Legislature(2015 - 2016)BARNES 124
04/15/2015 03:15 PM House LABOR & COMMERCE
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 | |
| HB12 | |
| HB159 | |
| HB185 | |
| SB71 | |
| SB47 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 12 | TELECONFERENCED | |
| += | SB 47 | TELECONFERENCED | |
| += | SB 71 | TELECONFERENCED | |
| *+ | HB 159 | TELECONFERENCED | |
| *+ | HB 185 | TELECONFERENCED | |
HB 159-HEALTH CARE RETAINER; INSURANCE EXEMPT
4:52:28 PM
CHAIR OLSON announced that the next order of business would be
HOUSE BILL NO. 159, "An Act exempting certain health care
agreements from regulation as insurance."
4:53:38 PM
REPRESENTATIVE WES KELLER, Alaska State Legislature, stated he
served on the Alaska Health Commission in 2007. He has become
convinced that health care reform means that the market must be
working. This bill would exempt direct primary care
associations from the Alaska insurance code definitions of
insurance. The bill would not propose any new regulations or
incur additional expenses. This would allow primary care
physicians to have contractual agreement with patients for
primary care services. It would remove the third party payer
since patients would subscribe to the primary care service. He
characterized it as the doctor being one call away. The
contracts would be handled by existing law. He offered that the
positive effects of this bill include improved quality and
access of care that patients would have with their provider,
which could reduce overall health care cost since administrative
costs are drastically reduced. Further, the number of patients
per doctor is also higher than the current system. He
highlighted that doctors often have 15 minutes per patient and
if one takes longer it can create stress for everyone.
4:57:04 PM
REPRESENTATIVE HUGHES thanked for bringing this concept forward.
She asked how reimbursement would work for the patient since it
will prohibit the provider from billing insurance.
KEN TRUITT, Staff, Representative Wes Keller, Alaska State
Legislature, on behalf of the prime sponsor, Representative Wes
Keller, said the concept behind the bill is that it wouldn't
change any existing relationship. Patients can still seek
reimbursement for their primary care costs, including membership
into the primary care network.
4:58:03 PM
REPRESENTATIVE HUGHES asked whether insurers will pay a monthly
service fee and if patient and doctor contracts happen in other
states.
MR. TRUITT said he was not certain. The language for HB 159 was
modeled on legislation that passed in Michigan. He has also
reviewed other states that have primary care legislation,
including Utah.
CHAIR OLSON answered that several bills before the legislature
this session are related to medical costs.
4:58:51 PM
REPRESENTATIVE LEDOUX asked for further clarification on whether
this bill would prohibit the doctors from billing insurance
companies.
MR. TRUITT answered yes; that the concept was to relieve
physicians from dealing with third-party payers. For example,
he said that billing manuals for Blue Cross was over 200 pages
and showed several. The benefit from the provider would be
payment via contract with the patient and no longer need to deal
with the third party payers.
5:00:00 PM
CHAIR OLSON asked for a copy of the manuals.
REPRESENTATIVE KELLER offered to provide it.
5:00:09 PM
REPRESENTATIVE LEDOUX said that currently some doctors hold down
fees by not billing insurance. She asked the reason to have
statutory provisions that prohibit doctors from billing an
insurance company since doctors can currently opt not to bill
insurance. She said it seemed to interfere, which didn't seem
like limited government to her.
REPRESENTATIVE KELLER offered to provide the logic from other
states.
5:01:06 PM
REPRESENTATIVE KITO asked which provider networks would use this
program. He asked whether any doctor's office or company was
seeking an alternate option or if it was a concept that the
sponsor wanted to make available.
REPRESENTATIVE KELLER replied he did not specifically know of
anyone although he has doctor friends who have expressed
interest or positively inclined. He said he became acquainted
with health care agreements via the Alaska Health Commission,
however, this type of contract is not currently available.
5:02:08 PM
REPRESENTATIVE KITO asked whether these health care agreement
contracts will result in monthly fees for patients or a fee for
services. He was unsure how the patient would find the billing
code and the amount of the procedure.
REPRESENTATIVE KELLER answered that this bill does not speak to
fees, but he noted it would need to be addressed. He said this
bill allows contracts between doctor and their patients. He
surmised that some of these contracts or subscriptions might
even include clauses for visitor care. For example, a patient
might pay a certain amount for a subscription for primary care,
which allows visiting family or friends to use the service when
in town. He said that in other states the rates have ranged
from $80-$200 per month for these subscriptions.
5:04:07 PM
REPRESENTATIVE JOSEPHSON asked for the client and patient care
protections that might be given up in terms of regulatory
protections in order to accrue the benefits.
REPRESENTATIVE KELLER answered that he wasn't aware of any
increased risk to patients.
5:04:55 PM
CHAIR OLSON offered that the sponsor may continue work during
the legislative interim.
REPRESENTATIVE KELLER said that the Division of Insurance has
indicated a willingness to work on this bill during the interim.
5:05:33 PM
REPRESENTATIVE LEDOUX noted that this bill doesn't prohibit
doctors from billing insurance, but the process would be
addressed as part of the contract. She recalled reading about
these services, also known as concierge services, in which
people pay $200-300 per month to have the benefit of private
physicians. She recalled that concierge plans have become
popular in California in order for people to avoid dealing with
Medicaid, Medicare, and the various private insurers. Again,
she said, it might be difficult if the doctor doesn't provide
billing information, but some people might be interested in this
to get a doctor's appointment.
5:06:56 PM
REPRESENTATIVE KELLER said many stories are available online
that illustrate the benefits of this type of health care.
[HB 159 was held over.]