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).