04/16/1997 09:07 AM Senate HES

                                                                               
        SB 122 INS.COVERAGE:MARRIAGE & FAMILY THERAPIST                       
                                                                              
 Number 459                                                                    
                                                                               
  CHAIRMAN WILKEN  introduced  SB 122  as the next order of business.          
 He noted that there was a CS from the Labor & Commerce Committee,             
 when saying that he would entertain a motion to place it before the           
 committee.                                                                    
                                                                               
  SENATOR WARD  moved to adopt CSSB 122(L&C) for discussion purposes.          
 Without objection, CSSB 122(L&C) was adopted.                                 
                                                                               
  RACHEAL MORELAND , Staff to Senator Leman, read the following                
 Sponsor statement into the record:                                            
                                                                               
 Senate Bill 122 was introduced by the Labor and Commerce Committee            
 at the request of the Alaska Association for Marriage and Family              
 Therapy (AAMFT).  SB 122 will add marital and family therapists to            
 the list of providers against whom insurers may not discriminate.             
                                                                               
 This bill does not require insurers to add coverage of marital and            
 family therapists where the coverage currently is not provided.  It           
 merely requires that insurers treat marital and family therapists             
 on equal footing with other licensed providers and extend the same            
 opportunities for coverage that the insurer offers others providing           
 the same services.  The definition of unfair discrimination is                
 clarified by this bill and codifies existing practice.                        
                                                                               
 Section 1, paragraph 1 adds marital and family therapists to the              
 unfair discrimination list under group health insurance policies              
 with an effective date of July 1, 1997.  Paragraph 2 defines unfair           
 discrimination.                                                               
                                                                               
 Legislation (Section 4, ch. 39, SLA 1993) affecting the unfair                
 discrimination clause was passed in 1993 with an effective date of            
 1998.  Section 2 repeals and reenacts this section to reflect the             
 addition of marital and family therapists and the definition of               
 unfair discrimination.                                                        
                                                                               
 Currently, health insurers offering mental health services may not            
 discriminate against licensed psychologists, psychological                    
 associates or clinical social workers.  SB 122 would allow those              
 insured with mental health coverage to choose treatment from a                
 licensed marital and family therapist.                                        
                                                                               
 AAMFT is a division of the American Association for Marriage and              
 Family Therapy, Inc.  Marriage and family therapists (MFTs) are a             
 group of mental health professionals with background in a variety             
 of disciplines, including psychology, social work, and family                 
 social science.  MFTs are licensed or certified in 37 states and              
 are recognized by the U.S. Department of Health and Human Services            
 as one of the five core mental health disciplines in the U.S.                 
                                                                               
  CATHERINE REARDON , Director of the Division of Occupational                 
 Licensing in the Department of Commerce & Economic Development,               
 informed the committee that the Board of Marital and Family                   
 Therapists works in association with this division.  The board                
 supports the inclusion of MFTs in this nondiscrimination clause.              
                                                                               
  SENATOR LEMAN  inquired as to how many people are licensed by the            
 board in this category.   CATHERINE REARDON  said that at the                 
 beginning of this fiscal year, there were 181 persons licensed in             
 this category.                                                                
                                                                               
 Number 515                                                                    
                                                                               
  BEVERLY LINDELL , President of AAMFT, requested the committee's              
 support for SB 122.  Ms. Lindell noted that SB 122 does not mandate           
 coverage nor increase the scope of service nor does the bill                  
 include any willing provider language.  This legislation is                   
 important for fairness.  Ms. Lindell noted that MFTs have been                
 licensed in this state since 1992 and pay fees to provide that                
 service.  MFTs are also one of the five core mental health groups             
 identified by the National Institute of Mental Health.                        
                                                                               
 With regard to the concern of cost, Ms. Lindell informed the                  
 committee that the Division of Insurance reported that there is no            
 evidence that costs would increase due to the increase in the pool            
 of providers.  In fact, the effect of competition may actually                
 decrease the costs.  Ms. Lindell explained that MFTs tend to be               
 solution focused which results in achieving a job efficiently and             
 quickly which could result in reduced costs to insurers.  Ms.                 
 Lindell also noted that a survey in the American Psychologist               
 reported that consumers refer to MFTs more often than other mental            
 health professionals.  Further there has been much information                
 about family problems across the nation and in Alaska which has the           
 highest rate of teen suicide and sexual abuse.  MFTs are the groups           
 that have expertise in that area and would like to practice that              
 with reimbursement.                                                           
                                                                               
  CHAIRMAN WILKEN  asked Ms. Burke to explain the term "unfair                 
 discrimination" to the committee.                                             
                                                                               
  MARIANNE BURKE , Director of the Division of Insurance for DCED,             
 explained that "unfair discrimination" does not include the purpose           
 of utilization review for standards of clinical appropriate health            
 care which Ms. Burke could support.  With regard to cost                      
 containment, Ms. Burke was a bit concerned that it could be used to           
 force an individual to seek the cheapest service available.  Ms.              
 Burke pointed out that the process of utilization review is a cost            
 containment measure.  Clinically appropriate health care services             
 have elements of cost containment.  Ms. Burke believed that the               
 amendment helps clarify this section of Title 21.                             
                                                                               
  SENATOR LEMAN  did not intend for "cost containment" to mean that            
 the lowest cost provider must be utilized, but rather that the                
 appropriate provider be utilized.  Senator Leman pointed out that             
 there may be appropriate measures to contain cost which would not             
 be an unfair discrimination practice.                                         
                                                                               
  CHAIRMAN WILKEN  asked if Ms. Burke had heard from insurance                 
 companies in Alaska with regard to the amendment.   MARIANNE BURKE            
 had only heard from one writer of health insurance in the state who           
 favored the amendment.                                                        
                                                                               
  SENATOR LEMAN  moved to report CSSB 122(L&C) out of committee with           
 individual recommendations and the accompanying zero fiscal note.             
 Without objection, it was so ordered.