05/05/2001 09:07 AM Senate HES

               HB 113-HEALTH CARE INSURANCE PAYMENTS                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN thanked  the sponsor and  all parties involved  in                                                            
this legislation.   She noted this  piece of legislation  is not one                                                            
that needed to be hammered  out at the committee table.  Instead, it                                                            
was  better  for all  parties  involved  to  come  to some  kind  of                                                            
workable agreement that  would solve the problems for physicians and                                                            
take into consideration  problems  faced by insurers when  trying to                                                            
deal with multi-state functions.                                                                                                
                                                                                                                                
REPRESENTATIVE  JOE GREEN, sponsor of HB 113, explained  that HB 113                                                            
is a  simple measure.   He believes  the modifications  made  by the                                                            
Senate HESS Committee  have improved the bill.  HB  113 ensures that                                                            
insurers of medical  practices, either hospitals or  physicians, pay                                                            
claims in  a timely fashion.   Insurance  companies must pay  claims                                                            
within 30  days of submittal  of a "clean"  claim. If, on the  other                                                            
hand, a submitted claim  is problematic, the insurer must notify the                                                            
medical  provider  as  to  what  is  needed.    Once  the  necessary                                                            
information is  provided, the insurer must pay that  claim within 15                                                            
calendar  days. This same  terminology is used  in 39 other  states.                                                            
The insurance  companies found this procedure to be  acceptable with                                                            
a  few exceptions  that  have  been  corrected  by the  Senate  HESS                                                            
Committee.   Interest   will  accrue   after  either   the  30   day                                                            
reimbursement  period  for a  clean  claim or  the extended  15  day                                                            
period for a problematic  claim beginning July 1 of  2002.  The bill                                                            
becomes effective on January  1 of 2002.  The six-month delay of the                                                            
interest  provision  will  ensure  that  the programs  used  by  the                                                            
insurance companies  are adequately  modified so that, for  example,                                                            
electronic claims can be  processed in a timely fashion.  The second                                                            
change is that  interest in the amount  of $1 or less will  not have                                                            
to be paid.                                                                                                                     
                                                                                                                                
Number 872                                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN  asked  if  this bill  addresses  claims  for  new                                                            
procedures  for which rates  have not been  set and whether  non- or                                                            
delayed payment  for those  procedures would  be considered to  be a                                                            
legitimate dispute.                                                                                                             
                                                                                                                                
REPRESENTATIVE   GREEN   said  that   is  not   addressed  by   this                                                            
legislation.  That matter would be addressed as it is now.                                                                      
                                                                                                                                
CHAIRWOMAN GREEN took public testimony.                                                                                         
                                                                                                                                
DR.  ROLAND GOWER,  president  of Alaska  Physicians  and  Surgeons,                                                            
which represents about  180 specialists and primary care physicians,                                                            
stated support for SCS  HB 113(HES).  This bill will help physicians                                                            
stabilize  cash   flow  and  is  long  overdue.    Members   of  his                                                            
organization  understand the need  to delay the implementation  date                                                            
of the bill and the $1 minimum on interest.                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN said had time permitted,  she would have  liked to                                                            
look into the fact that  some physicians and vendors will not do the                                                            
second  filing for  patients with  secondary insurance.   She  urged                                                            
physicians to do that.                                                                                                          
                                                                                                                                
There being no further  public testimony, SENATOR LEMAN moved SCS HB
(HES)  - Version  R, as the  working document  of the  committee.                                                            
There being no objection, the motion carried.                                                                                   
                                                                                                                                
SENATOR  LEMAN  then  moved  SCS HB  113(HES)  from  committee  with                                                            
individual  recommendations and its  zero fiscal note.  There  being                                                            
no objection, the motion carried.