00                            SENATE BILL NO. 129                                                                         
01 "An Act relating to emergency services and balance billing; relating to the                                             
02 determination by an insurer of a final payment for a covered service or supply; and                                     
03 annulling regulations relating to determination by an insurer of a final payment for a                                  
04 covered service or supply based on geographical areas."                                                                 
05 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:                                                                
06    * Section 1. AS 21.36 is amended by adding a new section to read:                                                  
07 Sec. 21.36.512. Emergency services; balance billing. (a) A health care                                              
08 provider or health care facility that provides emergency services or treatment of an                                    
09 emergency medical condition under AS 21.07.020 may not balance bill for services                                        
10 that results in a covered person's incurring greater out-of-pocket costs, including                                     
11 copayment, deductible, or coinsurance amounts, for emergency services or treatment                                      
12 of an emergency medical condition from a non-network health care provider than the                                      
13 covered person would have incurred from a health care provider that furnishes                                           
14 emergency services or treatment of an emergency medical condition through a                                             

01       network of health care providers that have entered into a contract with a health care                             
02       insurer.                                                                                                          
03            (b)  In this section,                                                                                        
04                 (1)  "emergency medical condition" has the meaning given in                                             
05       AS 21.07.250;                                                                                                     
06                 (2)  "health care facility" includes a hospital emergency room or stand-                                
07       alone emergency service facility;                                                                                 
08                 (3)  "health care insurer" has the meaning given in AS 21.54.500;                                       
09                 (4)  "health care provider" has the meaning given in AS 21.07.250.                                      
10    * Sec. 2. AS 21.42.205 is amended to read:                                                                         
11 Sec. 21.42.205. Coordination of benefits and determination of final                                                 
12 payment for a covered service or supply. (a) Unless prohibited by federal law, an                                   
13 insurer authorized under AS 21.09 to offer, issue for delivery, deliver, or renew an                                    
14 individual or group health insurance policy for major medical coverage on an expense                                    
15 incurred basis; a health maintenance organization authorized under AS 21.86 to offer a                                  
16 contract to provide major medical health care services on a prepaid basis; or a service                                 
17 corporation authorized under AS 21.87 to offer or renew an individual or group                                          
18       subscriber's contract for major medical coverage shall                                                            
19 (1)  include a coordination of benefits provision in a major medical                                                
20       policy or contract; and                                                                                       
21 (2)  determine the final payment for a covered service or supply                                                    
22 based on an amount that is at least 200 percent of the amount reimbursed by                                         
23 Medicare for that service or supply under an applicable Medicare fee schedule                                       
24       for the state.                                                                                                
25 (b)  The director may adopt regulations to implement this section, except that                                      
26 the director may not adopt a regulation that establishes the final payment for a                                    
27       covered service or supply.                                                                                    
28    * Sec. 3. 3 AAC 26.110(a)(2)(B) and (5)(A) are annulled.