Legislature(2013 - 2014)HOUSE FINANCE 519

04/15/2014 08:30 AM FINANCE


Download Mp3. <- Right click and save file as

* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 138 GAS PIPELINE; AGDC; OIL & GAS PROD. TAX TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 316 WORKERS' COMPENSATION MEDICAL FEES TELECONFERENCED
Moved CSHB 316(FIN) Out of Committee
HOUSE BILL NO. 136                                                                                                            
                                                                                                                                
     "An Act requiring the governor's fiscal plan to                                                                            
     include certain information."                                                                                              
                                                                                                                                
8:36:18 AM                                                                                                                    
                                                                                                                                
Co-Chair Stoltze referred to two amendments.                                                                                    
                                                                                                                                
Representative Thompson MOVED to ADOPT Amendment 2, 28-                                                                         
LS1362\P.1, Wallace, 4/8/14 (copy on file):                                                                                     
                                                                                                                                
     Page 1, line 11:                                                                                                           
     Delete "board and adopted by reference"                                                                                    
     Insert "medical services review committee [BOARD] and                                                                      
     adopted by the board [REFERENCE]"                                                                                          
                                                                                                                                
     Page 2, line 21:                                                                                                           
     Delete "(1)"                                                                                                               
     Delete "board"                                                                                                             
     Insert "medical services review committee"                                                                                 
                                                                                                                                
     Page 2, line 22:                                                                                                           
     Delete "board"                                                                                                             
     Insert "medical services review committee"                                                                                 
                                                                                                                                
     Page 2, line 23, following "adopted":                                                                                      
     Insert "by the board"                                                                                                      
                                                                                                                                
     Page 2, line 23:                                                                                                           
     Delete ";"                                                                                                                 
     Insert "."                                                                                                                 
                                                                                                                                
     Page 2, lines 24 - 29:                                                                                                     
     Delete all material.                                                                                                       
                                                                                                                                
     Page 3, following line 23:                                                                                                 
     Insert a new subsection to read:                                                                                           
     "(p) The medical services review committee shall                                                                           
     formulate a conversion factor and submit the                                                                               
     conversion  factor to  the  commissioner  of labor  and                                                                    
     workforce  development. If  the  commissioner does  not                                                                    
     approve  the conversion  factor,  the medical  services                                                                    
     review  committee shall  revise  the conversion  factor                                                                    
     and  submit  the  revised   conversion  factor  to  the                                                                    
     commissioner for approval."                                                                                                
                                                                                                                                
     Page 4, following line 15:                                                                                                 
     Insert a new bill section to read:                                                                                         
     "*  Sec. 4.  AS 23.30.395  is amended  by adding  a new                                                                    
     paragraph to read:                                                                                                         
     (42)  "medical  services  review committee"  means  the                                                                    
     committee established under AS 23.30.0950)."                                                                               
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 4, line 16:                                                                                                           
     Delete "AS 23.30.097(j) - (o)"                                                                                             
     Insert "AS 23.30.097(j) - (p)"                                                                                             
                                                                                                                                
     Page 4, line 18:                                                                                                           
     Delete "sec. 4"                                                                                                            
     Insert "sec. 5"                                                                                                            
                                                                                                                                
Co-Chair Stoltze OBJECTED for discussion.                                                                                       
                                                                                                                                
Representative  Thompson explained  that  Amendment 2  would                                                                    
allow the medical services review  committee to directly set                                                                    
the   conversion   rates   for   the   new   fee   schedule.                                                                    
Subsequently,  the  schedule  would   be  submitted  to  the                                                                    
Department of  Labor and Workforce  Development commissioner                                                                    
for  approval. In  the current  bill version  the conversion                                                                    
factors  were set  by the  18  member workers'  compensation                                                                    
board. The medical services review  committee was made up of                                                                    
9   people   including   members  of   the   state   medical                                                                    
association,    chiropractic     society,    nursing    home                                                                    
association,  a  healthcare  provider,  four  non-healthcare                                                                    
providers, and the  commissioner's designee. He communicated                                                                    
that the amendment  streamlined the process and  had come at                                                                    
the bill sponsor's request.                                                                                                     
                                                                                                                                
Co-Chair Stoltze reiterated that  the amendment language had                                                                    
been brought to the committee by the sponsor.                                                                                   
                                                                                                                                
ANNA  LATHAM, STAFF,  REPRESENTATIVE  KURT OLSON,  confirmed                                                                    
the sponsor's support of Amendment 2.                                                                                           
Co-Chair Stoltze  asked for verification that  the amendment                                                                    
language  had  originated  from   the  sponsor.  Ms.  Latham                                                                    
replied in the affirmative.                                                                                                     
                                                                                                                                
Co-Chair  Stoltze WITHDREW  his  OBJECTION.  There being  NO                                                                    
further OBJECTION, Amendment 2 was ADOPTED.                                                                                     
                                                                                                                                
Representative Gara MOVED to ADOPT replacement Amendment 1:                                                                     
                                                                                                                                
     Page 2, line 19:                                                                                                           
                                                                                                                                
     Insert  "(4) The  fee schedules  of (A)  - (C)  of this                                                                    
     subsection  shall  not be  used  for  any procedure  or                                                                    
     service  unless  they  satisfy the  service  charge  of                                                                    
     providers in an area so  that patient access to quality                                                                    
     medical care is not compromised."                                                                                          
                                                                                                                                
Co-Chair Stoltze OBJECTED for discussion.                                                                                       
                                                                                                                                
Representative Gara  pointed to a concern  that the workers'                                                                    
compensation rate  would be the  Medicare or  Medicaid rate.                                                                    
He  understood  that it  was  not  the sponsor's  intention;                                                                    
therefore,  replacement  Amendment   1  clarified  that  the                                                                    
workers'  compensation rate  would  not be  the Medicare  or                                                                    
Medicaid rates  unless they were adequate  to ensure patient                                                                    
access to quality  medical care. He stated  that the sponsor                                                                    
intended that there  would be a multiplier at  some point in                                                                    
time.                                                                                                                           
                                                                                                                                
Ms.  Latham  believed  the  amendment  had  good  intention;                                                                    
however, she  believed it was  unnecessary for  two reasons.                                                                    
First,  it  created  confusion in  the  interpretation  that                                                                    
Medicare or Medicaid rates would  be used. Second, currently                                                                    
32 states used the methodology  with a conversion factor set                                                                    
by  the state.  The  bill  had been  referred  to the  House                                                                    
Finance  Committee  because  of   its  $62,000  fiscal  note                                                                    
associated  with  the   medical  services  review  committee                                                                    
setting the conversion factors.                                                                                                 
                                                                                                                                
Representative   Gara  asked   for  verification   that  the                                                                    
Medicare  and Medicaid  language in  the bill  did not  mean                                                                    
that  the  state  would  adopt  those  rates  if  they  were                                                                    
inadequate to  provide quality medical services  and access.                                                                    
Ms. Latham replied  in the affirmative and  pointed out that                                                                    
the  conversion   factor  was  a  large   component  of  the                                                                    
legislation for that reason.                                                                                                    
                                                                                                                                
Representative Gara  was satisfied with the  information put                                                                    
on record by the sponsor's staff. He WITHDREW Amendment 1.                                                                      
                                                                                                                                
8:42:16 AM                                                                                                                    
                                                                                                                                
Vice-Chair  Neuman   referred  to   the  unique   nature  of                                                                    
widespread costs  in Alaska due  to availability  of medical                                                                    
services statewide.  He imagined that cost  differentials in                                                                    
rural  Alaska  could  be quite  varied.  He  wondered  about                                                                    
alignment with Medicaid values.  He asked if comparisons had                                                                    
been  done statewide  to determine  how costs  would average                                                                    
out.                                                                                                                            
                                                                                                                                
Ms. Latham  replied that  the geographical  differential had                                                                    
been included  specifically for rural areas.  She added that                                                                    
the bill  included an exemption for  rural (critical access)                                                                    
hospitals.                                                                                                                      
                                                                                                                                
Representative  Wilson asked  if there  was a  place on  the                                                                    
board  for  physical  therapists. Ms.  Latham  replied  that                                                                    
there was  one open  seat for a  healthcare provider  on the                                                                    
medical services  review committee.  She relayed  that based                                                                    
on testimony,  physical therapists  did not account  for the                                                                    
application  of  a  conversion factor.  The  testifiers  had                                                                    
discussed their experiences using  Medicare rates, which was                                                                    
not  the  intent  of  the  legislation.  She  believed  some                                                                    
confusion existed related to the testimony.                                                                                     
                                                                                                                                
Representative  Wilson   pointed  out  that  there   was  an                                                                    
opportunity for  physical therapists to apply  for a medical                                                                    
services review committee seat if they were interested.                                                                         
                                                                                                                                
Representative   Costello   discussed   the   fiscal   notes                                                                    
including  one fiscal  impact note  from  the Department  of                                                                    
Labor and  Workforce Development  totaling $62,000 in  FY 15                                                                    
and $54,000  in FY 16  through FY 20; and  one indeterminate                                                                    
note from the Department of Administration.                                                                                     
                                                                                                                                
Vice-Chair  Neuman  MOVED to  REPORT  CSHB  316(FIN) out  of                                                                    
committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal notes.                                                                                                      
                                                                                                                                
CSHB  316(FIN)  was  REPORTED  out  of  committee  with  "no                                                                    
recommendation"  and with  one new  fiscal impact  note from                                                                    
the Department  of Labor and  Workforce Development  and one                                                                    
new    indeterminate   note    from   the    Department   of                                                                    
Administration.                                                                                                                 
8:45:42 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
8:47:53 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                

Document Name Date/Time Subjects
HB 316 MSRC 4-15-14.docx HFIN 4/15/2014 8:30:00 AM
HB 316
SB 138 Letter from Legislators.pdf HFIN 4/15/2014 8:30:00 AM
SB 138
SB 138 4.16.14 Presentation HFIN Edgmon Question.pdf HFIN 4/15/2014 8:30:00 AM
SB 138
SB 138 4.16.14 Resource Reports Required by Appendix A to Part 380 of FERC Regulations.pdf HFIN 4/15/2014 8:30:00 AM
SB 138
SB 138 Public Testimony.pdf HFIN 4/15/2014 8:30:00 AM
SB 138