Legislature(2017 - 2018)BUTROVICH 205
04/04/2018 01:30 PM Senate HEALTH & SOCIAL SERVICES
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| Hb151 | |
| HB123 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 123 | TELECONFERENCED | |
| += | HB 151 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 123-DISCLOSURE OF HEALTH CARE COSTS
2:14:28 PM
CHAIR WILSON announced the consideration of HB 123. [The
committee adopted the work draft SCS for CSHB 123, labeled 30-
LS0380\G, on 3/16/18.]
2:15:01 PM
CHAIR WILSON moved Amendment 1, 30-LS0380\G.3.
30-LS0380\G.3
Bruce
3/30/18
AMENDMENT 1
OFFERED IN THE SENATE BY SENATOR WILSON
TO: SCS CSHB 123( ), Draft Version "G"
Page 5, line 26:
Delete "$5,000"
Insert "$10,000"
Page 6, line 25:
Delete all material.
Reletter the following subparagraph accordingly.
2:15:17 PM
SENATOR VON IMHOF objected for purposes of discussion.
2:15:30 PM
CHAIR WILSON explained that on page 5, line 26, Amendment 1
changes the cap on the amount of civil penalties from $5,000 to
$10,000 and on page 6, line 25, includes tribal facilities with
health care facilities so that they have to comply with the
bill's requirements.
SENATOR BEGICH asked if he worked with the bill sponsor.
2:16:10 PM
REPRESENATIVE IVY SPOHNHOLZ, Alaska State Legislature, sponsor
of HB 123 said she did discuss the changes and supports them.
2:16:32 PM
SENATOR VON IMHOF removed her objection.
2:16:37 PM
CHAIR WILSON found no further objection and Amendment 1 passed.
2:16:41 PM
CHAIR WILSON moved Amendment 2, labeled 30-LS0380\G.5.
30-LS0380\G.5
Bruce
4/3/18
AMENDMENT 2
OFFERED IN THE SENATE BY SENATOR WILSON
TO: SCS CSHB 123( ), Draft Version "G"
Page 7, following line 20:
Insert new bill sections to read:
"* Sec. 3. The uncodified law of the State of Alaska is
amended by adding a new section to read:
TRANSITION: REGULATIONS. The Department of Health and
Social Services may adopt regulations necessary to
implement the changes made by this Act. The regulations
take effect under AS 44.62 (Administrative Procedure Act),
but not before the effective date of the law implemented by
the regulation.
* Sec. 4. Section 3 of this Act takes effect immediately
under AS 01.10.070(c)."
Renumber the following bill section accordingly.
Page 7, line 21:
Delete "This"
Insert "Except as provided in sec. 4 of this Act, this"
SENATOR VON IMHOF objected for purposes of discussion.
2:16:52 PM
CHAIR WILSON said these changes were requested by DHSS so that
it can adopt regulations necessary to implement the changes made
by this Act.
2:17:34 PM
SENATOR VON IMHOF removed her objection.
2:17:41 PM
There being no objection, Amendment 2 passed.
2:17:46 PM
CHAIR WILSON moved Amendment 3, labeled 30-LS0380\G.6.
30-LS0380\G.6
Bruce
4/3/18
AMENDMENT 3
OFFERED IN THE SENATE BY SENATOR WILSON
TO: SCS CSHB 123( ), Draft Version "G"
Page 1, line 1, following "information;":
Insert "relating to health care insurers;"
Page 4, line 6:
Delete "or health care facility"
Insert ", health care facility, or health care
insurer"
Page 4, line 8:
Delete "or health care facility"
Insert ", health care facility, or health care
insurer"
Page 4, line 14:
Delete "or health care facility"
Insert ", health care facility, or health care
insurer"
Page 4, lines 23 - 24:
Delete "or health care facility"
Insert ", health care facility, or health care
insurer"
Page 5, line 17:
Delete "or health care facility"
Insert ", health care facility, or health care
insurer"
Page 5, line 25, following "section":
Insert "or a health care insurer that fails to comply
with the requirements of (g) and (h) of this section"
Page 5, line 31:
Delete "or health care facility"
Insert ", health care facility, or health care
insurer"
Page 7, following line 20:
Insert a new bill section to read:
"* Sec. 3. 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) and
(h)."
Renumber the following bill section accordingly.
2:18:08 PM
SENATOR VON IMHOF objected for purposes of discussion.
CHAIR WILSON said the amendment adds health care insurers to
entities that shall provide a good faith estimate to patients
who request non-emergency health care services.
SENATOR BEGICH asked what the intent of the amendment was.
CHAIR WILSON answered that the intent was to allow good faith
estimates to be provided not only from those providing the
services, but the insurers also because the posted prices may
not be applicable for people who have insurance. If the doctor's
office cannot contact the insurer, the patient can give the
codes to the insurer to get a more detailed, specific estimate.
It allows the same time frame to comply with the good faith
estimates.
SENATOR BEGICH asked if the bill sponsor supports the amendment.
2:20:20 PM
REPRESENTATIVE SPOHNHOLZ said it is welcomed. Getting a good
faith estimate from insurers in a timely manner is a reasonable
thing to expect.
SENATOR VON IMHOF asked for clarification that with this
amendment, insurers will be participating in good faith
estimates but not posting prices like health care facilities and
providers are being asked to do.
CHAIR WILSON said correct.
SENATOR VON IMHOF asked if there is another definition of
insurer that says private insurer, self-insured,
Medicare/Medicaid, TRICARE, etc.
2:21:47 PM
BERNICE NESBITT, Staff, Representative Ivy Spohnholz, Alaska
State Legislature, testified on HB 123. She said page 6, line
30, of the bill states that "health care insurer" has the
meaning given in AS 21.54.500.
2:22:25 PM
At ease.
2:24:26 PM
CHAIR WILSON reconvened the meeting.
2:24:41 PM
SENATOR GIESSEL asked Director Wing-Heier to comment on the
insurer component of the bill.
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development (DCCED), testified
on HB 123. She said that for transparency, the amount paid is an
important factor that needs to be addressed. The amount paid is
most often going to be what the insurance company has either
negotiated or the insurer can inform the consumer how they will
pay if it is the 80th percentile or some other formula, so that
the consumer will understand what they may pay out of pocket.
Without that component, a consumer might look at provider prices
and decide to not go forward because the cost of services look
too high.
SENATOR GIESSEL asked if it would be impossible for insurers to
put their reimbursement amounts up because it is so personalized
to each insured person.
MS. WING-HEIER said correct. Network contracts may differ
between employers and health care plans may differ in
deductibles and copays. Those factors have to be taken into
account when someone is looking at the cost.
SENATOR GIESSEL asked if insurers are required now to respond to
client's request for that information.
MS. WING-HEIER said yes. One of the largest insurers has a good
website for clients to go to. Insurers are becoming more
transparent to empower consumers to do the research on their
own. It's a long way from perfect, but the attempt is starting.
2:27:20 PM
SENATOR VON IMHOF removed her objection.
2:27:32 PM
CHAIR WILSON found no further objection and Amendment 3 passed.
SENATOR VON IMHOF thanked Representative Spohnholz for bringing
the bill forward. It is a good start. She said she has put a lot
of thought into this bill and would like to continue dialogue
with Representative Spohnholz to do a new bill next year that
adds the other components of the health care cycle. Providers
such as doctors and hospitals provide the procedures and then
insurers pay for the procedures. Health care trusts manage
health care plans for public entities and then patients need to
compare prices and pay attention to value and ask for good faith
estimates. HB 123 addresses providers and insurers to an extent,
it encourages patients to ask for good faith estimates, but
there is more work to be done building on this bill to bend the
cost of health care growth in the future.
CHAIR WILSON said as Representative Spohnholz described, the
bill is the first couple of steps in a marathon. There is a long
way to go to lower health cost and unravel the complexity of
health care in this state. This is a good faith effort toward
that.
2:30:23 PM
SENATOR VON IMHOF moved to report the Senate Committee
Substitute for Committee Substitute for HB 123, Version G, as
amended, from committee with individual recommendations and
forthcoming fiscal notes.
2:30:39 PM
CHAIR WILSON found no objection and SCS CSHB 123(HSS) moved from
the Senate Health and Social Services Standing Committee.