Legislature(2007 - 2008)BUTROVICH 205
03/26/2008 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HJR29 | |
| HB284 | |
| SB280 | |
| HB284 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 280 | TELECONFERENCED | |
| += | HB 284 | TELECONFERENCED | |
| += | HJR 29 | TELECONFERENCED | |
SB 280-MEDICAID/ INS FOR CANCER CLINICAL TRIALS
2:03:36 PM
CHAIR DAVIS announced consideration of SB 280 and noted the
proposed committee substitute (CS).
TOM OBERMEYER, Staff to Senator Davis, read an overview of
version \E CS to SB 280, labeled 25-LS1464\E.
The E version reflects and defines language routinely
found in other state statutes concerning clinical
trials. These changes make clear the objective of this
bill to require insurers to cover no more than routine
patient care costs and specifically exclude other
extraordinary non-clinical costs of housing, companion
costs, etc related to clinical trials.
In detail, the "E" version:
1. Replaces "coverage of the costs of medical care"
with "routine patient care costs" as defined on page
2, lines 30-31, ending page 3, line 17.
Specifically,
a. Routine patient care costs are medical care costs
which are related to cancer that would otherwise
be covered under a health care insurance plan if
the medical care was not in connection with an
approved clinical trial related to cancer,
including cost of transportation essential to the
medical care.
b. This section excludes:
1) A drug or device associated with the clinical
trial not approved by US Food & Drug
Administration;
2) Housing, companion expenses, or other
nonclinical expenses associated with the trial;
3) An item or service provided solely to satisfy
data collection and analysis and not used in
the clinical management of the patient;
4) An item or service excluded from coverage under
the patient's health care insurance plan; and
5) An item or service paid for or customarily paid
for through grants or other funding.
2. Requires insurer to provide coverage under this
section only if:
a. There were clearly no superior non-
investigational treatment alternative; and
b. Available clinical or preclinical data provide a
reasonable expectation that the treatment
provided in the clinical trial will be at least
as "efficacious" (i.e., capable of producing the
desired effect) as any non-investigational
alternative. (ref: page 1, line 13, beginning
with "The health care..., and ending on page 2,
line 7).
3. Coverage is subject to the standard policy
provisions applicable to other benefits, including
deductible or copayment provisions (page 2, lines
10-11).
CHAIR DAVIS added that these changes had been provided to the
people who asked that the bill be introduced and they had no
problem with them. She said they had also met with the Division
of Insurance and the changes were in line with their
recommendations. Although this was a Labor & Commerce Issue,
since the bill was in their presence she decided to go ahead
with the modifications.
SENATOR DYSON asked if this had to go to Labor & Commerce and
whether there were any other referrals.
CHAIR DAVIS answered yes, it had to go to Labor & Commerce, then
Finance.
SENATOR THOMAS said, as he understood it, unless he was
misunderstanding the routine patient care costs, it specifically
addressed only care that directly related to the clinical
procedures and would rule out other diagnoses or any other
issues that might arise during the trial. He asked if that was
correct.
MR. OBERMEYER responded that it was directed only to the
clinical trial and if routine patient care were to include a
contemporaneous discovery of other diseases or ailments, that
might be included but he did not know; he suggested that might
be a question for the medical doctors or even the insurers.
SENATOR THOMAS assumed that if it was considered something that
might be due to the treatment itself, it would be taken are of
by this bill.
MR. OBERMEYER answered yes, and said the language of the bill
itself defined the types of diseases and cancers that might be
discovered.
SENATOR COWDERY asked what other states had instituted this type
of language.
MR. OBERMEYER replied that with 5,000 to 6,000 cancer trials
going on at any one time, virtually every state in the United
States had trials going on; and he carefully examined the
statutes of a number of states before coming up with this
language.
SENATOR DYSON questioned what would happen if the treatment in a
clinical trial turned out to be 10 times as expensive as the
usual treatment and whether this bill would require the
insurance company to pay the unexpected cost.
CHAIR DAVIS responded that she would need to get more
information in order to answer Senator Dyson's question; but she
expected that the oncologists involved in the trial would bring
in other doctors to handle any other diseases discovered during
treatment.
SENATOR DYSON clarified that he was talking about [treatment]
for the cancer.
2:13:52 PM
TOM OBERMEYER answered that the [cost of the] clinical trial
would be completely separate. Routine costs meant the same costs
the patients would incur for treatment if they were not involved
in a clinical trial. This bill sought simply to ensure that
patients did not have to fear losing coverage for their routine
care through participation in a clinical trial.
SENATOR DYSON said Mr. Obermeyer had answered part of his
question. He persisted that if the cost of treatment for a
patient involved in a clinical trial was 10 times as much as the
alternative [treatment] would have been, he wanted to know if
the insurance company would be on the hook to pay 10 times as
much for the treatment because they had passed this bill.
MR. OBERMEYER said that was already remedied in the "E" version.
It required the insurer to provide coverage only if there was:
a) clearly no superior "non-investigational" treatment
alternative; and
b) available clinical or preclinical data provide a
reasonable expectation that the treatment provided in
the clinical trial will be at least as "efficacious"
as any non-investigational alternative
He continued that they did not want to drive up costs
unreasonably.
CHAIR DAVIS interjected that testimony from patients who had
been involved in clinical trials indicated that they were
concerned about whether their insurance companies would continue
to cover them. One individual said her insurance company had
approved coverage for the trial.
SENATOR DYSON stated that it was not a doctor question; it was a
legal question.
CHAIR DAVIS said they could get a legal opinion.
2:17:43 PM
SENATOR THOMAS asked for clarification on paragraph (d) on page
2, line 12: "This section does not apply to a fraternal benefit
society."
MR. OBERMEYER said the drafter explained during the last hearing
that this needed to be in here because there was language in
other statutes that required it.
SENATOR THOMAS moved to adopt the proposed committee substitute,
CSSB 280, Version E, as the working document of the committee.
There being no objection, the motion carried.
CHAIR DAVIS expressed her desire to move this out of committee.
2:19:37 PM
EMILY NEENAN, Alaska Government Relations Director, American
Cancer Society, responded to Senator Dyson that, in general, the
impetus behind this kind of legislation was not to increase any
cost to the insurance company, simply to make sure people had
access to clinical trials. That was what the whole piece around
routine care costs was referring to. She added that 20 other
states had this provision in statute and 4 that had worked out
voluntary agreements with all of the insurance companies in
their states.
CHAIR DAVIS asked if there was further testimony. There being
none, she asked for a motion.
2:21:43 PM
SENATOR THOMAS moved to report CSSB 280, Version \E, from
committee with individual recommendations and the attached
fiscal note(s). There being no objection, CSSB 280(HES).
| Document Name | Date/Time | Subjects |
|---|