Legislature(2015 - 2016)BELTZ 105 (TSBldg)
04/14/2016 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB290 | |
| HB234 | |
| HB372 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 125 | TELECONFERENCED | |
| += | HB 305 | TELECONFERENCED | |
| + | HB 290 | TELECONFERENCED | |
| + | HB 372 | TELECONFERENCED | |
| + | HB 234 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
HB 234-INSURANCE COVERAGE FOR TELEMEDICINE
2:09:03 PM
CHAIR COSTELLO announced the consideration of HB 234. She stated
that the intent is to hear from the sponsor and the
administration, take questions from members, hear public
testimony and hold the bill for further review.
2:09:34 PM
ANITA HALTERMAN, Staff, Representative Liz Vazquez, Alaska State
Legislature, stated that HB 234 seeks to require health care
insurers that offer, issue, or renew health insurance plans in
Alaska to reimburse mental health professionals for medically
necessary services delivered using telemedicine via secure phone
or internet video applications. This legislation would not
require an initial face-to-face visit but requires providers be
licensed in Alaska.
HB 234 is a parity bill. Currently, 32 states and the District
of Columbia have telehealth parity laws that require the option
of telemedicine. Only Arizona requires a face-to-face visit
before mental health services can be delivered via telehealth.
2:11:20 PM
CHAIR COSTELLO asked if the lack of face-to-face interactions
has been an issue in other states.
MS. HALTERMAN replied it is appropriate for a mental health
professional to require a face-to-face encounter if they deem it
appropriate. This legislation seeks to prohibit the insurance
industry from imposing that requirement.
CHAIR COSTELLO summarized that the insurance would not check to
see if there was a face to face interaction. The claim would be
handled absent that information.
MS. HALTERMAN agreed.
2:13:21 PM
REPRESENTATIVE LIZ VAZQUEZ, Alaska State Legislature, sponsor of
HB 234, stated that this legislation provides access to medical
care that is often difficult for people living in rural areas to
access. Even in a city as large as Fairbanks there can be access
issues. Some people are also limited by age, mobility, stamina,
and transportation from making a trip to a health care provider.
CHAIR COSTELLO asked if this would cover Medicaid recipients.
She shared that a constituent's son came home from the Alaska
Psychiatric Institute (API) and wasn't willing to visit the
doctor to renew a prescription. The doctor wasn't willing to
make a home visit because transportation wasn't reimbursed.
MS. VAZQUEZ answered yes; Medicaid has the gold standard
regulations for telehealth delivery.
CHAIR COSTELLO asked if she was saying that a phone call to the
doctor would have sufficed.
REPRESENTATIVE VAZQUEZ replied "it could be in that situation."
SENATOR STEVENS asked if the Alaska Native Tribal Health
Consortium delivers mental health services via telemedicine.
MS. HALTEMAN offered her understanding that tribal entities have
federal exemptions that allow flexibility in the use of
telemedicine. She said many of those beneficiaries have dual
eligibility through Medicaid so there is a parity issue and the
private sector is falling behind. She directed attention to the
50-state analysis that gives Alaska an A+ for telehealth for
Medicaid policies and an F for the private sector. She said this
bill is the first of many to come to help improve for people who
currently don't have access.
SENATOR STEVENS commented that parity is crucial and it
shouldn't matter what race you are.
2:18:40 PM
SENATOR GIESSEL added that the Alaska Native Tribal Health
Consortium has been very successful in providing mental health
services through telemedicine for many years. It leads the
nation in this area.
2:19:05 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development (DCCED), stated
that, as the sponsor said, HB 234 provides for telemedicine.
Currently, MODA provides for telemedicine in its policies but
Premera does not in the majority of its plans. The division
worked with the sponsor in the drafting and has no comments.
2:20:12 PM
STACY TONER, Deputy Director, Division of Behavioral health,
Department of Health and Social Services (DHSS), stated support
for HB 234. She stressed the importance of having mental health
services delivered via telehealth. She said tribal organizations
that use the division's services use telehealth to give village
residents access to psychiatrists and mental health
professionals. She noted that telemedicine has been available in
the Medicaid service array for years. The only recommendation is
to use the term "telehealth" rather than telemedicine.
2:21:32 PM
CHAIR COSTELLO opened public testimony.
2:21:44 PM
LYN FREEMAN, Mind Matters Research, testified in support of HB
234. She described her professional experience and education.
She described the mental health intervention she designed and
tested specifically for Alaskans. When she published the
outcomes, the National Institute of Health (NIH) directed her to
make the intervention available to people across Alaska. She was
specifically directed to utilize telemedicine as much as
possible to overcome the barriers to access to care. The NIH
wrote letters of support and asked insurance providers for
assurance that the intervention would be available for patients
in the office setting and through telemedicine. She said she
approached the insurance providers in the state asking for their
support and was stonewalled at every point. She was told that
her patients would not be covered unless she became part of one
of their programs or joined their Teladoc program. She decided
not to treat patients via telemedicine until legislation passed
that would protect both her patients and herself. She urged the
committee to pass the bill.
2:26:33 PM
KELLY PUFF, representing herself, testified in support of HB
234. She related her experience as a parent of a son with autism
and said the family wouldn't be intact if it weren't for home
telehealth. It's made all the difference to their family.
2:28:24 PM
DR. AROM EVANS, Medical Director, Orion Behavioral Health
Network, testified in support of HB 234. He described the
services the company provides throughout the state for children
and adolescents with mental health conditions. This is a
vulnerable population, many of which would not have access to
these services if it weren't for telehealth. Medicaid
beneficiaries are able to receive telehealth services in their
home, but individuals with private insurance don't have access
to these service because their insurance company won't pay.
Oftentimes the option is to pay for an expensive flight to
Anchorage or forego the care. He urged the committee to pass the
bill.
2:32:45 PM
CHAIR COSTELLO closed public testimony on HB 234 and held the
bill in committee for further review.