Legislature(2017 - 2018)
2018-05-12 House Journal
Full Journal pdf2018-05-12 House Journal Page 3725 SB 105 The following was read the second time: 2018-05-12 House Journal Page 3726 CS FOR SENATE BILL NO. 105(FIN) "An Act relating to the licensure of marital and family therapists; relating to medical assistance for marital and family therapy services; and providing for an effective date." with the: Journal Page FIN RPT HCS(FIN) 5DP 1DNP 1NR 4AM 3406 FN3: (CED) 3407 FN4: (DHS) 3407 Representative Tuck moved and asked unanimous consent that the following committee substitute be adopted in lieu of the original bill: HOUSE CS FOR CS FOR SENATE BILL NO. 105(FIN) (same title) There being no objection, it was so ordered. Amendment No. 1 was offered by Representatives Spohnholz, Grenn, Josephson, Gara, Kawasaki, Zulkosky, Sullivan-Leonard, Claman, Tarr, Wool, Parish, Tuck, and Drummond: Page 1, line 2, following "services;" (title amendment): Insert "relating to disclosure of health care services and price information; relating to health care insurers;" Page 3, following line 13: Insert new bill sections to read: "* Sec. 3. AS 18.15.360(a) is amended to read: (a) The department is authorized to collect, analyze, and maintain databases of information related to (1) risk factors identified for conditions of public health importance; (2) morbidity and mortality rates for conditions of public health importance; (3) community indicators relevant to conditions of public health importance; (4) longitudinal data on traumatic or acquired brain injury from the registry established under 2018-05-12 House Journal Page 3727 AS 47.80.500(c)(1); [AND] (5) health care services and price information collected under AS 18.23.400; and (6) any other data needed to accomplish or further the mission or goals of public health or provide essential public health services and functions. * Sec. 4. AS 18.23 is amended by adding a new section to read: Article 4. Health Care Services and Price Information. Sec. 18.23.400. Disclosure and reporting of health care services, price, and fee information. (a) A health care provider shall annually compile a list, including a brief description in plain language that an individual with no medical training can understand, of the 10 health care services most commonly performed by the health care provider in the state in the previous calendar year from each of the six sections of Category I, Current Procedural Terminology, adopted by the American Medical Association and, for each of those services, state (1) the procedure code; (2) the undiscounted price; and (3) any facility fees. (b) A health care facility in the state shall annually compile a list, including a brief description in plain language that an individual with no medical training can understand, of the 10 health care services most commonly performed at the health care facility in the previous calendar year from each of the six sections of Category I, Current Procedural Terminology, adopted by the American Medical Association and, for each of those services, state (1) the procedure code; (2) the undiscounted price; and (3) any facility fees. (c) If, in the annual reporting period under this section, fewer than the number of health care services described under (a) or (b) of this section are performed by a health care provider or at a health care facility in the state, the provider or facility shall include in the list required under this section all of the health care services performed by the provider or at the facility from each of the six sections described under (a) or (b) of this section. 2018-05-12 House Journal Page 3728 (d) A health care provider who provides health care services at a health care facility in a group practice is not required to compile and publish a list under (a) and (e) of this section if (1) the health care facility where the provider is in a group practice compiles and publishes a list in compliance with (b) and (e) of this section; and (2) the prices and fees that the provider charges are reflected in the list compiled and published by the health care facility. (e) A health care provider and health care facility shall publish the lists compiled under (a) and (b) of this section by January 31 each year (1) by providing the list to the department for entry in the department's database under AS 18.15.360 along with the name and location of the health care provider or health care facility; (2) by posting a copy of the list (A) in a font not smaller than 20 points; (B) in a conspicuous public reception area at the health care provider's office or health care facility where the services are performed; (C) that includes the address for the department's Internet website; (D) that may include a statement explaining that the undiscounted price may be higher or lower than the amount an individual actually pays for the health care services described in the list; (E) that includes a statement substantially similar to the following: "You will be provided with an estimate of the anticipated charges for your nonemergency care upon request. Please do not hesitate to ask for information."; and (F) that lists any health care insurers with which the health care provider or health care facility has a contract to provide health care services as an in-network preferred provider; and (3) if the health care provider or health care facility has an Internet website, by posting the list on the 2018-05-12 House Journal Page 3729 website. (f) The department shall annually compile the lists provided under (a) and (b) of this section by health care service and, where relevant, health care provider and health care facility name and location, post the information on the department's Internet website, and enter the information in the database maintained under AS 18.15.360. (g) If a patient who is receiving nonemergency health care services requests an estimate from a health care provider, health care facility, or health care insurer of the reasonably anticipated charges for treating the patient's specific condition, the health care provider, health care facility, or health care insurer (1) shall provide a good faith estimate before the nonemergency health care services are provided and not later than 10 business days after receiving the request; (2) shall provide the estimate in whichever of the following formats the patient requests: orally, in writing, or by electronic means; if the estimate is provided orally, the health care provider, health care facility, or health care insurer shall keep a record of the estimate; (3) is not required to disclose the charges for the total anticipated course of treatment for the patient, but if the estimate does not include charges for the total anticipated course of treatment, the estimate must include a statement explaining that the estimate only includes charges for a portion of the total anticipated course of treatment; and (4) may provide an estimate that includes a reasonable range of charges for anticipated health care services if the charges for the services will vary significantly in response to conditions that the health care provider, health care facility, or health care insurer cannot reasonably assess before the services are provided. (h) A good faith estimate provided by a health care provider or health care facility under (g) of this section must include (1) a brief description in plain language that an individual with no medical training can understand of the health care services, products, procedures, and supplies that are included in the estimate; 2018-05-12 House Journal Page 3730 (2) a notice disclosing the health care provider's or health care facility's in-network or out-of- network status that is substantially similar to one of the following forms: (A) "(Name of health care provider or health care facility) is a contracted, in-network preferred provider for ONLY the following plan networks: (list each network or state 'NONE. YOU MAY INCUR OUT-OF-NETWORK CHARGES.')"; (B) "(Name of health care provider or health care facility) is a contracted, in-network preferred provider for your insurance plan."; or (C) "(Name of health care provider or health care facility) is NOT a contracted, in- network preferred provider for your insurance plan. YOU MAY INCUR OUT-OF-NETWORK CHARGES."; (3) the procedure code for each health care service included in the estimate; (4) any facility fees, along with an explanation of the facility fees; and (5) the identity, or suspected identity, of any other person that may charge the patient for a service, product, procedure, or supply in connection with the health care services included in the estimate, along with an explanation of whether the charges are included in the estimate. (i) A health care provider or health care facility that provides a good faith estimate to a patient under (g) and (h) of this section or a health care insurer that provides a good faith estimate to a patient under (g) of this section is not liable for damages or other relief if the estimate differs from the amount actually charged to the patient. (j) The requirement for a health care facility to provide a good faith estimate of reasonably anticipated charges for nonemergency health care services under (e)(2)(E), (g), and (h) of this section does not apply to a health care facility that is an emergency department. (k) A health care provider or a health care facility that fails to comply with the requirements of (a) - (e), (g), or 2018-05-12 House Journal Page 3731 (h) of this section or a health care insurer that fails to comply with the requirements of (g) of this section is liable for a civil penalty not to exceed $10,000 for each violation. The department may impose a penalty, (1) for failure to comply with (a) - (e) of this section, of not more than $100 for each day of noncompliance after March 31; or (2) for failure to provide a good faith estimate under (g) or (h) of this section, of not more than $100 for each day of noncompliance. (l) A health care provider, health care facility, or health care insurer penalized under (k) of this section is entitled to a hearing conducted by the office of administrative hearings under AS 44.64. (m) A municipality may not enact or enforce an ordinance that is inconsistent with or imposes health care price or fee disclosure requirements in addition to the requirements under this section or regulations adopted under this section. (n) In this section, (1) "department" means the Department of Health and Social Services; (2) "facility fee" means a charge or fee billed by a health care provider or health care facility that is in addition to fees billed for a health care provider's professional services and is intended to cover building, electronic medical records system, billing, and other administrative and operational expenses; (3) "health care facility" means a private, municipal, or state hospital, psychiatric hospital, emergency department, independent diagnostic testing facility, residential psychiatric treatment center as defined in AS 47.32.900, kidney disease treatment center (including freestanding hemodialysis units), the offices of private physicians or dentists whether in individual or group practice, ambulatory surgical center as defined in AS 47.32.900, free-standing birth center as defined in AS 47.32.900, and rural health clinic as defined in AS 47.32.900; "health care facility" does not include (A) the Alaska Pioneers' Home and 2018-05-12 House Journal Page 3732 the Alaska Veterans' Home administered by the department under AS 47.55; (B) an assisted living home as defined in AS 47.33.990; (C) a nursing facility licensed by the department to provide long-term care; (D) a facility operated by an Alaska tribal health organization; and (E) a hospital operated by the United States Department of Veterans Affairs or the United States Department of Defense, or any other federally operated hospital or institution; (4) "health care insurer" has the meaning given in AS 21.54.500; (5) "health care provider" means an individual licensed, certified, or otherwise authorized or permitted by law to provide health care services in the ordinary course of business or practice of a profession; (6) "health care service" means a service or procedure provided in person or remotely by telemedicine or other means by a health care provider or at a health care facility for the purpose of or incidental to the care, prevention, or treatment of a physical or mental illness or injury; (7) "nonemergency health care service" means a health care service other than a health care service that is immediately necessary to prevent the death or serious impairment of the health of the patient; (8) "patient" means an individual to whom health care services are provided in the state by a health care provider or at a health care facility; (9) "third party" means a public or private entity, association, or organization that provides, by contract, agreement, or other arrangement, insurance, payment, price discount, or other benefit for all or a portion of the cost of health care services provided to a recipient; "third party" does not include a member of the recipient's immediate family; (10) "undiscounted price" means an amount billed for a service rendered without complications or exceptional circumstances; "undiscounted price" does not include a negotiated discount for an in-network or out-of- 2018-05-12 House Journal Page 3733 network service rendered or the cost paid by a third party for that service. * Sec. 5. AS 21.96 is amended by adding a new section to read: Sec. 21.96.200. Good faith estimate. Upon request of a covered person who is receiving nonemergency health care services, a health care insurer shall provide a good faith estimate of the amount of the reasonably anticipated charges for treating the patient's specific condition under AS 18.23.400(g)." Renumber the following bill sections accordingly. Page 4, line 13: Delete "sec. 3" Insert "sec. 6" Page 4, line 19: Delete "Section 4" Insert "Section 7" Page 4, line 20: Delete "sec. 6" Insert "sec. 9" Representative Spohnholz moved and asked unanimous consent that Amendment No. 1 be adopted. There was objection. The question being: "Shall Amendment No. 1 be adopted?" The roll was taken with the following result: HCS CSSB 105(FIN) Second Reading Amendment No. 1 YEAS: 31 NAYS: 8 EXCUSED: 0 ABSENT: 1 Yeas: Birch, Claman, Drummond, Edgmon, Foster, Gara, Grenn, Guttenberg, Johnston, Josephson, Kawasaki, Kito, Kopp, Kreiss-Tomkins, LeDoux, Lincoln, Millett, Ortiz, Parish, Pruitt, Saddler, Seaton, Spohnholz, Stutes, Sullivan-Leonard, Talerico, Tarr, Thompson, Tuck, Wool, Zulkosky 2018-05-12 House Journal Page 3734 Nays: Eastman, Johnson, Knopp, Neuman, Rauscher, Reinbold, Tilton, Wilson Absent: Chenault And so, Amendment No. 1 was adopted, and the new title follows: HOUSE CS FOR CS FOR SENATE BILL NO. 105(FIN) am H "An Act relating to the licensure of marital and family therapists; relating to medical assistance for marital and family therapy services; relating to disclosure of health care services and price information; relating to health care insurers; and providing for an effective date." Amendment No. 2 was offered by Representatives Tarr, Spohnholz, Kawasaki, Gara, Parish, Lincoln, Drummond, Seaton, Josephson, Ortiz, Stutes, and Millett: Page 1, line 1, following "therapists;" (title amendment): Insert "providing for a state policy relating to children;" Page 3, following line 13: Insert a new bill section to read: "* Sec. 3. AS 47.05.060 is amended to read: Sec. 47.05.060. Purpose and policy relating to children. The purpose of this title as it relates to children is to secure for each child the care and guidance, preferably in the child's own home, that will serve the moral, emotional, mental, and physical welfare of the child and the best interests of the community; to preserve and strengthen the child's family ties unless efforts to preserve and strengthen the ties are likely to result in physical or emotional damage to the child, removing the child from the custody of the parents only as a last resort when the child's welfare or safety or the protection of the public cannot be adequately safeguarded without removal; and, when the child is removed from the family, to secure for the child adequate custody and care and adequate planning for permanent placement of the child. It is the policy of the state to acknowledge and take into account the principles of early childhood and youth brain development and, whenever possible, consider the concepts of early adversity, toxic stress, childhood trauma, and the promotion 2018-05-12 House Journal Page 3735 of resilience through protective relationships, supports, self- regulation, and services." Renumber the following bill sections accordingly. Page 4, line 13: Delete "sec. 3" Insert "sec. 4" Page 4, line 19: Delete "Section 4" Insert "Section 5" Page 4, line 20: Delete "sec. 6" Insert "sec. 7" Representative Tarr moved and asked unanimous consent that Amendment No. 2 be adopted. Representative Wilson objected and withdrew the objection. There being no further objection, Amendment No. 2 was adopted, and the new title follows: HOUSE CS FOR CS FOR SENATE BILL NO. 105(FIN) am H "An Act relating to the licensure of marital and family therapists; providing for a state policy relating to children; relating to medical assistance for marital and family therapy services; relating to disclosure of health care services and price information; relating to health care insurers; and providing for an effective date." Representative Tuck moved and asked unanimous consent that HCS CSSB 105(FIN) am H be considered engrossed, advanced to third reading, and placed on final passage. There being no objection, it was so ordered. HCS CSSB 105(FIN) am H was read the third time. The question being: "Shall HCS CSSB 105(FIN) am H pass the House?" The roll was taken with the following result: 2018-05-12 House Journal Page 3736 HCS CSSB 105(FIN) am H Third Reading Final Passage YEAS: 29 NAYS: 11 EXCUSED: 0 ABSENT: 0 Yeas: Birch, Claman, Drummond, Edgmon, Foster, Gara, Grenn, Guttenberg, Johnson, Johnston, Josephson, Kawasaki, Kito, Kopp, Kreiss-Tomkins, Lincoln, Millett, Ortiz, Parish, Saddler, Seaton, Spohnholz, Stutes, Sullivan-Leonard, Talerico, Tarr, Tuck, Wool, Zulkosky Nays: Chenault, Eastman, Knopp, LeDoux, Neuman, Pruitt, Rauscher, Reinbold, Thompson, Tilton, Wilson And so, HCS CSSB 105(FIN) am H passed the House. Representative Tuck moved and asked unanimous consent that the roll call on the passage of the bill be considered the roll call on the effective date clause. There being no objection, it was so ordered. HCS CSSB 105(FIN) am H was referred to the Chief Clerk for engrossment.