Legislature(2025 - 2026)BUTROVICH 205
02/25/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB9 | |
| SB83 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 9 | TELECONFERENCED | |
| += | SB 83 | TELECONFERENCED | |
SB 83-TELEHEALTH REIMBURSEMENT RATES
4:30:31 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 83 "An Act relating to health
care insurance; relating to insurance reimbursement for health
care services provided through telehealth; and providing for an
effective date."
4:32:01 PM
CHAIR DUNBAR solicited a motion.
4:32:04 PM
SENATOR GIESSEL moved to adopt the committee substitute (CS) for
SB 83, work order 34-LS0413\I, as the working document.
4:32:15 PM
CHAIR DUNBAR objected for purposes of discussion.
4:32:24 PM
ARIELLE WIGGIN, Staff, Senator Forrest Dunbar, Alaska State
Legislature, Juneau, Alaska, provided the summary of changes for
SB 83 from version N to I.
[Original punctuation provided.]
Senate Bill 83
Explanation of Changes Version N to Version I (CS-
SHSS)
This version of SB 83 moves multiple sections that had
been added to or referred to a new section in Version
N (AS 21.42.450) into the existing statute covering
telehealth (AS 21.42.422) and makes conforming
changes. This version adds a requirement for health
care insurers to equally apply reimbursement rates for
each health care provider.
Title Change
Expanded to include "relating to health care insurance
reimbursement rates" on account of new language in
Section 3.
Section 1 (new section)
AS 21.42.422(b). Coverage for telehealth.
Adds new paragraph (3) to reference the definition of
"health care provider" as given in AS 21.07.250.
Section 2
Prior version Section 1 language is moved from AS
21.42.450 to existing statutes covering telehealth, AS
21.42.422.
Prior version Section 2 removed: referenced definition
of "telehealth" as given in AS 47.05.270.
Section 3 (new section)
AS 21.54.190. Reimbursement rates.
Requires health care insurers to equally apply
reimbursement rates for each health care provider.
Section 4 (prior version Section 3)
Section 5 (prior version Section 4; updates telehealth
reference AS 21.42.422)
Section 6 (prior version Section 5; updates telehealth
reference AS 21.42.422)
Section 7 (prior version Section 6; updates telehealth
reference AS 21.42.422)
Prior version Section 7 removed: repealed definition
of "telehealth" in AS 21.42.422
Section 8 (no change)
4:34:55 PM
SENATOR GIESSEL said Section 3 of CSSB 83 was her amendment
requiring uniform and equal pay for health care providers under
Current Procedural Terminology (CPT) codes, so if the service is
the same, the pay is equitable and uniform. She stated this
results in no change to the zero fiscal notes.
4:35:35 PM
CHAIR DUNBAR sought confirmation that the change achieves the
intended purpose.
SENATOR GIESSEL replied yes.
4:35:42 PM
CHAIR DUNBAR removed his objection, found no further objection
and CSSB 83 was adopted as the working document.
4:36:08 PM
SENATOR HUGHES said that, according to Ms. Wing-Heier, insurance
companies are paying parity. She stated her understanding that
during COVID, under Medicaid laws, parity was provided with a
sunset date in 2030, and insurance companies typically follow
Medicaid's model. She referenced a provider who testified she
only received 60 percent of what she would for an in-person
[visit], which conflicted with Ms. Wing-Heier's testimony. She
asked for an update on whether insurance companies are already
paying parity and, if so, expressed reservations about the
mandate. She said she viewed telehealth as a way to reduce
health care costs. She acknowledged the sponsor's point that
frequent provider visits can improve patient outcomes and reduce
long-term costs, however, she suggested compromise is needed.
4:38:25 PM
SENATOR CLAMAN deferred the question.
4:38:49 PM
HEATHER CARPENTER, Deputy Director, Division of Insurance,
Department of Commerce, Community, and Economic Development,
Juneau, Alaska, answered questions on SB 83, stated that the
Medicaid legislation referenced was House Bill 265, passed in
2022. She clarified that the 2030 sunset applied only to
Medicaid. She confirmed that insurers are generally paying at
parity. Moda reported paying at parity, and Premera stated it
follows Centers for Medicare and Medicaid Services (CMS)
guidelines, meaning payment depends on the patient's location,
which often results in parity, but not when the location is
somewhere other than the patient's home location.
4:40:11 PM
SENATOR HUGHES asked if the testimony from the provider who said
she only received 60 percent meant that payment was based on
location, even though the location was in-state.
4:40:30 PM
MS. CARPENTER replied that it depends on who the payor was. She
said the Division of Insurance only oversees about 15 percent of
the health insurance market.
4:41:26 PM
SENATOR HUGHES asked if SB 83 became law, would the federal
payors have to follow the law. She commented that 15 percent of
payors are currently paying at parity voluntarily. She asked
would the remaining 85 percent not regulated by the Division
have to comply if SB 83 became law.
MS. CARPENTER stated that SB 83 does not direct Medicaid or
Employee Retirement Income Security Act (ERISA) plans, except
that it does target AlaskaCare through SB 83, Sections 6 and 7.
She added that it also applies to two municipal plans under
Sections 4 and 5. SB 83 currently impacts the Division of
Insurance under AS 21. She directed the committee's attention to
Section 3, addressing Senator Giessel, and acknowledged
understanding her intent. However, she explained that the way
the drafter wrote it limits application to group insurance
coverage only, meaning it would not apply to all plans. It would
not affect plans in the individual market. She offered to
suggest alternatives to better achieve the intended policy
goals.
4:42:48 PM
SENATOR HUGHES asked if, based on the way SB 83 is drafted, it
covers the 15 percent regulated by the Division, AlaskaCare, and
any plans provided by municipalities in the state, but not the
85 percent outside the Division's authority.
4:43:04 PM
MS. CARPENTER replied that is the Division understanding.
4:43:15 PM
SENATOR HUGHES said that, for the provider who was reimbursed at
60 percent, it could be that the payer was one to which SB 83
would not apply. She reiterated her reservations regarding the
potential for telehealth to reduce health care costs and
expressed a preference for a compromise. However, she stated she
was not objecting to adopting the SB 83 and was fine with it
moving out.
4:43:47 PM
SENATOR GIESSEL said she believes everyone supports reducing the
cost of health care, but not at the expense of underfunding
providers who are trying to maintain clinics. She stated the
purpose of the amendment is to enforce parity of pay. Currently,
nurse practitioners and physician assistants are not reimbursed
at the same rate as physicians for the same CPT codes and
services.
4:44:24 PM
SENATOR HUGHES said she agreed with Senator Giessel and
clarified that her concern is the payment amount for a
telehealth visit compared to an in-person visit, noting that
seeing more patients reduces overhead costs. She stated that a
nurse practitioner providing the same service as a physician
should be reimbursed at the same rate.
4:45:02 PM
At ease.
4:46:03 PM
CHAIR DUNBAR reconvened the meeting and held SB 83 in committee.
4:46:32 PM
SENATOR CLAMAN stated that Senator Hughes raised interesting
points about the cost of care but stated his belief that her
analysis viewed the issue too narrowly, focusing only on the
cost comparison of a single telehealth and in-person visit. He
argued that a broader economic perspective, including overall
medical costs, shows that her analysis does not hold up. He
cited repeated evidence of cost savings and improved access
through telehealth. He added that the strongest indicator of
telehealth's value is the lack of opposition from insurance
companies, who support the legislation because it reduces
overall insurance costs. He concluded that while Senator
Hughes's view may be accurate within a narrow scope, the larger
picture shows telehealth improves access, keeps patients
healthier, and benefits both employers and insurers through
long-term savings.