Legislature(2011 - 2012)BELTZ 105 (TSBldg)
03/01/2012 01:30 PM Senate LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| SB190 | |
| SB116 | |
| SB199 | |
| SB217 | |
| HB168 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 217 | TELECONFERENCED | |
| + | SB 199 | TELECONFERENCED | |
| += | HB 168 | TELECONFERENCED | |
| += | SB 190 | TELECONFERENCED | |
| = | SB 116 | ||
SB 116-WORKERS' COMP.: COLL BARGAINING/MEDIATION
1:38:54 PM
CHAIR EGAN announced SB 116 to be up for consideration.
SENATOR PASKVAN moved to bring CSSB 116 (L&C), labeled 27-
LS0549\X, before the committee. There were no objections.
DANA OWEN, staff to the Senate Labor and Commerce Committee,
said this CS clarifies issues that were raised in the previous
hearing of the bill and adds one item that was not discussed. He
said the title was expanded to add, "An Act authorizing
employers and employees to mediate disputed workers'
compensation claims and to negotiate a collective bargaining
agreement that offers mediation and mandates arbitration..." The
remainder of the title stays the same. Section 1 remains the
same.
He said the changes begin in Section 2, collective bargaining
agreements. Subsection (a) expands language in (a)(1) of the
previous bill and provides more details of the appeals process.
Changes begin on line 28 where the bill establishes a process
for resolving disputes through mediation, arbitration or both.
The parties must agree before a particular dispute may be
submitted to mediation. Then if mediation fails, it provides for
arbitration.
1:42:27 PM
MR. OWEN pointed out that lines 2 and 3 of page 2 specify that
the arbitration will be conducted under AS 09.43. Title 9 is the
code of civil procedure and chapter 43 is arbitration; the
sections that are cited, 300 to 595, constitute Article 3, the
Revised Uniform Arbitration Act. In the last meeting they heard
there was some confusion over how the arbitration was to take
place. The drafter suggested that it would be most direct to
establish the arbitration as taking place under AS 09.43 because
attorneys and courts are familiar with it; everyone involved
should be familiar with it.
1:43:58 PM
He also said that placing it under AS 09.43 implies a different
appeals process than the Workers' Compensation Act where there
is an appeal to the Workers' Compensation Commission. This will
obviate that as appeals will no longer go to the Workers'
Compensation Commission (the original intent of the bill).
MR. OWEN said the bill clarifies that mediation or arbitration
will govern the dispute resolution process under this chapter.
It also says the dispute resolution process must result in
findings of fact, award in a final order or decision by the
arbitrator and that award order or decision has the same force
and effect as a finding of fact, award order or decision of a
hearing officer under AS 23.30.005 (Workers' Compensation
Board). This means the arbitrator's ruling under a collectively
bargained agreement will have the same effect and force as an
order of the board.
Subsection (b) on page 2, line 25, of the bill guarantees that
benefits under Chapter 23.30 (Workers' Compensation Act) cannot
be bargained away. It further clarifies that the agreement and
processes negotiated under this law cannot themselves be
considered a reduction of benefits.
1:45:39 PM
Subsection (c) on line 30 insures that physicians can meet and
communicate with parties to a negotiation in the process of
establishing lists of physicians who are the exclusive medical
providers in a collectively bargained agreement. Currently,
physicians are prevented by law from collaborating on contracts,
fees and things like that. Alaska has a very narrow exception
carved out in statute and this would be the only other
exception. Currently physicians are allowed to do that only if
they are negotiating a managed benefits organization. This would
allow physicians to talk to one another if they were going to
try and get on to the list that would be established under a
collectively bargained agreement under this statute.
1:47:20 PM
DENNIS BAILEY, drafting attorney, Legislative Affairs Agency,
Alaska State Legislature, said he was available to answer
questions on SB 116.
SENATOR GIESSEL said as a health care provider her overarching
concern is patients' choice in one of the most intimate aspects
of their lives. She invited her staff to explain her proposed
amendment.
1:48:32 PM
27-LS0549\X.1
Bailey
A M E N D M E N T
OFFERED IN THE SENATE BY SENATOR GIESSEL
TO: CSSB 116(L&C), Draft Version "X"
Page 3, lines 13 - 15:
Delete all material.
Renumber the following paragraphs accordingly.
Page 3, line 26, following "not":
Insert "(1)"
Page 3, lines 26 - 27:
Delete ". For purposes of this subsection"
Insert "; for purposes of this paragraph"
Page 3, line 29, following "chapter":
Insert "; or
(2) identify health care providers who are
the exclusive source of medical treatment provided
under this chapter; in this paragraph, "health care
provider" has the meaning given in AS 09.55.560"
Page 3, line 30, through page 4, line 4:
Delete all material.
Reletter the following subsection accordingly.
SHARON LONG, staff to Senator Giessel, directed them to page 3
of the amendment where lines 13-15 were deleted to show up
later. The second change begins on line 26 and inserts "1" after
"not" and deletes "for the purposes of this subsection" and
inserts "for the purposes of this paragraph." On line 29, "2" is
inserted after "chapter." The language that was deleted from
lines 13-15 is inserted after "chapter."
The last change deletes lines 30 and 31 on page 3 through line 4
on page 4. This preserves the right currently in statute for
injured workers to choose their own health care provider.
SENATOR PASKVAN said he understands that now there are generally
exclusive providers designated under plans and asked if that is
true and assuming it is, does this prohibit that in the future.
SENATOR GIESSEL replied the main purpose is to allow the patient
to choose whatever health care provider they want to: in other
words, their private physician or if they are part of a plan
that designates a physician. This addresses a collective
bargaining agreement not a person who is not part of a
collective bargaining agreement.
SENATOR PASKVAN said his belief is if you want to go to a
dentist, there are dentists the state has said are on the list
and those dentists have agreed with the state of Alaska, for
instance, that they will do a cavity for $100. His question is
if this would prohibit the State of Alaska from negotiating with
dentists to get a lower collective price for that service.
SENATOR GIESSEL said it wasn't her intent to do that, but the
drafter could help answer that.
MR. BAILEY said the focus of the bill allows an employer and
their employees in a union to negotiate a mediation and an
arbitration process. As part of that process they are allowed to
negotiate the selection of health care providers that would be
permitted to provide services to the union members (in section
2). The normal operation of the workers' compensation statute
that allows employers to negotiate with health care providers to
provide services under their workers' compensation coverage
isn't affected by this bill. The bill is restricted to the
concept of negotiating different terms under the provisions of
the collective bargaining agreement.
SENATOR PASKVAN remarked that the short answer is no or he is
confused. He rephrased his question; if you allow full choice to
the employee who goes to a dentist that charges $150 instead of
a contracted dentist who charges $100, who pays the $50?
MR. BAILEY replied under the current workers' compensation
statute outside of a collective bargaining agreement the
employee who makes a claim can choose his/her health care
provider and an alternate. The issue really is choosing who your
health care provider is. There may be circumstances where an
employer chooses the health care provider for an employee who
makes a claim, but that is limited to employees that don't make
their own choice. It may be that the employer could negotiate
with a group of physicians to provide that in those
circumstances, but the general rule is the employee gets to
choose their own physician in workers' compensation. So, the
question of negotiating a lower rate is more applicable to a
health care plan not within the context of a workers'
compensation claim.
SENATOR PASKVAN said he thinks where it talks about "competing
physicians may meet and communicate" means with respect to
whether they are participants in an exclusive source agreement
with an employer. His perception is if you have competitors
meeting, you have price fixing and wanted to know what the
result of that would be.
MR. BAILEY replied the purpose of allowing physicians to
communicate concerning providing services by the group is
intended under AS 23.50. In the absence of a provision like
that, whoever is negotiating with the physicians could go and
negotiate with each physician and pit one against another to
negotiate a lower price. It's included in this bill because it
provides for a negotiation of who the medical providers are. In
that negotiation physicians, presumably, would want to be able
to negotiate as a group not individually. That is the purpose of
Section (c).
SENATOR GIESSEL said the amendment would remove that section.
MR. BAILEY said the amendment takes out the provision about
negotiating who the health care provider is. It says we don't
want you to negotiate who the physicians are; we want the
existing method that allows an individual to choose their own
provider to apply instead.
2:01:51 PM
MS. LONG said the amendment takes away the ability to bargain
away one's right to choose a physician in a bargaining
agreement, but it doesn't change the ability of physicians
getting together to decide to provide a service through an
employer at certain rates. It doesn't take away the provisions
of the physicians under AS 23.50.020 outside of a bargaining
agreement.
MR. BAILEY added that AS 23.50 allows physicians to negotiate as
a group under certain circumstances. The only reason it was
included originally was as it applies to the collective
bargaining agreement sections. If you take it out of the
collective bargaining agreement context, it does not affect the
remainder of AS 23.50 which relates to bargaining by physicians.
SENATOR GIESSEL said Mr. Owen referred to a managed care group
and that provision is still there.
2:04:20 PM
SENATOR PASKVAN said the operative term is "competing
physicians." If the physicians formed as a group they are not in
competition with each other, but the question is if that second
group is comprised of competing individuals and how that affects
the analysis.
MR. BAILEY replied that you have to keep it in the context of
this bill that relates to collective bargaining for mediation
(to decide who the health care providers are for the union
employees). When a collective bargaining agreement allows for
(it's not mandated) designating a certain group of physicians to
provide medical services, then the provisions of (c) apply. So,
by taking that section out, you're saying that it doesn't apply
here because a particular physician isn't being chosen to
provide services.
SENATOR PASKVAN stated that lines 13-17 of the amendment say the
agreement may not identify health care providers who are the
exclusive source of medical treatment, but the inference is that
there is a list of exclusive source and you can't give it to the
employee. Is that a misunderstanding?
MS. LONG replied that she didn't understand the question.
SENATOR PASKVAN asked why put an amendment in that says they
cannot identify the list if they never put a list together.
SENATOR GIESSEL said this bill deals with a disputed works claim
issue (collective bargaining agreements) that would have a list
of exclusive health care providers. The injured worker would now
be confined to an exclusive list that might or might not include
their own personal healthcare provider. That is the piece the
amendment removes. It would allow them to go to their own
healthcare provider.
CHAIR EGAN stated that he wanted to make sure the committee had
enough time to get answers to the questions before passing this
bill.
MR. BAILEY said the amendment removes negotiation of medical
providers under the collective bargaining agreement.
2:11:51 PM
SENATOR PASKVAN clarified that it has no one with which to
negotiate reduced prices.
SENATOR DAVIS said she would feel comfortable acting on the bill
if Mr. Bailey could answer the question.
MR. BAILEY said the amendment does one thing: it removes the
negotiation of medical providers under the collective bargaining
agreement. The results of the provisions of the existing
workers' compensation statute, which allows you to choose your
own treating physician in a claim would continue to apply as
they normally do. Section (c) (about competing physicians
negotiating) doesn't apply anymore because there wouldn't be any
specified physicians under the collective bargaining agreement.
SENATOR PASKVAN remarked so this removes any negotiation between
an employer and physicians with respect to providing services,
and asked if it also means that the employer has no one with
whom they can negotiate reduced prices as a package for their
employees.
MR. BAILEY replied that the employer and the employee under the
existing bill without the amendment negotiate that. If that
section is removed, there isn't going to be a negotiation under
the collective bargaining agreement for selecting particular
employees. So the employer would not be in a position to
negotiate with physicians about what they provide or what the
costs of their services are.
SENATOR PASKVAN agreed that no price negotiation follows, but
pointed that out as a potential loss to the employees when the
employers' superior bargaining strength might be able to obtain
a discounted price.
MR. BAILEY said there is no negotiation by the employer for the
cost of paying for the employee's physician and that wouldn't
change if the amendment is adopted. If it doesn't pass, then
both the employer and employee negotiate that already in the
collective bargaining agreement.
SENATOR GIESSEL said the strength of having a person being able
to choose their own health care provider is that they will be
continuing to see that person and that healthcare provider knows
their physical condition both before the injury and after, how
they are progressing through it, family history and things like
that.
CHAIR EGAN said he would hold SB 116 for a future meeting.