Legislature(2025 - 2026)BELTZ 105 (TSBldg)
04/07/2025 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB83 | |
| SB21 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 21 | TELECONFERENCED | |
| + | SB 83 | TELECONFERENCED | |
SB 83-TELEHEALTH REIMBURSEMENT RATES
[CSSB 83(HSS)was before the committee.]
1:33:38 PM
CHAIR BJORKMAN announced the consideration of CS FOR SENATE BILL
NO. 83(HSS) "An Act relating to health care insurance; relating
to insurance reimbursement for health care services provided
through telehealth; relating to telehealth; providing for an
effective date by repealing the effective date of secs. 9 and
10, ch. 38, SLA 2022; and providing for an effective date."
1:34:02 PM
SENATOR MATT CLAMAN, District H, Alaska State Legislature,
Juneau, Alaska, as the sponsor of SB 83, he the bill:
[Original punctuation provided.]
Senate Bill 83 was brought forward by health care
providers in my district who provide both in-person
and telehealth services to Alaskans across the state.
SB 83 will ensure pay parity for telehealth, requiring
health care insurers to reimburse at the same payment
rate for telehealth services as in-person care.
1:34:31 PM
SENATOR CLAMAN continued with his presentation:
Telehealth reduces barriers to care and allows
patients to receive timely and convenient care from
the comfort of their own homes. In Alaska, barriers to
care affect individuals in rural areas, those with
disabilities, and those with limited transportation
options. Telehealth is especially important for
chronic disease management, mental health services,
and preventative care.
The COVID-19 pandemic highlighted the critical need
for telehealth access, prompting the Centers for
Medicare & Medicaid Services (CMS) to temporarily
implement telehealth parity. While this federal
mandate has expired, some telehealth provisions remain
in place. What was once a temporary need is now
standard practice, and many states have made efforts
to solidify permanent access to these services. Over
33 states have enacted similar legislation to SB 83 to
ensure fair reimbursement for telehealth services.
Alaska's Medicaid program already has telehealth pay
parity. This legislation builds upon that existing
framework to require the same parity by private
insurers. In our previous committee, we amended to
remove the sunset language in Alaska's Medicaid
telehealth statutes, ensuring that it will remain in
law.
Passage of this legislation will expand access to
care, improve and maintain quality of care, and
incentivize continued telehealth utilization.
1:36:13 PM
SARENA HACKENMILLER, Staff, Senator Matt Claman, Alaska State
Legislature, Juneau, Alaska, provided the sectional analysis for
SB 83:
[Original punctuation provided.]
Sectional Analysis Version O
Section 1
AS 21.42.422(b). Coverage for telehealth. Adds new
paragraph (3) and references the definition of "health
care provider" as given in AS 21.07.250.
1:36:38 PM
MS. HACKENMILLER continued with the sectional analysis of SB 83,
version O:
Section 2
AS 21.42.422. Coverage for telehealth. Establishes a
new subsection requiring health care insurers to
reimburse health care providers for telehealth
services, including behavioral health services, at the
same rate as for in-person services.
Section 3
AS 29.10.200. Limitation of home rule powers. Adds new
paragraph (68) "AS 29.20.420 (health care insurance
plans)" to the list of provisions which apply to home
rule municipalities
Section 4
AS 29.20.420. Health care insurance plans. Establishes
a new section requiring a home rule or general law
municipality offering a group health care insurance
plan to meet the requirements of AS 21.42.422(c)
(Section 2). Provides the definition of "health care
insurance plan" as given in AS 21.52.500.
Section 5
AS 39.30.090(a). Authorization for self-insurance and
excess loss insurance. Adds a new subsection (13)
requiring a policy or policies of group insurance
covering state employees and other specific employee
groups under the Department of Administration to meet
to the requirements of AS 21.42.422(c) (Section 2).
Section 6
AS 39.30.091. Authorization for self-insurance and
excess loss insurance. Amends this statute to require
those employers with a self-insured group health
insurance plan covering active state employees to meet
the requirements of AS 21.42.422(c) (Section 2).
Section 7
Repeals Sections 9, 10, and 13 of ch. 38, SLA 2022.
Section 8
Repeals Section 14 of ch. 38, SLA 2022.
Section 9
Establishes an effective date of January 1, 2026.
1:38:22 PM
CHAIR BJORKMAN announced invited testimony on SB 83.
1:38:40 PM
JIM REBITZER, Economist, Boston University, Boston,
Massachusetts, testified by invitation on SB 83:
[Original punctuation provided.]
I am here to testify about a new piece of legislation
regarding reimbursement for telehealth services. The
bill requires a health insurer to reimburse for
telehealth services on the same basis and at least at
the same rate as comparable healthcare services
provided in person.
Let me start with my conclusion: This legislation is
reasonable and deserving of your support. However, the
reasoning behind it may be of greater use to the
committee than my conclusion.
As an economist studying management, I generally
believe that a state legislature should not determine
how much private insurers pay for services. Typically,
legislatures lack essential information and
incentives, and they respond too slowly to set
appropriate reimbursement rates. It is better to leave
this to negotiations between insurers and providers.
However, telehealth might be the exception that proves
the rule. Mandating equal payment can help address an
economic issue that private parties cannot resolve
independently.
Like every new treatment modality, telehealth requires
providers to develop new capabilities for delivering
care at a distance. Payers may be willing to
compensate providers to encourage these costly
investments, but will they pay enough on their own?
Perhaps not. In our fragmented payment system, each
provider treats patients from many different payers:
Medicare, Medicaid, the State of Alaska, private
insurers, and private employers. This diversity of
payers creates an opportunity for free riding.
1:41:27 PM
MR. REBITZER continued with his testimony on SB 83:
Suppose a provider deals with 10 different payers,
each paying $50 for a telehealth visit. Suppose
providers are happy to invest adequately in telehealth
capacity at this price. What would happen if one payer
decided to pay $40 for a telehealth visit? Providers
might still be willing to deliver telehealth care to
this payer because they have already borne the cost of
developing the telehealth capacity. The insurer who
pays $40 would, in effect, be "free riding" on the
other payers' generosity. That would be annoying to
the other payers. If the rest followed suit, the
result would be an inadequate investment in telehealth
capacity or, in the extreme case, no investment at
all.
You can see where this is heading. The proposed bill
can be beneficial as it makes it more difficult for a
single insurer to take advantage of investments in
telehealth funded by other payers.
Some who object to payment parity might argue that the
marginal cost of telehealth is less than in-person
health, so "parity" in payments means you are
overpaying for telehealth. This reasoning makes sense
until you think about it for a minute. Much of the
cost of delivering telehealth is determined by what
else providers could do with their time. Payment
parity has the advantage of not making it more
expensive for providers who deliver telehealth
services.
Although I am not an Alaskan, I am impressed by the
vast distances' healthcare providers must travel to
reach all Alaskans. The cost of underinvestment in and
under provision of telehealth is especially severe for
Alaska, so the proposed legislation's value is likely
to be high.
1:44:25 PM
HOWARD DETWILER, Owner, Arctic Behavior Health LLC, Anchorage,
Alaska, testified by invitation on SB 83 and gave an example of
when a snowstorm, in Anchorage, prevented two clients from
visiting the office, requiring remote consultations for
medication management. The technological costs and system
failures for telehealth can equal or exceed in-person visits and
may increase the risk of emergency consultations. He emphasized
an experience of developing military telehealth systems in Iraq
and Afghanistan, emphasizing that telehealth is essential for
healthcare delivery in Alaska.
1:46:43 PM
CHAIR BJORKMAN asked Mr. Detwiler to give examples of how SB 83
would directly affect his business.
1:46:58 PM
MR. DETWILER replied that a snowstorm prevented two clients from
visiting the office for restricted medications, making in-person
evaluation and prescription continuation impossible. He said
telehealth is essential to maintain continuity of care,
especially given Alaska's distances and challenging climate.
[CHAIR BJORKMAN held SB 83 in committee.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB83 ver O.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Sponsor Statement ver O.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Sectional Analysis ver O.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Fiscal Note-DCCED-DOI 03.14.25.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Fiscal Note-DOA-DRB 02.04.25.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Supporting Document-AMA-State telehealth policy trends 11.30.23.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Supporting Document-AMA-Supporting equitable payment for telehealth 06.21.23.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |
| SB83 Public Testimony-Combined Letters of Support 04.04.25.pdf |
SL&C 4/7/2025 1:30:00 PM |
SB 83 |