Legislature(2001 - 2002)
02/21/2001 01:38 PM Senate JUD
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
Number 1599
SB 37-PHYSICIAN NEGOTIATIONS WITH HEALTH INSURE
MR. KRISTOPHER KNAUSS, staff to Senator Pete Kelly, said questions
from the Department of Law (DOL), Division of Insurance, and the
Nurse Practitioners and Midwives (NPM), in the last hearing have
been answered. NPM was concerned that their services could be
negotiated out of physician contracts with healthcare plans. As SB
37 is written this is not so. It is in statute that those with
special occupational licenses from health care plans or health care
in general cannot be discriminated against - the new amendment also
clarifies this point.
Number 1698
CHAIRMAN TAYLOR said there were concerns about enough state
involvement within the process so that under federal law the
constraints of the anti-trust legislation could be avoided. He
asked if SB 37 was sufficient for allowing the state to participate
in these negotiations.
MR. JAMES JORDAN, Executive Director for the Alaska State Medical
Association, testifying via teleconference from Anchorage, said
there is sufficient regulatory oversight in SB 37 to provide the
meeting of the act of oversight test, not only with the various
guidelines provided for the oversight agency but also the AG's
office.
MR. JORDAN said Texas enacted a similar law in June of 1999 and has
been going through a process of adopting regulations to make it
functional. Washington has a law that allows joint negotiation
under a state action doctrine exception. However, the Washington
law did not provide for anything more than is currently allowed
under new federal antitrust laws.
Number 1880
MR. MICHAEL HAUGEN, Alaska Physicians and Surgeons (APS),
testifying via teleconference from Anchorage, started by answering
a question that Senator Therriault asked in the last hearing
regarding safe harbors. APS has talked with the Alaska Medical
Association's (AMA) legal department and has done its own legal
analysis regarding whether or not SB 37 needs additional language
to protect physicians prior to active negotiations in simply
getting together to discuss the possibility of negotiation. Supreme
court cases from the 1960's say that provided the applicants are
working in good faith to apply for state protection they are
exempted from any liability under the Sherman antitrust laws and
the federal antitrust rules. The answer to Senator Therriault's
question is that provided the doctors are acting in good faith in
attempting to petition the AG to negotiate, they are protected.
MR. HAUGEN said APS suggests the AG issue a "Dear Doctor" letter
stating the "do's and don'ts" of getting together, before the safe
harbor provided under SB 37 goes into effect, to let the doctors
know they have to be organizing in good faith and that there may be
areas they should not discuss until the green light is given to
negotiate. APS does not think additional language would offer
additional protection.
Number 2018
MR. CLYDE SNIFFEN, JR., Attorney General, DOL, testifying via
teleconference from Anchorage, said he had not seen the amendment
or any answers to the questions referred to by Mr. Knauss. He does
not know how the concerns he raised at the last hearing have been
addressed and therefore cannot comment on them. DOL continues to
have serious concerns with SB 37. The only provision in SB 37
allowing DOL the authority to adopt regulations is specific only to
fee issues. DOL also has concerns about geographic and market
power issues, they are not well defined or related to anything that
would suggest the markets that SB 37 focuses on have an impact on
the ability to set prices.
CHAIRMAN TAYLOR asked if DOL had prepared amendments to take care
of these concerns.
MR. SNIFFEN replied no.
Number 2187
MS. SANDY PERRY-PROVOST, Alaska Nurse Practitioners Association
said she could not comment on the amendment because the nurses have
not seen it yet. She pointed out that there is not an (o) under AS
23.50.020 in the amendment.
SENATOR THERRIAULT asked if Chairman Taylor would afford the
drafter latitude in changing the language.
CHAIRMAN TAYLOR said the amendment is only conceptual.
TAPE 01-4, SIDE B
Number 2334
SENATOR ELLIS said there had been a request from the Alaska
Optometric Association (AOA) as well. AOA supports SB 37 but wants
an amendment that would encompass all the groups that have problems
with the bill.
CHAIRMAN TAYLOR said the wording of SB 37 is to encompass all
groups that would be defined within that category - "the
performance of services that are within the scope of their
occupational license." The amendment was structured to accomplish
this without listing each group.
CHAIRMAN TAYLOR moved to adopt the conceptual amendment. There
being no objection, the motion carried.
SENATOR COWDERY moved to pass CSSB 37 (JUD) from committee with
individual recommendations.
SENATOR ELLIS objected.
SENATOR ELLIS said there were still too many concerns that had not
been addressed.
CHAIRMAN TAYLOR said he shared some of the same concerns as Senator
Ellis about the questions on antitrust. He said he hoped these
issues would be resolved before SB 37 goes to the Floor of the
Senate. Chairman Taylor said the antitrust issue has to be
resolved or SB 37 will not have the desired effect.
SENATOR ELLIS noted there is a significant fiscal note and the
discomfort level would go up dramatically if the fiscal note were
to be significantly reduced or wiped out allowing no oversight
through the AG's office. He does not object to the amendment but
wondered if there would be restrictions in other parts of SB 37
that would cause concern that doctors would constrain trade of the
concerned groups.
CHAIRMAN TAYLOR said the first section is just legislative findings
and the only real substance to the bill is the amended section.
SENATOR ELLIS said, with all respect to the Chairman, if the
committee were to move SB 37 he would have a hard time feeling the
committee had done a full job.
CHAIRMAN TAYLOR said he shared many of those concerns and he
assured Senator Ellis that if these issues were not resolved, he
would request SB 37 back to the Judiciary Committee.
A roll call was taken. Senator Donley, Senator Cowdery, Senator
Therriault and Chairman Taylor voted "yea." Senator Ellis voted
"nay." The motion carried and CSSB 37 (JUD) passed out of
committee with individual recommendations.
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