05/01/1998 03:32 PM House L&C

HB 300 - ALASKA PATIENTS' BILL OF RIGHTS                                       
                                                                               
Number 0075                                                                    
                                                                               
CHAIRMAN ROKEBERG announced the committee's next order of business             
was HB 300, "An Act relating to health insurance; and providing for            
an effective date."  He stated there was a proposed committee                  
substitute, Version M, labeled 0-LS1248\M, Ford, dated 4/30/98, and            
he explained the changes which had been made.  Chairman Rokeberg               
indicated on page 1, line 1, the word "care" had been placed in the            
title so the language read, "health care insurance".  The chairman             
noted the same addition had been made on page 1, line 2, also in               
the bill title.  The next changes had been made in Section 3 of                
Version M, "AS 21 is amended by adding a new chapter to read:                  
Chapter 07.  Regulation of Health Care Insurance Plans.".  On page             
2, line 28, Sec. 21.07.010(5)(E) had been modified to read, "(E)               
current, usual, customary, and reasonable reimbursement schedules,             
and methodology.".  On page 3, line 3, Sec. 21.07.020(2), emergency            
room provisions had been changed to read, "(2) emergency room                  
services shall be covered if authorized by the attending                       
physician;".  Chairman Rokeberg indicated the language which had               
been subsection (3) in Version J, "copayment requirements shall be             
uniform between health care providers", had been deleted from                  
Version M.  He commented, "Subsection 3, the word 'provided' was               
put in there in Amendment 1.  We're still on page 3."  On page 3,              
line 13, in Sec. 21.07.030(a), after "insurer" the words "or                   
managed care contractor" had been inserted to "pick up the                     
definition."                                                                   
                                                                               
Number 0266                                                                    
                                                                               
CHAIRMAN ROKEBERG noted in Sec. 21.07.250(1) "health insurance" had            
been changed to "health care insurance", indicating this subsection            
had formerly been had been subsection (3) and was now (1).  He                 
indicated Sec. 21.07.250(3), on page 4, the health care services,              
had been redefined to mean "services for diagnosis, prevention,                
treatment, or cure or relief of a health condition, illness,                   
injury, or disease" ["subsection 2" stated on tape].  Managed care             
plan was redefined in Sec. 21.07.250(6).  In Sec.07.250(9) the                 
utilization review definition had been changed to read, "(9)                   
"utilization review" means a system of reviewing the medical                   
necessity, appropriateness, efficacy, or efficiency of health care             
services, procedures, settings, and supplies provided under a                  
managed care plan using specified guidelines, including                        
preadmission certification, case management,  second opinion, the              
application of practice guidelines, concurrent review, discharge               
planning, ambulatory review, and retrospective review.".  Chairman             
Rokeberg explained the change in Section 4, which would amend AS               
21.42 by adding new section, "Sec. 21.42.390.  Required health care            
insurance coverage provisions.".  He indicated the language, "this             
paragraph does not apply to a health care insurance plan or                    
contract if the covered person signs a written waiver of the                   
provisions of this paragraph" had been added to Sec.                           
21.42.390(a)(1) after "prohibits a covered person from obtaining               
health care service from a health care provider of the person's                
choice, including a specialist".  He continued, "And it goes on to             
... and the old 'c' sub '1' was deleted."  He noted those were the             
changes in Version M.                                                          
                                                                               
Number 0449                                                                    
                                                                               
CHAIRMAN ROKEBERG asked if he heard a motion to adopt the proposed             
committee substitute, Version M.  There being no motion to adopt               
Version M, Chairman Rokeberg stated HB 300 had been tabled.