SSSB 129: "An Act relating to the determination by an insurer of a final payment for a covered service or supply; annulling regulations relating to determination by an insurer of a final payment for a covered service or supply based on geographical areas; and providing for an effective date."
00 SPONSOR SUBSTITUTE FOR SENATE BILL NO. 129 01 "An Act relating to the determination by an insurer of a final payment for a covered 02 service or supply; annulling regulations relating to determination by an insurer of a 03 final payment for a covered service or supply based on geographical areas; and 04 providing for an effective date." 05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 06 * Section 1. AS 21.42.205 is amended to read: 07 Sec. 21.42.205. Coordination of benefits and determination of final 08 payment for a covered service or supply. (a) Unless prohibited by federal law, an 09 insurer authorized under AS 21.09 to offer, issue for delivery, deliver, or renew an 10 individual or group health insurance policy for major medical coverage on an expense 11 incurred basis; a health maintenance organization authorized under AS 21.86 to offer a 12 contract to provide major medical health care services on a prepaid basis; or a service 13 corporation authorized under AS 21.87 to offer or renew an individual or group 14 subscriber's contract for major medical coverage shall
01 (1) include a coordination of benefits provision in a major medical 02 policy or contract; and 03 (2) determine the final payment for a covered service or supply 04 based on an amount that is at least 300 percent of the amount reimbursed by 05 Medicare for that service or supply under an applicable Medicare fee schedule 06 for the state. 07 (b) The director may adopt regulations to implement this section, except that 08 the director may not adopt a regulation that establishes the final payment for a 09 covered service or supply. 10 * Sec. 2. 3 AAC 26.110(a)(2)(B) and (5)(A) are annulled. 11 * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 12 read: 13 TRANSITION: IMPLEMENTATION. The determination for final payment for a 14 covered service or supply under AS 21.42.205(a), as amended by sec. 1 of this Act, applies to 15 contracts or agreements entered into by an insurer, health maintenance organization, or 16 service corporation on or after the effective date of this Act. 17 * Sec. 4. This Act takes effect immediately under AS 01.10.070(c).