HB 29-INSURANCE COVERAGE FOR TELEHEALTH  4:42:12 PM CO-CHAIR LEDOUX announced that the final order of business would be HOUSE BILL NO. 29, "An Act relating to insurance coverage for benefits provided through telehealth; and providing for an effective date." 4:43:47 PM REPRESENTATIVE IVY SPOHNHOLZ, Alaska State Legislature, introduced HB 29, as prime sponsor, and paraphrased parts of the sponsor statement [included in the committee packet], which read in its entirety as follows [original punctuation provided]: HB 29 will enhance access to healthcare services, primarily mental health and primary care, for Alaskans who have insurance plans regulated by the state of Alaska. HB 29 does this by allowing providers who contract with insurers regulated by the state of Alaska to reimburse for services delivered through telehealth. Healthcare services are currently being delivered through telehealth all over the country, and Alaska is at the forefront of providing telehealth services for urban, rural, aging, and the underserved communities across the state, primarily through Medicaid and tribal health care. Some of the advantages of telehealth include: ? Better access and privacy in rural, remote, and urban areas of Alaska. ? Early intervention which can lead to savings. ? Greater access for referrals to providers who specialize in treating specific health issues. ? Better, and potentially quicker, access means a potential reduction in suicides, domestic violence and other serious events. ? Zero impact on state budget. ? Reduces the need for expensive medical travel. Under HB 29, telehealth benefits for covered healthcare services, including mental health benefits, will be reimbursable for health care providers licensed in the state without an initial in-person appointment. Depending on the patient's needs, a telehealth appointment can provide education, reviewing of prescriptions and checking symptoms, all at a distance on a secure system. Expanding access to healthcare delivered through telehealth will help to address some of Alaska's unique challenges due to our large geography, rural and aging communities, and statewide addiction epidemic. Telehealth can help Alaska improve access to healthcare, improve clinical outcomes and reduce health care costs. 4:45:29 PM CO-CHAIR LEDOUX sought clarification on what it means for a patient to be "monitored." REPRESENTATIVE SPOHNHOLZ related a personal anecdote to illustrate "self-monitoring" via telehealth. She explained that it's a method of transmitting information to a doctor without having to be there in person, adding that it's a way to use technology to improve access to care and reduce some of the burden of time and travel that comes with monitoring healthcare. CO-CHAIR LEDOUX asked if insurance would cover a consultation via telehealth. REPRESENTATIVE SPOHNHOLZ answered yes, consultations could be covered under insurance if this bill were to pass. She noted that some insurers in Alaska already cover telehealth, like Medicaid and tribal health, but not all private insurers do. 4:50:02 PM REPRESENTATIVE SPOHNHOLZ returned to her introduction of the bill. She stated that HB 29 would increase access to healthcare in Alaska, especially for rural communities, without having to travel for it. Referencing SB 74, she said one of the main reasons that telehealth coverage was included was to increase access to substance abuse and behavioral health treatment for individuals in rural Alaska. She said not every community can have their own behavioral healthcare provider; however, they could get access to telehealth care to speak with a substance abuse counselor, for example. She noted that Health Insurance Portability and Accountability Act (HIPAA) compliance is the reason special technology is used in telehealth communication. She offered her belief that HB 29 will reduce unnecessary medical travel, as well as unnecessary emergency room visits. She opined that even in urban communities where access to a doctor is readily available, telehealth is a better option than going in person. 4:53:29 PM BERNICE NISBETT, Staff, Representative Ivy Spohnholz, Alaska State Legislature, on behalf of Representative Spohnholz, prime sponsor of HB 29, presented the sectional analysis. She informed the committee that section 1 amends AS 21.42.422 to require insurance coverage for health benefits provided through telehealth technology. Section 2 provides the definitions for health care insurer and telehealth. Finally, sections 3 through 4, she said, speak to the insurance plans and the effective date, which is July 1, 2020. 4:55:08 PM REPRESENTATIVE FIELDS asked if the state of Alaska has quantified the amount of money spent on weekend ER or urgent care visits and how much money could be saved by using telehealth instead. REPRESENTATIVE SPOHNHOLZ replied that the state has not been able to quantify cost-savings, adding that there is cost avoidance, but there's no analysis that tracks the reduction in ER visits with the introduction of new telehealth services. She clarified that HB 29 is not covered by the Alaska Care plan because it's federally regulated. REPRESENTATIVE FIELDS asked what the potential savings are for plans covered by this bill. 4:58:31 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community & Economic Development, replied she did not have that answer right now. 4:58:49 PM REPRESENTATIVE STUTES asked if any "strictly telehealth medical facilities" currently exist. REPRESENTATIVE SPOHNHOLZ confirmed that they do, including Capstone Express and Teladoc. REPRESENTATIVE STUTES questioned whether these facilities use FaceTime. REPRESENTATIVE SPOHNHOLZ replied that they don't use FaceTime because it's not HIPAA compliant; however, there are several similar video conferencing technologies that are readily available to them. 5:01:09 PM REPRESENTATIVE HANNAN asked how many insurance companies currently use telehealth in Alaska. MS. WING-HEIER offered her understanding that currently, insurance companies are split on offering this as a benefit, adding that the reimbursement is what's in question. 5:03:01 PM MS. WING-HEIER, responding to a follow-up question from Representative Hannan, said she sees telehealth as an excellent way to allow innovation and reduce the cost of healthcare in Alaska, while increasing access to it. CO-CHAIR LEDOUX sought clarification on how someone would reach their doctor after hours via telehealth communication. REPRESENTATIVE SPOHNHOLZ explained that it depends on the clinic and the individual provider, noting that Teladoc, for example, is available 24/7. CO-CHAIR LEDOUX asked why FaceTime isn't HIPAA compliant. 5:07:08 PM WADE ERICKSON, MD, Capstone Family Medicine, replied that HIPAA compliance requires certain encryption standards that FaceTime doesn't have. CO-CHAIR LEDOUX asked if a regular telephone or cellphone can be used. DR. ERICKSON answered yes. He said it's the app on the phone that makes the difference. 5:08:12 PM CO-CHAIR LEDOUX announced that HB 29 was held over.