Legislature(2023 - 2024)

2023-05-10 Senate Journal

Full Journal pdf

2023-05-10                     Senate Journal                      Page 1033
SB 45                                                                                                                         
CS FOR SENATE BILL NO. 45(L&C) "An Act relating to insurance;                                                                   
relating to direct health care agreements; relating to the duties of the                                                        
director of the division of insurance in the Department of Commerce,                                                            
Community, and Economic Development; relating to unfair trade                                                                   
practices; and providing for an effective date" was read the third time.                                                        
                                                                                                                                
Senator Wielechowski moved the bill be returned to second reading                                                               
for amendments. Without objection, the bill was returned to second                                                              
reading.                                                                                                                        
                                                                                                                                

2023-05-10                     Senate Journal                      Page 1034
Senator Wielechowski offered Amendment No. 1 :                                                                                   
                                                                                                                                
Page 1, line 3:                                                                                                                 
     Delete "relating to unfair trade practices;"                                                                             
                                                                                                                                
Page 2, line 12:                                                                                                                
     Delete "cancellation"                                                                                                      
     Insert "termination"                                                                                                       
                                                                                                                                
Page 2, line 22, following "information;":                                                                                      
     Insert "and"                                                                                                               
                                                                                                                                
Page 2, line 25:                                                                                                                
     Delete "; and"                                                                                                             
     Insert "."                                                                                                                 
                                                                                                                                
Page 2, lines 26 - 28:                                                                                                          
     Delete all material.                                                                                                       
                                                                                                                                
Page 2, following line 30:                                                                                                      
     Insert new subsections to read:                                                                                            
          "(d)  A health care provider or health care business may not                                                          
     decline to enter into a direct health care agreement with a new                                                            
     patient or terminate a direct health care agreement with an existing                                                       
     patient solely because of the patient's race, religion, color, national                                                    
     origin, age, sex, physical or mental disability, marital status,                                                           
     change in marital status, pregnancy, parenthood, or any other                                                              
     characteristic of a class of persons protected by a state law that                                                         
     prohibits discrimination.                                                                                                  
          (e)  A health care provider or health care business may decline                                                       
     to enter into a direct health care agreement with a new patient if                                                         
     the health care provider or health care business                                                                           
              (1)  is unable to provide to the patient the health care                                                          
     services the patient requires; or                                                                                          
              (2)  does not have the capacity to accept new patients.                                                           
          (f)  A health care provider or health care business may                                                               
     terminate a direct health care agreement with an existing patient                                                          
     based on the patient's health status only if the health care provider                                                      
     is unable to provide to the patient the health care services the                                                           
     patient requires or in accordance with this section."                                                                      
                                                                                                                                

2023-05-10                     Senate Journal                      Page 1035
Reletter the following subsections accordingly.                                                                                 
                                                                                                                                
Page 3, line 29:                                                                                                                
     Delete "and in AS 45.45.915"                                                                                               
                                                                                                                                
Page 4, line 4:                                                                                                                 
     Delete "(d)"                                                                                                               
     Insert "(g)"                                                                                                               
                                                                                                                                
Page 4, line 6:                                                                                                                 
     Delete "(g) or (h)"                                                                                                        
     Insert "(j) or (k)"                                                                                                        
                                                                                                                                
Page 4, lines 20 - 23:                                                                                                          
     Delete all material.                                                                                                       
                                                                                                                                
Reletter the following subsections accordingly.                                                                                 
                                                                                                                                
Page 5, following line 3:                                                                                                       
     Insert a new subsection to read:                                                                                           
          "(q)  A health care provider or health care business may not                                                          
     make, publish, disseminate, circulate, broadcast, or place before                                                          
     the public, or cause, directly or indirectly, to be made, published,                                                       
     disseminated, circulated, broadcast, or placed before the public, in                                                       
     a newspaper, magazine, or other publication, or in the form of a                                                           
     notice, circular, pamphlet, letter, or poster, or over a radio or                                                          
     television station, or in any other way, an advertisement,                                                                 
     announcement, or statement containing an assertion,                                                                        
     representation, or statement that is untrue, deceptive, or                                                                 
     misleading with respect to                                                                                                 
              (1)  the terms of or the benefits or advantages provided by                                                       
     a direct health care agreement;                                                                                            
              (2)  the characterization of a direct health care agreement,                                                      
     including the characterization of a direct health care agreement as                                                        
     health insurance or an alternative to health insurance;                                                                    
              (3)  the business of a direct health care agreement."                                                             
                                                                                                                                
Reletter the following subsections accordingly.                                                                                 
                                                                                                                                

2023-05-10                     Senate Journal                      Page 1036
Page 5, line 14:                                                                                                                
     Delete "and"                                                                                                               
                                                                                                                                
Page 5, line 16, following "agreement":                                                                                         
     Insert "; and                                                                                                              
              (3)  suspend or revoke the business registration of a                                                             
     health care provider or health care business for repeat violations"                                                       
                                                                                                                                
Page 6, line 12, through page 7, line 20:                                                                                       
     Delete all material.                                                                                                       
                                                                                                                                
Renumber the following bill sections accordingly.                                                                               
                                                                                                                                
Page 7, line 27:                                                                                                                
     Delete "Section 4"                                                                                                         
     Insert "Section 2"                                                                                                         
                                                                                                                                
Page 7, line 28:                                                                                                                
     Delete "sec. 5"                                                                                                            
     Insert "sec. 3"                                                                                                            
                                                                                                                                
Page 7, line 28:                                                                                                                
     Delete "September 1, 2023"                                                                                                 
     Insert "January 1, 2024"                                                                                                   
                                                                                                                                
Senator Wielechowski moved for the adoption of Amendment No. 1.                                                                 
Without objection, Amendment No. 1 was adopted.                                                                                 
                                                                                                                                
Senator Hughes offered Amendment No. 2 :                                                                                         
                                                                                                                                
Page 5, lines 25 - 26:                                                                                                          
     Delete "physicians licensed under AS 08.64 who have established                                                            
residency in the state under AS 01.10.055"                                                                                      
     Insert "health care providers"                                                                                             
                                                                                                                                
Senator Hughes moved for the adoption of Amendment No. 2. Senator                                                               
Tobin objected.                                                                                                                 
                                                                                                                                
Senator Hughes moved and asked unanimous consent to withdraw                                                                    
Amendment No. 2. Without objection, Amendment No. 2 was                                                                         
withdrawn.                                                                                                                      
                                                                                                                                

2023-05-10                     Senate Journal                      Page 1037
Senator Hughes offered Amendment No. 3 :                                                                                         
                                                                                                                                
Page 1, lines 9 - 11:                                                                                                           
     Delete "Health care services provided under a direct health care                                                           
agreement are limited to the type of health care services that a primary                                                        
care provider may provide to a patient."                                                                                        
                                                                                                                                
Page 6, line 10:                                                                                                                
     Delete ";"                                                                                                                 
     Insert "."                                                                                                                 
                                                                                                                                
Page 6, line 11:                                                                                                                
     Delete all material.                                                                                                       
                                                                                                                                
Senator Hughes moved for the adoption of Amendment No. 3. Senator                                                               
Giessel objected.                                                                                                               
                                                                                                                                
The question being: "Shall Amendment No. 3 be adopted?" The roll                                                                
was taken with the following result:                                                                                            
                                                                                                                                
CSSB 45(L&C) am                                                                                                                 
Second Reading                                                                                                                  
Amendment No. 3?                                                                                                                
                                                                                                                                
YEAS:  5   NAYS:  14   EXCUSED:  0   ABSENT:  1                                                                               
                                                                                                                                
Yeas:  Hughes, Kaufman, Myers, Shower, Wilson                                                                                   
                                                                                                                                
Nays:  Bishop, Bjorkman, Claman, Dunbar, Giessel, Gray-Jackson,                                                                 
Hoffman, Kawasaki, Kiehl, Merrick, Olson, Stevens, Tobin,                                                                       
Wielechowski                                                                                                                    
                                                                                                                                
Absent:  Stedman                                                                                                                
                                                                                                                                
and so, Amendment No. 3 failed.                                                                                                 
                                                                                                                                
Senator Wielechowski offered Amendment No. 4 :                                                                                   
                                                                                                                                
Page 1, following line 14:                                                                                                      
     Insert a new subsection to read:                                                                                           
          "(b)  To be eligible to enter into a direct health care agreement                                                     
     under this section, a health care provider or health care business                                                         
     must                                                                                                                       

2023-05-10                     Senate Journal                      Page 1038
              (1)  accept new patients who receive assistance under                                                             
     AS 47.07 (Medical Assistance for Needy Persons) or AS 47.08                                                                
     (Assistance for Catastrophic Illness and Chronic or Acute Medical                                                          
     Conditions) or who are enrolled in the Medicare program; or                                                                
              (2)  maintain a practice in which 20 percent or more of                                                           
     the patients                                                                                                               
                   (A)  are eligible to receive assistance under AS 47.07                                                       
          or AS 47.08;                                                                                                          
                   (B)  are enrolled in the Medicare program; or                                                                
                   (C)  do not have health insurance."                                                                          
                                                                                                                                
Reletter the following subsections accordingly.                                                                                 
                                                                                                                                
Page 4, line 4:                                                                                                                 
     Delete "(d)"                                                                                                               
     Insert "(e)"                                                                                                               
                                                                                                                                
Page 4, line 6:                                                                                                                 
     Delete "(g) or (h)"                                                                                                        
     Insert "(h) or (i)"                                                                                                        
                                                                                                                                
Senator Wielechowski moved for the adoption of Amendment No. 4.                                                                 
Senator Wilson objected.                                                                                                        
                                                                                                                                
The question being: "Shall Amendment No. 4 be adopted?" The roll                                                                
was taken with the following result:                                                                                            
                                                                                                                                
CSSB 45(L&C) am                                                                                                                 
Second Reading                                                                                                                  
Amendment No. 4?                                                                                                                
                                                                                                                                
YEAS:  18   NAYS:  1   EXCUSED:  0   ABSENT:  1                                                                               
                                                                                                                                
Yeas:  Bishop, Bjorkman, Claman, Dunbar, Giessel, Gray-Jackson,                                                                 
Hoffman, Hughes, Kaufman, Kiehl, Merrick, Olson, Shower,                                                                        
Stedman, Stevens, Tobin, Wielechowski, Wilson                                                                                   
                                                                                                                                
Nays:  Myers                                                                                                                    
                                                                                                                                
Absent:  Kawasaki                                                                                                               
                                                                                                                                
and so, Amendment No. 4 was adopted.                                                                                            
                                                                                                                                

2023-05-10                     Senate Journal                      Page 1039
Senators Hughes, Kiehl offered Amendment No. 5 :                                                                                 
                                                                                                                                
Page 5, lines 25 - 26:                                                                                                          
     Delete "who have established residency in the state under                                                                  
AS 01.10.055"                                                                                                                   
                                                                                                                                
Senator Hughes moved for the adoption of Amendment No. 5.                                                                       
Objections were heard.                                                                                                          
                                                                                                                                
The question being: "Shall Amendment No. 5 be adopted?" The roll                                                                
was taken with the following result:                                                                                            
                                                                                                                                
CSSB 45(L&C) am                                                                                                                 
Second Reading                                                                                                                  
Amendment No. 5?                                                                                                                
                                                                                                                                
YEAS:  8   NAYS:  12   EXCUSED:  0   ABSENT:  0                                                                               
                                                                                                                                
Yeas:  Hughes, Kaufman, Kiehl, Myers, Olson, Shower, Tobin,                                                                     
Wilson                                                                                                                          
                                                                                                                                
Nays:  Bishop, Bjorkman, Claman, Dunbar, Giessel, Gray-Jackson,                                                                 
Hoffman, Kawasaki, Merrick, Stedman, Stevens, Wielechowski                                                                      
                                                                                                                                
and so, Amendment No. 5 failed.                                                                                                 
                                                                                                                                
CS FOR SENATE BILL NO. 45(L&C) am "An Act relating to                                                                           
insurance; relating to direct health care agreements; relating to the                                                           
duties of the director of the division of insurance in the Department of                                                        
Commerce, Community, and Economic Development; and providing                                                                    
for an effective date" was automatically in third reading.                                                                      
                                                                                                                                
The question being: "Shall CS FOR SENATE BILL NO. 45(L&C) am                                                                    
"An Act relating to insurance; relating to direct health care                                                                   
agreements; relating to the duties of the director of the division of                                                           
insurance in the Department of Commerce, Community, and                                                                         
Economic Development; and providing for an effective date" pass the                                                             
Senate?" The roll was taken with the following result:                                                                          
                                                                                                                                
                                                                                                                                

2023-05-10                     Senate Journal                      Page 1040
CSSB 45(L&C) am                                                                                                                 
Third Reading - Final Passage                                                                                                   
Effective Date(s)                                                                                                               
                                                                                                                                
YEAS:  18   NAYS:  2   EXCUSED:  0   ABSENT:  0                                                                               
                                                                                                                                
Yeas:  Bishop, Bjorkman, Claman, Dunbar, Giessel, Gray-Jackson,                                                                 
Hoffman, Hughes, Kaufman, Merrick, Myers, Olson, Shower,                                                                        
Stedman, Stevens, Tobin, Wielechowski, Wilson                                                                                   
                                                                                                                                
Nays:  Kawasaki, Kiehl                                                                                                          
                                                                                                                                
and so, CS FOR SENATE BILL NO. 45(L&C) am passed the Senate.                                                                    
                                                                                                                                
Senator Giessel moved and asked unanimous consent the vote on the                                                               
passage of the bill be considered the vote on the effective date                                                                
clause(s). Without objection, it was so ordered and the bill was                                                                
referred to the Secretary for engrossment.