04/20/2018 01:30 PM Senate JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| HB355 | |
| HB123 | |
| HB259 | |
| HB336 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 355 | TELECONFERENCED | |
| += | HB 208 | TELECONFERENCED | |
| += | HB 123 | TELECONFERENCED | |
| + | HB 259 | TELECONFERENCED | |
| + | HB 336 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE JUDICIARY STANDING COMMITTEE
April 20, 2018
1:37 p.m.
MEMBERS PRESENT
Senator John Coghill, Chair
Senator Mia Costello
Senator Pete Kelly
Senator Bill Wielechowski
Senator Mike Shower
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 355(JUD)
"An Act relating to the crime of criminally negligent burning;
relating to protection of and fire management on forested land;
relating to prohibited acts and penalties for prohibited acts on
forested land; requiring the Alaska Supreme Court to establish a
bail schedule; and providing for an effective date."
- MOVED SCS CSHB 355(JUD) OUT OF COMMITTEE
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 123(HSS)
"An Act relating to disclosure of health care services and price
information; and providing for an effective date."
- HEARD & HELD
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 259(JUD) AM
"An Act relating to containing or confining loads being
transported on highways."
- HEARD & HELD
COMMITTEE SUBSTITUTE FOR HOUSE BILL NO. 336(JUD) AM
"An Act relating to supported decision-making agreements to
provide for decision- making assistance; and amending Rule 402,
Alaska Rules of Evidence."
- HEARD & HELD
HOUSE BILL NO. 208
"An Act relating to trusts and powers of appointment; and
providing for an effective date."
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 355
SHORT TITLE: FIRE;FOREST LAND; CRIMES;FIRE PREVENTION
SPONSOR(s): REPRESENTATIVE(s) GUTTENBERG
02/16/18 (H) READ THE FIRST TIME - REFERRALS
02/16/18 (H) RES, JUD
02/28/18 (H) RES AT 1:00 PM BARNES 124
02/28/18 (H) Heard & Held
02/28/18 (H) MINUTE(RES)
02/28/18 (H) RES AT 6:00 PM BARNES 124
02/28/18 (H) Heard & Held
02/28/18 (H) MINUTE(RES)
03/05/18 (H) RES AT 1:00 PM BARNES 124
03/05/18 (H) Heard & Held
03/05/18 (H) MINUTE(RES)
03/09/18 (H) RES AT 1:00 PM BARNES 124
03/09/18 (H) Moved CSHB 355(RES) Out of Committee
03/09/18 (H) MINUTE(RES)
03/12/18 (H) RES RPT CS(RES) NT 4DP 3NR 1AM
03/12/18 (H) DP: LINCOLN, DRUMMOND, JOSEPHSON, TARR
03/12/18 (H) NR: BIRCH, PARISH, TALERICO
03/12/18 (H) AM: RAUSCHER
03/14/18 (H) JUD AT 1:00 PM GRUENBERG 120
03/14/18 (H) Heard & Held
03/14/18 (H) MINUTE(JUD)
03/19/18 (H) JUD AT 1:00 PM GRUENBERG 120
03/19/18 (H) Heard & Held
03/19/18 (H) MINUTE(JUD)
03/26/18 (H) JUD AT 1:00 PM GRUENBERG 120
03/26/18 (H) Scheduled but Not Heard
03/30/18 (H) JUD AT 1:00 PM GRUENBERG 120
03/30/18 (H) <Bill Hearing Canceled>
04/02/18 (H) JUD AT 1:00 PM GRUENBERG 120
04/02/18 (H) Heard & Held
04/02/18 (H) MINUTE(JUD)
04/02/18 (H) JUD AT 7:00 PM GRUENBERG 120
04/02/18 (H) Moved CSHB 355(RES) Out of Committee
04/02/18 (H) MINUTE(JUD)
04/04/18 (H) JUD RPT CS(JUD) NT 3DP 1NR 2AM
04/04/18 (H) DP: KREISS-TOMKINS, STUTES, CLAMAN
04/04/18 (H) NR: LEDOUX
04/04/18 (H) AM: EASTMAN, KOPP
04/09/18 (H) TRANSMITTED TO (S)
04/09/18 (H) VERSION: CSHB 355(JUD)
04/10/18 (S) READ THE FIRST TIME - REFERRALS
04/10/18 (S) JUD
04/17/18 (S) JUD AT 9:00 AM BELTZ 105 (TSBldg)
04/17/18 (S) Heard & Held
04/17/18 (S) MINUTE(JUD)
04/18/18 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
04/18/18 (S) Heard & Held
04/18/18 (S) MINUTE(JUD)
04/19/18 (S) JUD AT 9:00 AM BELTZ 105 (TSBldg)
04/19/18 (S) Heard & Held
04/19/18 (S) MINUTE(JUD)
04/20/18 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
BILL: HB 123
SHORT TITLE: DISCLOSURE OF HEALTH CARE COSTS
SPONSOR(s): REPRESENTATIVE(s) SPOHNHOLZ
02/13/17 (H) READ THE FIRST TIME - REFERRALS
02/13/17 (H) HSS, JUD
03/02/17 (H) HSS AT 3:00 PM CAPITOL 106
03/02/17 (H) Heard & Held
03/02/17 (H) MINUTE(HSS)
03/09/17 (H) HSS AT 3:00 PM CAPITOL 106
03/09/17 (H) Moved CSHB 123(HSS) Out of Committee
03/09/17 (H) MINUTE(HSS)
03/10/17 (H) HSS RPT CS(HSS) 5DP 2NR
03/10/17 (H) DP: JOHNSTON, TARR, EDGMON, SULLIVAN-
LEONARD, SPOHNHOLZ
03/10/17 (H) NR: KITO, EASTMAN
03/24/17 (H) JUD AT 1:00 PM GRUENBERG 120
03/24/17 (H) Heard & Held
03/24/17 (H) MINUTE(JUD)
03/27/17 (H) JUD AT 1:00 PM GRUENBERG 120
03/27/17 (H) Heard & Held
03/27/17 (H) MINUTE(JUD)
03/29/17 (H) JUD AT 1:00 PM GRUENBERG 120
03/29/17 (H) Moved CSHB 123(HSS) Out of Committee
03/29/17 (H) MINUTE(JUD)
03/31/17 (H) JUD RPT CS(HSS) 1DP 1NR 4AM
03/31/17 (H) DP: CLAMAN
03/31/17 (H) NR: EASTMAN
03/31/17 (H) AM: KOPP, KREISS-TOMKINS, FANSLER,
REINBOLD
04/07/17 (H) TRANSMITTED TO (S)
04/07/17 (H) VERSION: CSHB 123(HSS)
04/10/17 (S) READ THE FIRST TIME - REFERRALS
04/10/17 (S) HSS, JUD
03/16/18 (S) HSS AT 1:30 PM BUTROVICH 205
03/16/18 (S) Heard & Held
03/16/18 (S) MINUTE(HSS)
04/04/18 (S) HSS AT 1:30 PM BUTROVICH 205
04/04/18 (S) Moved SCS CSHB 123(HSS) Out of
Committee
04/04/18 (S) MINUTE(HSS)
04/06/18 (S) HSS RPT SCS 4DP NEW TITLE
04/06/18 (S) DP: WILSON, BEGICH, VON IMHOF, GIESSEL
04/16/18 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
04/16/18 (S) <Above Item Removed from Agenda>
04/16/18 (S) MINUTE(JUD)
04/19/18 (S) JUD AT 9:00 AM BELTZ 105 (TSBldg)
04/19/18 (S) Heard & Held
04/19/18 (S) MINUTE(JUD)
04/20/18 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
BILL: HB 259
SHORT TITLE: CONFINING VEHICLE LOADS
SPONSOR(s): REPRESENTATIVE(s) STUTES
01/08/18 (H) PREFILE RELEASED 1/8/18
01/16/18 (H) READ THE FIRST TIME - REFERRALS
01/16/18 (H) TRA, JUD
01/25/18 (H) TRA AT 1:15 PM BARNES 124
01/25/18 (H) -- MEETING CANCELED --
01/30/18 (H) TRA AT 1:00 PM BARNES 124
01/30/18 (H) -- MEETING CANCELED --
02/01/18 (H) TRA AT 1:00 PM BARNES 124
02/01/18 (H) Heard & Held
02/01/18 (H) MINUTE(TRA)
02/08/18 (H) TRA AT 1:00 PM BARNES 124
02/08/18 (H) Moved CSHB 259(TRA) Out of Committee
02/08/18 (H) MINUTE(TRA)
02/09/18 (H) TRA RPT CS(TRA) 1DP 5AM
02/09/18 (H) DP: STUTES
02/09/18 (H) AM: KOPP, CLAMAN, DRUMMOND, EASTMAN,
WOOL
02/21/18 (H) JUD AT 1:00 PM GRUENBERG 120
02/21/18 (H) <Bill Hearing Canceled>
02/23/18 (H) JUD AT 1:30 PM GRUENBERG 120
02/23/18 (H) Heard & Held
02/23/18 (H) MINUTE(JUD)
03/05/18 (H) JUD AT 1:00 PM GRUENBERG 120
03/05/18 (H) Moved CSHB 259(JUD) Out of Committee
03/05/18 (H) MINUTE(JUD)
03/07/18 (H) JUD RPT CS(JUD) 5DP 1NR 1AM
03/07/18 (H) DP: KOPP, KREISS-TOMKINS, STUTES,
LEDOUX, CLAMAN
03/07/18 (H) NR: REINBOLD
03/07/18 (H) AM: EASTMAN
03/15/18 (H) TRANSMITTED TO (S)
03/15/18 (H) VERSION: CSHB 259(JUD) AM
03/16/18 (S) READ THE FIRST TIME - REFERRALS
03/16/18 (S) TRA, JUD
03/29/18 (S) TRA AT 1:30 PM BUTROVICH 205
03/29/18 (S) -- MEETING CANCELED --
04/03/18 (S) TRA AT 1:30 PM BUTROVICH 205
04/03/18 (S) Heard & Held
04/03/18 (S) MINUTE(TRA)
04/17/18 (S) TRA AT 1:30 PM BUTROVICH 205
04/17/18 (S) Moved SCS CSHB 259(TRA) Out of
Committee
04/17/18 (S) MINUTE(TRA)
04/18/18 (S) TRA RPT SCS 1DP 3NR SAME TITLE
04/18/18 (S) NR: STEDMAN, WILSON, BISHOP
04/18/18 (S) DP: EGAN
04/20/18 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
BILL: HB 336
SHORT TITLE: SUPPORTIVE DECISION-MAKING AGREEMENTS
SPONSOR(s): REPRESENTATIVE(s) MILLETT
02/07/18 (H) READ THE FIRST TIME - REFERRALS
02/07/18 (H) HSS, JUD
03/01/18 (H) HSS AT 3:00 PM CAPITOL 106
03/01/18 (H) Heard & Held
03/01/18 (H) MINUTE(HSS)
03/08/18 (H) HSS AT 3:00 PM CAPITOL 106
03/08/18 (H) Moved CSHB 336(HSS) Out of Committee
03/08/18 (H) MINUTE(HSS)
03/09/18 (H) HSS RPT CS(HSS) 6DP
03/09/18 (H) DP: JOHNSTON, CLAMAN, EDGMON, SULLIVAN-
LEONARD, KITO, TARR
04/09/18 (H) JUD AT 1:00 PM GRUENBERG 120
04/09/18 (H) Heard & Held
04/09/18 (H) MINUTE(JUD)
04/11/18 (H) JUD AT 1:00 PM GRUENBERG 120
04/11/18 (H) Moved CSHB 336(JUD) Out of Committee
04/11/18 (H) MINUTE(JUD)
04/11/18 (H) JUD AT 7:00 PM GRUENBERG 120
04/11/18 (H) -- MEETING CANCELED --
04/12/18 (H) JUD RPT CS(JUD) 4DP 2NR 1AM
04/12/18 (H) DP: KOPP, KREISS-TOMKINS, STUTES,
CLAMAN
04/12/18 (H) NR: LEDOUX, REINBOLD
04/12/18 (H) AM: EASTMAN
04/14/18 (H) TRANSMITTED TO (S)
04/14/18 (H) VERSION: CSHB 336(JUD) AM
04/15/18 (S) READ THE FIRST TIME - REFERRALS
04/15/18 (S) JUD
04/20/18 (S) JUD AT 1:30 PM BELTZ 105 (TSBldg)
WITNESS REGISTER
ALLIANA SALANGUIT, Staff
Representative David Guttenberg
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Stated that the sponsor supports the
language in Amendment 6 for HB 355.
ANN NELSON, Assistant Attorney General
Department of Law
Juneau, Alaska
POSITION STATEMENT: Discussed the effect of Amendment 6 for HB
355.
CHRIS MAISCH, State Forester and Director
Division of Forestry
Department of Natural Resources (DNR)
Fairbanks, Alaska,
POSITION STATEMENT: Discussed the practical effect of Amendment
6 for HB 355.
JORDAN SHILLING, Staff
Senator John Coghill
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Described the changes between version B and
version Q of HB 123 and version S and version G of HB 259.
REPRESENTATIVE IVY SPOHNHOLZ
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 123.
GINA BOSNAKIS, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 123.
JENNIFER MEYHOFF, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 123.
SHAUN LEWIS, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 123.
TERRY ALLARD
Alaska Association of Health Underwriters
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 123.
ELIZABETH WARLICK, Advocacy Coordinator
Greater Fairbanks Chamber of Commerce
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 123.
DR. THOMAS KOBYLARZ, representing self
Soldotna, Alaska
POSITION STATEMENT: Testified that he appreciates that HB 123 is
an effort to control costs health care costs, but he does not
want to post a menu in his office to describe the cost of each
procedure.
DR. HEATHER WILLIS, Governmental Affairs Chair
Alaska Dental Society (ADS)
Fairbanks, Alaska
POSITION STATEMENT: Testified that ADS appreciates the intent of
HB 123 to increase transparency, but believes it will have
unintended consequences as currently drafted.
DR. GRAHAM GLASS, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified that his concern with HB 123 is
that rack rates for services almost never reflect what the
patient actually pays.
RHONDA PROWELL-KITTER, Chief Financial Officer
Public Education Health Trust
Anchorage, Alaska
POSITION STATEMENT: Testified in full support of HB 123.
NIBERT LUJAN
Alaska Association of School Business Officials
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 123.
JEANNIE MONK
Alaska State Hospital and Nursing Association (ASHNA)
Juneau, Alaska
POSITION STATEMENT: Testified that HB 123 is a reasonable first
step to control health care costs.
DR. JOSEPH ROTH, MD and President elect
Alaska State Medical Association (ASMA)
Juneau, Alaska
POSITION STATEMENT: During the hearing on HB 123, stated that
ASMA does not support the requirement that providers list
undiscounted charges.
DIANE WENDLANDT, Assistant Attorney General
Criminal Division
Office of Criminal Appeals
Department of Law
Anchorage, Alaska
POSITION STATEMENT: Provided supporting testimony for version G
of the Senate CS for HB 259.
REPRESENTATIVE LOUISE STUTES
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 259.
MATT GRUENING, Staff
Representative Louise Stutes
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis for HB 259
on behalf of the sponsor.
REPRESENTATIVE CHARISSE MILLETT
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of HB 336.
HANS RODVICK, Staff
Representative Charisse Millett
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis for HB 336
on behalf of the sponsor.
ACTION NARRATIVE
1:37:04 PM
CHAIR JOHN COGHILL called the Senate Judiciary Standing
Committee meeting to order at 1:37 p.m. Present at the call to
order were Senators Costello, Shower, Wielechowski, and Chair
Coghill. Senator Kelly arrived during the meeting.
HB 355-FIRE;FOREST LAND; CRIMES;FIRE PREVENTION
1:38:29 PM
CHAIR COGHILL announced the consideration of HB 355 and
recognized Senator Shower.
1:39:00 PM
SENATOR SHOWER moved to rescind the action [on 4/18/2018] to
adopt Amendment 3, 30-LS1382.O.18.
CHAIR COGHILL found no objection and Amendment 3 was withdrawn.
1:40:07 PM
SENATOR SHOWER moved Amendment 6, 30-LS1382\O.28.
30-LS1382\O.28
Radford
4/20/18
AMENDMENT 6
OFFERED IN THE SENATE BY SENATOR SHOWER
TO: CSHB 355(JUD)
Page 3, line 9, following "regulation":
Insert "under (a) of this section"
CHAIR COGHILL objected for an explanation.
SENATOR SHOWER explained that withdrawing Amendment 3 and
adopting Amendment 6 is an agreement he came to with the bill
sponsor, the Division of Forestry, and the Department of Law.
His initial concern was that the definition of "other land use"
was too broad. The amendment maintains the intent for
consistency between Sections 5, 6, and 7 while also meeting his
intention to tighten the language regarding other land uses. It
essentially establishes that whatever the commissioner puts in
regulation is what the inspector must adhere to.
1:42:04 PM
At ease
1:42:57 PM
CHAIR COGHILL reconvened the meeting.
1:43:06 PM
ALLIANA SALANGUIT, Staff, Representative David Guttenberg,
Alaska State Legislature, Juneau, Alaska, said the sponsor
supports the language in Amendment 6 for HB 355.
CHAIR COGHILL asked Ms. Nelson to discuss the effect of the
amendment.
1:43:37 PM
ANN NELSON, Assistant Attorney General, Department of Law,
Juneau, Alaska, explained that the language clarifies that the
permit enforcement authority is limited to activities for which
a permit is required.
1:44:11 PM
SENATOR KELLY joined the committee.
CHAIR COGHILL asked Mr. Maisch to discuss the practical effect
of the amendment.
CHRIS MAISCH, State Forester and Director, Division of Forestry,
Department of Natural Resources (DNR), Fairbanks, Alaska, said
the language would tighten the statute and tie it to the
regulation process. Responding to a question, he confirmed that
it would be a more public process tied to the enforcement piece.
1:45:08 PM
CHAIR COGHILL found no objection and Amendment 6 was adopted.
SENATOR SHOWER asked to hear either the Division of Forestry or
the Department of Law state that civil immunity would apply if a
citizen was directed by a state official to take certain action.
That was part of the agreement to withdrew Amendment 3.
MS. NELSON confirmed that the civil immunity statute under AS
41.15.045 would apply to a homeowner or other member of the
public who is directed to take certain action at the direction
of a federal or state fire official.
MR. MAISCH added that he also committed to provide training and
educational material to the public so they understand that is an
option. The division will also be doing a lot of education about
the bail schedule should the bill pass.
CHAIR COGHILL noted who was available to answer questions.
1:47:57 PM
SENATOR COSTELLO moved to report the CS for HB 355, version O as
amended, from committee with individual recommendations and
attached fiscal note(s).
1:48:09 PM
At ease
1:48:23 PM
CHAIR COGHILL reconvened the meeting and advised that the motion
referenced the wrong version. He asked Senator Costello to
restate the motion.
CHAIR COSTELLO moved to report the Senate CS for CSHB 355,
version U as amended, from committee with individual
recommendations and attached fiscal note(s).
CHAIR COGHILL found no objected and SCS CSHB 355(JUD moved from
the Senate Judiciary Standing Committee) with the understanding
that conforming technical changes may be necessary.
1:49:12 PM
At ease
HB 123-DISCLOSURE OF HEALTH CARE COSTS
1:51:32 PM
CHAIR COGHILL announced the consideration of HB 123 and noted
the proposed committee substitute (CS).
1:52:11 PM
SENATOR COSTELLO moved to adopt the work draft Senate CS for
CSHB [123], version 30-LS0380\Q, as the working document.
CHAIR COGHILL objected for an explanation.
1:52:45 PM
JORDAN SHILLING, Staff, Senator John Coghill, Alaska State
Legislature, Juneau, Alaska, reviewed the following substantive
changes between version B and version Q of HB 123:
Page 2, the disclosed price information that is
required to be posted no longer reflects the Medicaid
price. It will reflect the undiscounted price.
Also on page 2, the requirement for a health care
facility to post the 50 most common procedures is
changed to the 25 most common procedures.
Page 4, line 22, insurers were removed from the
requirements under subsection (h). They will no longer
have to comply with the components of (h) that are a
part of the good faith estimate.
MR. SHILLING explained that insurers indicated they would not be
able to comply with a few elements of subsection (h). They would
have difficulty providing the procedure code unless the provider
or patient supplied it. Further, Primera said they could not
provide, as part of a good faith estimate, the information
required under subsection (h)(5). This information is the
identity or suspected identity of any other person who "may
charge the patient for a service, product, procedure, or supply
in connection with the health care services included in the
estimate,".
Page 6, line 26, under subsection (n)(3), a facility
operated by an Alaska tribal health organization is
exempted from the definition thereby exempting them
from the requirements of the bill.
CHAIR COGHILL said it was a federal preemption issue.
1:55:52 PM
REPRESENTATIVE IVY SPOHNHOLZ, Alaska State Legislature, Juneau,
Alaska, sponsor of HB 123, said her minor concern about reducing
the number of prices a facility is required to post from 50 to
[25] is ameliorated by a forthcoming amendment.
CHAIR COGHILL advised that the amendment he had drafted would
take 10 common health care services from each of the six
sections of Category I, Current Procedural Terminology. The idea
is to provide patients with the most relevant information.
REPRESENTATIVE SPONHOLHLZ clarified that she supports the CS
with the forthcoming amendment.
1:57:51 PM
CHAIR COGHILL opened public testimony on HB 123.
1:58:34 PM
GINA BOSNAKIS, representing self, Anchorage, Alaska, said she is
a small business owner and has worked in the Alaska employee
benefits industry for over 30 years. Outside of a death claim,
the most difficult part of her job is receiving a call from a
patient who thought they'd done everything they were supposed to
do to make sure they were getting their procedure from the right
doctor or facility, but they did not ask if the provider was a
preferred provider or in-network with their insurance company.
If they aren't, it changes the whole dynamic for the patient.
She said HB 123 will make it easier for the patient to find out
approximately what their out-of-pocket expenses will be if the
provider is in-network with their insurance company and what the
procedure code for the recommended treatment will be. If the
provider is not in-network, the patient will know their out-of-
pocket expenses will almost certainly be much more than
anticipated. At that point they can and probably should consider
other options such as traveling outside of the state for their
care. Most insurance companies in Alaska offer that option.
If HB 123 becomes law as written, it will absolutely save a lot
of Alaskans from unnecessary debt and potentially curb the high
cost of health care and therefore health insurance in Alaska.
She said she believes with all her heart that the positive
impacts of HB 123 will be felt in every city, borough, and
village in Alaska.
2:02:03 PM
JENNIFER MEYHOFF, representing self, Anchorage, Alaska, said she
is a principal with Marsh & McLennan Agency which is part of the
worldwide consulting firm, Marsh & McLennan Company. She has
over 25 years of experience working with employers on their
employee benefits and what can be affordable. She asked members
to think about the economic decisions they make in an average
day about purchasing various goods and services in the market.
She also asked them to think about the complexity of exploring
for oil and getting it to market and that the company can tell
you to the penny what the price will be before you buy it. She
pointed out that throughout the day and in virtually all aspects
of life, consumers are participants in the market and the
exchange of goods and services. The price of the good or service
is known and communicated before every transaction, except when
you go to the doctor or the hospital.
Medical providers have said they can't disclose prices because
it's just too complicated, but there are a lot of complicated
goods and services in the marketplace and somehow consumers
figure it out. She said a lot needs to be done to help rebalance
the health care marketplace and HB 123 is an important part.
It's time to empower consumers with information to make good
economic decisions about their health care just like the
information most consumers use to make good economic decisions
throughout their average day. HB 123 provides that opportunity
and will help toward containing the cost of health care.
CHAIR COGHILL noted who was available to answer questions.
2:05:08 PM
SHAUN LEWIS, representing self, Fairbanks, Alaska, said he has
been in the health insurance industry for the last 25 years. He
believes that HB 123 is a good bill because it is good for
businesses to have transparency. It will also make the consumer
responsible for looking at why doctor XYZ charges more than
doctor ABC. He said he believes posting the 25 most common
procedures is a step in the right direction. HB 123 is not a
silver bullet that will magically drive costs down, but it's a
good start in the marathon.
2:08:04 PM
TERRY ALLARD, representing the Alaska Association of Health
Underwriters, said she is a Senior Benefits Advisor with The
Wilson Agency in Anchorage, Alaska. She has been in the industry
for over 25 years and is testifying in support of HB 123. The
very high cost of health insurance is an issue the state has
been dealing with for some time. Some might say we've reached a
crisis point. Her clients have asked why expenses are so high
and what can be done about it/ There isn't a single solution,
but HB 123 is a starting point. It gives consumers the tools
they need to access information from their providers so they can
make informed decisions about when to get services, who to get
services from, and how to deal with that in their own personal
budgets. There is no silver bullet, but passage of HB 123 will,
over time, help bring health care costs down.
2:11:25 PM
ELIZABETH WARLICK, Advocacy Coordinator, Greater Fairbanks
Chamber of Commerce, Fairbanks, Alaska, said the more than 700
businesses they represent absolutely support market
transparency, information availability, and the role in
government to bring the cost of health care into balance.
2:12:13 PM
DR. THOMAS KOBYLARZ, representing self, Soldotna, Alaska, said
he appreciates the legislative efforts to control costs health
care costs. He related a personal experience of trying to get
quotes from five clinics on the cost of getting a physical
examination. He was given five different quotes over the phone.
The only issue was the lab tests were different. The exam he
chose to have took about one hour, whereas other exams he's had
lasted about 10 minutes. That illustrates a difference in the
equality of health care.
He said the biggest problem he has in his private practice is
with insurance companies. Preauthorized services are often not
paid as promised. This is frustrating to both providers and
consumers. He believes in health care transparency and
disclosure of health care costs. However, he does not want to
post a menu in his office to describe the cost of each
procedure. That won't lower prices but will make his office look
different.
2:14:28 PM
DR. HEATHER WILLIS, Governmental Affairs Chair, Alaska Dental
Society (ADS), Fairbanks, Alaska, said ADS appreciates the
intent of HB 123 to increase transparency. She highlighted that
in the dental industry it is not difficult to get accurate
estimates for a service. They have no issues with that part of
the bill. However, they do have concerns with posting the top 25
procedures and the fees. The highest fees consumers will see
will be from specialists but they won't necessarily know it is
for specialty care. Based on the fee alone, patients may go to
the wrong or an unqualified provider. She opined that posting
the fees for services tells consumers that health care is a
commodity, but it is not gas or oil. She concluded that the bill
is a step in the right directions for consumers overall, but it
will have unintended consequences as currently drafted.
2:17:24 PM
DR. GRAHAM GLASS, representing self, Anchorage, Alaska, said he
is a neurologist and past president of the Alaska State Medical
Association/ He applauds the sponsor for pushing for
transparency in health care. He referenced his practice and
noted that it can be particularly difficult for patients to ask
the right questions and get needed information about health care
costs when they've just been told they have something like
Parkinson's or ALS. He said he strongly supports good-faith
estimates and his office has been proactive in doing this. It is
appreciated and also helps the office because patients do not
like to pay surprise bills.
He said his concern with the bill relates to listing rack rates
for services because those rates almost never reflect what the
patient will actually pay for their contracted rates. It's a
little misleading on the transparency scale. He said contracted
rates would be the most valuable but that's difficult to do. He
supports good faith estimates and believes the bill could be
amended to say that "no contracts with providers are allowed to
have nondisclosure clauses." Consumers should know basically
what they're going to pay and some of that burden should be on
insurance companies, he said.
2:21:25 PM
RHONDA PROWELL-KITTER, Chief Financial Officer, Public Education
Health Trust, Anchorage, Alaska, said she is testifying as the
president of Alaskans for Sustainable Healthcare Costs. This is
a group of Alaskan employers who are working to find solutions
to the rising health care costs. They fully support HB 123 and
urge its passage. Their employees are being asked to contribute
more out-of-pocket, increase their deductibles, and to be
informed consumers. Part of being an informed consumer is
knowing the cost of services, starting with the rack rate. She
said HB 123 is not the silver bullet to bring down health care
costs, but it is the silver BB that is needed in the market.
2:23:09 PM
NIBERT LUJAN, Alaska Association of School Business Officials
(ALASBO), Juneau, Alaska, said there is a recognition in the
capitol that there are lots of cost pressures on school
districts. Flat funding results in a cut to education services.
The high cost of health care is one of those cost pressures that
school districts and all employers face. HB 123 is a bill that
can help school districts that are struggling with costs. It
won't solve the problem, but it will help health care consumers
become better consumers and hopefully bend the cost curve. She
urged passage of HB 123.
2:24:53 PM
JEANNIE MONK, Alaska State Hospital and Nursing Association
(ASHNA), Juneau, Alaska, thanked the sponsor for working with
stakeholders in the development of HB 123. She said ASHNA
supports price transparency and believes that this legislation
is a reasonable first step. They appreciate that the CS removes
the posting of Medicaid prices. Medicaid payment rates are
negotiated between the state and provider and are already
published. ASHNA also supports good faith price estimates.
Hospitals have existing systems to help patients get estimates
for planned procedures and ASHNA members believe they will be
able to comply with this legislation. She said insurers often
have access to the best data on prices and that is who consumers
should work with to get accurate information on the cost of
services, out-of-pocket expenses, and to make sure the provider
is part of the insurer's network. HB 123 is a first step toward
transparency and ASHNA looks forward to continuing to work with
the legislature on this initiative and others to help consumers.
She highlighted the fairhealthconsumer.org website as an example
of what can be done to make price transparency meaningful.
2:28:06 PM
DR. JOSEPH ROTH, MD and President elect Alaska State Medical
Association (ASMA), Juneau, Alaska, stated that ASMA supports
transparency in medicine, ongoing work on improving health care
and its costs, and good faith estimates by physicians and
insurers. However, ASMA does not support the requirement for
providers to list undiscounted charges. These charges do not
reflect what a patient will actually pay. What they pay is based
on the patient's type of insurance and whether their provider is
in-network or out-of-network. Most procedural charges cannot be
listed accurately because changes in the description of the
procedure can lead to marked changes in charges. For example,
there can be a wide disparity in cost to treat an ankle fracture
because it depends on what is done to the ankle. Another problem
is that studies show that the posting of prices by physicians
leads to increased overall health care costs. They are able to
see what other providers charge and price discrepancies narrow
in an upward fashion. Also, medical billing is a complicated
process. His office of 15 providers has 3.5 billers who are
always available to discuss the cost of a patient's medical care
based on their insurance type.
DR. ROTH advised that both he and ASMA support good faith
estimates from providers and insurers, but they believe that an
all-claims database would serve patients more fully. This means
that both insurers and providers would fully disclosure their
prices. He cautioned members against using information from an
undisclosed cost list to determine health care costs, and
encouraged them to talk to their providers and insurance
companies to get accurate information.
CHAIR COGHILL said he's been working with the sponsor to make
the information a little more valuable, but having the rack
price will be a big part of having one end of the
conversation."
DR ROTH replied the concern is that patient won't get the
information they want if insurers aren't also involved. It
shouldn't be any more difficult for insurers to provide that
information than it is for providers.
CHAIR COGHILL noted that they learned that the insurers wouldn't
be able to provide some of the information that was originally
required.
CHAIR COGHILL asked Mr. Shilling the substance of the proposed
amendment that seeks to make the price information more
valuable.
2:34:04 PM
MR. SHILLING explained that an ongoing concern has been that
listing the 25 most common procedures could result in a list of
admission or diagnostic and admission codes that are not
relevant to some consumers. To make the data more relevant, the
amendment models a bill in the Senate that provides for the
posting of the most common procedures and services within the
six different Current Procedural Terminology (CPT) categories.
CHAIR COGHILL asked the sponsor to comment on the proposed
amendment.
2:35:42 PM
REPRESENTATIVE SPOHNHOLZ said the amendment works conceptually
and it makes sense for hospitals, but the applicability may be
problematic in the various health care settings. The legal
definition of health care facility is any practice that has more
than one health care provider, which encompasses the many
facilities that do not provide services such as radiology,
anesthesiology, or surgery. She said finding something that
works for everybody has been very complicated and that is why
she and the other sponsors decided on the 50 most offered
services. That is simple enough to implement in any health care
setting.
2:37:35 PM
SENATOR WIELECHOWSKI asked for an explanation of the six
sections of Category I, Current Procedural Terminology.
REPRESENTATIVE SPOHNHOLZ listed evaluation and management,
anesthesia, surgery, radiology, pathology labs, and medicine.
The idea is to serve patients who go to a hospital as well as
the patients who only visit their local provider.
CHAIR COGHILL said he wouldn't offer the amendment today but
would bring it up again when the bill is heard on Monday. He
reiterated his concern about providing relevant information.
REPRESENTATIVE SPOHNHOLZ noted she had samples from members of
ASHNA that show the top 50 procedures in several health care
facilities in the state.
CHAIR COGHILL removed his objection and version Q was adopted.
2:40:15 PM
CHAIR COGHILL held HB 123 in committee for further
consideration.
2:40:37 PM
At ease
HB 259-CONFINING VEHICLE LOADS
2:42:36 PM
CHAIR COGHILL reconvened the meeting and announced the
consideration of HB 259. He noted the proposed committee
substitute (CS) that corrects an issue that the sponsor and the
Department of Law identified.
2:43:37 PM
SENATOR COSTELLO moved to adopt the [Senate CS] for HB 259,
version G, as the working document.
CHAIR COGHILL objected for an explanation.
2:44:17 PM
JORDAN SHILLING, Staff, Senator John Coghill, Alaska State
Legislature, Juneau, Alaska, advised that the CS for HB 259
removes subsection (e) on page 2, line 24, of version S that
came to the committee. He deferred further explanation to Diane
Wendlandt with the Department of Law.
2:45:01 PM
DIANE WENDLANDT, Assistant Attorney General, Criminal Division,
Office of Criminal Appeals, Department of Law, Anchorage,
Alaska, said the primary concern is burden shifting. Subsection
(e) relies on the proof of one fact (the prior conviction) to
prove another fact (criminal negligence). There isn't a close
connection between the prior violation and the proof of criminal
negligence because there are too many factual variables in
proving criminal negligence. She noted that other statutes are
illustrative. For example, if you're trying to prove the fact
that a defendant knew he had an obligation to register as a sex
offender, proof that he has a prior conviction is a very direct
and close connection to the fact you're trying to prove.
A prior conviction of what was found to be criminal negligence
may have turned on the type of load, the means of securing the
load, the vehicle, or the route traveled. The risk really
depends on very specific facts in each case. Trying to tie the
finding of criminal negligence in a prior case with a current
one doesn't require any similarity between the two cases. That
effectively shifts the burden of showing why the cases aren't
similar to the defendant, which is generally not allowed.
MS. WENDLANDT advised that not requiring similarity between the
past and current event means you're essentially defining
criminal negligence based strictly on propensity. The defendant
was careless in the past and therefore is presumed to be
careless in the current case. Evidence Rule 404(b) allows
evidence of prior acts to be presented to the extent that it
proves things such as the absence of mistake or knowledge. What
isn't allowed is to say a person is bad or careless and that's
enough to prove that they were careless of bad in the current
case.
CHAIR COGHILL found no questions and asked the sponsor to
present the bill.
2:49:12 PM
REPRESENTATIVE LOUISE STUTES, Alaska State Legislature, Juneau,
Alaska, sponsor of HB 259, stated that the bill addresses a
serious gap in the confined load statute that only allows a $300
traffic infraction, even if a person is seriously injured as a
result of someone's negligence in securing their load. The bill
also updates the statute to include all materials that escape a
vehicle, with a few specific exemptions. It requires maintaining
six inches of freeboard or tarping loads of sand, gravel, rock,
or similar materials. This is a responsible public safety
measure that will reduce fatalities, property damage, and
roadway litter.
CHAIR COGHILL asked Mr. Gruening to go through the sectional.
2:50:50 PM
MATT GRUENING, Staff Representative Louise Stutes, Alaska State
Legislature, Juneau, Alaska, presented the following sectional
analysis for HB 259.
Section 1 on Page 1, line 3 through Page 3, line 9: AS
28.35.251 is repealed and reenacted:
Subsection (a) on Page 1, lines 4 through 7:
This subsection states that a person is guilty of the
crime of failure to contain or confine a load in the
first degree if, with a mental state of criminal
negligence, they violate (c) and as result, cause
serious physical injury to another person. Criminal
negligence applies to the act of the securing the
load. Failure to contain or confine a load in the
first degree is a class A misdemeanor.
Subsection (b) on Page 1, lines 8 through 10:
This subsection states that a person is guilty of the
crime of failure to contain or confine a load in the
second degree if, with criminal negligence, they
violate (c) and as result, cause property damage of
$5,000 or more to another person's property. Criminal
negligence applies to the act of the securing the
load. Failure to contain or confine a load in the
second degree is a class B misdemeanor.
Subsection (c)(1)(A)(i)(ii) and (B) on Page 1, line 11
through Page 2, line 7:
This subsection specifies that a person commits the
offense of failure to contain or confine a load in the
third degree if the person drives or moves a motor
vehicle loaded with any material on a highway unless
it is secured or situated in a way that prevents it
from escaping the vehicle or shifting to the extent
that the vehicle's maneuverability or stability is
adversely affected and the load is treated by methods
approved through regulation by the Department of
Public Safety that are designed to settle the load or
remove loose material before it is driven on a
highway. Failure to contain or confine a load in the
third degree is an infraction.
Subsection (c)(2) on Page 2, lines 9 through 12:
This subsection specifies that a person may drive or
move a motor vehicle loaded with sand, gravel, dirt,
rock, or similar materials if at least 6 inches of
freeboard is maintained around the perimeter of the
load or a cover is used and securely fastened.
Subsection (d)(1) on Page 2, lines 13 through 16:
This subsection is an exemption that specifies that
the provisions of this act do not apply to a vehicle
that deposits sand, liquids, or other materials for
the purpose of cleaning, maintaining, or improving
traction on the highway.
Subsection (d)(2) on Page 2, lines 17 through 18:
This subsection is an exemption that specifies that
the provisions of this act do not apply to commercial
motor vehicles that are subject to federal motor
carrier securement standards implemented through state
or federal law.
Subsection (d)(3) on Page 2, lines 19 through 20:
This subsection is an exemption that specifies that
the provisions of this act do not apply to the natural
accumulation of snow, ice, mud, dirt, or similar
materials.
Subsection (d)(4) on Page 2, line 21:
This subsection is an exemption that specifies that
the provisions of this act do not apply to a vehicle
that is removing snow or hauling snow after removal.
Subsection (d)(5) on Page 2, lines 22 through 23:
This subsection is an exemption that specifies that
the provisions of this act do not apply to random
litter escaping a vehicle. Litter is defined in this
section as plastic wrappers, empty plastic bags,
leaves, paper, or similar soft materials. "Random"
modifies "litter" to clarify that a load of litter is
not exempted.
Subsection (e)(1) on Page 2, lines 25 through 26:
This subsection specifies that failure to contain or
confine a load in the first degree is a class A
misdemeanor.
Subsection (e)(2) on Page 2, lines 27 through 28:
This subsection specifies that failure to contain or
confine a load in the second degree is a class B
misdemeanor.
Subsection (e)(3)(A), (B), (C), and (D) on Page 2,
line 29 through Page 3, line 6:
This subsection specifies that failure to contain or
confine a load in the third degree is an infraction
punishable by a fine of not more than $300 on the
first offense, $750 on the second offense, $1,500 on
the third offense, and $2,500 on the fourth offense.
The penalty for the first violation is consistent with
current statute.
Subsection (f) on Page 3, lines 7 through 8:
This subsection specifies that criminal negligence in
this section has the meaning given in AS 11.81.900.
Section 2 on Page 3, lines 9 through 10. AS 28.35.253
is amended by adding a new subsection:
This section is a conforming amendment to reflect the
repeal and reenactment of AS 28.35.251 in Section 1 of
the bill and the repeal of AS 28.35.255. AS 28.35.255
currently houses the penalties for violations of both
AS 28.35.251 and AS 28.35.253. Violating AS 28.35.253
is currently an infraction and there is no substantive
change.
Section 3 on Page 3, line 11:
This section repeals 28.35.255. This is a section that
requires people to have anti-spray devices such as mud
flaps and fenders on vehicles.
2:57:39 PM
CHAIR COGHILL held HB 259 in committee for further
consideration.
HB 336-SUPPORTIVE DECISION-MAKING AGREEMENTS
2:57:53 PM
CHAIR COGHILL announced the consideration of HB 336. [CSHB
336(JUD)am was before the committee.]
2:58:11 PM
REPRESENTATIVE CHARISSE MILLETT, Alaska State Legislature,
Juneau, Alaska, introduced HB 336 speaking to the following
sponsor statement:
With over 100 wards per public guardian Alaska has one
of the highest rates of full guardianship in the
nation. Studies concerning individuals under full
guardianship have found that such individuals were
significantly less likely to have any kind of paid
employment and are less likely to be integrated into
their community, than people provided less restrictive
options to full guardianship.
Policy makers should engage in efforts to provide
adults with intellectual and developmental
disabilities (IDD) the needed tools to experience
lives with the most autonomy, freedom and independence
as possible. The Supported Decision-Making Agreements
Act does just that.
Designed as a mechanism to enable adults with IDD to
enter into newly created legal structures called
supported decision-making agreements (SDMA), House
Bill 336 will provide a less restrictive alternative
to full guardianship for adults with IDD. Guided by
the experience of other states, HB 336 will enable
adults with disabilities to maintain their rights to
make decisions currently being taken away from them by
guardianship orders.
The philosophy underpinning HB 336 contends that
adults with IDD do have and should retain their
constitutional and civil rights to live as freely and
autonomously as possible. HB 336 will help change the
current system in which one person tends makes every
decision for adults with IDD, even though those adults
have capacity to make many decisions on their own; to
a system where adults who can make life decisions with
support from others no longer have the right to make
those decisions taken away from them by the
government.
HB 336 will enable OPA to focus its efforts on adults
who truly need full guardianship, while providing
Alaskans experiencing varying levels of IDD an avenue
to live happier and healthier lives.
CHAIR COGHILL offered his understand that the bill fills the gap
between full guardianship and the need for a little help and
support.
REPRESENTATIVE MILLETT said that's correct. It's an idea that is
gaining traction throughout the nation.
3:00:35 PM
HANS RODVICK, Staff, Representative Charisse Millett, Alaska
State Legislature, Juneau, Alaska, presented the sectional
analysis for HB 336 speaking to the following prepared document:
Section One: Amending AS 13, which related to
decedents' estates, guardianships, transfers, trusts
and health care decisions, by adding a new chapter
chapter 56
13.56.010: Authorizes adults to enter into a
supported decision-making agreement (SDMA) and
spells out reasons why an adult may not enter a
SDMA.
13.56.020: Describes the requirements adults must
meet to be qualified as supporters in SDMAs.
13.56.030: Sets the parameters for what a SDMA
must contain to be legitimate. Also deals with
alternate supporters and sharing of information
amongst supporters.
13.56.040: This section lays out the precise
requirements for a SDMA to be valid, and how the
principal and supporter(s) may formalize the
signing of the SDMA.
13.56.050: Mandates that each supporter
acknowledge their relationship with the principal
and their responsibilities to support the
principal.
13.56.060: Delineates who a witness to the
signing of the SDMA can and cannot be.
13.56.070: Clarifies when a SDMA becomes
effective and how long they last.
13.56.080: This section details how either a
principal or supporter(s) of a SDMA may terminate
all or portions of a SDMA. Likewise, explains
what happens to a SDMA if only portions of it are
terminated.
13.56.090: States the general duties of
supporters.
13.56.100: Outlines the areas of a principal's
life, including health, finances, education and
communication, that a supporter may provide
support in. Also provides a way for supporters to
help the principal deal with health information
covered under federal healthcare privacy laws.
13.56.110: Prohibits supporters from wrongfully
guiding and influencing the principal in a
harmful manner. This section also prohibits
supporters from using or obtaining the
principal's personal information without their
consent.
13.56.120: Requires the supporter(s) of a
principal to keep all information related to the
principal confidential, protected and shielded
from unauthorized use.
13.56.130: Directs people who interact with
principals/supporter(s) to recognize the
communication, requests and decisions made by the
principal (with support from the supporter(s)) as
if that communication, request or decision was
made solely by the principal.
13.56.140: This section absolves a person (for
three distinct reasons) from civil or criminal
liability or discipline for unprofessional
conduct if they either comply or decline to
comply with an authorization in a SDMA.
13.56.150: Delineates the circumstances in which
a principal is capable and has capacity. A
principal doesn't lack capacity based on how they
communicate. Likewise, a principal may make
decisions without the support of a supporter(s).
Lastly, the existence of a SDMA doesn't mean a
principal lacks capacity.
13.56.160: Deals entirely with the affairs of a
principal that a SDMA may cover. Work,
healthcare, support services education, finances,
living arrangements and more are all discussed.
13.56.170: This section spells out the multitude
of support services, as referenced in 13.56.160,
that supporters may provide the principal as
agreed upon in the SDMA.
13.56.180: This section creates a statutory form
for supported decision-making agreements as
prescribed in the other sections of HB 336.
1) Introduction: Principal declares their
desire to enter a SDMA.
2) Supporters: Supporters fill out their
information and select what they will be
helping the principal with. Provides for an
alternate supporter to enter the SDMA.
3) Information Access Forms: Enables
supporters to obtain the principal's private
information.
4) Guardians and Conservators: Principal
must declare whether they have a guardian or
conservator.
5) Notice to Third Parties: Outlines the
rights and obligations of supporters and
ensures that a third party must recognize a
principal's request or decision as declared
under AS 13.56.130.
6) Duration and Termination of Agreement:
Principals may end the agreement at any time
by giving notice to their supporters.
7) Signature of Principal: Recognition of
voluntary signature of the principal to
enter the SDMA
8) Signatures of Supporters: Self
explanatory
9) Declaration of Supporters: Supporters and
possible alternate supporter sign again and
acknowledge their role to help the principal
with the mutually agreed upon terms.
10) Notarization or Witnessing: Provides
area for notary or two witnesses to sign and
make the SDMA official.
11) Approval by Guardian: Space for the
guardian to approve the principal entering
the SDMA.
12) Approval by Conservator: Space for a
conservator to approve the principal
entering the SDMA.
13.56.190: Definitions
13.56.195: The short title of House Bill 336 is
the Supported Decision-Making Agreements Act.
Section 2: Amends Alaska Court Rule 402, Alaska Rules
of Evidence, to clarify that the execution of a SDMA
cannot be used as evidence of a principal's
incapacity.
Section 3: Amends the uncodified law of Alaska by
amending Court Rule 402 and clarifies the two-thirds
majority vote of each house needed to achieve such
action.
3:05:10 PM
CHAIR COGHILL asked if this was based on a model act.
MR. RODVIK said no, but the association that deals with
guardianships and this type of disability legislation recognizes
supported decision-making agreements as a legitimate alternative
to guardianship and recommends it in their national legislation.
3:05:45 PM
CHAIR COGHILL held HB 336 in committee for future consideration.
3:06:41 PM
There being no further business to come before the committee,
Chair Coghill adjourned the Senate Judiciary Standing Committee
meeting at 3:06 p.m.