Legislature(1999 - 2000)
04/04/2000 02:00 PM House FIN
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE BILL NO. 325
An Act relating to priorities, claims, and liens for
payment for certain medical services provided to
medical assistance recipients; and providing for an
effective date.
JON SHERWOOD, DIVISION OF MEDICAL ASSISTANCE, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES, testified in support of the
legislation. He noted that HB 325 would:
? Provide the Department of Health and Social Services
with unambiguous authority to recover medical costs
incurred by the Division of Medical Assistance when a
legal settlement making a monetary award to cover
injuries has been made; and
? Allow providers to bill the Division for services up to
twelve months from the date of service. The current
period is six months.
Mr. Sherwood stated that the Department would like to
provide an exemption for good cause. If there was good cause
for missing a deadline, then the services that have been
provided should be paid for by the Department.
Co-Chair Therriault noted that the members were provided
with a proposed committee substitute, 1-GH2058\H,
Lauterbach, 4/4/00. [Copy on File]. He noted that the
proposed committee substitute would separate the two issues.
The draft contains the provisions of the bill going after
the third party payments. He noted that he was attempting
to determine a way to cover the assisted living aspect of
the bill.
In response to a question by Representative Phillips, Mr.
Sherwood explained that the legislation would apply to
Medicaid and chronic and acute medical assistance
recipients.
Co-Chair Therriault inquired if a third party claim could go
beyond the six months. Mr. Sherwood responded that at
present time, you could. If you have private insurance, the
provider bills insurance and then bills the Division for the
balance of the claims. The proposed legislation does not
change that provision.
Co-Chair Therriault noted that the committee substitute
drops off the blanket extension to twelve months from
payments of providers. He referenced the fiscal note,
pointing out that the committee substitute would capture
additional revenue.
In response to concerns voiced by Representative J. Davies,
Mr. Sherwood noted that in the portion being deleted, the
Division had proposed to extend the filing deadline for
providers. If there was no insurance to provide service,
the third party providers would then have six months. Under
the proposed change, the period would be extended to twelve
months; the committee substitute would keep it at six
months. Mr. Sherwood added that the committee substitute
would also eliminate exemptions for cause. He observed that
twelve months is the national standard practice for the
industry.
Co-Chair Therriault questioned the fiscal impact of allowing
exemptions for "good cause". Mr. Sherwood did not know the
amount.
Representative J. Davies questioned the intent of the
committee substitute. He recommended that providers should
have the opportunity to collect.
Co-Chair Mulder pointed out that most claims would be made
by doctors and hospitals and that it would be "reasonable"
to expect billing within six months. He added, that is
standard practice in Alaska.
BOB LABBE, DIRECTOR, DIVISION OF MEDICAL ASSISTANCE,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES, provided
information on the legislation. He stated that there is not
a lot of business that comes this way, but emphasized that
there are some small providers with late filings. Mr. Labbe
noted that the federal government allows twelve months to
file a claim. Alaska has a six-month filing time. He
stressed that the cost of longer filings is minimal and it
would help the "provider community".
Co-Chair Mulder asked if passage of the legislation would
provide an "incentive" for companies to be late in their
submissions. Mr. Labbe responded that 90% percent is
received within the first 30 days. He stated that it is the
anomalies that come in later. He admitted that the
Department would have changed it in regulation if it had
been possible.
Co-Chair Mulder suggested that it would take longer to close
out the State's accounting books. Mr. Labbe explained that
the Medicaid process runs on a cash basis and he did not
foresee a problem in the Department's bookkeeping.
Representative J. Davies pointed out that the incentive to
file timely exists in order to receive payment.
LEONARD ANDERSON, (TESTIFIED VIA TELECONFERENCE),
REPRESENATIVE FOR THE STATE OF ALASKA THIRD PARTY RECOVERY
FOR MEDICAID MATTERS, ANCHORAGE, stated that the current
bill contains a "notice" problem and recognition in the
State's right to recover Medicaid payments from a liable
third party. Currently, when cases are made and payments
are paid, the State finds out about third party recipients
through the third party. The State Medicaid portion is
included in any recovery. Mr. Anderson found that the State
is receiving notice of a potentially liable third party well
into the case, possibly during settlement or after. The
bill would allow absolute notice of a third party earlier in
the process.
Mr. Anderson continued, the second problem is that current
statute is based on segregation principles. The new
legislation gives the State the opportunity to get a better
bargaining position and would allow them to have an
opportunity to affect what is liable.
LISA KIRSCH, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW,
offered to answer questions of the Committee members.
LORRAINE DERR, ALASKA STATE HOSPITAL AND NURSING HOME
ASSOCIATION (ASHANHA), JUNEAU, testified in support of the
legislation as originally written.
Co-Chair Therriault advised that he would not offer the
committee substitute. He noted that the Legislature would
continue to work with the Department on the expenditure side
of the fiscal note through the Conference Committee.
Co-Chair Mulder MOVED to report CS HB 325 (JUD) out of
Committee with individual recommendations and with the
accompanying fiscal note.
CS HB 325 (JUD) was reported out of Committee with a "do
pass" recommendation and with a fiscal note by Department of
Health and Social Services dated 2/2/00.
(TAPE CHANGE, HFC 00 - 100, Side 2).
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