services; 07 (2) "facility fee" means a charge or fee billed by a health care provider 08 or health care facility that is in addition to fees billed for a health care provider's 09 professional services and is intended to cover building, electronic medical records 10 system, billing, and other administrative and operational expenses; 11 (3) "health care facility" means a private, municipal, or state hospital, 12 psychiatric hospital, emergency department, independent diagnostic testing facility, 13 residential psychiatric treatment center as defined in AS 47.32.900, kidney disease 14 treatment center (including freestanding hemodialysis units), the offices of private 15 physicians or dentists whether in individual or group practice, ambulatory surgical 16 center as defined in AS 47.32.900, free-standing birth center as defined in 17 AS 47.32.900, and rural health clinic as defined in AS 47.32.900; "health care facility" 18 does not include 19 (A) the Alaska Pioneers' Home and the Alaska Veterans' Home 20 administered by the department under AS 47.55; 21 (B) an assisted living home as defined in AS 47.33.990; 22 (C) a nursing facility licensed by the department to provide 23 long-term care; 24 (D) a facility operated by an Alaska tribal health organization; 25 and 26 (E) a hospital operated by the United States Department of 27 Veterans Affairs or the United States Department of Defense, or any other 28 federally operated hospital or institution; 29 (4) "health care insurer" has the meaning given in AS 21.54.500; 30 (5) "health care provider" means an individual licensed, certified, or 31 otherwise authorized or permitted by law to provide health care services in the
01 ordinary course of business or practice of a profession; 02 (6) "health care service" means a service or procedure provided in 03 person or remotely by telemedicine or other means by a health care provider or at a 04 health care facility for the purpose of or incidental to the care, prevention, or treatment 05 of a physical or mental illness or injury; 06 (7) "nonemergency health care service" means a health care service 07 other than a health care service that is immediately necessary to prevent the death or 08 serious impairment of the health of the patient; 09 (8) "patient" means an individual to whom health care services are 10 provided in the state by a health care provider or at a health care facility; 11 (9) "third party" means a public or private entity, association, or 12 organization that provides, by contract, agreement, or other arrangement, insurance, 13 payment, price discount, or other benefit for all or a portion of the cost of health care 14 services provided to a recipient; "third party" does not include a member of the 15 recipient's immediate family; 16 (10) "undiscounted price" means an amount billed for a service 17 rendered without complications or exceptional circumstances; "undiscounted price" 18 does not include a negotiated discount for an in-network or out-of-network service 19 rendered or the cost paid by a third party for that service. 20 * Sec. 5. AS 21.96 is amended by adding a new section to read: 21 Sec. 21.96.200. Good faith estimate. Upon request of a covered person who is 22 receiving nonemergency health care services, a health care insurer shall provide a 23 good faith estimate of the amount of the reasonably anticipated charges for treating the 24 patient's specific condition under AS 18.23.400(g). 25 * Sec. 6. AS 47.05.060 is amended to read: 26 Sec. 47.05.060. Purpose and policy relating to children. The purpose of this 27 title as it relates to children is to secure for each child the care and guidance, 28 preferably in the child's own home, that will serve the moral, emotional, mental, and 29 physical welfare of the child and the best interests of the community; to preserve and 30 strengthen the child's family ties unless efforts to preserve and strengthen the ties are 31 likely to result in physical or emotional damage to the child, removing the child from
01 the custody of the parents only as a last resort when the child's welfare or safety or the 02 protection of the public cannot be adequately safeguarded without removal; and, when 03 the child is removed from the family, to secure for the child adequate custody and care 04 and adequate planning for permanent placement of the child. It is the policy of the 05 state to acknowledge and take into account the principles of early childhood and 06 youth brain development and, whenever possible, consider the concepts of early 07 adversity, toxic stress, childhood trauma, and the promotion of resilience through 08 protective relationships, supports, self-regulation, and services. 09 * Sec. 7. AS 47.07.030(b) is amended to read: 10 (b) In addition to the mandatory services specified in (a) of this section and the 11 services provided under (d) of this section, the department may offer only the 12 following optional services: case management services for traumatic or acquired brain 13 injury; case management and nutrition services for pregnant women; personal care 14 services in a recipient's home; emergency hospital services; long-term care 15 noninstitutional services; medical supplies and equipment; advanced practice 16 registered nurse services; clinic services; rehabilitative services for children eligible 17 for services under AS 47.07.063, substance abusers, and emotionally disturbed or 18 chronically mentally ill adults; targeted case management services; inpatient 19 psychiatric facility services for individuals 65 years of age or older and individuals 20 under 21 years of age; psychologists' services; clinical social workers' services; 21 marital and family therapy services; midwife services; prescribed drugs; physical 22 therapy; occupational therapy; chiropractic services; low-dose mammography 23 screening, as defined in AS 21.42.375(e); hospice care; treatment of speech, hearing, 24 and language disorders; adult dental services; prosthetic devices and eyeglasses; 25 optometrists' services; intermediate care facility services, including intermediate care 26 facility services for persons with intellectual and developmental disabilities; skilled 27 nursing facility services for individuals under 21 years of age; and reasonable 28 transportation to and from the point of medical care. 29 * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to 30 read: 31 TRANSITION: REGULATIONS. The Department of Health and Social Services and
01 the Board of Marital and Family Therapy may adopt regulations necessary to implement the 02 changes made by this Act. The regulations take effect under AS 44.62 (Administrative 03 Procedure Act), but not before the effective date of the law implemented by the regulation. 04 * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to 05 read: 06 REPORT TO LEGISLATURE. (a) The Department of Health and Social Services 07 shall prepare a report that describes the effectiveness and cost-effectiveness of the coverage of 08 marital and family therapy services as provided in AS 47.07.030(b), as amended by sec. 7 of 09 this Act. The report must include the distribution of services provided by billing code and the 10 diversion from more expensive alternatives. 11 (b) On or before November 30, 2021, the Department of Health and Social Services 12 shall deliver the report under (a) of this section to the senate secretary and the chief clerk of 13 the house of representatives and notify the legislature that the report is available. 14 * Sec. 10. Section 8 of this Act takes effect immediately under AS 01.10.070(c). 15 * Sec. 11. Except as provided in sec. 10 of this Act, this Act takes effect January 1, 2019.