Legislature(2009 - 2010)CAPITOL 106
03/25/2010 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB309 | |
| HB361 | |
| HB392 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 309 | TELECONFERENCED | |
| + | HB 361 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 392 | TELECONFERENCED | |
HB 309-DENTAL CARE INSURANCE
3:13:52 PM
CO-CHAIR KELLER announced that the first order of business would
be HOUSE BILL NO. 309, "An Act prohibiting health care insurers
that provide dental care coverage from setting a minimum age for
receiving dental care coverage, allowing those insurers to set a
maximum age for receiving dental care coverage as a dependent,
and prohibiting those insurers from setting fees that a dentist
may charge for dental services not covered under the insurer's
policy." [In front of the committee was the proposed Committee
Substitute (CS) for HB 309, 26-LS1315\C, Bailey, 3/24/10.]
3:14:38 PM
CECILE ELLIOTT, Staff to Representative Bill Thomas, Alaska
State Legislature, explained that Version C resulted as a
compromise between the dental community, the insurance industry,
and the small business community. She pointed out that the
section regarding age limit had been removed, as it was covered
elsewhere in statute; and the second section, prohibiting fee
capping, was amended to reflect the compromise. She explained
that dentists would now be offered the opportunity to sign
contracts for covered and, if desired, non-covered services.
3:16:25 PM
CO-CHAIR HERRON moved to adopt the proposed Committee Substitute
(CS) for HB 309, 26-LS1315\C, Bailey, 3/24/10, as the working
draft. There being no objection, Version C was before the
committee.
3:16:54 PM
REPRESENTATIVE T. WILSON asked if this affected self insured
policies.
3:17:11 PM
MS. ELLIOTT said that it did not.
REPRESENTATIVE T. WILSON asked if this would only affect small
businesses with policies similar to Blue Cross/ Blue Shield.
MS. ELLIOTT explained that HB 309 referenced preferred provider
contracts. In response to Representative T. Wilson, she
explained that these were contracts negotiated between the
insurance company and the dentist on a fee schedule.
REPRESENTATIVE T. WILSON asked if there was a mechanism for the
self insured to abide by the same rules.
3:18:33 PM
DAVID LOGAN, Dentist, Alaska Dental Society, explained that the
two broad categories of insurance were the traditional indemnity
plans, where the provider billed the insurance company and the
managed plans, which included Preferred Provider Organization
(PPO) plans. He explained that with PPOs, the insurance company
had contracted with dentists to provide services at a set fee
schedule. In response to Representative T. Wilson, he pointed
out that federal legislation regulated the Employee Retirement
Income Security Act of 1974 (ERISA) plans.
3:20:15 PM
REPRESENTATIVE SEATON asked how HB 309 would ensure that the
insurance company notified the insured about the costs charged
by each provider.
MS. ELLIOTT offered her belief that the insurance company would
provide that information to the consumer, but she did not know
how it was provided. She pointed out that the insurance
companies had provided the language for the CS.
3:22:23 PM
REPRESENTATIVE SEATON pointed to the permissive language on page
2, line 15, and noted that this was a change from prior policy
which had required notification to the insured.
CO-CHAIR KELLER re opened public testimony.
REPRESENTATIVE SEATON asked if the new uncapped plan had any
requirement for the dentist to notify the PPO patient that some
fees were no longer capped.
MS. ELLIOTT deferred the question to Dr. David Logan.
3:25:32 PM
DR. LOGAN said that the committee substitute did not stipulate
this, and there was not any statutory requirement for
notification to the insured. He opined that most medical
offices attempted to inform patients about the fee structure for
services.
CO-CHAIR KELLER directed attention to page 2, lines 6 and 10,
and asked for clarification of the phrase "take an action
against the dentist."
DR. LOGAN explained the intent to be that if a dentist signed a
contract for either covered services, or covered and non-covered
services, there would not be a differential in the fee schedule
that would apply to the insured based on the contract. He
reported that there was also language in Version C that the
insurers may differentiate between the types of provider
contract, but not fail to notify the insured that the dentist
has signed a contract.
3:27:41 PM
REED STOOPS, Lobbyist, Aetna, in response to Representative T.
Wilson, said that Linda Hall could best respond to questions
about ERISA. He said that a self insured plan would be exempt
from mandated coverage, and he offered the minimum age
requirement as an example of mandated coverage.
3:29:21 PM
MR. STOOPS, in response to Co-Chair Keller, said that the
employee handbook explains the benefits. Currently, there was
no obligation from the insurer for prior notice. He said that
Version C dictated a change of the current notification
procedure.
3:31:27 PM
REPRESENTATIVE T. WILSON asked about the rate change for small
business.
3:31:49 PM
MR. STOOPS said that the cost of insurance would not change, but
that the cost to the consumer for non-covered service could
change. He suggested asking the dentists if charges would
increase.
3:32:24 PM
REPRESENTATIVE SEATON asked if non-covered services might be
offered at a lower cost than through the insurance fee schedule.
MR. STOOPS replied that a dentist could charge less, but he
opined those costs to be greater, or HB 309 would not be
necessary.
3:33:33 PM
REPRESENTATIVE SEATON directed attention to Version C, page 2,
line 15, and asked if the insurance providers would object to a
change from "may authorize the insurer to provide information to
the insured" to "shall notify the insured." He pointed out that
this notification would include both the list of all covered
fees, and that there was no fee cap for the uncovered services
from the provider.
3:34:18 PM
MR. STOOPS replied that he would research this.
REPRESENTATIVE SEATON opined that these were forward contracts,
and the providers would be listed in the policy handbook. He
asked when the provider list would be updated.
MR. STOOPS said that existing contracts would be affected by HB
309, and that dentists would have the option to opt out of the
non-covered service portions of the contracts, without a new
contract being reissued. He said that it could be an extended
period of time for contracts to be modified, and for new
publications to be distributed.
DR. LOGAN, in response to Mr. Stoops, stated that this did
present a challenge for notification to the consumer, as the
contracts were constantly changing.
3:39:49 PM
CO-CHAIR KELLER asked why this was not occurring with primary
care, as well.
MR. STOOPS offered his belief that it was the dental providers
who had introduced this legislation.
DR. LOGAN, in response to Co-Chair Keller, said that dentists
joined PPOs, which offered care at a discount rate, to fill
otherwise unscheduled office time and to allow an opportunity
for customary service rates to procedures not included under the
insurance plans.
3:42:40 PM
CO-CHAIR KELLER asked if HB 309 would affect current and future
contracts with regard to information distribution to the
consumer.
DENNIS BAILEY, Attorney, Legislative Legal Counsel, Legislative
Legal and Research Services, Legislative Affairs Agency, said
that HB 309 would only apply to new contracts and that this
would be an ongoing process.
3:44:44 PM
REPRESENTATIVE SEATON asked for clarification that providers
could opt out, without renewing the contract.
MR. BAILEY replied that this was not specified in the bill, but
would apply if it was in an existing contract.
3:45:44 PM
REPRESENTATIVE SEATON expressed concern for notification to the
insured that there would now be two types of PPO contracts. He
directed attention to Version C, page 2, line 15, and asked if
the language could change to ensure that the insured would
understand the fees prior to the services.
MR. BAILEY replied that Version C was currently permissive. He
agreed that it was possible to describe the requested
information and state that it was mandatory to provide the
information. He opined that it may already exist in insurance
statute.
3:47:49 PM
REPRESENTATIVE SEATON asked if this could be changed with a
conceptual amendment.
MR. BAILEY agreed that a conceptual amendment for "may" to be
changed to "shall" and to include both the insurer and the
provider was acceptable.
3:49:11 PM
CHRIS HENRY, Treasurer, Alaska Dental Society, said that he had
been following the bill and that he was available to answer any
questions.
3:49:45 PM
JIM TOWLE, Executive Director, Alaska Dental Society, stated
that he was also available to answer any questions.
3:50:27 PM
CO-CHAIR KELLER closed public testimony.
3:50:46 PM
REPRESENTATIVE T. WILSON offered her belief that although both
the insurance industry and the dental providers had come to
agreement, HB 309 was not fair to the self insurers.
3:51:16 PM
CO-CHAIR HERRON moved to adopt Amendment 1, which read:
Page 1, Line 14
After (2)
Insert "not"
REPRESENTATIVE T. WILSON objected for discussion.
MS. ELLIOTT explained that during the changes to the bill, this
was an oversight and the amendment would correct this.
REPRESENTATIVE T. WILSON removed her objection.
There being no objection, Amendment 1 was adopted.
3:52:30 PM
REPRESENTATIVE SEATON moved to adopt Conceptual Amendment 2, as
follows:
Page 2, line 15, following (ii)
Delete "may authorize"
Insert "shall require both";
Following "insurer"
Insert "and the dentist"
REPRESENTATIVE T. WILSON objected for discussion.
REPRESENTATIVE SEATON read the proposed line 15:
(ii) shall require both the insurer and the dentist to
provide information to the insured describing the
dentist's choice of contract and fee schedules;
3:53:29 PM
MS. ELLIOTT, in response to Representative T. Wilson, said that
the sponsor was neutral on Conceptual Amendment 2 and would
defer to the will of the committee.
3:53:51 PM
REPRESENTATIVE HOLMES asked to clarify if the costs would be
increased.
MS. ELLIOTT said that she did not know.
3:54:46 PM
CO-CHAIR KELLER opened public testimony.
MS. ELLIOTT asked to clarify proposed Conceptual Amendment 2.
REPRESENTATIVE SEATON restated proposed Conceptual Amendment 2,
as follows:
(ii) shall require both the insurer and the dentist to
provide information to the insured describing the
dentist's choice of contract and fee schedules;
3:55:45 PM
DR. LOGAN, in response to Representative Holmes, said that
Conceptual Amendment 2 would not increase dental rates.
3:56:28 PM
DR. LOGAN, in response to Representative T. Wilson, offered his
belief that Conceptual Amendment 2 would inform the insured
whether the contract was for covered services only, or for
covered and non-covered services. He noted that the fee
schedule for non covered services would also be provided.
REPRESENTATIVE T. WILSON asked if the entire fee schedule would
need to be revealed.
DR. LOGAN replied that the contract for the covered fee schedule
was with the insurance company. He opined that the provider
would show the fees not included in the negotiated fee schedule.
3:58:13 PM
REPRESENTATIVE SEATON clarified that he had only modified the
language from the dentists and the insured community. He stated
his intention to be for the insured person to know the cost for
service.
3:59:08 PM
CO-CHAIR KELLER closed public testimony.
3:59:26 PM
REPRESENTATIVE T. WILSON removed her objection to Conceptual
Amendment 2.
There being no further objection, Conceptual Amendment 2 was
adopted.
4:00:04 PM
REPRESENTATIVE SEATON relayed that he was uncomfortable with
this as a procedure as it could raise costs for individuals. He
stated that he did not want to have this procedure expanded to
include other medical fields.
4:00:50 PM
CO-CHAIR KELLER pointed out that new federal legislation may
make some changes to this bill.
4:01:38 PM
REPRESENTATIVE LYNN asked if dental service was covered under
the federal health care bill.
CHAIR KELLER said that he did not know.
The committee took a brief at-ease.
4:02:44 PM
REPRESENTATIVE T. WILSON moved to report CSHB 309, 26-LS1315\C,
Bailey, 3/24/10, as amended, out of committee with individual
recommendations and the accompanying fiscal notes.
There being no objection, CSHB 309 (HSS) was forwarded from the
House Health and Social Services Standing Committee.
4:03:21 PM
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