SENATE LABOR AND COMMERCE COMMITTEE  April 18, 2000 2:04 p.m.   MEMBERS PRESENT    Senator Jerry Mackie, Chairman Senator Tim Kelly, Vice Chairman Senator Dave Donley Senator Loren Leman Senator Lyman Hoffman MEMBERS ABSENT    All Members Present   COMMITTEE CALENDAR    CS FOR HOUSE BILL NO. 121(L&C) "An Act relating to patients' rights under a health care insurance plan or contract providing coverage for dental care, and prohibiting certain practices by health care insurers relating to dental care." -MOVED OUT OF COMMITTEE HOUSE BILL NO. 303 "An Act relating to the method of payment of fees and adoption of regulations under AS 21; relating to orders under AS 21 regarding risk based capital instructions; relating to accounting standards for insurance companies; amending the definitions of 'creditable coverage' and 'late enrollees' in AS 21.54; relating to requirements for small employer insurers; relating to requirements for issuance of new voting securities by an insurance company; requiring health care insurance coverage for reconstructive surgery following mastectomy; requiring guaranteed renewability of and certification of coverage regarding certain individual health insurance policies; and providing for an effective date." -MOVED SCSHB 303 (L&C) OUT OF COMMITTEE HOUSE BILL NO. 422 "An Act relating to workers' compensation benefits for injuries resulting from consumption of alcohol or use of drugs; and providing for an effective date." -MOVED SCSHB 422 (L&C) OUT OF COMMITTEE   PREVIOUS SENATE COMMITTEE ACTION    HB 121 - No previous Senate action. HB 303 - No previous Senate action. HB 422 - No previous Senate action.   WITNESS REGISTER    Ms. Patty Swenson Staff to Representative Con Bunde Alaska State Capitol Juneau, AK 99802-1182 POSITION STATEMENT: Commented on CSHB 121. Ms. Katie Campbell Actuary L/H Division of Insurance Department of Community & Economic Development P.O. Box 110805 Juneau, AK 99811-0805 POSITION STATEMENT: Commented on HB 303.   Mr. Paul Grassi Director of Division of Workers' Compensation Department of Labor & Workforce Development P.O. Box 25512 Juneau, AK 99802-5512 POSITION STATEMENT: Commented on HB 422. Mr. William Walters Chief of Adjudications Division of Workers' Compensation Department of Labor & Workforce Development P.O. Box 107019 Anchorage, AK 99510-7019 POSITION STATEMENT: Commented on HB 422.   ACTION NARRATIVE    TAPE 00-16, SIDE A  Number 001 CHAIRMAN MACKIE called the Senate Labor and Commerce Committee meeting to order at 2:04 p.m. Present were Senators Hoffman, Leman, T. Kelly, and Mackie. The first order of business to come before the committee was CS for HB 121. HB 121-DENTAL CARE INSURANCE    MS. PATTY SWENSON, legislative aide to Representative Con Bunde, stated CSHB 121(L&C) will allow consumers to choose any dentist they wish to see including specialists. It will prevent insurers from reimbursing a covered person at a different rate because of the person's choice of dentist. CSHB 121(L&C) gives consumers the right to receive full information regarding their care options without the fear of adverse actions from insurance companies. The bill will also allow patients to take civil action against health care insurers to enforce their rights, and it requires any dental treatment plan review or utilization review to be conducted by a dentist. SENATOR LEMAN suggested letting the drafters know of the technical change to the bill in Section 1. SENATOR KELLY asked if dentists are supporting CSHB 121(L&C).   MS. SWENSON answered yes. SENATOR LEMAN moved CSHB 121(L&C) with individual recommendations and accompanying fiscal notes. Without objection, the motion carried. HB 303-MISC. INSURANCE PROVISIONS    MS. KATIE CAMPBELL, actuarial for the Division of Insurance, Department of Community & Economic Development, stated HB 303 will bring Alaska laws into compliance with federal law and it will update and clarify many of Alaska's health laws. SENATOR LEMAN moved HB 303 from committee with individual recommendations and accompanying fiscal notes. Without objection, the motion carried.   SENATOR LEMAN moved to withdraw his motion for the purpose of a specific amendment. Without objection, the motion to move HB 303 from committee was withdrawn. SENATOR LEMAN moved Amendment 1 which reads: on page 5, line 27, delete the words "and interpret." Without objection, Amendment 1 was adopted thus creating SCSHB 303 (L&C). SENATOR LEMAN moved SCSHB 303(L&C) from committee with individual recommendations and accompanying fiscal notes. Without objection, the motion carried. HB 422-WORKERS' COMPENSATION:DRUGS & ALCOHOL  CHAIRMAN MACKIE stated HB 422 was heard at a previous committee hearing but was held because Senator Donley had concerns about the proximate cause of injuries that occur on the job. Number 519 SENATOR DONLEY asked what the outcome would be if a person was excluded from workers' compensation coverage because of proximate cause. MR. PAUL GROSSI, Director of the Division of Workers' Compensation, Department of Labor & Workforce Development (DOLWD), stated Mr. Walters will answer Senator Donley's questions. SENATOR DONLEY asked what the definition of "proximate cause" is in workers' compensation claims. MR. WILLIAM WALTERS, Chief of Adjudications for the Division of Workers' Compensation, DOLWD, stated "proximate cause" is defined as the substantial cause of an accident. SENATOR DONLEY asked if, under HB 422, intoxication was a cause of an injury but the majority of the causation was from other factors, whether an employee would be excluded from workers' compensation coverage. MR. WALTERS stated HB 422 does not change the standard for intoxication at the workplace. SENATOR DONLEY stated the standard under present law is intoxication which is a higher standard than consumption. A person may have consumed alcohol but not be intoxicated so the alcohol may not have been a dominant cause. If another person was intoxicated and alcohol was the major cause of the accident, the person who had merely consumed alcohol is out of luck. He asked where that employee turns if kicked out of the workers' compensation system because of the accident. CHAIRMAN MACKIE asked whether a person who consumed two beers and, while on the work premises, was severely injured when a pallet fell off of a vehicle driving by, would be denied a workers' compensation claim. MR. WALTERS replied the person would not lose benefits if it was proven that the alcohol consumed was not a factor and the person was not impaired. CHAIRMAN MACKIE asked if Mr. Walters could think of a scenario in which a person had consumed alcohol and was involved in an accident and would be denied workers' compensation. MR. WALTERS stated any person involved in an accident who was impaired would be denied workers' compensation. CHAIRMAN MACKIE stated it would have to be proven that the impairment from the alcohol was the proximate cause of the accident. SENATOR DONLEY stated there can be more than one proximate cause of an accident. If one of the events or causes involves the consumption of alcohol, that person is denied workers' compensation. CHAIRMAN MACKIE asked if the intent of HB 422 is to give an employer who has a zero tolerance policy the ability to show that the consumption of alcohol was the cause of an accident versus having to prove absolute intoxication of an employee. MR. WALTERS stated those scenarios are hypothetical. The outcome would be different if an employer was trying to prove intoxication versus consumption and which of the two was the proximate cause of an accident. SENATOR DONLEY stated that a better standard might be to shift from intoxication to consumption and that consumption was not the dominant cause of the injury. After the situation has been assessed, consumption of alcohol may not be the only factor of proximate cause. He asked what happens to people who are denied workers' compensation coverage. MR. WALTERS stated a situation with many proximate causes, one being alcohol consumption but not intoxication, should be turned over to the Superior Court for a ruling on Workers' Compensation. SENATOR DONLEY stated that would be a good safety valve if it were part of HB 422. If 51 percent of the proximate cause was a factor other than the consumption of alcohol, that person could pursue workers' compensation or damages. CHAIRMAN MACKIE asked if Mr. Walters could see a potential problem dealing with HB 422 if it passes. MR. WALTERS replied if HB 422 passes, it should not affect the workload. SENATOR DONLEY moved a conceptual amendment (Amendment 1) as follows: on page 2, delete lines 9 and 10 and insert, on line 9, "the consumption of an alcoholic beverage, injury was not proximately caused by the intoxication of the injured employee or". SENATOR LEMAN objected. The motion carried with Senators Hoffman, Donley, and T. Kelly voting "Yea," and Senators Leman and Mackie voting "Nay." SENATOR LEMAN moved SCSHB 422 (L&C) from committee with individual recommendations and accompanying fiscal notes. Without objection, the motion carried. There being no further business to come before the committee, CHAIRMAN MACKIE adjourned the meeting at 2:27 p.m.