Legislature(2009 - 2010)CAPITOL 106
02/23/2010 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB188 | |
| HB309 | |
| HB265 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 188 | TELECONFERENCED | |
| *+ | HB 309 | TELECONFERENCED | |
| *+ | HB 265 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 309-DENTAL CARE INSURANCE
CO-CHAIR KELLER announced that the next order of business would
be HOUSE BILL NO. 309, "An Act prohibiting health care insurers
that provide dental care coverage from setting a minimum age for
receiving dental care coverage, allowing those insurers to set a
maximum age for receiving dental care coverage as a dependent,
and prohibiting those insurers from setting fees that a dentist
may charge for dental services not covered under the insurer's
policy."
4:25:59 PM
CECILE ELLIOTT, Staff for Representative Bill Thomas, Alaska
State Legislature, testified that the first provision of HB 309
"prohibits insurance companies from establishing age limitations
on young children receiving dental care services." She
explained that there was a current national trend for minimum
age requirements, limiting dental care coverage to 4 years and
older.
MS. ELLIOTT stated that the second provision of HB 309
prohibited insurance companies from fee capping non-covered
services, which she explained to be the practice by insurance
companies for dictating the cost of dental services that were
not covered by insurance.
4:27:04 PM
CO-CHAIR HERRON asked for an explanation of the contracts
between dentists and health insurers, and he noted that the
constitution prohibited the passage of any law impairing
obligation of contracts.
4:27:29 PM
MS. ELLIOTT replied that she would need to research this.
4:27:36 PM
CO-CHAIR HERRON asked about the effect of the bill on Alaskans
who exceeded the cap on dental insurance coverage.
4:28:01 PM
MS. ELLIOTT replied that HB 309 would allow the dentist to offer
any additional service for a reasonable fee, without the
insurance company dictating that fee. She pointed out that
dentists already had published fee schedules.
4:29:12 PM
MS. ELLIOTT, in response to Representative Wilson, agreed that
the contracts for managed care "were entered into with the
dentists' knowing," but that the additional clause for non-
covered service was problematic.
4:29:52 PM
REPRESENTATIVE T. WILSON asked to clarify that HB 309 would
limit "what they could put in a contractual agreement."
4:30:20 PM
MS. ELLIOTT agreed that dentists entered into a contractual
agreement for covered services, but that there was a fee
schedule for non-covered services, as well.
REPRESENTATIVE T. WILSON pointed out that this was regulating
contracts.
4:30:50 PM
CO-CHAIR KELLER opined that it was hard to analyze the real cost
resulting from insurance regulation.
4:32:03 PM
SHEILA TALLMAN stated that Premera had concerns with the
provision limiting the fees for non-covered services. She
opined that HB 309 would increase the cost to consumers, as it
would not allow dentists to consistently pass on the discounted
rates for non-covered services which insurers did negotiate.
She expressed concern that a Premera policy holder may not know
to ask for, and receive, a discount. She pointed to the bill
language, which stated that, should a benefit maximum be
reached, a patient would be billed, sometimes at a higher rate.
4:33:30 PM
CO-CHAIR KELLER asked about similar bills in other states.
MS. TALLMAN replied that new bills were being offered in other
states, including Oregon and Washington. She shared that she
had not seen any cost impacts.
4:34:21 PM
CO-CHAIR KELLER asked for a reason to the legislation.
MS. TALLMAN offered her belief that some insurance providers
were not providing options for the dentists, but that this was a
negotiated provision between the dentists and the insurance
providers.
4:35:18 PM
REPRESENTATIVE T. WILSON asked if HB 309 would affect insurance
rates.
MS. TALLMAN replied that the main impact would be on the
consumers for out of pocket costs. She added that insurance
premium rates could be affected as consumers visited non-
participating dentists, which would bring lower revenues for
participating dentists.
MS. TALLMAN, in response to Representative T. Wilson, stated
that dental providers were free to negotiate the contracts, but
that consumers were directed to participating dentists through
the contract, which was a benefit to the dentist.
4:36:49 PM
REPRESENTATIVE SEATON asked if a dentist could charge a higher
amount for the same service when it was in addition to the
covered service.
4:37:54 PM
MS. ELLIOTT replied that the dentist had a posted fee schedule,
which was available to the consumer. She agreed that, as fees
were discounted with the insurer, the non-covered service could
be more expensive. She highlighted that the non-covered clause
of the managed care contract was not negotiable.
4:39:23 PM
REPRESENTATIVE SEATON asked to clarify the notice of coverage.
4:40:47 PM
MS. ELLIOTT said that Dr. Mark Prator could better answer this.
4:42:05 PM
JOHN WOLLER, Dentist, Alaska Dental Society, explained that HB
309 was attempting to level the playing field for non-covered
services. He said that dentists were not allowed to enter into
collective bargaining agreements with insurance companies, but
that it was possible to seek legislative action. In response to
Representative T. Wilson, he clarified that dentists were not
allowed to negotiate with insurers. He expressed a desire to
limit the impact an insurance company could have for pricing a
service which they did not cover. He pointed out that, although
the insurance company stated a desire to limit fees for
consumers, it was the dental provider who absorbed all the
costs. He clarified that the contracts were a small percentage
of dental care in Alaska. He stated that the reason to sign on
to the insurance provider fee schedule was to get more patients.
He declared that most dental practices were small businesses and
they needed to remain profitable. He reported that contracted
fee schedules were at cost, and did not offer any profit; the
profit was from non-covered services at the regular fee
schedule. He said the contracts had language to limit the
regular fee schedule. He asked that the committee pass a law
for insurance companies to help defray the cost, as the cost
should not all be the responsibility of the dentist.
4:46:51 PM
REPRESENTATIVE T. WILSON asked to clarify that the contract with
the insurance company was only for covered care.
DR. WOLLER said that HB 309 would prevent insurance companies
from setting the fee for all non-covered services.
4:48:16 PM
REPRESENTATIVE T. WILSON asked to clarify how the insurance
company could dictate this.
4:48:38 PM
DR. WOLLER agreed that was what HB 309 was all about.
DR. WOLLER, in response to Representative T. Wilson, said that
the insurance companies would threaten to withdraw the contracts
if the agreement for fee setting to all non-covered services was
not included. He offered an example of a hotel contracting with
a tour company for discounted rooms, and then having the tour
company state that the hotel needed to also discount its food,
gifts, and tours. He said that the costs would just be shifted
to other patients without insurance.
4:51:52 PM
REPRESENTATIVE SEATON asked if the insurance company was only
trying to limit the fee for non-covered service to the policy
holders of the insurance.
DR. WOLLER agreed.
4:52:38 PM
MARK PRATOR, Dentist, Alaska Dental Society, noted that there
was speculation as to who was going to benefit, and he pointed
to the concern for non-covered services. He opined that a
greater problem was for access to care, as insurance companies
were attempting to limit patients according to age. He pointed
out that, as rural dentists dropped out of these contracts,
there would not be any care for rural residents. He stated that
allowing insurance companies "to dictate what we can charge for
services that are not even a part of their plan" would create a
lot of problems.
4:55:32 PM
CO-CHAIR KELLER closed public testimony.
[HB 309 was held over.]
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