03/10/1998 08:00 AM House STA

HB 359 - HEALTH INSURANCE REGULATION                                           
                                                                               
TAPE 98-34, SIDE B                                                             
Number 0980                                                                    
                                                                               
CHAIR JAMES announced the committee would hear HB 359, "An Act                 
relating to regulation of health insurance plans; and providing for            
an effective date."  She said she hasn't had a chance to listen to             
the Children's Caucus tapes that were provided to her.  Chair James            
said Representative Dyson is willing to give an overview of the                
comments that were made in the Children's Caucus.                              
                                                                               
Number 1000                                                                    
                                                                               
REPRESENTATIVE JOE RYAN noted there is a proposed committee                    
substitute (CS) which takes care of some of the fiscal concerns of             
the department.  He said, "We have held the Appeals Committee                  
harmless so we don't need a AG and we've also stated that they                 
don't need staff support.  It will be -- any costs incurred in the             
meetings and so forth will be paid for by the insurance company.               
So it dramatically reduces any fiscal impact and since there is not            
personal services, there is no reason for $34,000 and $48,000 worth            
of travel and supplies and equipment and so forth.  I am still not             
sure what the contractual amount is, but since we don't have state             
employees performing these functions as it is taken care of on the             
other end, I would think that the contractual should go away too.              
So that makes your committee fiscal note appropriate."                         
                                                                               
CHAIR JAMES said she would accept a motion to put the CS, Version              
B, dated 3/5/98, before the committee.                                         
                                                                               
REPRESENTATIVE DYSON moved the CS be put before the committee.                 
There being no objection, CSHB 359, Version B, was before the                  
committee.                                                                     
                                                                               
REPRESENTATIVE ETHAN BERKOWITZ asked if the only change is on page             
9 to Section 21.07.110.                                                        
                                                                               
REPRESENTATIVE JOE RYAN said the last sentence in (e) of Section               
21.07.090 has been removed.  Also removed is the last sentence in              
(a) of Section 21.07.110.                                                      
                                                                               
REPRESENTATIVE FRED DYSON referred to the testimony given in the               
Children's Caucus and said most of the people there were Alaskan               
service providers.  They expressed a great deal of frustration with            
the Administration having to deal with time zones and calling                  
somebody in Tennessee to get authorization to proceed with a                   
treatment plan.  He said the Administration, who was there,                    
admitted that there had been a whole bunch of start-up problems.               
Representative Ryan stated there was also testimony about the                  
difficulty of getting people in Tennessee to understand Alaska, the            
logistics problem and how isolated many care providers are.  He                
continued to inform the committee of the problems such as fetal                
alcohol syndrome, fetal alcohol effects, child abuse problems, et              
cetera.                                                                        
                                                                               
CHAIR JAMES asked, "Were they supportive of this piece of                      
legislation?"                                                                  
                                                                               
REPRESENTATIVE DYSON said his recollection is that this specific               
legislation wasn't presented to them, but universally the folks                
that testified didn't like the change, didn't like dealing with                
somebody outside the state and didn't like having to get over a                
huge hurdle in order to (indisc.) treatment.  They were wanting to             
deal with somebody locally and somebody with knowledge of the                  
unique situations of our environment.                                          
                                                                               
REPRESENTATIVE ELTON said, "My recollection of the situation arose             
out of the Tennessee vender is that a large part of the problem                
came from this end, came from some rather nonspecific contract                 
language that the department had with the Tennessee people - came              
with some things that I think the department probably should have              
anticipated in setting up a system like (indisc.).  And this piece             
of the legislation deals with (indisc.).  This piece of legislation            
deals with what the insurer's obligation may be and it doesn't                 
really address the situation that occurred with the Tennessee end.             
I don't find myself blaming the Tennessee people as much as I do               
the people who did the contract with the Tennessee people.  So it              
seems to me that we're solving it by fixing the wrong end."                    
                                                                               
REPRESENTATIVE RYAN pointed out that there is an appeal process in             
the Department of Health and Social Services.                                  
                                                                               
TAPE 98-35, SIDE A                                                             
Number 0001                                                                    
                                                                               
REPRESENTATIVE RYAN said, "Under this legislation, we have this                
independent board which is made up of a diverse group of                       
individuals, who may - not all of whom may have esoteric knowledge,            
but who look at it from a consumer point of view, and especially               
the public people who will ask the questions of the professionals              
which sometimes get to be embarrassing."                                       
                                                                               
REPRESENTATIVE RYAN said he was at the caucus.  He said, "Part of              
the frustration with the people, as I recall - I was at the meeting            
that Representative Dyson (indisc.), was providers who are having              
to prepare an hour, an hour and a half, two hours before they made             
this phone call.  And they were professionals who were treating a              
patient, who had the credentials.  And instead of the people in                
Tennessee saying, 'Have you done ba, ba, ba and ba,' they would                
say, 'You just tell us the symptoms and we'll make the diagnosis.'"            
He continued to discuss the expenses involved and the people in                
Tennessee questioning the doctors who have the credentials.                    
                                                                               
Number 0089                                                                    
                                                                               
REPRESENTATIVE ELTON said he thinks the way to solve the problem is            
to fix it at this end rather than regulate industry.                           
                                                                               
REPRESENTATIVE DYSON said that apparently the Tennessee                        
organization has done well on other similar things in the past, but            
the learning curve for them and never having a presence in Alaska,             
produces all these unfortunate results that he doesn't think were              
intended to happen.  He said, "I think probably we should buy our              
way out of this contract and start over.  That would be my                     
solution."                                                                     
                                                                               
Number 0162                                                                    
                                                                               
REPRESENTATIVE HODGINS made a motion to move CSHB 359 out of                   
committee with individual recommendations and with the attached                
zero fiscal note.  There being no objection, CSHB 359(STA) moved               
out of the House State Affairs Standing Committee.