CSHB 414(HES): "An Act creating the Alaska Health Commission; relating to the delivery, quality, access, and financing of health care; relating to health insurers, health maintenance organizations, and medical service corporations; relating to certain civil actions against health care providers and health insurers; amending Alaska Rules of Civil Procedure 26 and 27 and Alaska Rules of Evidence 802, 803, and 804; repealing Alaska Rule of Civil Procedure 72.1; and providing for an effective date."
00CS FOR HOUSE BILL NO. 414(HES) 01 "An Act creating the Alaska Health Commission; relating to the delivery, quality, 02 access, and financing of health care; relating to health insurers, health 03 maintenance organizations, and medical service corporations; relating to certain 04 civil actions against health care providers and health insurers; amending Alaska 05 Rules of Civil Procedure 26 and 27 and Alaska Rules of Evidence 802, 803, and 06 804; repealing Alaska Rule of Civil Procedure 72.1; and providing for an effective 07 date." 08 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 09 * Section 1. FINDINGS AND INTENT. (a) The legislature finds that the access to 10 quality and affordable health care and maintenance of the public's health are vital to the public 11 interest. The legislature further finds that health care costs have grown at a rate far in excess 12 of the overall inflation rate in the economy due to several factors, including variations in 13 treatment practices of providers, cost shifting by health care providers, administrative costs 14 of insurance claims practices, unavailability of affordable insurance, costs of increasing claims
01 and liability for medical malpractice, and lack of coordination of population based public 02 health services. The legislature therefore finds a present need for long-term reform of the 03 health care system in the state. 04 (b) It is the intent of the legislature to promote access to affordable, quality health 05 care for Alaskans by the implementation of health care reform measures, the stabilization of 06 health care service costs, the collection and analysis of information and data concerning health 07 care services, and the making of recommendations based on that data to the governor and the 08 legislature. 09 * Sec. 2. AS 08.64.326 is amended to read: 10 Sec. 08.64.326. GROUNDS FOR IMPOSITION OF DISCIPLINARY 11 SANCTIONS. (a) The board may impose a sanction if the board finds after a hearing 12 that a licensee 13 (1) secured a license through deceit, fraud, or intentional 14 misrepresentation; 15 (2) engaged in deceit, fraud, or intentional misrepresentation while 16 providing professional services or engaging in professional activities; 17 (3) advertised professional services in a false or misleading manner; 18 (4) has been convicted, including conviction based on a guilty plea or 19 plea of nolo contendere, of 20 (A) a felony or other crime if the felony or other crime is 21 substantially related to the qualifications, functions, or duties of the licensee; 22 or 23 (B) a crime involving the unlawful procurement, sale, 24 prescription, or dispensing of drugs; 25 (5) has procured, sold, prescribed, or dispensed drugs in violation of 26 a law, regardless of whether there has been a criminal action; 27 (6) intentionally or negligently permitted the performance of patient 28 care by persons under the licensee's supervision that does not conform to minimum 29 professional standards even if the patient was not injured; 30 (7) failed to comply with this chapter, a regulation adopted under this 31 chapter, or an order of the board;
01 (8) has demonstrated 02 (A) professional incompetence, gross negligence, or repeated 03 negligent conduct; the board may not base a finding of professional 04 incompetence solely on the basis that a licensee's practice is unconventional or 05 experimental in the absence of demonstrable physical harm to a patient; 06 (B) addiction to, severe dependency on, or habitual overuse of 07 alcohol or other drugs that impairs the licensee's ability to practice safely; 08 (C) unfitness because of physical or mental disability; 09 (9) engaged in unprofessional conduct or in lewd or immoral conduct 10 in connection with the delivery of professional services to patients; 11 (10) has violated AS 18.16.010; 12 (11) has violated any code of ethics adopted by regulation by the board; 13 or 14 (12) [HAS DENIED CARE OR TREATMENT TO A PATIENT OR 15 PERSON SEEKING ASSISTANCE FROM THE PHYSICIAN IF THE ONLY 16 REASON FOR THE DENIAL IS THE FAILURE OR REFUSAL OF THE PATIENT 17 TO AGREE TO ARBITRATE AS PROVIDED IN AS 09.55.535(a); OR 18 (13)] has had a license or certificate to practice medicine in another 19 state or territory of the United States, or a province or territory of Canada suspended 20 or revoked unless the suspension or revocation was caused by the failure of the 21 licensee to pay fees to that state, territory, or province. 22 (b) In a case involving (a)(12) [(a)(13)] of this section, the final findings of 23 fact, conclusions of law, and order of the authority that suspended or revoked a license 24 or certificate constitutes a prima facie case that the license or certificate was suspended 25 or revoked and the grounds under which the suspension or revocation was granted. 26 * Sec. 3. AS 08.68.270 is amended to read: 27 Sec. 08.68.270. GROUNDS FOR DENIAL, SUSPENSION, OR 28 REVOCATION. The board may deny, suspend, or revoke the license of a person who 29 (1) has obtained or attempted to obtain a license to practice nursing by 30 fraud or deceit; 31 (2) has been convicted of a felony or other crime if the felony or other
01 crime is substantially related to the qualifications, functions or duties of the licensee; 02 (3) habitually abuses alcoholic beverages, or illegally uses controlled 03 substances; 04 (4) has impersonated a registered or practical nurse; 05 (5) has intentionally or negligently engaged in conduct that has resulted 06 in a significant risk to the health or safety of a client or in injury to a client; 07 (6) practices or attempts to practice nursing while afflicted with 08 physical or mental illness, deterioration, or disability that interferes with the 09 individual's performance of nursing functions; 10 (7) is guilty of unprofessional conduct as defined by regulations 11 adopted by the board; 12 (8) has wilfully or repeatedly violated a provision of this chapter or 13 regulations adopted under it; 14 (9) is professionally incompetent [; 15 (10) DENIES CARE OR TREATMENT TO A PATIENT OR PERSON 16 SEEKING ASSISTANCE IF THE SOLE REASON FOR THE DENIAL IS THE 17 FAILURE OR REFUSAL OF THE PATIENT OR PERSON SEEKING ASSISTANCE 18 TO AGREE TO ARBITRATE AS PROVIDED IN AS 09.55.535(a)]. 19 * Sec. 4. AS 09.55.535 is repealed and reenacted to read: 20 Sec. 09.55.535. MANDATORY ARBITRATION. (a) A person who files an 21 action for damages against a health care provider resulting from medical malpractice 22 shall also submit the claim to the court for arbitration. 23 (b) When a claim is submitted as required by (a) of this section, the court shall 24 appoint an arbitrator to review the claim. The arbitrator appointed to review the claim 25 shall interview the parties and examine all records or materials relating to the claim 26 and may compel the attendance of witnesses, interview the parties, or consult with 27 medical specialists. 28 (c) An arbitrator appointed under this section shall conduct a prehearing 29 settlement conference within 30 days after the appointment. The arbitrator shall 30 establish a period for discovery and a date for a hearing. The hearing date may not 31 be more than 120 days after the settlement conference.
01 (d) An arbitrator shall render a decision within 30 days after hearing a claim 02 under (c) of this section. The decision must contain findings of fact and conclusions 03 of law. The decision of the arbitrator may be rejected by a party. 04 (e) If the decision of the arbitrator is rejected by a party, the action may 05 proceed in the appropriate court. The arbitrator's decision is admissible evidence in 06 that action and may be used by a party to support or oppose a claim of damages. 07 (f) The provisions of AS 09.43.010 - 09.43.180 (Uniform Arbitration Act) 08 apply to an arbitration under this section to the extent the provisions do not conflict 09 with the provisions of this section. 10 * Sec. 5. AS 09.55.536 is amended to read: 11 Sec. 09.55.536. EXPERT ADVISOR [ADVISORY PANEL]. (a) In an action 12 for damages due to personal injury or death based upon the provision of professional 13 services by a health care provider [WHEN THE PARTIES HAVE NOT AGREED TO 14 ARBITRATION OF THE CLAIM UNDER AS 09.55.535,] the court shall appoint 15 within 20 days after filing of answer to a summons and complaint an [A THREE-PERSON] expert medical 16 advisor [EXPERT ADVISORY PANEL] unless the court 17 decides that an expert advisory opinion is not necessary for a decision in the case. 18 When the action is filed the court shall, by order, determine the professions or 19 specialties to be represented by [ON] the medical expert [ADVISORY PANEL], 20 giving the parties the opportunity to object or make suggestions. 21 (b) The expert advisor [ADVISORY PANEL] may compel the attendance of 22 witnesses, interview the parties, physically examine the injured person if alive, consult 23 with the specialists or learned works the advisor considers [THEY CONSIDER] 24 appropriate, and compel the production of and examine all relevant hospital, medical, 25 or other records or materials relating to the health care in issue. The advisor 26 [PANEL] may meet in camera, but shall maintain a record of any testimony or oral 27 statements of witnesses, and shall keep copies of all written statements received [IT 28 RECEIVES]. 29 (c) Not more than 30 days after selection of the advisor, the advisor [PANEL, 30 IT] shall make a written report to the parties and to the court, answering the following 31 questions and other questions submitted to the advisor [PANEL] by the court:
01 (1) What was the disorder for which the plaintiff came to medical care? 02 (2) What would have been the probable outcome without medical care? 03 (3) Was the treatment selected appropriate for the case? 04 (4) Did an injury arise from the medical care? 05 (5) What is the nature and extent of the medical injury? 06 (6) What specifically caused the medical injury? 07 (7) Was the medical injury caused by unskillful care? 08 (8) If a medical injury had not occurred, how would the plaintiff's 09 condition differ from the plaintiff's present condition? 10 (d) In any case in which the answer to one or more of the questions submitted 11 to the advisor [PANEL] depends upon the resolution of factual questions that 12 [WHICH] are not the proper subject of expert opinion, the report shall so state and 13 may answer questions based upon hypothetical facts that are fully set out in the 14 opinion. The report must [SHALL] include copies of all written statements, opinions, 15 or records relied upon by the advisor [PANEL] and either a transcription or other 16 record of any oral statements or opinions; must [SHALL] specify any medical or 17 scientific authority relied upon by the advisor [PANEL]; and must [SHALL] include 18 the results of any physical or mental examination performed on the plaintiff. The 19 advisor [EACH MEMBER] shall sign the report and the signature constitutes the 20 advisor's [MEMBER'S] adoption of all statements and opinions contained in it. An 21 advisor [; HOWEVER, A MEMBER MAY, INSTEAD OF SIGNING THE REPORT, 22 SUBMIT A CONCURRING OR DISSENTING REPORT WHICH COMPLIES WITH 23 THE REQUIREMENTS OF THIS SUBSECTION. A MEMBER] may not attest to 24 any portion of the report as to which the advisor [MEMBER] is not qualified to give 25 expert testimony. 26 (e) The report of the advisor [PANEL WITH ANY DISSENTING OR 27 CONCURRING OPINION] is admissible in evidence to the same extent as though its 28 contents were orally testified to by the person [OR PERSONS] preparing it. The court 29 shall delete any portion that would not be admissible because of lack of foundation for 30 opinion testimony, or otherwise. Either party may submit testimony to support or 31 refute the report. The jury shall be instructed in general terms that the report shall be
01 considered and evaluated in the same manner as any other expert testimony. The 02 expert advisor [ANY MEMBER OF THE PANEL] may be called by any party and 03 may be cross-examined as to the contents of the report [OR OF THAT MEMBER'S 04 DISSENTING OR CONCURRING OPINION]. 05 (f) Discovery [NO DISCOVERY] may not be undertaken in a case until the 06 report of the expert advisor [ADVISORY PANEL] is received. However, the court 07 may relax this prohibition upon a showing of good cause by a [ANY] party. If the 08 advisor [PANEL] has not completed the [ITS] report within the 30-day period 09 prescribed in (c) of this section, the court may, upon application, grant [IT] an 10 additional 30 days. 11 (g) The expert advisor is [MEMBERS OF A PANEL ARE] entitled to travel 12 expenses and per diem in accordance with state law pertaining to members of boards 13 and commissions for all time spent in preparing the [ITS] report. If an advisor [A 14 PANEL MEMBER] is called upon as a witness at trial or upon deposition, the advisor 15 [MEMBER] is entitled to payment of an expert witness fee, which may not exceed 16 $150 per day. All expenses incurred by the advisor [PANEL] shall be paid by the 17 court. However, in any case in which the court determines that a party has made a 18 patently frivolous claim or a patently frivolous denial of liability, it shall order that all 19 costs of the expert advisor [ADVISORY PANEL] be borne by the party making that 20 claim or denial. 21 (h) Parties to the case and their counsel may not initiate communication out 22 of court with an expert advisor [MEMBERS OF THE PANEL] on the subject matter 23 of the advisor's [ITS] inquiry and report or cause or solicit others to do so, except 24 through ordinary discovery proceedings. 25 * Sec. 6. AS 09.55 is amended by adding a new section to read: 26 ARTICLE 5A. CERTAIN CLAIMS AGAINST HEALTH INSURERS. 27 Sec. 09.55.565. PROCEDURE FOR CERTAIN CLAIMS AGAINST A 28 HEALTH INSURER. (a) Unless preempted by federal law that provides otherwise, 29 a person who files an action against a health insurer resulting from a failure to timely 30 pay a claim or to authorize a health care service under a plan or policy shall also 31 submit the claim to the court for arbitration.
01 (b) When a claim is submitted as required by (a) of this section, the court shall 02 appoint an arbitrator to review the claim. The arbitrator appointed to review the claim 03 shall interview the parties and examine all records or materials relating to the claim 04 and may compel the attendance of witnesses, interview the parties, or consult with 05 medical specialists. 06 (c) An arbitrator appointed under this section shall conduct a prehearing 07 settlement conference within 30 days after the appointment. The arbitrator shall 08 establish a period for discovery and a date for a hearing. The hearing date may not 09 be more than 120 days after the settlement conference. 10 (d) An arbitrator shall render a decision within 30 days after hearing a claim 11 under (c) of this section. The decision must contain findings of fact and conclusions 12 of law. The decision of the arbitrator may be rejected by a party. 13 (e) If the decision of the arbitrator is rejected by a party, the action may 14 proceed in the appropriate court. The arbitrator's decision is admissible evidence in 15 that action and may be used by a party to support or oppose a claim of damages. 16 (f) The provisions of AS 09.43.010 - 09.43.180 (Uniform Arbitration Act) 17 apply to an arbitration under this section to the extent the provisions do not conflict 18 with the provisions of this section. 19 (g) In this section, 20 (1) "health care service" has the meaning given in AS 21.86.900; 21 (2) "health insurer" has the meaning given in AS 44.19.639. 22 * Sec. 7. AS 21.51 is amended by adding new sections to read: 23 Sec. 21.51.350. PREMIUM RATES AND RATING FACTORS. A disability 24 insurer 25 (1) shall file with the director rates or rating factors for disability 26 insurance before the intended effective date of the rate or rating factor; 27 (2) may not use a rate or rating factor that has not been filed with the 28 director; and 29 (3) may file a new rate or rating factor at any time. 30 Sec. 21.51.360. RISK SHARING AND PURCHASING POOLS. After 31 consulting with and considering any reports or recommendations of the Alaska Health
01 Commission, the director shall adopt regulations to allow for the creation of pools, 02 including pools for the primary benefit of children, for the purpose of sharing risks or 03 purchasing insurance under this chapter. 04 * Sec. 8. AS 21.86.070(g) is amended to read: 05 (g) The director may require that additional relevant material considered 06 necessary by the director be submitted in order to determine the acceptability of a 07 filing made under [EITHER] (b) [OR (e)] of this section. 08 * Sec. 9. AS 21.86 is amended by adding a new section to read: 09 Sec. 21.86.075. PREMIUM RATES AND CHARGES. A health maintenance 10 organization 11 (1) shall file with the director rates, rating factors, premiums, fees for 12 services, and enrollee fees, including a change to a rate, rating factor, premium, or fee, 13 used in providing health care services to enrollees of the health maintenance 14 organization; 15 (2) may not use a rate, rating factor, premium, or fee that has not been 16 filed with the director; and 17 (3) may file a new rate, rating factor, premium, or fee at any time. 18 * Sec. 10. AS 21.86 is amended by adding a new section to read: 19 Sec. 21.86.320. RISK SHARING AND PURCHASING POOLS. After 20 consulting with and considering any reports or recommendations of the Alaska Health 21 Commission, the director shall adopt regulations to allow for the creation of pools, 22 including pools for the primary benefit of children, for the purpose of sharing risks or 23 purchasing insurance under this chapter. 24 * Sec. 11. AS 21.87.190 is repealed and reenacted to read: 25 Sec. 21.87.190. RATES AND CHARGES. A service corporation 26 (1) shall file with the director subscription rates, rating factors, fees, 27 and payment charges, including a change to a rate, rating factor, fee, or payment 28 charge, to be charged to or on account of the service corporation's subscribers; 29 (2) may not use a rate, rating factor, fee, or payment charge that has 30 not been filed with the director; and 31 (3) may file a new rate, rating factor, fee, or payment charge at any
01 time. 02 * Sec. 12. AS 21.87 is amended by adding a new section to read: 03 Sec. 21.87.285. RISK SHARING AND PURCHASING POOLS. After 04 consulting with and considering any reports or recommendations of the Alaska Health 05 Commission, the director shall adopt regulations to allow for the creation of pools, 06 including pools for the primary benefit of children, for the purpose of sharing risks or 07 purchasing insurance under this chapter. 08 * Sec. 13. AS 36.30.015 is amended by adding a new subsection to read: 09 (h) The Alaska Health Commission shall adopt regulations to manage the 10 procurement of supplies, services, and professional services necessary for its operations 11 under AS 44.19.619 - 44.19.639. The regulations must be based on principles of 12 competitive procurement, consistent with this chapter, to satisfy the requirements of 13 the Alaska Health Commission as determined by that commission. 14 * Sec. 14. AS 36.30.990(1) is amended to read: 15 (1) "agency" 16 (A) means a department, institution, board, commission, 17 division, authority, public corporation, the Alaska Pioneers' Home, or other 18 administrative unit of the executive branch of state government; 19 (B) does not include 20 (i) the University of Alaska; 21 (ii) the Alaska Railroad Corporation; 22 (iii) the Alaska Housing Finance Corporation; 23 (iv) a regional Native housing authority created under 24 AS 18.55.996 or a regional electrical authority created under 25 AS 18.57.020; 26 (v) the Department of Transportation and Public 27 Facilities, in regard to the repair, maintenance, and reconstruction of 28 vessels, docking facilities, and passenger and vehicle transfer facilities 29 of the Alaska marine highway system; 30 (vi) the Alaska Aerospace Development Corporation; 31 (vii) the Alaska State Pension Investment Board;
01 (viii) the Alaska Health Commission; 02 * Sec. 15. AS 39.25.110(11) is amended to read: 03 (11) the officers and employees of the following boards, commissions, 04 and authorities: 05 (A) Alaska Gas Pipeline Financing Authority; 06 (B) Alaska Permanent Fund Corporation; 07 (C) Alaska Industrial Development and Export Authority; 08 (D) Alaska Commercial Fisheries Entry Commission; 09 (E) Alaska Commission on Postsecondary Education; 10 (F) Alaska Aerospace Development Corporation; 11 (G) Alaska Health Commission; 12 * Sec. 16. AS 44.19 is amended by adding new sections to read: 13 ARTICLE 12. ALASKA HEALTH COMMISSION. 14 Sec. 44.19.619. CREATION OF COMMISSION. The Alaska Health 15 Commission is created in the Office of the Governor. 16 Sec. 44.19.621. PURPOSE OF COMMISSION. The purpose of the 17 commission is to improve health care in this state by 18 (1) establishing and implementing a system for collecting and analyzing 19 information and data relating to the individual and public health care needs of and 20 services provided to residents of the state; 21 (2) promoting the use of electronic data transfer and the implementation 22 of uniform procedures for billing, payment, and claim systems; 23 (3) promoting consumer confidence in the health care system through 24 rate filings by health insurers and disclosure of charges by health care providers; 25 (4) promoting consumer confidence in the health care system by 26 requiring insurers and managed care plans to fully disclose the health care benefits 27 provided under the policy or plan and explain any exclusions or restrictions on 28 benefits; disclosure should include an explanation of limitations on 29 (A) referral to a specialty physician or other provider; 30 (B) the insured's choice of provider; 31 (C) diagnostic tests, including mammography;
01 (D) prescription drugs; 02 (E) dental services; 03 (F) laboratory tests; 04 (G) mental health services; and 05 (H) reproductive tests; 06 (5) promoting the creation of pools, including pools for the primary 07 benefit of children, for the purpose of sharing risks or purchasing insurance for health 08 care services; and 09 (6) analyzing health care reform proposals, including a proposal that 10 is based on a market based single payer system; recommending health care reform 11 proposals to the governor and the legislature; and reporting to and making 12 recommendations to the governor and legislature on the following: 13 (A) defining a range of potential benefit packages for universal 14 health care coverage for residents of the state; a benefit package must include 15 coverage for health care services without containing an exclusion based on a 16 preexisting condition; 17 (B) determining the needs and requirements imposed on the 18 state by federal enactments that affect health care reform; the commission shall 19 make the determination required under this subparagraph within 60 days after 20 each measure is enacted into law; 21 (C) determining the prospective costs for recommended 22 comprehensive health care reform proposals, as requested by the governor or 23 as determined by a majority vote of the commission; 24 (D) determining financing plans for recommended proposals; 25 (E) describing administrative structures necessary to implement 26 recommended proposals; 27 (F) identifying a process to implement statewide expenditure 28 measures for health care goods and services; 29 (G) investigating health care standards of practice and 30 determining their effect on medical tort liability and other aspects of health care 31 delivery; and
01 (H) investigating alternatives to existing hospital licensing 02 requirements to allow for less use of acute care facilities. 03 Sec. 44.19.622. COMPOSITION; QUALIFICATIONS; TERMS; REMOVAL; 04 DESIGNATION OF CHAIR. (a) The commission consists of three members 05 appointed by the governor and confirmed by the legislature for six-year terms. Not 06 more than one member of the commission may be 07 (1) a health care provider; or 08 (2) employed by a health insurance company. 09 (b) A commission member may serve only one six-year term plus the 10 remainder of any unexpired term to which the member was appointed. 11 (c) The governor may remove a member of the commission only for cause. 12 (d) The governor shall designate a member of the commission to serve, at the 13 pleasure of the governor, as chair of the commission for a term of two years. The 14 governor may reappoint the same member for additional terms as chair. 15 (e) A commission member shall comply with the applicable requirements of 16 AS 39.50, and must be a state resident throughout the person's term as a member of 17 the commission. 18 Sec. 44.19.623. STAFF. The commission may employ staff as necessary to 19 carry out the purposes of this chapter. The staff of the commission is in the exempt 20 service. 21 Sec. 44.19.624. COMPENSATION. Members of the commission are in the 22 exempt service and are entitled to a monthly salary equal to Step C, Range 26, of the 23 salary schedule set out in AS 39.27.011(a) for Anchorage, Alaska. Subject to the 24 availability of appropriations, the chair may be paid at a higher step in the same range, 25 if approved by the governor. 26 Sec. 44.19.625. MEETINGS. (a) The commission shall meet publicly not less 27 than quarterly to accomplish its duties under AS 44.19.619 - 44.19.639. The 28 commission shall comply with AS 44.62.310 - 44.62.312. 29 (b) Two members of the commission constitute a quorum for the transaction 30 of business and the exercise of the powers and duties of the commission. 31 Sec. 44.19.626. POWERS AND DUTIES. (a) The commission may
01 (1) enter into contracts and execute instruments necessary for carrying 02 out its business; 03 (2) establish advisory committees to the commission to conduct 04 research or investigation and report back to the commission on findings; an advisory 05 committee must consist of at least one member of the commission and may include 06 other individuals with appropriate expertise appointed by the commission; 07 (3) adopt regulations necessary to interpret or implement 08 AS 44.19.619 - 44.19.639, including regulations establishing reasonable, necessary fees 09 for services provided by the commission. 10 (b) The commission shall 11 (1) conduct public meetings in accordance with AS 44.19.625, 12 including holding public hearings as necessary; 13 (2) collect and analyze data and information from public, private, or 14 other sources relating to the cost, delivery, or financing of health care services 15 provided to state residents; 16 (3) monitor the costs of and the access to health care services to state 17 residents; 18 (4) make reports and recommendations to the governor and legislature 19 in accordance with AS 44.19.619 - 44.19.639; 20 (5) establish a public health advisory committee that 21 (A) consists of at least one member of the commission and 22 other individuals with significant public health expertise appointed by the 23 commission; the commission shall consider public and private health care 24 professionals, labor organizations, businesses, the education system, the Alaska 25 Public Health Association, the Alaska Mental Health Board, and the Alaska 26 Native Health Board for service on the public health advisory committee, as 27 well as recognizing the need for geographic, ethnic, and cultural diversity; 28 (B) advises the commission on public health matters and the 29 integration of public health services under AS 44.19.621; 30 (C) develops a public health improvement plan as described 31 under (c) of this section;
01 (6) obtain waivers from federal agencies or under applicable federal law 02 to the extent necessary to maximize the collection and analysis of health care data. 03 (c) The plan developed by the committee under (b)(5) of this section may 04 (1) recognize the need for 05 (A) community involvement in health care planning and 06 delivery; 07 (B) attention to local needs that may vary from place to place; 08 (C) accountability for the use of public funds; 09 (D) equity and stability in the distribution of public funds; 10 (E) shared responsibility of all levels of government for 11 administering and financing public health care delivery; and 12 (F) coordination of basic public health services; and 13 (2) include 14 (A) an analysis of the health status of the residents of the state; 15 (B) an assessment of the most appropriate role for various levels 16 of government to play in addressing the health care needs of the residents of 17 the state; 18 (C) a delineation of the standards that should be used in 19 performing assessment, policy development, and quality assurance in the 20 delivery of public health services; 21 (D) documentation of the extent to which the current public 22 health system implements or achieves the standards identified under (C) of this 23 paragraph; 24 (E) identification of interjurisdictional issues involved in health 25 care access and delivery; 26 (F) recommendations, including recommendations for specific 27 legislative action when necessary, pertaining to the following: 28 (i) strategies, time lines, financial needs, and specific 29 sources of stable revenue for bringing the state public health care 30 system up to standards identified by the committee; 31 (ii) appropriate sharing of the responsibility of local,
01 regional, state, and federal government entities to deliver public health 02 care services efficiently and effectively, including recommendations for 03 organization within state government; 04 (iii) integration of the public health care system with 05 state and national health care reform efforts; 06 (iv) the committee's estimate of the optimal share that 07 public health should represent in the total health care delivery system 08 of the state, expressed in terms of a percentage of health care dollars 09 spent or in terms of public dollars per state resident; 10 (v) a program designed to give incentives to primary 11 care providers to practice in the state, especially in rural and under 12 served areas of the state. 13 Sec. 44.19.627. DUTY TO REPORT. At the request of the governor, the 14 commission shall compile and issue to the governor, the legislature, and the public a 15 report concerning its activities. 16 Sec. 44.19.628. UNIFORM DATA AND PROCEDURES FOR HEALTH 17 CLAIMS. (a) The director of the division of insurance, after considering the advice 18 of the commission, shall adopt by regulation uniform claims forms, uniform standards, 19 and uniform procedures for the processing of data relating to billing for and payment 20 of health care services provided to state residents. All health insurers shall comply 21 with the uniform claims forms, standards, and procedures established under this 22 section. 23 (b) To the extent that there is a conflict or inconsistency between a provision 24 of AS 21 that applies to a health insurer and a provision of a regulation adopted under 25 (a) of this section, the regulation governs. The director of the division of insurance 26 shall ensure that regulations adopted by the director under AS 21 that apply to a health 27 insurer are not in conflict or inconsistent with regulations adopted under (a) of this 28 section. 29 Sec. 44.19.631. DISCLOSURE OF INFORMATION; PENALTY. (a) A 30 person providing or insuring health care services in the state shall provide, upon 31 request or order of the commission, reports, data, health information, insurance
01 schedules, statistics, and other information, as determined necessary by the 02 commission, by regulation, to carry out the purposes of AS 44.19.619 - 44.19.639. 03 This subsection applies to the state and to a municipality; as well as to public and 04 private health care facilities and providers, and health care insurers and self-insurers. 05 (b) Information and data obtained or produced by the commission is subject 06 to AS 09.25.110 and 09.25.120 and regulations adopted under AS 09.25.110 and 07 09.25.120. Information or data that identifies a recipient of health care services is 08 considered to be a medical and related public health record that is subject to the 09 exception to public inspection under AS 09.25.120 and shall be kept confidential. 10 (c) A member, an employee, or an agent of the commission, or a member of 11 an advisory committee to the commission, who wrongfully discloses or who uses or 12 permits the use of confidential information or data in violation of (b) of this section 13 is guilty of a class B misdemeanor. 14 Sec. 44.19.632. IMMUNITY FROM LIABILITY. Members of the 15 commission, its employees, its agents, its advisory committee members, and persons 16 providing information and data to the commission as required under AS 44.19.619 - 17 44.19.639 are not liable for civil damages for an act or omission in the execution of 18 their authorized activities or duties under AS 44.19.619 - 44.19.639. This section does 19 not preclude liability for civil damages as a result of reckless or intentional 20 misconduct. 21 Sec. 44.19.633. OATHS; SUBPOENAS. (a) The commission may administer 22 oaths and may issue subpoenas to persons to require testimony or to require the 23 production of records, information, or data under AS 44.19.631. 24 (b) If a person disobeys or resists a lawful subpoena issued by the commission, 25 the commission may certify the facts to the superior court, and upon certification the 26 court shall issue an order directing the person to appear before the court and show 27 cause why the person should not be punished for contempt. 28 Sec. 44.19.634. APPROPRIATIONS. The legislature may appropriate a 29 portion of the proceeds of the tax on insurance premiums collected under 30 AS 21.09.210 to the Alaska Health Commission for the commission's operating costs. 31 Sec. 44.19.635. DISCLOSURE OF PROVIDER CHARGES; FINE FOR
01 NONDISCLOSURE. (a) At least annually, a provider shall compile a list of charges 02 for the 20 health care services most commonly provided by that provider. Charges for 03 hospital services may be prepared on the basis of diagnosis-related groups. Upon 04 request of a person who is considering obtaining services from a provider, the provider 05 shall provide the list of charges to the person for use in comparing charges among 06 providers. 07 (b) Upon the request of a patient and before the commencement of a medical 08 procedure, the provider shall disclose to that patient the estimated charge for the 09 procedure. The estimated charge shall be made in good faith and must be based on 10 the provider's history of charges for that procedure. Nothing in this subsection 11 requires a provider to make a charge estimate if the provider does not agree to perform 12 the procedure. 13 (c) A provider shall place the following statement either on a form to be 14 signed by the patient or in a conspicuous location on an easily readable sign: "You 15 are entitled to a charge estimate for a medical procedure before the procedure is 16 performed by your health provider." 17 (d) If the commission, after investigation of a complaint by a patient, 18 determines that a provider has not complied with this section, the commission may 19 impose a fine of up to $1,000 against the provider. The commission may impose only 20 one fine under this section against a provider in a calendar year. A provider's 21 violation of this section does not preclude the provider from collecting payment for 22 services provided. 23 (e) A provider aggrieved by a decision of the commission under this section 24 may appeal the decision to the superior court. 25 Sec. 44.19.639. DEFINITIONS. In AS 44.19.619 - 44.19.639, unless the 26 context requires otherwise, 27 (1) "commission" means the Alaska Health Commission; 28 (2) "division of insurance" means the division of insurance in the 29 Department of Commerce and Economic Development; 30 (3) "health care services" has the meaning given in AS 21.86.900; 31 (4) "health information" means all information and data relating to
01 access to or delivery or financing of health care services; 02 (5) "health insurance" has the meaning given "disability insurance" in 03 AS 21.12.050; 04 (6) "health insurer" means an entity transacting the business of health 05 insurance, a health maintenance organization under AS 21.86, a hospital service 06 corporation under AS 21.87, a medical service corporation under AS 21.87, or a 07 combined medical service and hospital service corporation under AS 21.87; 08 (7) "market based single payer system" means a system in which a 09 single entity provides health insurance to all residents of the state and the insurance 10 is based on market forces, and may include provider defined fees, defined patient 11 copayments, sliding scale copayments for the indigent, provider fees that are posted 12 or made otherwise available at the point of services, published or disseminated fees in 13 comparative lists that allow fee comparison by consumers, voluntary expenditure 14 targets, provider peer review and control of volume, utilization, and quality of health 15 services, and a regularly published description of the various types of providers 16 licensed to provide services in the benefit package; 17 (8) "pool" means a mechanism to facilitate or provide for sharing risks 18 or the purchase of health insurance in the event coverage is unavailable or 19 unobtainable; 20 (9) "provider" has the meaning given in AS 21.86.900. 21 * Sec. 17. AS 44.62.310(d) is amended to read: 22 (d) This section does not apply to 23 (1) judicial or quasi-judicial bodies when holding a meeting solely to 24 make a decision in an adjudicatory proceeding; 25 (2) juries; 26 (3) parole or pardon boards; 27 (4) meetings of a hospital medical staff; or 28 (5) meetings of the governing body or any committee of a hospital 29 when holding a meeting solely to act upon matters of professional qualifications, 30 privileges or discipline; or 31 (6) meetings of the Alaska Health Commission, except for meetings
01 concerning the adoption of regulations. 02 * Sec. 18. AS 44.66.010(a) is amended by adding a new paragraph to read: 03 (20) Alaska Health Commission (AS 44.19.619) -- June 30, 1999. 04 * Sec. 19. AS 09.55.560(2), 09.55.560(3); AS 21.86.070(e), and 21.86.070(f) are repealed. 05 * Sec. 20. Alaska Rule of Civil Procedure 72.1 is repealed. 06 * Sec. 21. APPLICABILITY. Sections 4, 5, and 6 of this Act apply to a cause of action 07 accruing on or after the effective date of this Act. 08 * Sec. 22. INITIAL APPOINTMENT OF COMMISSION MEMBERS. Notwithstanding 09 AS 44.19.622(a), enacted by sec. 16 of this Act, the terms of persons initially appointed to the 10 Alaska Health Commission under AS 44.19.622 shall be staggered as provided in 11 AS 39.05.055. 12 * Sec. 23. REAPPOINTMENT OF INITIAL APPOINTEES. Notwithstanding 13 AS 44.19.622(b), enacted by sec. 16 of this Act, a person initially appointed to the Alaska 14 Health Commission under (a) of this section may be reappointed to serve no more than one 15 six-year term as a member of the Alaska Health Commission. 16 * Sec. 24. PHASED TRANSITION PERIOD. (a) Notwithstanding the provisions of 17 AS 44.19.621 - 44.19.639, the Alaska Health Commission shall implement the provisions of 18 AS 44.19.621 - 44.19.639 on a orderly and gradual basis as follows: 19 (1) by July 1, 1995, the director of the division of insurance shall adopt 20 regulations necessary to implement the uniform claim form described by AS 44.19.628(a); 21 (2) by January 1, 1996, the commission shall complete the research necessary 22 to report recommendations to the governor and the legislature on the issues described under 23 AS 44.19.621(a)(6)(A), (C), (D), (E), and (G); 24 (3) by July 1, 1996, the commission shall complete the research necessary to 25 report recommendations to the governor and the legislature on the issues described under 26 AS 44.19.621(a)(6)(F); 27 (4) by January 1, 1997, the commission shall complete the research necessary 28 to report recommendations to the governor and the legislature on the issues described under 29 AS 44.19.621(a)(6)(H). 30 (b) Upon request of the commission, and for good cause shown, the governor may 31 grant an extension of a deadline set in (a) of this section. The governor shall inform the
01 legislature of a decision on a request to extend a deadline. 02 * Sec. 25. AS 09.55.536(f), amended by sec. 5 of this Act, amends Alaska Rules of Civil 03 Procedure 26 and 27 by providing that discovery may not be undertaken until the expert 04 advisor's report is received. 05 * Sec. 26. AS 09.55.536(e), amended by sec. 5 of this Act, amends Alaska Rules of 06 Evidence 802, 803, and 804 by providing that the expert advisor's report is admissible in 07 evidence to the same extent as though its contents were orally testified to by the advisor. 08 * Sec. 27. Section 20 of this Act takes effect July 1, 1994, only if that section receives the 09 two-thirds majority vote of each house required by art. IV, sec. 15, Constitution of the State 10 of Alaska. 11 * Sec. 28. This Act takes effect July 1, 1994.