Legislature(2001 - 2002)
02/21/2001 01:38 PM JUD
* first hearing in first committee of referral
= bill was previously heard/scheduled
= 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.