HOUSE BILL NO. 316 "An Act relating to workers' compensation fees for medical treatment and services; relating to workers' compensation regulations; and providing for an effective date." 4:55:50 PM AT EASE 4:57:27 PM RECONVENED Co-Chair Stoltze expressed intent to introduce and hold the amendments. Representative Gara MOVED to ADOPT Amendment 1 (copy on file): Insert "(4) The fee schedules of (A) - (C) of this subsection shall not be used for any procedure or service without modification unless those fees are adequate as written to meet the service charge of providers in an area so that patient access to quality medical care is not compromised." Co-Chair Stoltze OBJECTED for discussion. Representative Gara pointed to a concern that the workers' compensation rate would be the Medicare or Medicaid rate. He understood that it was not the sponsor's intention; therefore, Amendment 1 clarified that the workers' compensation rate would not be the Medicare or Medicaid rates unless they were adequate to ensure patient access to quality medical care. He stated that the sponsor's intention was that there would be a multiplier at some point in time. Co-Chair Stoltze asked Representative Gara to withdraw the amendment to be reoffered and heard at a later time. Representative Gara WITHDREW Amendment 1. Co-Chair Stoltze explained that the amendment would be taken up at a later time and the sponsor would have a chance to comment. Representative Thompson MOVED to ADOPT Amendment 2 (28- LS1362\P.l Wallace, 4/8/14) (copy on file): Page 1, line 11: Delete "board and adopted by reference" Insert "medical services review committee [BOARD] and adopted by the board [REFERENCE]" Page 2, line 21: Delete "(1)" Delete "board" Insert "medical services review committee" Page 2, line 22: Delete "board" Insert "medical services review committee" Page 2, line 23, following "adopted": Insert "by the board" Page 2, line 23: Delete ";" Insert "." Page 2, lines 24 - 29: Delete all material. Page 3, following line 23: Insert a new subsection to read: "(p) The medical services review committee shall formulate a conversion factor and submit the conversion factor to the commissioner of labor and workforce development. If the commissioner does not approve the conversion factor, the medical services review committee shall revise the conversion factor and submit the revised conversion factor to the commissioner for approval." Page 4, following line 15: Insert a new bill section to read: "* Sec. 4. AS 23.30.395 is amended by adding a new paragraph to read: (42) "medical services review committee" means the committee established under AS 23.30.0950)." Renumber the following bill sections accordingly. Page 4, line 16: Delete "AS 23.30.097(j) - (o)" Insert "AS 23.30.097(j) - (p)" Page 4, line 18: Delete "sec. 4" Insert "sec. 5" Co-Chair Stoltze OBJECTED for discussion. Representative Thompson relayed that the amendment came at the sponsor's request. He explained that in the bill version P [CSHB 316 (L&C)] the conversion factors were set by the workers' compensation board with the recommendation of the medical services review board. Under the amendment the medical services review committee would directly set the conversion factor for the new fee schedule, which would then be submitted to the commissioner of the Department of Labor and Workforce Development (DLWD). He detailed that the workers' compensation board was comprised of 18 people. He stated that it was simpler to use the board that was already responsible for oversight of the workers' compensation system, regulation review, and serving on the hearing panels. The medical services review committee was made up of 9 people including members of the state medical association, chiropractic society, nursing home association, and a healthcare provider. ANNA LATHAM, STAFF, REPRESENTATIVE KURT OLSON, confirmed the sponsor's support of Amendment 2. She stated that the amendment would clean up the current bill so that the medical services review committee would directly set the conversion factor instead of an 18 person board tasked with other duties. The amendment would allow the DLWD commissioner to approve or deny the conversion factor set by the medical services review committee before the board adopted it into regulation. The intent was to have a person at the commissioner level approving the conversion factor to ensure that it was set at a fair and reasonable price. Vice-Chair Neuman asked what would happen to the fee schedule when a new commissioner was appointed. Ms. Latham replied that the conversion factors would continue to be set by the medical services review committee on an annual basis. The commissioner would approve the rates annually. Vice-Chair Neuman asked about sending a patient outside of the state for services. Ms. Latham referred to other legislation sponsored by Representative Olson that would require that any workers' compensation treatment out-of- state would be billed at the jurisdiction in which the patient was treated. Vice-Chair Neuman noted that it was a different bill. Ms. Latham replied that currently when a person was treated out-of-state for workers' compensation claims they could be billed at Alaska's rates. Representative Holmes asked about the intent related to Amendment 2. She wanted more information about the members on the medical services review committee. Co-Chair Stoltze replied that no action would be taken on the amendments during the current meeting. HB 316 was HEARD and HELD in committee for further consideration.