Legislature(1999 - 2000)
03/20/2000 09:02 AM Senate FIN
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SENATE BILL NO. 276
"An Act requiring that health care insurers provide
coverage for treatment of diabetes."
This was the first hearing for this bill in the Senate
Finance Committee.
SHARON CLARK, Aide to Senator Miller read the sponsor
statement into the record.
SB 276 would require that health insurers in Alaska
provide coverage for diabetes equipment, training and
education as deemed necessary by state licensed health
care providers. To date, 37 states have enacted
legislation providing similar diabetes coverage.
Over 30,000 Alaskans are affected by diabetes. Without
education or proper treatment, diabetes can lead to
kidney failure, amputation, nerve damage, blindness and
other associated suffering; and the resulting costs are
often avoidable through patient education on proper
nutrition, exercise, blood sugar monitoring and
medication.
Education is the foundation of quality diabetes care.
It is the process of providing the person with diabetes
the knowledge and skills needed to perform self-care,
prevent crisis and make important life style changes
required to effectively avoid complications. Through
proper education, the diabetic may assume his/her
appropriate role as an active participant in the
treatment plan.
A number of published studies by the American Diabetes
Association (ADA) show decreased in health care
utilization for people with diabetes receiving
appropriate education and access to supplies.
A Milliman study for the ADA estimates annual savings
of $917 per person with diabetes that translates into
savings for the insurance industry as well.
SB 276 promotes better health, and ultimately, lower
health costs for the people of Alaska.
I urge your support of SB 276.
She told of Ms. Betsy Turner-Bogren and her son, Max
Bogren's visit to Juneau and the Senate Labor and Commerce
Committee to testify about Max's experiences with diabetes.
She referred to a handout detailing the visit. [Copy on
file.]
She mentioned two concerns voiced in the previous committee.
One dealt with whether the coverage should be mandated and
the other was raised by Senator P. Kelly and related to the
use of the word "nutrition". She stated the concerns were
addressed in two proposed amendments before the Committee.
Co-Chair Torgerson stated his intent was not to consider any
amendments at this meeting to allow members an opportunity
to review them.
Senator Leman supported the bill in concept but was
concerned that if the coverage is provided, the door is
opened for reimbursement of all types of charges without
review.
Tape: SFC - 00 #53, Side B 9:49 AM
Senator Leman mentioned a pump that cost $5,600, as an
example. He was also concerned about the amount of time
necessary to provide education. He had initially heard that
an average of six hours of training per year at $250 would
be average, but had since heard that training could go much
longer and cost up to $1500.
Ms. Clark remembered when the issue was raised in the Senate
Labor and Commerce Committee but noted that different
patients had different needs, different types of diabetes
and therefore, different amounts of training. She agreed
there would be situations where some patients would require
more training than just six hours per year. She said that
Senator Miller thought there would be justification for the
additional training for some people.
Co-Chair Torgerson thought this was an important bill but
also thought the education provision was broad based. He
suggested that a patient could go to college to learn about
diabetes and the insurance company would have to pay the
tuition.
Ms. Clark said Senator Miller had stated in the previous
committee that he hoped health care providers would be self-
limiting and that statute would not impose a limit to the
amount of money to reimburse training. She deferred to
members in the audience waiting to testify who live with
diabetes every day.
Co-Chair Torgerson wanted to know how other states and other
insurance carriers addressed this issue.
DON LOVATNY, Volunteer, American Diabetes Association, Board
Member, Pacific Northwest Board of ADA testified that he has
had diabetes for 21 years and that diabetes takes a lot of
time in one's life. He explained there are two types of
diabetes: Type 2 affects about 80 percent of those with the
disease and usually requires no insulin treatment and Type 1
does require insulin and also extends hospital stays by an
average of one day per visit. He stated that
hospitalization costs about $1620 per day in Alaska for a
patient with diabetes. His organizations' goals are to keep
those people out of the hospital.
Mr. Lovatny told the Committee that diabetes is on the rise
and is the seventh leading cause of death in Alaska,
according to the Bureau of Vital Statistics. He listed
percentages of those affected and the costs for treatment.
Mr. Lovatny stressed that rationing of services was not the
answer and urged the Committee to pass the legislation.
CHRIS HOLZWARTH passed out buttons to the Committee members.
He spoke of his history with diabetes and how his recently
acquired insulin pump has improved his life. He stated that
different people require different amounts of care and that
the educational needs differ for different patients to learn
what they need to know to survive the disease. He stated
that Mr. Lovatny had given up much of his time to assist
with learning how to use the pump and give general insight
on living with the disease.
Senator Leman clarified that he was not opposed to funding
the education, but warned that without some constraint, the
highest costing method of service would always be utilized.
He praised Mr. Lovatny for donating his time to Mr.
Hollsworth in helping educate Mr. Hollsworth.
JULIE BURNS Mother of Chris Hollsworth, talked about Mr.
Lovatny's assistance. However, she noted that it was only
because of his employment with the provider of the pump that
he was able to help them.
She stressed that family members need training as well. As
the family cook, she said it is important for her to know
what to feed her son and the implications his diet has on
his health.
She then talked about the amount of time diabetics must
spend on insurance matters to obtain coverage for daily
needs. She went into detail about the supplies, such as
syringes and test strips, that are not covered by insurance
yet still necessary.
MICHELLE CASSANO spoke of her appreciation that 37 other
states adopted similar legislation to what was before the
Committee. She noted that of these states, there have been
no repeals of these statutes.
Ms. Cassano stressed that a diabetic has diabetes every day
and that there is no cure. She added there have been no
reports of abuse of the new laws in other states.
She told of studies showing that when a patient properly
cares for diabetes, the incidence of related complications
is greatly decreased.
GORDON EVANS, Lobbyist representing the Health Insurance
Association of America (HIAA) testified that his
organization opposed any mandate but had since made some
concessions. He told of how he proposed to his client, a cap
of $250 per person per year. He said he then agreed to a
$1000 cap with a sunset clause to review the appropriateness
of the amount that but his client said he had spoken out of
line and could only offer a maximum of $750. He stated that
the average annual cost for these diabetes-related services
is $1000 and that his client directed him to meet the amount
halfway at $500. He had warned his client that the
legislation would be adopted in some form, either with a
reasonable cap or no cap at all and insurance would be
required to pay the entire amount.
Mr. Gordon relayed that the HIAA was in support of the
proposed Amendment #2.
Co-Chair Torgerson commented that it was not his intent to
negotiate a cap amount. He stated that the Committee planned
to research the matter, learn what other states allow and
discuss the merits of the coverage.
Co-Chair Torgerson ordered the bill HELD in Committee.
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