CSHB 314(JUD): "An Act relating to fees and charges for medical treatment or services, civil damages, investigations, and penalties as they relate to workers' compensation; and providing for an effective date."
00 CS FOR HOUSE BILL NO. 314(JUD) 01 "An Act relating to fees and charges for medical treatment or services, civil damages, 02 investigations, and penalties as they relate to workers' compensation; and providing for 03 an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 23.30.097(a) is amended to read: 06 (a) All fees and other charges for medical treatment or service are subject to 07 regulation by the board consistent with this section. A fee or other charge for medical 08 treatment or service may not exceed the lowest of 09 (1) the usual, customary, and reasonable fees for the treatment or 10 service in the community in which it is rendered, for treatment or service 11 (A) provided before August 1, 2007, not to exceed the fees in 12 the board's fee schedule dated December 1, 2004; 13 (B) provided on or after August 1, 2007, but before March 31, 14 2009, not to exceed the fees otherwise applicable in (A) of this paragraph
01 adjusted by the percentage change from 2004 to 2006 in the medical care 02 component of the Consumer Price Index for all urban consumers compiled by 03 the United States Department of Labor, Bureau of Labor Statistics; 04 (C) provided on or after March 31, 2009, but before 05 December 31, 2010, not to exceed the fees otherwise applicable in (A) of this 06 paragraph adjusted by the percentage change from 2004 to 2008 in the medical 07 care component of the Consumer Price Index for all urban consumers compiled 08 by the United States Department of Labor, Bureau of Labor Statistics; 09 (D) provided on or after December 31, 2010, not to exceed 10 the fees or other charges as specified in a fee schedule established by the 11 board and adopted by reference in regulation; the fee schedule must be 12 based on statistically credible data, including charges for the most recent 13 category I, II, and III medical services maintained by the American 14 Medical Association and the Health Care Procedure Coding System for 15 medical supplies, injections, emergency transportation, and other 16 medically related services, and must result in a schedule that 17 (i) reflects the cost in the geographical area where 18 services are provided; and 19 (ii) is at the 90th percentile; 20 (2) the fee or charge for the treatment or service when provided to the 21 general public; or 22 (3) the fee or charge for the treatment or service negotiated by the 23 provider and the employer under (c) of this section. 24 * Sec. 2. AS 23.30.250(a) is amended to read: 25 (a) A person who (1) knowingly makes a false or misleading statement, 26 representation, or submission related to a benefit under this chapter; (2) knowingly 27 assists, abets, solicits, or conspires in making a false or misleading submission 28 affecting the payment, coverage, or other benefit under this chapter; (3) knowingly 29 misclassifies employees or engages in deceptive leasing practices for the purpose of 30 evading full payment of workers' compensation insurance premiums; or (4) employs 31 or contracts with a person or firm to coerce or encourage an individual to file a
01 fraudulent compensation claim is guilty of workers' compensation fraud, which 02 may be punished under AS 11.46.120 - 11.46.150, and may also be guilty of 03 perjury and related offenses under AS 11.56.200 - 11.56.230 [CIVILLY LIABLE 04 TO A PERSON ADVERSELY AFFECTED BY THE CONDUCT, IS GUILTY OF 05 THEFT BY DECEPTION AS DEFINED IN AS 11.46.180, AND MAY BE 06 PUNISHED AS PROVIDED BY AS 11.46.120 - 11.46.150]. 07 * Sec. 3. AS 23.30.250(c) is repealed and reenacted to read: 08 (c) In addition to criminal penalties under this section, a person who violates 09 this chapter is liable in a civil action brought by or on behalf of a person who suffers 10 economic damages as a result of the violation for an award of three times the amount 11 of compensatory damages resulting from the violation, subject to adjustment under 12 AS 09.17, and an award of reasonable attorney fees. 13 * Sec. 4. AS 23.30.280(a) is amended to read: 14 (a) The director shall establish a section within the division for the 15 investigation of fraudulent or misleading acts under this chapter [AS 23.30.250] and 16 other fraudulent acts relating to workers' compensation. 17 * Sec. 5. AS 23.30.280(b) is amended to read: 18 (b) The director may investigate facts reported under this section and may 19 refer facts indicating a possible violation of law to the appropriate prosecutor or 20 agency. If the director determines that there is credible evidence that a person obtained 21 a payment, compensation, medical treatment, or other benefit provided under this 22 chapter by a fraudulent act or false or misleading statement or representation [AS 23 PROVIDED IN AS 23.30.250(a)], the director shall notify the affected employer, 24 insurer, and adjuster upon conclusion of the investigation. If the fraudulent act or false 25 or misleading statement or representation was perpetrated against the division, the 26 director may file a petition as provided in AS 23.30.110 for an order of forfeiture 27 against the person, precluding, in whole or in part, the person from future payment, 28 compensation, medical treatment, or other benefit provided under this chapter. 29 * Sec. 6. This Act takes effect immediately under AS 01.10.070(c).