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30th Legislature(2017-2018)

Bill Text 30th Legislature


00 Enrolled SB 105                                                                                                         
01 Relating to the licensure of marital and family therapists; providing for a state policy relating                       
02 to children; relating to medical assistance for marital and family therapy services; relating to                        
03 disclosure of health care services and price information; relating to health care insurers; and                         
04 providing for an effective date.                                                                                        
05                           _______________                                                                               
06    * Section 1. AS 08.63.100(a) is amended to read:                                                                     
07            (a)  The board shall issue a license to practice marital and family therapy to a                             
08       person who                                                                                                        
09                 (1)  applies on a form provided by the board;                                                           
10                 (2)  pays the fee established under AS 08.01.065;                                                       
11                 (3)  furnishes evidence satisfactory to the board that the person                                       
12                      (A)  has not engaged in conduct that is a ground for imposing                                      
13            disciplinary sanctions under AS 08.63.210;                                                                   
14                      (B)  holds a master's degree or doctorate in marital and family                                    
01            therapy or allied mental health field from a regionally accredited educational                               
02            institution approved by the board for which the person completed a course of                                 
03            study that included instruction substantially equivalent to the following:                                   
04                           (i)  three courses or nine semester or 12 quarter hours of                                    
05                 course work in marital and family therapy;                                                              
06                           (ii)  three courses or nine semester or 12 quarter hours of                                   
07                 course work in marital and family studies;                                                              
08                           (iii)  three courses or nine semester or 12 quarter hours                                     
09                 of course work in human development;                                                                    
10 (iv)  one course or three semester or four quarter hours                                                                
11                 of course work in professional studies or professional ethics and law;                                  
12 (v)  one course or three semester or four quarter hours of                                                              
13                 course work in research; and                                                                            
14 (vi)  one year of supervised clinical practice in marital                                                               
15                 and family therapy;                                                                                     
16 (C)  after receiving a degree described in (B) of this paragraph,                                                       
17            has                                                                                                          
18 [(i)]  practiced supervised marital and family therapy,                                                               
19 including 1,700 [1,500] hours of [DIRECT] clinical contact with                                                       
20                 couples, individuals, and families; the 1,700 hours of [AND                                           
21 (ii)  BEEN SUPERVISED IN THE] clinical contact                                                                          
22 must include [FOR] at least [200 HOURS, INCLUDING] 100 hours                                                          
23 of individual supervision and 100 hours of group supervision approved                                                   
24 by the board; the 100 hours of individual supervision and 100 hours                                                   
25 of group supervision may be conducted by one or more                                                                  
26                 supervisors;                                                                                          
27                      (D)  has received training related to domestic violence; and                                       
28 (E)  has passed a written or oral examination administered by                                                           
29            the board.                                                                                                   
30    * Sec. 2. AS 08.63.120(b) is amended to read:                                                                        
31            (b)  A person who supervises a licensee under this section during                                          
01                 (1)  individual supervision must                                                                      
02                      (A) [(1)]  have practiced marital and family therapy for five                                    
03            years;                                                                                                       
04                      (B) [(2)]  be licensed under this chapter; and                                                   
05                      (C) [(3)]  meet the minimum standards established by the board                                   
06            for approved supervisors; or                                                                               
07                 (2)  group supervision must be licensed to practice as                                                
08                      (A)  a professional counselor under AS 08.29;                                                    
09                      (B)  a marital and family therapist under this chapter;                                          
10                      (C)  a physician under AS 08.64 who is a psychiatrist;                                           
11 (D)  an advanced practice registered nurse under AS 08.68                                                             
12 who is certified to provide psychiatric or mental health services by an                                               
13            entity recognized by the Board of Nursing;                                                                 
14                      (E)  a psychologist under AS 08.86; or                                                           
15                      (F)  a clinical social worker under AS 08.95.                                                    
16    * Sec. 3. AS 18.15.360(a) is amended to read:                                                                        
17 (a)  The department is authorized to collect, analyze, and maintain databases of                                        
18       information related to                                                                                            
19                 (1)  risk factors identified for conditions of public health importance;                                
20 (2)  morbidity and mortality rates for conditions of public health                                                      
21       importance;                                                                                                       
22 (3)  community indicators relevant to conditions of public health                                                       
23       importance;                                                                                                       
24 (4)  longitudinal data on traumatic or acquired brain injury from the                                                   
25       registry established under AS 47.80.500(c)(1); [AND]                                                              
26 (5)  health care services and price information collected under                                                       
27       AS 18.23.400; and                                                                                               
28 (6)  any other data needed to accomplish or further the mission or goals                                              
29       of public health or provide essential public health services and functions.                                       
30    * Sec. 4. AS 18.23 is amended by adding a new section to read:                                                       
31              Article 4. Health Care Services and Price Information.                                                     
01 Sec. 18.23.400. Disclosure and reporting of health care services, price, and                                            
02 fee information. (a) A health care provider shall annually compile a list, including a                                  
03 brief description in plain language that an individual with no medical training can                                     
04 understand, of the 10 health care services most commonly performed by the health                                        
05 care provider in the state in the previous calendar year from each of the six sections of                               
06 Category I, Current Procedural Terminology, adopted by the American Medical                                             
07       Association and, for each of those services, state                                                                
08                 (1)  the procedure code;                                                                                
09                 (2)  the undiscounted price; and                                                                        
10                 (3)  any facility fees.                                                                                 
11 (b)  A health care facility in the state shall annually compile a list, including a                                     
12 brief description in plain language that an individual with no medical training can                                     
13 understand, of the 10 health care services most commonly performed at the health care                                   
14 facility in the previous calendar year from each of the six sections of Category I,                                     
15 Current Procedural Terminology, adopted by the American Medical Association and,                                        
16       for each of those services, state                                                                                 
17                 (1)  the procedure code;                                                                                
18                 (2)  the undiscounted price; and                                                                        
19                 (3)  any facility fees.                                                                                 
20 (c)  If, in the annual reporting period under this section, fewer than the number                                       
21 of health care services described under (a) or (b) of this section are performed by a                                   
22 health care provider or at a health care facility in the state, the provider or facility shall                          
23 include in the list required under this section all of the health care services performed                               
24 by the provider or at the facility from each of the six sections described under (a) or                                 
25       (b) of this section.                                                                                              
26 (d)  A health care provider who provides health care services at a health care                                          
27 facility in a group practice is not required to compile and publish a list under (a) and                                
28       (e) of this section if                                                                                            
29 (1)  the health care facility where the provider is in a group practice                                                 
30       compiles and publishes a list in compliance with (b) and (e) of this section; and                                 
31 (2)  the prices and fees that the provider charges are reflected in the list                                            
01       compiled and published by the health care facility.                                                               
02            (e)  A health care provider and health care facility shall publish the lists                                 
03       compiled under (a) and (b) of this section by January 31 each year                                                
04                 (1)  by providing the list to the department for entry in the department's                              
05       database under AS 18.15.360 along with the name and location of the health care                                   
06       provider or health care facility;                                                                                 
07                 (2)  by posting a copy of the list                                                                      
08                      (A)  in a font not smaller than 20 points;                                                         
09                      (B)  in a conspicuous public reception area at the health care                                     
10            provider's office or health care facility where the services are performed;                                  
11 (C)  that includes the address for the department's Internet                                                            
12            website;                                                                                                     
13 (D)  that may include a statement explaining that the                                                                   
14 undiscounted price may be higher or lower than the amount an individual                                                 
15            actually pays for the health care services described in the list;                                            
16 (E)  that includes a statement substantially similar to the                                                             
17 following: "You will be provided with an estimate of the anticipated charges                                            
18 for your nonemergency care upon request. Please do not hesitate to ask for                                              
19            information."; and                                                                                           
20 (F)  that lists any health care insurers with which the health care                                                     
21 provider or health care facility has a contract to provide health care services as                                      
22            an in-network preferred provider; and                                                                        
23 (3)  if the health care provider or health care facility has an Internet                                                
24       website, by posting the list on the website.                                                                      
25 (f)  The department shall annually compile the lists provided under (a) and (b)                                         
26 of this section by health care service and, where relevant, health care provider and                                    
27 health care facility name and location, post the information on the department's                                        
28 Internet website, and enter the information in the database maintained under                                            
29       AS 18.15.360.                                                                                                     
30 (g)  If a patient who is receiving nonemergency health care services requests an                                        
31 estimate from a health care provider, health care facility, or health care insurer of the                               
01       reasonably anticipated charges for treating the patient's specific condition, the health                          
02       care provider, health care facility, or health care insurer                                                       
03                 (1)  shall provide a good faith estimate before the nonemergency health                                 
04       care services are provided and not later than 10 business days after receiving the                                
05       request;                                                                                                          
06 (2)  shall provide the estimate in whichever of the following formats                                                   
07 the patient requests: orally, in writing, or by electronic means; if the estimate is                                    
08 provided orally, the health care provider, health care facility, or health care insurer                                 
09       shall keep a record of the estimate;                                                                              
10 (3)  is not required to disclose the charges for the total anticipated                                                  
11 course of treatment for the patient, but if the estimate does not include charges for the                               
12 total anticipated course of treatment, the estimate must include a statement explaining                                 
13 that the estimate only includes charges for a portion of the total anticipated course of                                
14       treatment; and                                                                                                    
15 (4)  may provide an estimate that includes a reasonable range of                                                        
16 charges for anticipated health care services if the charges for the services will vary                                  
17 significantly in response to conditions that the health care provider, health care                                      
18 facility, or health care insurer cannot reasonably assess before the services are                                       
19       provided.                                                                                                         
20 (h)  A good faith estimate provided by a health care provider or health care                                            
21       facility under (g) of this section must include                                                                   
22 (1)  a brief description in plain language that an individual with no                                                   
23 medical training can understand of the health care services, products, procedures, and                                  
24       supplies that are included in the estimate;                                                                       
25 (2)  a notice disclosing the health care provider's or health care facility's                                           
26 in-network or out-of-network status that is substantially similar to one of the following                               
27       forms:                                                                                                            
28 (A)  "(Name of health care provider or health care facility) is a                                                       
29 contracted, in-network preferred provider for ONLY the following plan                                                   
30 networks: (list each network or state 'NONE. YOU MAY INCUR OUT-OF-                                                      
31            NETWORK CHARGES.')";                                                                                         
01                      (B)  "(Name of health care provider or health care facility) is a                                  
02            contracted, in-network preferred provider for your insurance plan."; or                                      
03                      (C)  "(Name of health care provider or health care facility) is                                    
04            NOT a contracted, in-network preferred provider for your insurance plan.                                     
05            YOU MAY INCUR OUT-OF-NETWORK CHARGES.";                                                                      
06                 (3)  the procedure code for each health care service included in the                                    
07       estimate;                                                                                                         
08                 (4)  any facility fees, along with an explanation of the facility fees; and                             
09                 (5)  the identity, or suspected identity, of any other person that may                                  
10 charge the patient for a service, product, procedure, or supply in connection with the                                  
11 health care services included in the estimate, along with an explanation of whether the                                 
12       charges are included in the estimate.                                                                             
13 (i)  A health care provider or health care facility that provides a good faith                                          
14 estimate to a patient under (g) and (h) of this section or a health care insurer that                                   
15 provides a good faith estimate to a patient under (g) of this section is not liable for                                 
16 damages or other relief if the estimate differs from the amount actually charged to the                                 
17       patient.                                                                                                          
18 (j)  The requirement for a health care facility to provide a good faith estimate                                        
19 of reasonably anticipated charges for nonemergency health care services under                                           
20 (e)(2)(E), (g), and (h) of this section does not apply to a health care facility that is an                             
21       emergency department.                                                                                             
22 (k)  A health care provider or a health care facility that fails to comply with the                                     
23 requirements of (a) - (e), (g), or (h) of this section or a health care insurer that fails to                           
24 comply with the requirements of (g) of this section is liable for a civil penalty not to                                
25       exceed $10,000 for each violation. The department may impose a penalty                                            
26 (1)  for failure to comply with (a) - (e) of this section of not more than                                              
27       $100 for each day of noncompliance after March 31; or                                                             
28 (2)  for failure to provide a good faith estimate under (g) or (h) of this                                              
29       section of not more than $100 for each day of noncompliance.                                                      
30 (l)  A health care provider, health care facility, or health care insurer penalized                                     
31 under (k) of this section is entitled to a hearing conducted by the office of                                           
01       administrative hearings under AS 44.64.                                                                           
02            (m)  A municipality may not enact or enforce an ordinance that is inconsistent                               
03       with or imposes health care price or fee disclosure requirements in addition to the                               
04       requirements under this section or regulations adopted under this section.                                        
05            (n)  In this section,                                                                                        
06                 (1)  "department" means the Department of Health and Social Services;                                   
07 (2)  "facility fee" means a charge or fee billed by a health care provider                                              
08 or health care facility that is in addition to fees billed for a health care provider's                                 
09 professional services and is intended to cover building, electronic medical records                                     
10       system, billing, and other administrative and operational expenses;                                               
11 (3)  "health care facility" means a private, municipal, or state hospital,                                              
12 psychiatric hospital, emergency department, independent diagnostic testing facility,                                    
13 residential psychiatric treatment center as defined in AS 47.32.900, kidney disease                                     
14 treatment center (including freestanding hemodialysis units), office of a private                                       
15 physician or dentist whether in individual or group practice, ambulatory surgical                                       
16 center as defined in AS 47.32.900, free-standing birth center as defined in                                             
17 AS 47.32.900, and rural health clinic as defined in AS 47.32.900; "health care facility"                                
18       does not include                                                                                                  
19 (A)  the Alaska Pioneers' Home and the Alaska Veterans' Home                                                            
20            administered by the department under AS 47.55;                                                               
21                      (B)  an assisted living home as defined in AS 47.33.990;                                           
22 (C)  a nursing facility licensed by the department to provide                                                           
23            long-term care;                                                                                              
24 (D)  a facility operated by an Alaska tribal health organization;                                                       
25            and                                                                                                          
26 (E)  a hospital operated by the United States Department of                                                             
27 Veterans Affairs or the United States Department of Defense, or any other                                               
28            federally operated hospital or institution;                                                                  
29                 (4)  "health care insurer" has the meaning given in AS 21.54.500;                                       
30 (5)  "health care provider" means an individual licensed, certified, or                                                 
31 otherwise authorized or permitted by law to provide health care services in the                                         
01       ordinary course of business or practice of a profession;                                                          
02 (6)  "health care service" means a service or procedure provided in                                                     
03 person or remotely by telemedicine or other means by a health care provider or at a                                     
04 health care facility for the purpose of or incidental to the care, prevention, or treatment                             
05       of a physical or mental illness or injury;                                                                        
06                 (7)  "nonemergency health care service" means a health care service                                     
07       other than a health care service that is immediately necessary to prevent the death or                            
08       serious impairment of the health of the patient;                                                                  
09                 (8)  "patient" means an individual to whom health care services are                                     
10       provided in the state by a health care provider or at a health care facility;                                     
11 (9)  "third party" means a public or private entity, association, or                                                    
12 organization that provides, by contract, agreement, or other arrangement, insurance,                                    
13 payment, price discount, or other benefit for all or a portion of the cost of health care                               
14 services provided to a recipient; "third party" does not include a member of the                                        
15       recipient's immediate family;                                                                                     
16 (10)  "undiscounted price" means an amount billed for a service                                                         
17 rendered without complications or exceptional circumstances; "undiscounted price"                                       
18 does not include a negotiated discount for an in-network or out-of-network service                                      
19       rendered or the cost paid by a third party for that service.                                                      
20    * Sec. 5. AS 21.96 is amended by adding a new section to read:                                                       
21 Sec. 21.96.200. Good faith estimate. Upon request of a covered person who is                                            
22 receiving nonemergency health care services, a health care insurer shall provide a                                      
23 good faith estimate of the amount of the reasonably anticipated charges for treating the                                
24       patient's specific condition under AS 18.23.400(g).                                                               
25    * Sec. 6. AS 47.05.060 is amended to read:                                                                           
26 Sec. 47.05.060. Purpose and policy relating to children. The purpose of this                                            
27 title as it relates to children is to secure for each child the care and guidance,                                      
28 preferably in the child's own home, that will serve the moral, emotional, mental, and                                   
29 physical welfare of the child and the best interests of the community; to preserve and                                  
30 strengthen the child's family ties unless efforts to preserve and strengthen the ties are                               
31 likely to result in physical or emotional damage to the child, removing the child from                                  
01 the custody of the parents only as a last resort when the child's welfare or safety or the                              
02 protection of the public cannot be adequately safeguarded without removal; and, when                                    
03 the child is removed from the family, to secure for the child adequate custody and care                                 
04 and adequate planning for permanent placement of the child. It is the policy of the                                   
05 state to acknowledge and take into account the principles of early childhood and                                      
06 youth brain development and, whenever possible, consider the concepts of early                                        
07 adversity, toxic stress, childhood trauma, and the promotion of resilience through                                    
08       protective relationships, supports, self-regulation, and services.                                              
09    * Sec. 7. AS 47.07.030(b) is amended to read:                                                                        
10 (b)  In addition to the mandatory services specified in (a) of this section and the                                     
11 services provided under (d) of this section, the department may offer only the                                          
12 following optional services: case management services for traumatic or acquired brain                                   
13 injury; case management and nutrition services for pregnant women; personal care                                        
14 services in a recipient's home; emergency hospital services; long-term care                                             
15 noninstitutional services; medical supplies and equipment; advanced practice                                            
16 registered nurse services; clinic services; rehabilitative services for children eligible                               
17 for services under AS 47.07.063, substance abusers, and emotionally disturbed or                                        
18 chronically mentally ill adults; targeted case management services; inpatient                                           
19 psychiatric facility services for individuals 65 years of age or older and individuals                                  
20 under 21 years of age; psychologists' services; clinical social workers' services;                                      
21 marital and family therapy services; midwife services; prescribed drugs; physical                                     
22 therapy; occupational therapy; chiropractic services; low-dose mammography                                              
23 screening, as defined in AS 21.42.375(e); hospice care; treatment of speech, hearing,                                   
24 and language disorders; adult dental services; prosthetic devices and eyeglasses;                                       
25 optometrists' services; intermediate care facility services, including intermediate care                                
26 facility services for persons with intellectual and developmental disabilities; skilled                                 
27 nursing facility services for individuals under 21 years of age; and reasonable                                         
28       transportation to and from the point of medical care.                                                             
29    * Sec. 8. The uncodified law of the State of Alaska is amended by adding a new section to                            
30 read:                                                                                                                   
31 TRANSITION: REGULATIONS. The Department of Health and Social Services and                                               
01 the Board of Marital and Family Therapy may adopt regulations necessary to implement the                                
02 changes made by this Act. The regulations take effect under AS 44.62 (Administrative                                    
03 Procedure Act), but not before the effective date of the law implemented by the regulation.                             
04    * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to                            
05 read:                                                                                                                   
06 REPORT TO LEGISLATURE. (a) The Department of Health and Social Services                                                 
07 shall prepare a report that describes the effectiveness and cost-effectiveness of the coverage of                       
08 marital and family therapy services as provided in AS 47.07.030(b), as amended by sec. 7 of                             
09 this Act. The report must include the distribution of services provided by billing code and the                         
10 diversion from more expensive alternatives.                                                                             
11       (b)  On or before November 30, 2021, the Department of Health and Social Services                                 
12 shall deliver the report under (a) of this section to the senate secretary and the chief clerk of                       
13 the house of representatives and notify the legislature that the report is available.                                   
14    * Sec. 10. Section 8 of this Act takes effect immediately under AS 01.10.070(c).                                     
15    * Sec. 11. Except as provided in sec. 10 of this Act, this Act takes effect January 1, 2019.                         
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