Legislature(2005 - 2006)BUTROVICH 205

02/27/2006 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 251 POSTSEC. STUDENT MENINGITIS IMMUNIZATION TELECONFERENCED
Moved SB 251 Out of Committee
+ SB 244 NO DISCRIMINATION AGAINST ACUPUNCTURIST TELECONFERENCED
Heard & Held
*+ SJR 19 TASK FORCE ON HOSPITAL INFECTIONS TELECONFERENCED
Moved SJR 19 Out of Committee
*+ SB 242 STATUTORY REFERENCES TO DISABILITIES TELECONFERENCED
Heard & Held
+ HB 357 STATUTORY REFERENCES TO DISABILITIES TELECONFERENCED
Moved CSHB 357(FIN) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
         SB 244-NO DISCRIMINATION AGAINST ACUPUNCTURIST                                                                     
                                                                                                                                
CHAIR FRED DYSON announced SB 244 to be up for consideration.                                                                   
                                                                                                                                
1:49:56 PM                                                                                                                    
                                                                                                                                
AMY  SEITZ, Staff  to  Senator  Wagoner, said  that  SB 244  adds                                                               
acupuncturists to  the list of  licensed providers in  the Unfair                                                               
Discrimination Statute.  This  would prohibit insurance companies                                                               
that offer  group policies  from unfairly  discriminating against                                                               
them.                                                                                                                           
                                                                                                                                
She added  that the sponsor  introduced the bill  after reviewing                                                               
the  results of  several  studies that  demonstrate the  positive                                                               
affects of acupuncture. She referenced  a 1993 Swedish study on a                                                               
group  of  recovering  stroke patients  that  were  treated  with                                                               
acupuncture.   According  to the  study, the  treatment of  these                                                               
patients cost $26,000 less than  patients without acupuncture and                                                               
required half the normal time for recovery.                                                                                     
                                                                                                                                
She  referenced  another  study  on  knee  surgery  patients  who                                                               
underwent acupuncture  therapy before surgery.   According to the                                                               
study,  the treatment  of  these patients  cost  $9,000 less  per                                                               
patient  than   for  patients   without  acupuncture.   A  Boston                                                               
University   researcher   recently   claimed   that   acupuncture                                                               
treatment for stroke and Carpel  Tunnel Syndrome could reduce the                                                               
nation's medical bill by 11 million.                                                                                            
                                                                                                                                
She said,  in addition to  positive health  benefits, acupuncture                                                               
has  an  extremely  low  rate   of  malpractice  associated  with                                                               
acupuncture. A bill was recently  introduced at the federal level                                                               
to include  acupuncturists into the  Federal Insurance Act.   She                                                               
continued   to  say   that  several   insurance  companies   have                                                               
volunteered to cover acupuncturists.                                                                                            
                                                                                                                                
1:53:12 PM                                                                                                                    
                                                                                                                                
SENATOR  OLSON   asked  how  long  the   results  of  acupuncture                                                               
treatment lasted for patients in the stroke study.                                                                              
                                                                                                                                
MS. SEITZ believed that they were long-term results.                                                                            
                                                                                                                                
SENATOR  OLSON asked  how often  acupuncture  treatment causes  a                                                               
major bleeding event.                                                                                                           
                                                                                                                                
MS. SEITZ  said all the  information she  has read shows  that it                                                               
happens very infrequently.                                                                                                      
                                                                                                                                
SENATOR  OLSON  asked the  amount  of  education required  for  a                                                               
person to legally practice acupuncture.                                                                                         
                                                                                                                                
MS. SEITZ replied that it requires a three-year graduate degree.                                                                
                                                                                                                                
1:56:50 PM                                                                                                                    
                                                                                                                                
MELANIE MILLHORN,  Director, Division of Retirement  and Benefits                                                               
(DRB), Department  of Administration (DOA),  provided information                                                               
on  the state's  health  plans  and discussed  how  SB 244  would                                                               
affect  them.   She  said  the  Division administers  two  health                                                               
plans,  one for  the active  population and  one for  the retired                                                               
population.  She said that  the commissioner of The Department of                                                               
Administration has  the authority to  make changes to  the health                                                               
plans.                                                                                                                          
                                                                                                                                
FREDA MILLER,  Health Benefits Manager,  DRB, DOA,  reported that                                                               
the health plans  only cover acupuncture if  a physician performs                                                               
it in lieu  of anesthetic during surgery.  She  said that passage                                                               
of SB  244 would allow  acupuncturists to bill for  office visits                                                               
related to the  evaluation and management of a  condition.  Since                                                               
SB 244 only  expands coverage options, the bill  is cost neutral.                                                               
She  remarked that  acupuncture  therapy itself  would remain  an                                                               
uncovered  benefit   unless  there   is  a  signed   plan  change                                                               
authorized   by   the   commissioner   of   The   Department   of                                                               
Administration.                                                                                                                 
                                                                                                                                
SENATOR ELTON asked if SB 244  would allow coverage for visits to                                                               
an acupuncturist  that are related to  evaluation and management,                                                               
but not to therapy.                                                                                                             
                                                                                                                                
MS.  MILLER  replied  that SB  244  confers  recognized  provider                                                               
status  upon acupuncturists  thereby  allowing them  to bill  for                                                               
visits related to  evaluation and management.  She  added that SB
244  would not  change any  existing coverage  for therapy  since                                                               
that is determined by one's particular health plan.                                                                             
                                                                                                                                
SENATOR   OLSON   asked  whether   SB   244   would  change   the                                                               
impatient/outpatient status of acupuncture treatment.                                                                           
                                                                                                                                
MS. MILLER replied it would not do so.                                                                                          
                                                                                                                                
SENATOR WILKEN asked  whether the bill would open up  a new level                                                               
of service for  plan members and create additional  costs for the                                                               
system.                                                                                                                         
                                                                                                                                
MS.  MILLER  replied  that  it  only allows  members  to  see  an                                                               
acupuncturist instead  of a  physician to  evaluate and  manage a                                                               
condition. She  stressed that it  does not increase the  level of                                                               
coverage  to which  members are  already entitled  for evaluation                                                               
and management.                                                                                                                 
                                                                                                                                
SENATOR  WILKEN  remarked  that  he  would  like  Ms.  Millhorn's                                                               
reassurance that the legislation would indeed be cost-neutral.                                                                  
                                                                                                                                
MS. MILLHORN said that according  to Delloit Consulting, it costs                                                               
less   to  visit   an  acupuncturist   than   a  physician,   and                                                               
consequently, the cost-neutral designation is conservative.                                                                     
                                                                                                                                
SENATOR  WILKEN  said  he  was  concerned  that  the  bill  would                                                               
generate additional  costs because  it would create  coverage for                                                               
the alternative treatment of conditions  for which some would not                                                               
otherwise see a physician.                                                                                                      
                                                                                                                                
SENATOR  OLSON said  he was  concerned about  the possibility  of                                                               
additional  costs from  lawsuits  arising from  the inability  of                                                               
acupuncturists to evaluate and manage certain conditions.                                                                       
                                                                                                                                
CHAIR  DYSON asked  Ms. DeLaune  to  explain how  the bill  would                                                               
benefit the people of Alaska.                                                                                                   
                                                                                                                                
VALERIE DeLAUNE,  licensed acupuncturist, testified that  she has                                                               
personally saved  the state and its  residents a lot of  money by                                                               
providing   an  effective   alternative   to  some   conventional                                                               
procedures.  She remarked  that coverage  for acupuncture  is the                                                               
number  one requested  benefit among  insurance  consumers.   She                                                               
added   that   many   insurance   companies   voluntarily   cover                                                               
acupuncture and  suggested that they  would not  do so if  it did                                                               
not save them money.                                                                                                            
                                                                                                                                
CHAIR  DYSON  said  that  he  is  struck  by  the  fact  that  an                                                               
acupuncturist can mitigate  the pain of surgery,  but cannot seek                                                               
reimbursement for evaluating a condition.                                                                                       
                                                                                                                                
MS. DeLAUNE  said, with regard  to Senator Olson's  concern about                                                               
malpractice,   that   the    incidence   of   malpractice   among                                                               
acupuncturists is very low.                                                                                                     
                                                                                                                                
2:21:03 PM                                                                                                                    
                                                                                                                                
SENATOR  OLSON  asked  the  number  of  licensed  and  unlicensed                                                               
acupuncturists practice in the state.                                                                                           
                                                                                                                                
MS. DeLAUNE replied that about  65 acupuncturists are licensed in                                                               
the state.                                                                                                                      
                                                                                                                                
MS. MILLER added it is  illegal to practice acupuncture without a                                                               
license in the state.                                                                                                           
                                                                                                                                
SENATOR  ELTON  asked whether  an  acupuncture  license could  be                                                               
revoked in the case of malpractice.                                                                                             
                                                                                                                                
MS. DeLAUNE  replied that is  correct, but  the state has  yet to                                                               
revoke an acupuncture license.                                                                                                  
                                                                                                                                
SENATOR OLSON asked how an acupuncturist is licensed.                                                                           
                                                                                                                                
MS. DeLAUNE  replied the state  requires at least three  years of                                                               
graduate level education for licensure.                                                                                         
                                                                                                                                
SENATOR OLSON  asked whether  the state  requires a  written exam                                                               
for licensure.                                                                                                                  
                                                                                                                                
MS.  DeLAUNE  replied  the  state  requires  that  a  prospective                                                               
licensee take  certain courses on  AIDS, CPR, pass a  written and                                                               
practical  exam, and  complete 15  hours of  continuing education                                                               
every two years.                                                                                                                
                                                                                                                                
SENATOR OLSON  asked how this  bill compares to similar  bills in                                                               
other states.                                                                                                                   
                                                                                                                                
MS.  DeLAUNE   replied  the  State  of   Washington  has  similar                                                               
legislation.                                                                                                                    
                                                                                                                                
MS. SEITZ said that as of 1991, ten states covered acupuncture.                                                                 
                                                                                                                                
SENATOR  WILKEN  asked  whether acupuncture  treatment  would  be                                                               
covered for small businesses under this bill.                                                                                   
                                                                                                                                
MS. SEITZ replied that it would.                                                                                                
                                                                                                                                
SENATOR WILKEN  asked if the  legislation would  require managers                                                               
of private  insurance plans to cover  acupuncture treatments that                                                               
they do not cover at the present time.                                                                                          
                                                                                                                                
MS.  SEITZ replied  that the  bill does  not affect  the coverage                                                               
plans  of  any insurance  provider;  it  only allows  members  to                                                               
choose  acupuncture for  services  already  provided under  their                                                               
plans.                                                                                                                          
                                                                                                                                
2:39:25 PM                                                                                                                    
                                                                                                                                
SENATOR WILKEN asked if private  plan managers would have to make                                                               
a   plan   modification   before  covering   acupuncturists   for                                                               
evaluation and management and therapy services.                                                                                 
                                                                                                                                
MS. MILLER answered that adding  acupuncturists to the recognized                                                               
provider list  allows them to  submit charges for  evaluation and                                                               
management for any plan that covers  it.  The managers would have                                                               
to decide  whether or not  to cover acupuncture therapy  in their                                                               
benefit plans.                                                                                                                  
                                                                                                                                
SENATOR WILKEN cited Alaska Sales and  Service as an example of a                                                               
small  private   company  and  asked  whether   its  plan  covers                                                               
acupuncturists for providing evaluation and management services.                                                                
                                                                                                                                
MS. DeLAUNE did not know.                                                                                                       
                                                                                                                                
SENATOR WILKEN asked if the  state and private providers would be                                                               
able to  decide whether or  not to cover acupuncture  therapy and                                                               
evaluation and management services if the bill is passed.                                                                       
                                                                                                                                
MS. MILLER replied that is the  case and added it is important to                                                               
remember that  typically the  evaluation and  management services                                                               
are already covered in all insurance plans.                                                                                     
                                                                                                                                
SENATOR  WILKEN asked  if conferring  recognized provider  status                                                               
upon acupuncturists  would allow  them to receive  coverage under                                                               
the  state   plan  since  it  currently   covers  evaluation  and                                                               
management services.                                                                                                            
                                                                                                                                
MS. MILLER replied that is correct.                                                                                             
                                                                                                                                
SENATOR WILKEN asked if acupuncture  therapy would not be covered                                                               
under  the state  plan until  the commissioner  of administration                                                               
amends the design of the benefit plan.                                                                                          
                                                                                                                                
MS. MILLER replied that is correct.                                                                                             
                                                                                                                                
SENATOR  WILKEN  asked  if  the   commissioner  or  private  plan                                                               
managers could  decide to cover  acupuncture therapy  without the                                                               
passage of SB 244.                                                                                                              
                                                                                                                                
MS. SEITZ replied that they could do so.                                                                                        
                                                                                                                                
SENATOR WILKEN asked why the bill is needed.                                                                                    
                                                                                                                                
MS.  MILLER   replied  the  bill  would   ensure  that  insurance                                                               
companies  could not  refuse plan  managers who  decide to  cover                                                               
acupuncture.                                                                                                                    
                                                                                                                                
SENATOR ELTON  said it is  important to  note that the  bill only                                                               
prevents   insurance   companies  from   discriminating   against                                                               
acupuncturists; it does  not preclude them from  charging for the                                                               
added service.                                                                                                                  
                                                                                                                                
CHAIR DYSON remarked it is not a pro-choice bill, but an anti-                                                                  
discrimination bill for a profession that is widely recognized.                                                                 
                                                                                                                                
SENATOR WILKEN expressed  concern over costs that  the bill would                                                               
generate for both the state and private insurance companies.                                                                    
                                                                                                                                
CHAIR  DYSON asked  Ms.  Seitz  if she  heard  anything from  the                                                               
insurance  industry when  the bill  was  heard in  the Labor  and                                                               
Commerce Committee.                                                                                                             
                                                                                                                                
MS.  SEITZ  said  she  has  not heard  any  opposition  from  the                                                               
insurance industry.   She remarked that  many insurance companies                                                               
already voluntarily cover acupuncture.                                                                                          
                                                                                                                                
CHAIR DYSON asked whether insurance  companies have been notified                                                               
about the bill.                                                                                                                 
                                                                                                                                
MS. SEITZ said  she has been trying to solicit  comments from the                                                               
insurance companies,  but it doesn't seem  to be a big  issue for                                                               
them.                                                                                                                           
                                                                                                                                
SENATOR WILKEN remarked that while  no one wants to discriminate,                                                               
the bill might be less benign than it seems.                                                                                    
                                                                                                                                
MS.   SEITZ  remarked   that  it   might  actually   save  money.                                                               
Acupuncture is the only licensed  profession in the state that is                                                               
not on the recognized providers list.                                                                                           
                                                                                                                                
SENATOR ELTON  said it  would be  important to  determine whether                                                               
the amount of money saved  by visits to acupuncturists instead of                                                               
physicians would offset  the cost of visits  to acupuncturists by                                                               
people who would not otherwise see a physician.                                                                                 
                                                                                                                                
SENATOR  OLSON said  a  study  done five  years  ago showed  that                                                               
people  saved money  when  they  underwent effective  acupuncture                                                               
therapy  as opposed  to drug  therapy because  there are  no side                                                               
effects associated with acupuncture.                                                                                            
                                                                                                                                
2:54:46 PM                                                                                                                    
                                                                                                                                
CHAIR DYSON held SB 244 in committee.                                                                                           

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