Legislature(1997 - 1998)
03/10/1998 08:00 AM STA
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HB 359 - HEALTH INSURANCE REGULATION TAPE 98-34, SIDE B Number 0980 CHAIR JAMES announced the committee would hear HB 359, "An Act relating to regulation of health insurance plans; and providing for an effective date." She said she hasn't had a chance to listen to the Children's Caucus tapes that were provided to her. Chair James said Representative Dyson is willing to give an overview of the comments that were made in the Children's Caucus. Number 1000 REPRESENTATIVE JOE RYAN noted there is a proposed committee substitute (CS) which takes care of some of the fiscal concerns of the department. He said, "We have held the Appeals Committee harmless so we don't need a AG and we've also stated that they don't need staff support. It will be -- any costs incurred in the meetings and so forth will be paid for by the insurance company. So it dramatically reduces any fiscal impact and since there is not personal services, there is no reason for $34,000 and $48,000 worth of travel and supplies and equipment and so forth. I am still not sure what the contractual amount is, but since we don't have state employees performing these functions as it is taken care of on the other end, I would think that the contractual should go away too. So that makes your committee fiscal note appropriate." CHAIR JAMES said she would accept a motion to put the CS, Version B, dated 3/5/98, before the committee. REPRESENTATIVE DYSON moved the CS be put before the committee. There being no objection, CSHB 359, Version B, was before the committee. REPRESENTATIVE ETHAN BERKOWITZ asked if the only change is on page 9 to Section 21.07.110. REPRESENTATIVE JOE RYAN said the last sentence in (e) of Section 21.07.090 has been removed. Also removed is the last sentence in (a) of Section 21.07.110. REPRESENTATIVE FRED DYSON referred to the testimony given in the Children's Caucus and said most of the people there were Alaskan service providers. They expressed a great deal of frustration with the Administration having to deal with time zones and calling somebody in Tennessee to get authorization to proceed with a treatment plan. He said the Administration, who was there, admitted that there had been a whole bunch of start-up problems. Representative Ryan stated there was also testimony about the difficulty of getting people in Tennessee to understand Alaska, the logistics problem and how isolated many care providers are. He continued to inform the committee of the problems such as fetal alcohol syndrome, fetal alcohol effects, child abuse problems, et cetera. CHAIR JAMES asked, "Were they supportive of this piece of legislation?" REPRESENTATIVE DYSON said his recollection is that this specific legislation wasn't presented to them, but universally the folks that testified didn't like the change, didn't like dealing with somebody outside the state and didn't like having to get over a huge hurdle in order to (indisc.) treatment. They were wanting to deal with somebody locally and somebody with knowledge of the unique situations of our environment. REPRESENTATIVE ELTON said, "My recollection of the situation arose out of the Tennessee vender is that a large part of the problem came from this end, came from some rather nonspecific contract language that the department had with the Tennessee people - came with some things that I think the department probably should have anticipated in setting up a system like (indisc.). And this piece of the legislation deals with (indisc.). This piece of legislation deals with what the insurer's obligation may be and it doesn't really address the situation that occurred with the Tennessee end. I don't find myself blaming the Tennessee people as much as I do the people who did the contract with the Tennessee people. So it seems to me that we're solving it by fixing the wrong end." REPRESENTATIVE RYAN pointed out that there is an appeal process in the Department of Health and Social Services. TAPE 98-35, SIDE A Number 0001 REPRESENTATIVE RYAN said, "Under this legislation, we have this independent board which is made up of a diverse group of individuals, who may - not all of whom may have esoteric knowledge, but who look at it from a consumer point of view, and especially the public people who will ask the questions of the professionals which sometimes get to be embarrassing." REPRESENTATIVE RYAN said he was at the caucus. He said, "Part of the frustration with the people, as I recall - I was at the meeting that Representative Dyson (indisc.), was providers who are having to prepare an hour, an hour and a half, two hours before they made this phone call. And they were professionals who were treating a patient, who had the credentials. And instead of the people in Tennessee saying, 'Have you done ba, ba, ba and ba,' they would say, 'You just tell us the symptoms and we'll make the diagnosis.'" He continued to discuss the expenses involved and the people in Tennessee questioning the doctors who have the credentials. Number 0089 REPRESENTATIVE ELTON said he thinks the way to solve the problem is to fix it at this end rather than regulate industry. REPRESENTATIVE DYSON said that apparently the Tennessee organization has done well on other similar things in the past, but the learning curve for them and never having a presence in Alaska, produces all these unfortunate results that he doesn't think were intended to happen. He said, "I think probably we should buy our way out of this contract and start over. That would be my solution." Number 0162 REPRESENTATIVE HODGINS made a motion to move CSHB 359 out of committee with individual recommendations and with the attached zero fiscal note. There being no objection, CSHB 359(STA) moved out of the House State Affairs Standing Committee.