Legislature(1997 - 1998)
04/16/1997 09:07 AM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SB 122 INS.COVERAGE:MARRIAGE & FAMILY THERAPIST Number 459 CHAIRMAN WILKEN introduced SB 122 as the next order of business. He noted that there was a CS from the Labor & Commerce Committee, when saying that he would entertain a motion to place it before the committee. SENATOR WARD moved to adopt CSSB 122(L&C) for discussion purposes. Without objection, CSSB 122(L&C) was adopted. RACHEAL MORELAND , Staff to Senator Leman, read the following Sponsor statement into the record: Senate Bill 122 was introduced by the Labor and Commerce Committee at the request of the Alaska Association for Marriage and Family Therapy (AAMFT). SB 122 will add marital and family therapists to the list of providers against whom insurers may not discriminate. This bill does not require insurers to add coverage of marital and family therapists where the coverage currently is not provided. It merely requires that insurers treat marital and family therapists on equal footing with other licensed providers and extend the same opportunities for coverage that the insurer offers others providing the same services. The definition of unfair discrimination is clarified by this bill and codifies existing practice. Section 1, paragraph 1 adds marital and family therapists to the unfair discrimination list under group health insurance policies with an effective date of July 1, 1997. Paragraph 2 defines unfair discrimination. Legislation (Section 4, ch. 39, SLA 1993) affecting the unfair discrimination clause was passed in 1993 with an effective date of 1998. Section 2 repeals and reenacts this section to reflect the addition of marital and family therapists and the definition of unfair discrimination. Currently, health insurers offering mental health services may not discriminate against licensed psychologists, psychological associates or clinical social workers. SB 122 would allow those insured with mental health coverage to choose treatment from a licensed marital and family therapist. AAMFT is a division of the American Association for Marriage and Family Therapy, Inc. Marriage and family therapists (MFTs) are a group of mental health professionals with background in a variety of disciplines, including psychology, social work, and family social science. MFTs are licensed or certified in 37 states and are recognized by the U.S. Department of Health and Human Services as one of the five core mental health disciplines in the U.S. CATHERINE REARDON , Director of the Division of Occupational Licensing in the Department of Commerce & Economic Development, informed the committee that the Board of Marital and Family Therapists works in association with this division. The board supports the inclusion of MFTs in this nondiscrimination clause. SENATOR LEMAN inquired as to how many people are licensed by the board in this category. CATHERINE REARDON said that at the beginning of this fiscal year, there were 181 persons licensed in this category. Number 515 BEVERLY LINDELL , President of AAMFT, requested the committee's support for SB 122. Ms. Lindell noted that SB 122 does not mandate coverage nor increase the scope of service nor does the bill include any willing provider language. This legislation is important for fairness. Ms. Lindell noted that MFTs have been licensed in this state since 1992 and pay fees to provide that service. MFTs are also one of the five core mental health groups identified by the National Institute of Mental Health. With regard to the concern of cost, Ms. Lindell informed the committee that the Division of Insurance reported that there is no evidence that costs would increase due to the increase in the pool of providers. In fact, the effect of competition may actually decrease the costs. Ms. Lindell explained that MFTs tend to be solution focused which results in achieving a job efficiently and quickly which could result in reduced costs to insurers. Ms. Lindell also noted that a survey in the American Psychologist reported that consumers refer to MFTs more often than other mental health professionals. Further there has been much information about family problems across the nation and in Alaska which has the highest rate of teen suicide and sexual abuse. MFTs are the groups that have expertise in that area and would like to practice that with reimbursement. CHAIRMAN WILKEN asked Ms. Burke to explain the term "unfair discrimination" to the committee. MARIANNE BURKE , Director of the Division of Insurance for DCED, explained that "unfair discrimination" does not include the purpose of utilization review for standards of clinical appropriate health care which Ms. Burke could support. With regard to cost containment, Ms. Burke was a bit concerned that it could be used to force an individual to seek the cheapest service available. Ms. Burke pointed out that the process of utilization review is a cost containment measure. Clinically appropriate health care services have elements of cost containment. Ms. Burke believed that the amendment helps clarify this section of Title 21. SENATOR LEMAN did not intend for "cost containment" to mean that the lowest cost provider must be utilized, but rather that the appropriate provider be utilized. Senator Leman pointed out that there may be appropriate measures to contain cost which would not be an unfair discrimination practice. CHAIRMAN WILKEN asked if Ms. Burke had heard from insurance companies in Alaska with regard to the amendment. MARIANNE BURKE had only heard from one writer of health insurance in the state who favored the amendment. SENATOR LEMAN moved to report CSSB 122(L&C) out of committee with individual recommendations and the accompanying zero fiscal note. Without objection, it was so ordered.