02/17/1998 11:22 AM Senate RLS

                                                                               
           SB 197 - REGULATING HEALTH MAINTENANCE ORGS.                        
                                                                               
CHAIRMAN KELLY brought SB 197 before the committee and noted there             
was a proposed Rules CS for the committee's consideration.                     
                                                                               
SENATOR DAVE DONLEY, prime sponsor of SB 197, explained the                    
committee substitute adds language on page 3, line 21, which                   
provides that health maintenance organizations would have to                   
provide an 'point of service' option that could require additional             
costs on the part of  the people that choose option, but it would              
allow them to go to other types of health care.  He said it is a               
way of making sure the consumers have an option to buy additional              
coverages of the types  that they may feel is appropriate and not              
be limited by HMOs to not have that option available to them.                  
                                                                               
Senator Donley voiced his support for an amendment that was being              
offered by Senator Leman.  He said the amendment also increases                
consumer options within the HMO system.                                        
                                                                               
SENATOR TAYLOR moved the adoption of CSSB 197(RLS).  Hearing no                
objection, the motion carried.                                                 
                                                                               
SENATOR LEMAN moved adoption of the following amendment to CSSB
(RLS).  CHAIRMAN KELLY objected for the purpose of discussion on            
the amendment.                                                                 
                                                                               
Amendment No. 1                                                                
                                                                               
Page 1, following line 7, insert a new bill section to read:                   
   "*Section 1.  AS 21.36.090(d) is amended to read:                           
          (d)  Except to the extent necessary to comply with AS                
21.42.365 and AS 21.56, a person may not practice or permit unfair             
discrimination against a person who provides a service covered                 
under a group health insurance policy that extends coverage on an              
expense incurred basis, or under a group service or indemnity type             
contract issued by a health maintenance organization or a nonprofit            
corporation, if the service is within the scope of the provider's              
occupational license.  In this subsection, "provider" means a state            
licensed physician, dentist, osteopath, optometrist, chiropractor,             
nurse midwife, advanced nurse practitioner, naturopath, physical               
therapist, occupational therapist, psychologist, psychological                 
associate, or licensed clinical social worker, or certified direct-            
entry midwife."                                                                
                                                                               
Page 1, line 8:  Delete "Section 1." and insert "Sec. 2."                      
                                                                               
Renumber the following bill sections accordingly.                              
                                                                               
CHAIRMAN KELLY stated the committee would take testimony from                  
Anchorage via the teleconference network.                                      
                                                                               
LYNN HARTZ, a family nurse practitioner and a legislative                      
representative of the Alaska Nurse Practitioner Association,                   
testified in support of CSSB 197(RLS).  She said it contains some              
important consumer protection aspects relating to disclosure to the            
enrollee of what is covered and what will not be covered, as well              
as protecting the lines of communication between the clinician and             
patient.                                                                       
                                                                               
Ms. Hartz suggested that in addition to the changes in the                     
committee substitute and the proposed amendment, there is                      
additional language in the HMO statutes that would need to be                  
changed to allow enrollees continued choice in their health care               
providers inside the HMO network.  She said it is their view that              
the change will allow health care consumer choice in their                     
preferred health care provider inside the HMO network as Senator               
Donley's amendment provides for choice in providers outside the HMO            
network.  She said she would fax the suggested change to the                   
Chairman.                                                                      
                                                                               
KATHY VOLZ, testifying from Anchorage on behalf of the Alaska                  
Physical Therapy Association, voiced their support for the                     
committee substitute and Senator Leman's amendment.                            
                                                                               
CHAIRMAN KELLY removed his objection to the adoption of Amendment              
No. 1, and there being no further objection, he stated the                     
amendment was adopted and it would be incorporated into a new Rules            
CS.                                                                            
                                                                               
SENATOR TAYLOR moved and asked unanimous consent CSSB 197(RLS), as             
amended, be approved for calendaring at the discretion of the                  
Chair.  Hearing no objection, it was so ordered.