Legislature(2005 - 2006)CAPITOL 106


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03:06:27 PM Start
03:07:13 PM Overview: Office of Children's Services
03:50:53 PM HB393
04:33:15 PM HB414
04:58:01 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation by Dept. of Health & Social TELECONFERENCED
Services on the Office of Children's
Services (OCS)
Scheduled But Not Heard
Moved CSHB 393(HES) Out of Committee
Moved CSHB 414(HES) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
HB 393-INSURANCE FOR COLORECTAL CANCER SCREENING                                                                              
3:50:53 PM                                                                                                                    
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL  NO. 393, "An  Act requiring that certain  health care                                                               
insurance  plans provide  coverage  for the  costs of  colorectal                                                               
cancer   screening  examinations   and   laboratory  tests;   and                                                               
providing for an effective date."                                                                                               
3:51:13 PM                                                                                                                    
REPRESENTATIVE   ANDERSON,  speaking   as   the  prime   sponsor,                                                               
introduced  HB 393  and paraphrased  from  his sponsor  statement                                                               
[original punctuation provided]:                                                                                                
     Colon cancer  (technically known as  colorectal cancer)                                                                    
     is the second leading cause  of cancer deaths in Alaska                                                                    
     and across  the nation.  An estimated  57,000 Americans                                                                    
     died from the  colon cancer in 2005.  Screening has the                                                                    
     potential to  drastically reduce this  number. Consider                                                                    
     these facts:                                                                                                               
     When caught through routine  screening at the localized                                                                  
     stage, the  5-year survival rate  from colon  cancer is                                                                  
     over 90%.                                                                                                                
      If not caught until it has distant metastasis, when                                                                     
       symptoms are likely to appear, the 5-year survival                                                                     
     rate is only 10%.                                                                                                        
      Colonoscopy is over 90% effective at detecting colon                                                                    
      cancer and can remove pre-cancerous polyps, actually                                                                      
     preventing cancer from ever developing.                                                                                  
3:54:50 PM                                                                                                                    
REPRESENTATIVE  ANDERSON   moved  to  adopt   proposed  committee                                                               
substitute  (CS)   for  HB  393,  Version   24-LS0780\Y,  Bailey,                                                               
2/13/06.   There  being no  objection, Version  Y was  before the                                                               
3:55:36 PM                                                                                                                    
HEATH  HILYARD, Staff  to Representative  Anderson, Alaska  State                                                               
Legislature, explained the key changes  between CSHB 393(L&C) and                                                               
Version Y;  directing the committee's  attention to page  2, line                                                               
3.     This  change  establishes  the   American  Cancer  Society                                                               
standards as the guidelines for  colorectal cancer screening, and                                                               
removes  the  United  States  Preventative  Services  Task  Force                                                               
guidelines reference from the bill.   In addition, he pointed out                                                               
that  the word  "current"  was  removed [in  this  section] as  a                                                               
suggestion  from the  legal drafters,  who opined  that including                                                               
the word  "current" would require  Alaska law to comport  with an                                                               
outside standard; an unconstitutional delegation of authority.                                                                  
3:57:11 PM                                                                                                                    
EMILY  NENON,  Director,  Alaska Government  Relations,  American                                                               
Cancer  Society (ACS),  echoed Representative  Anderson's sponsor                                                               
statement  adding that  with  the  colonoscopy screening  method,                                                               
precancerous polyps  can be immediately removed,  making this the                                                               
only screening tool  that can actually prevent cancer.   She said                                                               
that for the  average risk patient, the  ACS guidelines recommend                                                               
this procedure every  10 years after the age of  50.  She pointed                                                               
out that  this could limit an  insurance plan from having  to pay                                                               
for  more than  two  of these  procedures,  as Medicare  coverage                                                               
would apply after age 65.   She highlighted that the cost savings                                                               
of early  diagnosis and prevention versus  contracting cancer and                                                               
undergoing cancer treatment, are significant.                                                                                   
4:01:27 PM                                                                                                                    
MS. NENON  pointed out that  colon cancer occurs  more frequently                                                               
in Alaska than  in the general U.S. population and  is the second                                                               
leading cause of  cancer death.  She said that  the Alaska Native                                                               
population represents  an anomaly, with the  single highest rates                                                               
of colon cancer  of any population group in  America; double that                                                               
of the  U.S. white  population.   The ACS  and the  Alaska Native                                                               
Tribal  Health   Consortium  are  researching   this  phenomenon;                                                               
however, she  reiterated that the screening  tools and procedures                                                               
are available to prevent this cancer.                                                                                           
4:02:47 PM                                                                                                                    
REPRESENTATIVE GARDNER asked Ms. Nenon  to estimate the number of                                                               
Alaskan lives  that might be saved  if this bill passes  and what                                                               
the diagnosis frequency represents.                                                                                             
MS.  NENON said  that colon  cancer screening  increases survival                                                               
rates  by 80  percent,  and  provided that  5-10  percent of  the                                                               
general population will develop colorectal cancer.                                                                              
4:04:41 PM                                                                                                                    
REPRESENTATIVE GATTO stated that the  cost for screening is about                                                               
$2,500.00, including the hospital fees,  and that about 3 percent                                                               
who  come  in  for  screening  have  polyps  removed  during  the                                                               
procedure.   In  comparison, he  noted  the high  cost of  cancer                                                               
treatment.   He  also noted  that, with  these facts  and figures                                                               
before them,  it is evident  that this bill  is a benefit  to the                                                               
population and the insurance companies.                                                                                         
4:07:38 PM                                                                                                                    
REPRESENTATIVE  ANDERSON,  pointing  out   whom  this  bill  will                                                               
effect,  stated  that  current  State  of  Alaska  employees  are                                                               
already  covered  for  this screening,  along  with  other  self-                                                               
insured employers such as Providence  Medical Center, adding that                                                               
this bill targets  retirees.  He also noted that  there are three                                                               
types   of  screening   procedures,  with   various  degrees   of                                                               
MR. HILYARD added  that this screening is subject  to policy plan                                                               
provisions already in place with  regard to co-pay and deductible                                                               
4:10:21 PM                                                                                                                    
MARIANNE  BURKE stated  strong support  for HB  393, saying  that                                                               
this  coverage  should  be  mandated.    She  said  that  from  a                                                               
humanistic and financial  point of view, "it is  a no-brainer" to                                                               
mandate  insurance coverage  for a  procedure that  can eliminate                                                               
colon cancer.   Having served as the director of  the Division of                                                               
Insurance for the  State of Alaska, she said that  she has upheld                                                               
the belief that  personal choice issues should not  be covered by                                                               
statute.    However, she  opined,  that  this issue  goes  beyond                                                               
personal choice given the fiscal and life-saving impacts.                                                                       
REPRESENTATIVE  ANDERSON  asked  whether  Ms.  Burke,  as  former                                                               
director  of the  Division of  Insurance, would  concur with  the                                                               
zero fiscal note issued from the Division of Insurance.                                                                         
MS. BURKE  said that  she would concur,  and further  stated that                                                               
there would  be no impact on  the state as the  state's insurance                                                               
coverage is not affected by this bill.                                                                                          
4:14:31 PM                                                                                                                    
REED STOOPS, Lobbyist, Aetna and  American Health Insurance Plans                                                               
(AHIP), presented  a proposal  for an  amendment to  HB 393.   He                                                               
said  that the  amendment will  serve to  reflect the  updates of                                                               
screening standards by  ACS and prevent the need  to change state                                                               
statute  accordingly.   He also  proposed an  amendment to  allow                                                               
health  plan  administrators  to  notify  policyholders  of  this                                                               
screening  coverage   in  conjunction  with  other   health  care                                                               
communications/mailings.   He pointed out that  this mandate will                                                               
only apply to  a small number of Alaskans who  are not insured or                                                               
whose coverage  does not  already encompass  this procedure.   In                                                               
answer to  a question, he  clarified that the  "legislature can't                                                               
mandate  coverages  on  any  self-insured  program  or  federally                                                               
funded  programs  that don't  come  through  the  state."   To  a                                                               
further question, he  stated that it is hard to  project who will                                                               
take advantage of this screening coverage.                                                                                      
4:20:02 PM                                                                                                                    
REPRESENTATIVE  ANDERSON directed  the  committee's attention  to                                                               
the amendment to CSHB 393(L&C).                                                                                                 
4:20:43 PM                                                                                                                    
MR. HILYARD  described the  two versions  of the  same amendment,                                                               
explaining  that the  concern was  who would  be responsible  for                                                               
notification of  coverage to policyholders  and the  frequency of                                                               
notification.   He  pointed out  that the  amendment inserts  the                                                               
word "annually," and the word "current" is omitted.                                                                             
4:22:21 PM                                                                                                                    
VICE CHAIR SEATON   moved to adopt Amendment 1,  which read [with                                                               
handwritten changes]:                                                                                                           
     Page 2, Lines 21-25                                                                                                        
     (f) Each  [HEALTH CARE INSURER OR]  health benefit plan                                                                    
     shall  notify each  enrollee annually  of the  coverage                                                                    
     for  colorectal  cancer   screenings  and  provide  the                                                                    
     [CURRENT]  American   Cancer  Society   guidelines  for                                                                    
     colorectal  cancer screenings.    The  notice shall  be                                                                    
     [DELIVERED  BY  MAIL  UNLESS THE  ENROLLEE  AND  HEALTH                                                                    
     CARRIER HAVE AGREED ON  ANOTHER METHOD OF NOTIFICATION]                                                                    
     included in health benefit handbooks  or be provided by                                                                  
     written  or  electronic  communication  between  health                                                                  
     plan administrators and enrollees.                                                                                       
There being no objection, Amendment 1 was adopted.                                                                              
REPRESENTATIVE CISSNA  asked for clarity regarding  how the state                                                               
will be informing policyholders of this benefit.                                                                                
CHAIR  WILSON  explained  that  the  state  plan  already  covers                                                               
employees for colorectal screening  procedures and this bill will                                                               
encompass state retirees as well.                                                                                               
REPRESENTATIVE CISSNA said she was  inquiring about the broadcast                                                               
of information regarding colorectal  screening procedures and the                                                               
screening coverage.                                                                                                             
CHAIR WILSON said  that Amendment 1 specifies  that each enrollee                                                               
will have to  be notified annually of the  coverage provided from                                                               
colorectal  cancer screenings  and provide  the ACS's  guidelines                                                               
for colorectal cancer screening.                                                                                                
REPRESENTATIVE ANDERSON offered that  Aetna and Blue Cross should                                                               
not  be  mandated  to provide  monthly/annually  notification  to                                                               
policyholders   versus   the    electronic   correspondence   and                                                               
[edited/issued policy pamphlet].                                                                                                
4:26:58 PM                                                                                                                    
REPRESENTATIVE  CISSNA clarified  that she  wants to  ensure that                                                               
the  ACS  guidelines are  contained  in  the current  information                                                               
provided to state employees.                                                                                                    
MR.  HILYARD stated  that this  information is  currently in  the                                                               
state insurance pamphlet.                                                                                                       
4:27:47 PM                                                                                                                    
CHAIR WILSON reiterated that in  the long run this procedure will                                                               
save  human suffering  and the  insurance company's  money.   She                                                               
relayed   her  personal   experiences   relating  to   colorectal                                                               
screening and cancer.                                                                                                           
4:30:16 PM                                                                                                                    
REPRESENTATIVE  SEATON  moved to  report  CSHB  393, Version  24-                                                               
LS0780\Y,  Bailey, 2/13/06,  as  amended, out  of committee  with                                                               
individual  recommendations  and  the  accompanying  zero  fiscal                                                               
REPRESENTATIVE GATTO objected  to the effective date  of the bill                                                               
and asked how this date was established.                                                                                        
MR.  STOOPS  explained  how  the   employees,  who  sign  up  for                                                               
insurance  after  this  legislation   passes,  will  receive  the                                                               
information in their handbook at that  time.  The bill allows for                                                               
"other communication," which  may be used by  the employer during                                                               
the interim of issuing the updated annual handbook.                                                                             
REPRESENTATIVE GATTO removed his objection.                                                                                     
4:32:29 PM                                                                                                                    
CHAIR WILSON stated that there  being no objection, CSHB 393(HES)                                                               
was  reported  out  of  the House  Health  Education  and  Social                                                               
Services Standing Committee.                                                                                                    

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