04/17/2024 03:15 PM House LABOR & COMMERCE

         HB 187-PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS                                                                      
                                                                                                                                
3:50:35 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced  that the next order of  business would be                                                               
HOUSE  BILL  NO. 187,  "An  Act  relating to  utilization  review                                                               
entities;  exempting certain  health care  providers from  making                                                               
preauthorization  requests for  certain  services; and  providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
3:51:01 PM                                                                                                                    
                                                                                                                                
SARENA HACKENMILLER,  Staff, Representative Jesse  Sumner, Alaska                                                               
State  Legislature, on  behalf  of  Representative Sumner,  prime                                                               
sponsor, gave the  sponsor statement for HB 187  [included in the                                                               
committee packet],  which read  as follows  [original punctuation                                                               
provided]:                                                                                                                      
                                                                                                                                
          HB 187  aims to reduce  the wait time  for certain                                                                    
     health   care  services   by   exempting  health   care                                                                    
     providers  from  making preauthorization  requests  for                                                                    
     said services.                                                                                                             
          Currently, Alaskans  who need certain  health care                                                                    
     services must  wait days  and even weeks  at a  time to                                                                    
     get  pre-authorized  to  receive health  care  services                                                                    
     because of the processing  time between the health care                                                                    
     provider and insurance companies.  This bill would help                                                                    
     Alaskans  receive  health  care  services  immediately,                                                                    
     especially health  care services that could  save their                                                                    
     lives.                                                                                                                     
          This  bill  would   create  a  utilization  review                                                                    
     entity  that   may  evaluate  whether  a   health  care                                                                    
     provider  continues  to  qualify for  an  exemption  if                                                                    
     during   the   most   recent   12-month   period,   the                                                                    
     utilization  review   entity  has  approved   or  would                                                                    
     approve  at  least  80%   of  the  prior  authorization                                                                    
     requests  submitted by  the  health  care provider  for                                                                    
     that health care service.                                                                                                  
          The  Health  Care  provider  is  not  required  to                                                                    
     request  an exemption  to qualify  for an  exemption. A                                                                    
     utilization review  may not deny or  reduce payment for                                                                    
     a health care service that is exempted.                                                                                    
          Other states  with prior  authorization exemptions                                                                    
     have seen  increased frequency of patients  who receive                                                                    
     the health care services they need expediently.                                                                            
          This  bill   will  help  Alaskans   receive  fast,                                                                    
     efficient,  and quality  healthcare when  they need  it                                                                    
     without  waiting for  a  preauthorization process  that                                                                    
     could cause their health to decline even more.                                                                             
                                                                                                                                
3:53:18 PM                                                                                                                    
                                                                                                                                
JEFF DAVIS, Former  President, Premera Blue Cross  Blue Shield of                                                               
Alaska, began invited testimony by  giving his history of working                                                               
in Alaska's  health insurance industry and  sharing what problems                                                               
he thinks  might be  solved by  HB 187.   He said  that currently                                                               
patients are bearing the cost  of unnecessary prior authorization                                                               
in the  form of delays  in care.  He  said the original  goals of                                                               
prior authorization  were well meaning  but because  of unchecked                                                               
expansion have grown ineffective.  He  said the issue is the fact                                                               
that  there are  a huge  number of  prior authorization  requests                                                               
that are  denied initially by  the payer.   He shared  his belief                                                               
that  HB   187  would  restore  the   balance  between  patients,                                                               
physicians, and health insurance providers.                                                                                     
                                                                                                                                
4:00:38 PM                                                                                                                    
                                                                                                                                
PAM   VENTGEN,   Executive   Director,   Alaska   State   Medical                                                               
Association, began her invited testimony  on HB 187 by explaining                                                               
that  when a  prior authorization  request is  denied it  must be                                                               
appealed, which can delay adequate  and timely care to a patient.                                                               
She  said that  in the  case of  a denial,  either a  nurse or  a                                                               
physician assistant  may request the prior  authorization appeal,                                                               
both  of  whom  must  educate  the  prior  authorization  request                                                               
reviewer  on  new  technologies  that  affect  the  appeal  which                                                               
further takes time away from care to the patient.                                                                               
                                                                                                                                
4:03:31 PM                                                                                                                    
                                                                                                                                
JOHN  KELLY, Chief  Executive Officer,  Alaska  Air Group,  began                                                               
invited testimony on  HB 187 by giving an example  of someone who                                                               
was  diagnosed   with  a   disease  and   was  affected   by  the                                                               
complexities   of   insurance   and   delays   in   their   prior                                                               
authorization  request.   He said  that  prior authorization  has                                                               
gone awry  and emphasized that  the time  used in the  review and                                                               
appeals process  is harmful  to patients in  the form  of delayed                                                               
and lost time.                                                                                                                  
                                                                                                                                
4:11:19 PM                                                                                                                    
                                                                                                                                
JARED   KOSIN,  President/CEO,   Alaska  Hospital   &  Healthcare                                                               
Association (AHHA),  began invited testimony by  noting that AHHA                                                               
is in  strong support of HB  187.  He said  that currently, prior                                                               
authorization is causing  major delays with patient  care that is                                                               
at times detrimental  to their quality of life, and  HB 187 would                                                               
help  to alleviate  some of  the downfalls  of the  current prior                                                               
authorization process.                                                                                                          
                                                                                                                                
4:13:56 PM                                                                                                                    
                                                                                                                                
CHAIR SUMNER announced that HB 187 was held over.