CSSB 367(FIN): "An Act prohibiting a civil action based on professional negligence against a health care provider by a person who on the date of the negligent act or omission is less than two years of age, unless the action is brought before the person's eighth birthday; relating to health insurance fees, charges, premiums, rates, and rating factors; relating to disclosure of health care provider prices, a health care data system, and uniform data and procedures for health care billing and payment of claims; relating to coordination of insurance benefits and to determination and disclosure of fees paid to an insured or health care provider; establishing an advisory committee on a health care plan and an advisory committee on public health; and providing for an effective date."
00CS FOR SENATE BILL NO. 367(FIN) 01 "An Act prohibiting a civil action based on professional negligence against a 02 health care provider by a person who on the date of the negligent act or 03 omission is less than two years of age, unless the action is brought before the 04 person's eighth birthday; relating to health insurance fees, charges, premiums, 05 rates, and rating factors; relating to disclosure of health care provider prices, a 06 health care data system, and uniform data and procedures for health care billing 07 and payment of claims; relating to coordination of insurance benefits and to 08 determination and disclosure of fees paid to an insured or health care provider; 09 establishing an advisory committee on a health care plan and an advisory 10 committee on public health; and providing for an effective date." 11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 12 * Section 1. AS 09.10 is amended by adding a new section to read: 13 Sec. 09.10.065. LIMITATION ON ACTIONS BY CERTAIN MINORS 14 AGAINST HEALTH CARE PROVIDERS. (a) Notwithstanding AS 09.10.140, an
01 action based on professional negligence may not be brought against a health care 02 provider by a person who is, on the date of the alleged negligent act or omission less 03 than two years of age, unless the action is brought before the person's eighth birthday. 04 (b) The limitation imposed under (a) of this section is tolled during any period 05 in which there exists 06 (1) fraud, including fraud or collusion by a parent, guardian, insurer, 07 or health care provider, resulting in the failure to bring an action on behalf of an 08 injured minor; 09 (2) intentional concealment; or 10 (3) the undiscovered presence of a foreign body, that has no therapeutic 11 or diagnostic purpose or effect, in the body of the injured person and the action is 12 based on the presence of the foreign body. 13 (c) In this section, 14 (1) "health care provider" has the meaning given in AS 21.58.400; 15 (2) "professional negligence" means a negligent act or omission by a 16 physician in rendering professional services; 17 (3) "professional services" means services provided by a health care 18 provider that are within the scope of services for which the health care provider is 19 licensed, and that are not prohibited under the health care provider's license or by a 20 hospital in which the health care provider practices. 21 * Sec. 2. AS 21.51 is amended by adding a new section to read: 22 Sec. 21.51.350. PREMIUM RATES AND RATING FACTORS. A disability 23 insurer 24 (1) shall file with the director rates or rating factors for disability 25 insurance before the intended effective date of the rate or rating factor; 26 (2) may not use a rate or rating factor that has not been filed with the 27 director; and 28 (3) may file a new rate or rating factor at any time. 29 * Sec. 3. AS 21 is amended by adding a new chapter to read: 30 CHAPTER 58. HEALTH CARE. 31 Sec. 21.58.010. REQUIRED AVAILABILITY OF PRICE LIST. A health care
01 provider shall prepare a list of the provider's prices that includes the dates during 02 which the prices will be applicable. The price list shall be made available either by 03 posting the price list in a conspicuous location in the health care provider's office or 04 by similarly posting a notice that the price list is available for review upon request. 05 The contents of the price list required under this section must include the provider's 06 40 most commonly provided health care services or those health care services provided 07 more than five times in a calendar year, whichever would result in a shorter price list 08 of health care services. 09 Sec. 21.58.020. HEALTH CARE DATA SYSTEM. (a) The Department of 10 Commerce and Economic Development shall develop and may, subject to 11 appropriation, periodically update a health care data system. To the extent practicable, 12 the data system base year shall be calendar year 1995 and the system may include 13 (1) health care expenditures, including capital expenditures associated 14 with receiving health care; 15 (2) demographic data; 16 (3) clinical information in a format that does not identify individual 17 patients, including diagnosis, type of provider, type of service, location and length of 18 care, referral patterns, quality of care, and result of care; 19 (4) billing and payment data in a format that does not identify 20 individual patients; and 21 (5) public health data, including vital statistics and health status. 22 (b) The commissioner may request health care data necessary to develop or 23 update the data system required under (a) of this section from a health care provider 24 or insurer. A health care provider or insurer who receives a request from the 25 commissioner under this subsection may, but is not required to, comply with the 26 request. 27 (c) Information and data obtained or produced by the director under this 28 section, except as provided under (d) of this section, shall be kept confidential as a 29 matter of law. A person who wrongfully discloses or who uses or permits the use of 30 confidential information or data in violation of this subsection is guilty of a class B 31 misdemeanor.
01 (d) Information or data regarding health care services 02 (1) may be disclosed in an aggregate form that does not identify an 03 individual recipient or health care provider; and 04 (2) that identify an individual recipient may be disclosed to a health 05 care provider, if the individual recipient has agreed to release the information or data. 06 Sec. 21.58.030. UNIFORM DATA AND PROCEDURES FOR HEALTH 07 CLAIMS. (a) The director shall adopt by regulation uniform claims forms, uniform 08 standards, and uniform procedures for the processing of data relating to billing for and 09 payment of health care services provided to residents of the state. A health insurance 10 company shall comply with the uniform claims forms, standards, and procedures 11 established under this section. 12 (b) The director shall ensure that other regulations adopted by the director 13 under this title that apply to a health insurer are not in conflict or inconsistent with 14 regulations adopted under (a) of this section. 15 Sec. 21.58.040. APPROPRIATIONS. The legislature may appropriate a 16 portion of the proceeds of the tax on insurance premiums collected under 17 AS 21.09.210 to pay the administrative costs of this chapter. 18 Sec. 21.58.400. DEFINITIONS. In this chapter, 19 (1) "commissioner" means the commissioner of commerce and 20 economic development; 21 (2) "health care provider" means an acupuncturist licensed under 22 AS 08.06; an audiologist licensed under AS 08.11; a chiropractor licensed under 23 AS 08.20; a dental hygienist licensed under AS 08.32; a dentist licensed under 24 AS 08.36; a marital or family therapist licensed under AS 08.63; a direct-entry 25 midwife certified under AS 08.65; a nurse licensed under AS 08.68; a dispensing 26 optician licensed under AS 08.71; a naturopath licensed under AS 08.45; an 27 optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a physical 28 therapist or occupational therapist licensed under AS 08.84; or a physician's assistant 29 certified under AS 08.64; a physician licensed under AS 08.64; a podiatrist; a 30 psychologist and a psychological associate licensed under AS 08.86; a clinical social 31 worker licensed under AS 08.95; an emergency medical technician certified under
01 AS 18.08.082; a mobile intensive care paramedic trained as required under 02 AS 18.08.082; a health maintenance organization as defined in AS 21.86.900; a 03 hospital or medical service corporation as defined in AS 21.87.330; a hospital as 04 defined in AS 18.20.130, including a governmentally owned or operated hospital; and 05 an employee of a health care provider acting within the course and scope of 06 employment; 07 (3) "health care services" means preventive, diagnostic, medical, 08 surgical, reproductive, psychiatric, psychologic, rehabilitative, health maintenance, 09 dental, podiatric, optometric, optical, audiologic, nutritive, and chiropractic care; 10 prescription drugs, laboratory and radiologic services, medical supplies, durable 11 medical equipment and devices; personal assistance services; inpatient and outpatient 12 care; home health care; hospice care; and long-term or institutional care; 13 (4) "health insurance" means an individual or group contract or other 14 plan providing coverage of health care services that is issued by the corporation or by 15 a health insurance company, a hospital service corporation, a medical service 16 corporation, or a health maintenance organization; "health insurance" includes disability 17 insurance under AS 21.12.050; 18 (5) "health insurance company" means an insurer that is authorized to 19 transact health insurance. 20 * Sec. 4. AS 21.86.070(g) is amended to read: 21 (g) The director may require that additional relevant material considered 22 necessary by the director be submitted in order to determine the acceptability of a 23 filing made under [EITHER] (b) [OR (e)] of this section. 24 * Sec. 5. AS 21.86 is amended by adding a new section to read: 25 Sec. 21.86.075. PREMIUM RATES AND CHARGES. A health maintenance 26 organization 27 (1) shall file with the director rates, rating factors, premiums, fees for 28 services, and enrollee fees, including a change to a rate, rating factor, premium, or fee, 29 used in providing health care services to enrollees of the health maintenance 30 organization; 31 (2) may not use a rate, rating factor, premium, or fee that has not been
01 filed with the director; and 02 (3) may use a new rate, rating factor, premium, or fee at any time. 03 * Sec. 6. AS 21.86.260(a) is amended to read: 04 (a) Except as provided in AS 21.56, AS 21.89.100 - 21.89.120, and in this 05 chapter, this title does not apply to a health maintenance organization that obtains a 06 certificate of authority under this chapter. This subsection does not apply to an insurer 07 licensed under AS 21.09 or a hospital or medical service corporation licensed under 08 AS 21.87 except with respect to its health maintenance organization activities 09 authorized by and regulated under this chapter. 10 * Sec. 7. AS 21.87.190 is repealed and reenacted to read: 11 Sec. 21.87.190. RATES AND CHARGES. A service corporation 12 (1) shall file with the director subscription rates, rating factors, fees, 13 and payment charges, including a change to a rate, rating factor, fee, or payment 14 charge, to be charged to or on account of the service corporation's subscribers; 15 (2) may not use a rate, rating factor, fee, or payment charge that has 16 not been filed with the director; and 17 (3) may file a new rate, rating factor, fee, or payment charge at any 18 time. 19 * Sec. 8. AS 21.87.340 is amended to read: 20 Sec. 21.87.340. OTHER PROVISIONS APPLICABLE. In addition to the 21 provisions contained or referred to previously in this chapter, the following chapters 22 and provisions of this title also apply with respect to service corporations to the extent 23 applicable and not in conflict with the express provisions of this chapter and the 24 reasonable implications of the express provisions, and for the purposes of the 25 application the corporations shall be considered to be mutual "insurers": 26 (1) AS 21.03; 27 (2) AS 21.06; 28 (3) AS 21.09, except AS 21.09.090; 29 (4) AS 21.18.010; 30 (5) AS 21.18.030; 31 (6) AS 21.18.040;
01 (7) AS 21.18.120; 02 (8) AS 21.21.321; 03 (9) AS 21.36; 04 (10) AS 21.42.345 - 21.42.365, 21.42.375, 21.42.380, and 21.42.385; 05 (11) AS 21.51.120; 06 (12) AS 21.53; 07 (13) AS 21.54.020; 08 (14) AS 21.56; 09 (15) AS 21.69.400; 10 (16) AS 21.69.520; 11 (17) AS 21.69.600, 21.69.620, and 21.69.630; 12 (18) AS 21.78; 13 (19) AS 21.89.040; 14 (20) AS 21.89.060 and 21.89.100 - 21.89.120; 15 (21) AS 21.90. 16 * Sec. 9. AS 21.89 is amended by adding new sections to read: 17 Sec. 21.89.100. REQUIRED PROVISIONS REGARDING COORDINATION 18 OF BENEFITS. (a) When an insured has coverage under two or more plans that 19 provide for coordination of benefits, the coverage from those plans must be 20 coordinated so that the insured receives the maximum allowable benefit from each 21 plan. The aggregate benefit should be more than that offered by any of the plans 22 individually, but the insured may not receive more than the total of the charges for the 23 health care services received. 24 (b) A plan that provides for coordination of benefits must contain a provision 25 that 26 (1) discloses that coordination of benefits applies when the insured has 27 health care coverage under more than one plan; 28 (2) states what benefits from the plan and other sources are recognized 29 under the coordinating provision and that indicates if one or more plan benefits are 30 exempt from the coordinating provision; 31 (3) states what health care expenses are allowable and what health care
01 expenses are excluded under the coordinating provision; 02 (4) states the claim period to be used in applying the coordinating 03 benefits provision; a claim period may not be less than 12 months, but may exclude 04 a period before coverage starts or after coverage ends; 05 (5) indicates the manner in which benefits are reduced by coordination; 06 a reduction in benefits is subject to the following order of benefit provisions: 07 (A) plan benefits applicable to an insured as an employee, 08 member, or subscriber, and also as a dependent, are first determined as benefits 09 applicable to the insured as employee, member, or subscriber; 10 (B) if a minor is eligible for benefits as a dependent of more 11 than one insured, the plan of the insured whose date of birth falls earlier in the 12 year is applied first, unless a different order of application is required by a 13 court; 14 (C) benefits not determined under this paragraph that are 15 applicable under more than one plan are determined under that plan applicable 16 to the insured for the longer period of time; 17 (D) when one of the plans is a medical plan and the other is a 18 dental plan, and a determination cannot be made under the provisions of (A) -(C) of this paragraph, the medical plan 19 shall be considered as the primary 20 coverage; 21 (E) if under the provisions of (A) - (D) of this paragraph the 22 plan is secondary to another source of benefits, the benefits of the plan may not 23 be reduced unless the sum of benefits payable for allowable expenses and the 24 benefits payable for allowable expenses under the other source exceed the 25 allowable expenses in a claim determination period; 26 (6) provides that the insurer has the right to receive and to release 27 information necessary to expedite a claim payment when coordinating benefits; 28 (7) allows the insurer to make a payment necessary to repay another 29 insurer for a payment that should have been made under the policy applicable to the 30 insured; and 31 (8) gives the insurer the right to recover excess payments from the
01 insured paid to another insurer providing benefits to the insured. 02 (c) In coordinating benefits from a plan that contractually reduces the fees for 03 services that participating health care providers accept as payment in full, the following 04 rules apply: 05 (1) when the reduced fee plan is the primary coverage and treatment 06 is provided by a participating health care provider, the reduced fee is that health care 07 provider's full fee; a secondary plan shall pay the lesser of its allowed benefit or the 08 difference between the primary plan's benefit and the reduced fee; 09 (2) when the reduced fee plan is the primary coverage and treatment 10 is provided by a nonparticipating health care provider, the reduced fee plan shall 11 provide its allowed amount for nonparticipating health care providers and the 12 secondary plan shall pay the lesser of 13 (A) its allowed benefit for the service; 14 (B) the difference between the primary plan's benefits for the 15 service and the health care provider's full fee; 16 (3) when a full fee plan is the primary coverage and a reduced fee plan 17 is secondary coverage, the full fee plan shall provide its allowed amount for the 18 service and the secondary plan shall pay the lesser of its allowed benefit for the service 19 or the difference between the primary plan's benefits and the health care provider's full 20 fee. 21 (d) In coordinating benefits between an indemnity and a capitation plan, the 22 following rules apply: 23 (1) when the capitation plan is the primary coverage, the capitation 24 payments to the treating health care provider remain the capitation plan's usual 25 benefits; the indemnity plan shall pay benefits for the patient's surcharges or 26 copayments up to the indemnity plan's allowable benefit; 27 (2) when the indemnity plan is the primary coverage and treatment is 28 received from a health care provider who is participating in a capitation plan, the 29 indemnity plan shall pay its allowable benefits; the capitation payments to the health 30 care provider are secondary coverage; 31 (3) when the indemnity plan or policy is the primary coverage, and
01 treatment is received from a health care provider who is not participating in a 02 capitation plan , the indemnity plan shall pay its allowable benefits; the capitation plan 03 shall pay benefits, in keeping with the capitation plan's allowed amount for treatment 04 by nonparticipating health care providers; 05 (4) a plan may not contractually direct a health care provider to charge 06 a secondary insurer for more than the amount that would be charged to the insured 07 absent secondary coverage. 08 (e) A certificate indicating insurance coverage must contain a summary of the 09 provisions in this section regarding coordination of benefits. 10 Sec. 21.89.110. DETERMINATION AND DISCLOSURE OF USUAL, 11 CUSTOMARY, AND REASONABLE FEES. An insurer who pays a claim under a 12 disability policy or an indemnity under a group or blanket disability insurance policy, 13 a health maintenance organization that adopts a schedule of charges, or a hospital or 14 medical service corporation that pays a subscriber or compensates a health care 15 provider on the basis of a usual, customary, or reasonable fee or charge shall 16 (1) maintain and use a statistically credible profile of fees of health care 17 providers in this state on which to base payment of the claim; the profile must (A) be 18 updated at least once every six months and may not contain fees for services 19 performed more than one year before the date of the most recent profile; (B) contain 20 fees for the geographic area in which a claimant might receive treatment; and (C) may 21 not include fees clearly marked "DO NOT PROFILE"; if statistically credible data for 22 a particular health care service in a certain geographic area does not exist, the insurer 23 may include in the profile a sufficient number of fees for that service from another 24 geographic area in order to establish a reliable data base; however, the final basis for 25 payment must be adjusted to reflect the general cost difference between the geographic 26 area where the service was performed and the other geographic area used in 27 establishing the statistically credible profile; the adjustment may be based upon the 28 Consumer Price Index, the medical care component of the Consumer Price Index, or 29 a reasonable basis stated in writing and determined acceptable by the director; 30 (2) respond within 15 working days after receiving a written request 31 from an insured, a health care provider with a valid assignment of payments, or a
01 health care provider engaged to provide services under a professional services contract, 02 with a full written disclosure of the methods employed under (1) of this section that 03 resulted in the difference between the amount paid on a claim for benefits and the 04 actual charges submitted; and 05 (3) disclose in a proposal for insurance, a policy of insurance, a 06 certificate of insurance, an employee benefit description or supplemental document, or 07 a professional service contract between an insurer and a health care provider 08 (A) the frequency with which the insurer determines the usual, 09 customary, and reasonable fee; 10 (B) a general description of the methodology used to determine 11 the usual, customary, and reasonable fee; 12 (C) the percentile of usual, customary, and reasonable fees at 13 which the insurer will reimburse the insured, or the contract health care 14 provider. 15 Sec. 21.89.120. DEFINITIONS FOR AS 21.89.100 - 21.89.120. In 16 AS 21.89.100 - 21.89.120, 17 (1) "health care provider" has the meaning given in AS 21.58.400; 18 (2) "health care service" has the meaning given in AS 21.87.330; 19 (3) "plan" means a group or blanket disability policy issued under 20 AS 21.54, small employer coverage issued under AS 21.56, evidence of coverage 21 issued under AS 21.86, or a subscriber contract issued under AS 21.87; 22 (4) "professional services contract" includes a contract for professional 23 services between a health care provider and insurer or health maintenance corporation, 24 and a service contract between a health care provider and a hospital or medical service 25 corporation; 26 (5) "service corporation" has the meaning given in AS 21.87.330. 27 * Sec. 10. Section 7, ch. 39, SLA 1993, is amended to read: 28 Sec. 7. AS 21.86.260(a) is repealed and reenacted to read: 29 (a) Except as provided in AS 21.89.100 - 21.89.120 and this chapter, this title 30 does not apply to a health maintenance organization that obtains a certificate of 31 authority under this chapter. This subsection does not apply to an insurer licensed
01 under AS 21.09 or a hospital or medical service corporation licensed under AS 21.87 02 except with respect to its health maintenance organization activities authorized by and 03 regulated under this chapter. 04 * Sec. 11. Section 9, ch. 39, SLA 1993, is amended to read: 05 Sec. 9. AS 21.87.340 is repealed and reenacted to read: 06 Sec. 21.87.340. OTHER PROVISIONS APPLICABLE. In addition to the 07 provisions contained or referred to previously in this chapter, the following chapters 08 and provisions of this title also apply with respect to service corporations to the extent 09 applicable and not in conflict with the express provisions of this chapter and the 10 reasonable implications of the express provisions, and for the purposes of the 11 application the corporations shall be considered to be mutual "insurers": 12 (1) AS 21.03 13 (2) AS 21.06 14 (3) AS 21.09, except AS 21.09.090 15 (4) AS 21.18.010 16 (5) AS 21.18.030 17 (6) AS 21.18.040 18 (7) AS 21.18.120 19 (8) AS 21.21.321 20 (9) AS 21.36 21 (10) AS 21.42.345 - 21.42.365, 21.42.375, 21.42.380, and 21.42.385 22 (11) AS 21.51.120 23 (12) AS 21.53 24 (13) AS 21.54.020 25 (14) AS 21.69.400 26 (15) AS 21.69.520 27 (16) AS 21.69.600, 21.69.620, and 21.69.630 28 (17) AS 21.78 29 (18) AS 21.89.040 30 (19) AS 21.89.060 and 21.89.100 - 21.89.120 31 (20) AS 21.90.
01 * Sec. 12. AS 21.86.070(e) and 21.86.070(f) are repealed. 02 * Sec. 13. APPLICABILITY. Sections 6, 8, and 9 of this Act apply to a policy of 03 insurance, evidence of coverage under AS 21.86, or a service agreement or subscriber's 04 contract under AS 21.87, issued or renewed on or after the effective date of this Act. 05 * Sec. 14. HEALTH CARE PLAN ADVISORY COMMITTEE. (a) The legislature finds 06 that it is necessary to have reliable information on the specific content and cost of any 07 proposed mandatory health care plan, before it can be taken to the public for review. The 08 legislature further finds that questions of a single payer system versus a multi payer system 09 for any mandatory coverage, and questions regarding inclusion or exclusion of certain groups 10 of Alaskans who are covered by other federal health insurance, are not prejudiced by the 11 direction given to the advisory committee created in this section. 12 (b) The Health Care Plan Advisory Committee is established in the Office of the 13 Governor. The committee consists of seven members who are appointed by the governor as 14 follows: 15 (1) one person with experience in providing health care services on an inpatient 16 basis; 17 (2) one person with experience in providing health care services on an 18 outpatient basis; 19 (3) one person with experience as a health care provider; 20 (4) one person who has experience in health care insurance; and 21 (5) three persons who represent the public. 22 (c) Notwithstanding any other provision of law, a committee member is subject to the 23 provisions of AS 39.50 as if the committee member were a member of a state commission or 24 board described under AS 39.50.200(b). 25 (d) A committee member is entitled to receive compensation at the rate of $250 a day 26 for each day spent in performing duties as a committee member and to travel and per diem 27 expenses authorized by law for boards and commissions under AS 39.20.180. 28 (e) The committee may 29 (1) establish subcommittees; 30 (2) conduct hearings; 31 (3) employ personnel necessary to complete assigned duties;
01 (4) enter into contracts; 02 (5) subject to appropriation, expend money. 03 (f) By December 15, 1994, the committee shall report to the legislature on the scope 04 of the health care insurance coverage and the cost of providing health care insurance if health 05 care insurance were to be offered under the following conditions: 06 (1) participation is mandatory by all state residents; coverage shall include a 07 spouse and dependent children; 08 (2) health care services that are covered must include preventive care and 09 immunizations, prenatal care, children's health care, and catastrophic medical expense 10 coverage; 11 (3) coverage shall be designed to impose a family deductible of $3,000 for all 12 covered health care services other than prenatal care, preventive care, and immunizations, and 13 to allow reimbursement in a calendar year at not more than 80 percent for all covered health 14 care services, other than prenatal care, preventive care, and immunizations, after the first 15 $3,000 in covered expenses; prenatal care, preventive care, and immunizations may be 16 reimbursed at more than 80 percent for a covered expense; coverage for health care services 17 that are offered on an outpatient basis shall provide reimbursement for outpatient health care 18 services at a rate equal to or higher than the rate for inpatient services; 19 (4) premiums shall be set at a single rate for all covered individuals, except 20 (A) a surcharge for coverage of each dependent child or spouse may 21 be imposed; a surcharge may not exceed 50 percent of the individual premium; it is 22 the intent of the legislature that the premium be set at a rate that does not exceed $100 23 per month or 14 percent of the individual's monthly gross income, whichever is lower; 24 (B) premium rates are allowed to vary depending on whether the 25 individual smokes or any other factors within the control of an individual, and 26 depending on whether the individual is less than 30 years of age; a premium may not 27 vary under a community rating system, other than as specified in this section; 28 (5) a one-year exclusion for preexisting conditions for new enrollees is 29 imposed; this paragraph does not apply to a person who has resided in the state for at least 30 one year, or who is less than one year old and was born in this state. 31 (g) By December 15, 1995, the committee shall report to the legislature on
01 (1) the cost of providing health insurance coverage under the following 02 conditions: 03 (A) coverage shall meet the conditions set out under (f)(1) - (5) of this 04 section; 05 (B) additional medical benefits are included as recommended by the 06 committee; 07 (C) it is the intent of the legislature that the premium be set at a rate 08 that does not exceed $150 per month or 14 percent of the individual's monthly gross 09 income, whichever is lower; 10 (2) the effect of the following conditions assuming that insurance coverage as 11 specified under (f) of this section is provided: 12 (A) premium payment is by payroll deduction, employer contribution, 13 or a combination of employer contribution and payroll deduction; 14 (B) premium payment by an unemployed or self-employed person is 15 by direct payment; 16 (3) assuming that the state requires all residents to participate in a state health 17 insurance plan, changes necessary in existing provisions of law to 18 (A) allow integration of optional health insurance plans with the 19 mandatory insurance plan; the integration should allow an individual or group to 20 purchase supplemental insurance coverage without duplication of coverage; and 21 (B) discourage health insurance that reimburses covered benefits at a 22 rate greater than 80 percent of the cost of the benefits; 23 (4) recommended legislation regarding public health issues; 24 (5) recommended legislation to simplify health care administration; 25 (6) recommended legislation regarding antitrust changes necessary to allow the 26 use of pooled purchasing to reduce the cost of health care if required under federal law; 27 (7) recommended legislation to enact tort reform measures intended to reduce 28 the cost of health care, including changes to statutes of limitation, contingent fee agreements, 29 and to the Alaska Rules of Civil Procedure; 30 (8) recommended legislation regarding long-term health care, including 31 methods to encourage individual savings for the cost of long-term health care;
01 (9) recommended legislation regarding how the state should educate residents 02 on health care, including how to be a prudent consumer, increasing awareness of provider 03 charges, and a curriculum that should be used in public schools in the state. 04 (h) By December 15, 1995, the committee shall recommend to the legislature 05 legislation necessary to improve data collection used to control health care expenditures or to 06 improve the efficiency of the health care system in the state. 07 (i) In this section, "health care provider" has the meaning given in AS 21.58.400. 08 * Sec. 15. PUBLIC HEALTH ADVISORY COMMITTEE. (a) The Public Health 09 Advisory Committee is established in the Office of the Governor. The committee consists of 10 nine members with significant public health expertise who are appointed by the governor. The 11 governor shall consider public and private health care professionals, labor organizations, 12 businesses, the education system, the Alaska Public Health Association, the Alaska Mental 13 Health Board, and the Alaska Native Health Board for service on the Public Health Advisory 14 Committee, as well as recognizing the need for geographic, ethnic, and cultural diversity. 15 (b) A committee member is entitled to travel and per diem expenses authorized by law 16 for boards and commissions under AS 39.20.180. 17 (c) The committee may 18 (1) establish subcommittees; 19 (2) conduct hearings; 20 (3) employ personnel necessary to complete assigned duties; 21 (4) enter into contracts; 22 (5) subject to appropriation, expend money. 23 (d) The committee shall 24 (1) advise the commissioner of health and social services, the commissioner 25 of administration, and the commissioner of commerce and economic development on public 26 health matters; 27 (2) develop a public health improvement plan as described under (e) of this 28 section. 29 (e) The plan developed by the committee may 30 (1) recognize the need for 31 (A) community involvement in health care planning and delivery;
01 (B) attention to local needs that may vary from place to place; 02 (C) accountability for the use of public funds; 03 (D) equity and stability in the distribution of public funds; 04 (E) shared responsibility of all levels of government for administering 05 and financing public health care delivery; and 06 (F) coordination of basic public health services; and 07 (2) include 08 (A) an analysis of the health status of the residents of the state; 09 (B) an assessment of the most appropriate role for various levels of 10 government to play in addressing the health care needs of the residents of the state; 11 (C) a delineation of the standards that should be used in assessment, 12 policy development, and quality assurance in the delivery of public health services; 13 (D) documentation of the extent to which the current public health 14 system implements or achieves the standards identified under (C) of this paragraph; 15 (E) identification of interjurisdictional issues involved in health care 16 access and delivery; 17 (F) recommendations, including recommendations for specific 18 legislative action when necessary, pertaining to the following: 19 (i) strategies, time lines, financial needs, and specific sources 20 of stable revenue for bringing the state public health care system up to 21 standards identified by the committee; 22 (ii) appropriate sharing of the responsibility of local, regional, 23 state, and federal government entities to deliver public health care services 24 efficiently and effectively, including recommendations for organization within 25 state government; 26 (iii) integration of the public health care system with state and 27 national health care reform efforts; 28 (iv) the committee's estimate of the optimal share that public 29 health should represent in the total health care delivery system of the state, 30 expressed in terms of a percentage of health care dollars spent or in terms of 31 public dollars per state resident;
01 (v) a program designed to give incentives to a primary health 02 care provider to practice in the state, especially in rural and underserved areas 03 of the state. 04 (f) In this section, "health care provider" has the meaning given in AS 21.58.400. 05 * Sec. 16. Sections 14 and 15 of this Act are repealed June 30, 1996. 06 * Sec. 17. This Act takes effect July 1, 1994.