Legislature(2017 - 2018)

2017-04-07 House Journal

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2017-04-07                     House Journal                      Page 0905
HB 123                                                                                                                        
The following, which was advanced to third reading from the April 5                                                             
calendar (page 858), was read the third time:                                                                                   
                                                                                                                                
    CS FOR HOUSE BILL NO. 123(HSS)                                                                                              
    "An Act relating to disclosure of health care services and price                                                            
    information; and providing for an effective date."                                                                          
                                                                                                                                
Representative Reinbold moved and asked unanimous consent that                                                                  
HB 123 be returned to second reading for the specific purpose of                                                                
considering Amendment No. 1.  There being no objection, it was so                                                               
ordered.                                                                                                                        
                                                                                                                                
Amendment No. 1 was offered  by Representative Reinbold:                                                                         
                                                                                                                                
Page 1, line 1 (title amendment):                                                                                               
    Delete "services and"                                                                                                     
                                                                                                                                
                                                                                                                                

2017-04-07                     House Journal                      Page 0906
Page 1, line 4, through page 3, line 15:                                                                                        
    Delete all material and insert:                                                                                             
   "* Section 1. AS 18.23 is amended by adding a new section to read:                                                         
    Article 4. Health Care Price Information.                                                                                 
         Sec. 18.23.400. Disclosure of health care price information.                                                         
    (a) Upon written request by a patient or prospective patient, a                                                             
    health care provider shall provide the patient or prospective                                                               
    patient with an estimate of reasonably anticipated charges for                                                              
    treating the patient's or prospective patient's specific condition.                                                         
    The health care provider shall provide the estimate in writing or                                                           
    by electronic means before providing nonemergency health care                                                               
    services and not later than 10 business days after receiving the                                                            
    request. The health care provider is not required to disclose the                                                           
    charges for the total anticipated course of treatment for the patient                                                       
    or prospective patient, but if the estimate does not include charges                                                        
    for the total anticipated course of treatment, the estimate must                                                            
    include a statement explaining that the estimate only includes                                                              
    costs for a portion of the total anticipated course of treatment. If                                                        
    the charge for a health care service varies significantly in response                                                       
    to conditions that the health care provider cannot reasonably                                                               
    assess before providing the service, the estimate may include a                                                             
    reasonable range of charges for the service.                                                                                
         (b)  Upon written request by a patient or prospective patient, a                                                       
    health care facility shall provide the patient or prospective patient                                                       
    with an estimate of reasonably anticipated charges for treating the                                                         
    patient's or prospective patient's specific condition. The health                                                           
    care facility shall provide the estimate in writing or by electronic                                                        
    means before providing nonemergency health care services and                                                                
    not later than 10 business days after receiving the request. The                                                            
    health care facility is not required to disclose the charges for the                                                        
    total anticipated course of treatment for the patient or prospective                                                        
    patient, but if the estimate does not include charges for the total                                                         
    anticipated course of treatment, the estimate must include a                                                                
    statement explaining that the estimate only includes costs for a                                                            
    portion of the total anticipated course of treatment. If the charge                                                         
    for a health care service varies significantly in response to                                                               
    conditions that the health care facility cannot reasonably assess                                                           
    before providing the service, the estimate may include a                                                                    
    reasonable range of charges for the service.                                                                                
         (c)  An estimate required under (a) or (b) of this section must                                                        

2017-04-07                     House Journal                      Page 0907
    include, for the patient's or prospective patient's specific condition,                                                     
    the following information:                                                                                                  
             (1)  a brief description, in plain language that an                                                                
    individual with no medical training can understand, of all health                                                           
    care services, procedures, products, and supplies for which the                                                             
    health care provider or health care facility is likely to charge for                                                        
    treatment;                                                                                                                  
             (2)  the standardized billing code for each health care                                                            
    service, procedure, product, and supply described under (1) of this                                                         
    subsection;                                                                                                                 
             (3)  any facility fee or other additional fee, along with a                                                        
    brief statement, in plain language that an individual with no                                                               
    medical training can understand, describing the fee;                                                                        
             (4)  for each charge included in the estimate,                                                                    
                  (A)  the amount the health care provider or health                                                            
         care facility charges a patient or prospective patient with no                                                         
         health care insurance, along with a statement explaining that                                                          
         the charges disclosed do not account for any insurance                                                                 
         benefits to which the patient or prospective patient may be                                                            
         entitled and explaining that the amount the patient or                                                                 
         prospective patient pays may vary by insurer;                                                                          
                  (B)  the amount the health care provider or health                                                            
         care facility anticipates charging the patient or prospective                                                          
         patient who requests the estimate, taking into account any                                                             
         insurance policy held by the patient or prospective patient and                                                        
         any status of the patient or prospective patient that may affect                                                       
         the charge; in this paragraph, "status" includes a person's                                                            
         status as an Alaska Native, American Indian, or veteran or                                                             
         indigent status;                                                                                                       
             (5)  the identity, or suspected identity, of any other                                                             
    person, entity, health care provider, or health care facility that may                                                      
    charge the patient or prospective patient in connection with any                                                            
    health care service, procedure, product, or supply included in the                                                          
    estimate; the estimate must also state whether the amount of any                                                            
    charges described under this paragraph are included in the                                                                  
    estimate or would be charged in addition to the total amount of the                                                         
    estimate;                                                                                                                   
             (6)  a notification that the patient or prospective patient                                                        
    may contact the patient's or prospective patient's insurer for                                                              
    additional information regarding cost-sharing responsibilities; and                                                         

2017-04-07                     House Journal                      Page 0908
             (7)  a notice disclosing the health care provider's or health                                                      
    care facility's in-network or out-of-network status that is                                                                 
    substantially similar to one of the following forms:                                                                        
                  (A)  "(Name of health care provider or health care                                                            
         facility) is a contracted, in-network, preferred provider for                                                          
         ONLY the following plan networks: (list each network or                                                                
         state 'NONE. YOU MAY INCUR OUT-OF-NETWORK                                                                              
         CHARGES.')";                                                                                                           
                  (B)  "(Name of health care provider or health care                                                            
         facility) is a contracted, in-network, preferred provider for                                                          
         your insurance plan."; or                                                                                              
                  (C)  "(Name of health care provider or health care                                                            
         facility) is NOT a contracted, in-network, preferred provider                                                          
         for your insurance plan. YOU MAY INCUR OUT-OF-                                                                         
         NETWORK CHARGES."                                                                                                      
         (d)  A health care provider and a health care facility shall post                                                      
    a sign in a conspicuous public reception area at the office of the                                                          
    health care provider or at the health care facility where the                                                               
    services are performed that contains at least the following                                                                 
    language: "You will be provided with an estimate of the                                                                     
    anticipated charges for your care upon request. Please do not                                                               
    hesitate to ask for information. AS 18.23.400.                                                                              
         (e)  A health care provider or health care facility that fails to                                                      
    comply with the requirements under this section is liable for a                                                             
    civil penalty. The department may impose a civil penalty of not                                                             
    more than $100 for each day after the time allowed to provide an                                                            
    estimate under (a) or (b) of this section that a health care provider                                                       
    or a health care facility fails to provide an estimate in compliance                                                        
    with the requirements under (a) - (c) of this section. The total                                                            
    penalty may not exceed $1,000. The department may impose a                                                                  
    civil penalty of not more than $100 for each day that a health care                                                         
    provider or health care facility fails to post a sign as required                                                           
    under (d) of this section. The total penalty may not exceed $1,000.                                                         
    A person penalized under this subsection is entitled to a hearing                                                           
    conducted by the office of administrative hearings under                                                                    
    AS 44.64."                                                                                                                  
                                                                                                                                
Renumber the following bill section accordingly.                                                                                
                                                                                                                                
                                                                                                                                

2017-04-07                     House Journal                      Page 0909
Page 3, line 16:                                                                                                                
    Delete "(h)"                                                                                                                
    Insert "(f)"                                                                                                                
                                                                                                                                
Page 3, line 18, through page 4, line 3:                                                                                        
    Delete all material and insert:                                                                                             
             "(2)  "health care facility" means a private, municipal,                                                           
    state, or federal hospital, psychiatric hospital, independent                                                               
    diagnostic testing facility, primary care outpatient facility,                                                              
    residential psychiatric treatment center as defined in                                                                      
    AS 47.32.900, tuberculosis hospital, skilled nursing facility,                                                              
    kidney disease treatment center (including freestanding                                                                     
    hemodialysis units), an intermediate care facility, a private,                                                              
    municipal, or state facility employing one or more public health                                                            
    nurses, a long-term care facility, an ambulatory surgical center as                                                         
    defined in AS 47.32.900, and the office of a private physician or                                                           
    dentist in group or individual practice; "health care facility" does                                                        
    not include the Alaska Pioneers' Home and the Alaska Veterans'                                                              
    Home administered by the department under AS 47.55."                                                                        
                                                                                                                                
Page 4, lines 11 - 21:                                                                                                          
    Delete all material and insert:                                                                                             
             "(5)  "nonemergency health care service" means a health                                                            
    care service that is not provided in response to the perceived need                                                         
    for immediate health care to prevent loss of life or aggravation of                                                         
    physiological or psychological illness or injury;                                                                           
             (6)  "standardized billing code" includes an international                                                         
    classification of diseases code, a current procedural terminology                                                           
    code published by the American Medical Association, a current                                                               
    dental terminology code published by the American Dental                                                                    
    Association, or a code used in the Healthcare Common Procedure                                                              
    Coding System."                                                                                                             
                                                                                                                                
Representative Reinbold moved and asked unanimous consent that                                                                  
Amendment No. 1 be adopted.                                                                                                     
                                                                                                                                
Representative Spohnholz objected and rose to a point of order.                                                                 
                                                                                                                                
The Speaker cautioned the member to confine remarks to the                                                                      
amendment.                                                                                                                      
                                                                                                                                

2017-04-07                     House Journal                      Page 0910
Representative Wilson placed a call of the House.                                                                               
                                                                                                                                
Representative Guttenberg rose to a point of order.                                                                             
                                                                                                                                
The Speaker cautioned the member to confine remarks to the                                                                      
amendment.                                                                                                                      
                                                                                                                                
The call was satisfied.                                                                                                         
                                                                                                                                
The question being:  "Shall Amendment No. 1 be adopted?"  The roll                                                              
was taken with the following result:                                                                                            
                                                                                                                                
CSHB 123(HSS)                                                                                                                   
Second Reading                                                                                                                  
Amendment No. 1                                                                                                                 
                                                                                                                                
YEAS:  13   NAYS:  27   EXCUSED:  0   ABSENT:  0                                                                              
                                                                                                                                
Yeas:  Chenault, Eastman, Johnson, Johnston, Knopp, Millett,                                                                    
Rauscher, Reinbold, Sullivan-Leonard, Talerico, Thompson, Tilton,                                                               
Wilson                                                                                                                          
                                                                                                                                
Nays:  Birch, Claman, Drummond, Edgmon, Fansler, Foster, Gara,                                                                  
Grenn, Guttenberg, Josephson, Kawasaki, Kito, Kopp,                                                                             
Kreiss-Tomkins, LeDoux, Neuman, Ortiz, Parish, Pruitt, Saddler,                                                                 
Seaton, Spohnholz, Stutes, Tarr, Tuck, Westlake, Wool                                                                           
                                                                                                                                
And so, Amendment No. 1 was not adopted.                                                                                        
                                                                                                                                
CSHB 123(HSS) was automatically in third reading.                                                                               
                                                                                                                                
The question being:  "Shall CSHB 123(HSS) pass the House?"  The                                                                 
roll was taken with the following result:                                                                                       
                                                                                                                                
CSHB 123(HSS)                                                                                                                   
Third Reading                                                                                                                   
Final Passage                                                                                                                   
                                                                                                                                
YEAS:  34   NAYS:  6   EXCUSED:  0   ABSENT:  0                                                                               
                                                                                                                                
Yeas:  Birch, Chenault, Claman, Drummond, Edgmon, Fansler, Foster,                                                              
Gara, Grenn, Guttenberg, Johnston, Josephson, Kawasaki, Kito,                                                                   
Knopp, Kopp, Kreiss-Tomkins, LeDoux, Millett, Neuman, Ortiz,                                                                    
Parish, Pruitt, Saddler, Seaton, Spohnholz, Stutes, Sullivan-Leonard,                                                           
Talerico, Tarr, Thompson, Tuck, Westlake, Wool                                                                                  

2017-04-07                     House Journal                      Page 0911
Nays:  Eastman, Johnson, Rauscher, Reinbold, Tilton, Wilson                                                                     
                                                                                                                                
And so, CSHB 123(HSS) passed the House.                                                                                         
                                                                                                                                
Representative Tuck moved and asked unanimous consent that the roll                                                             
call on the passage of the bill be considered the roll call on the                                                              
effective date clause.  There being no objection, it was so ordered.                                                            
                                                                                                                                
CSHB 123(HSS) was referred to the Chief Clerk for engrossment.